Obama and Health Care Reform: A Feckless Approach

The fate of the potentially historic health care reform initiative hangs precariously by the figurative thread. Passage of a plan that conforms to the core elements of the House bill could legitimately be called a success insofar as it promises to extend insurance coverage to tens of millions using subsidies from the federal government to pay for it.

Let us have no illusions, though, as to how much of the existing non-system is actually going to be reformed. All of the structural features that have been the source of gross inefficiencies will remain in place, only slightly amended. Whatever modifications in care and treatment do occur will depend mainly on the goodwill of the interested parties with the barest of governmental oversight. If the House bill is amended by the Senate in ways that weaken either the public plan option or the provision for partial funding via a tax surcharge on the super rich, we will have failed a once-in-a-lifetime opportunity.

Primary responsibility for this disappointing outcome rests in the Oval Office. Obama's approach to the health reform effort has been feckless. He never laid down markers specific enough and firm enough to serve as strategic guideposts for the backers of reform. He made no concerted effort to marshal support nationwide for his plan; indeed, he never presented a plan.

He temporized about all crucial reform components, including the public option which just two weeks ago Rahm Emanuel and David Axelrod publicly stated was expendable. He condemned at the same time ad campaigns directed at recalcitrant Democratic Senators. He invited into the White House every organization with a vested interest in perpetuating the status quo while continuing the high-minded rhetoric about keeping lobbyists from entering his administration's side door.

Finally, he seems totally ignorant of the elementary truth that for a president to get what he wants from Congress, he has to wade in, twist arms, jawbone, offer enticements, make threats, etc. A half-hearted facsimile of such a vigorous, savvy campaign at the eleventh hour is a futile gesture. That's why Lyndon Johnson succeeded on the civil rights front while John Kennedy failed. That at least is something Mr. Obama should know and take to heart.

Comments

[globalcitizenlinda]

I still remember that during the primary and later after BO's nomination, articles under-estimating were the in-thing and with titles such as "nervous democrats worry Obama is loosing the race" and for a while this was the mainstream thing to advocate. We all know how under-estimating Obama tunred out at the end.

Ps. President Obama cannot do this alone, he need all of us who care about healthcare reform to take it to the resistant senators and congress

[commentator101]

Brenner is right. If anything he is being to charitable in suggesting that there might still be a chance for Obama to bring this home. I think Obama missed the last chance about 4 weeks ago. At that point he could have isolated the moderates simply by drawing a firm line in the sand. Now the issue is framed for failure. And it is all on Obama. The blue dogs and the Republicans aren't at fault - they are part of the environment. Obama's job was to manage them.

I am very disappointed.

[harriscrl3]

It always amaze me how dogmatic some people are. What you all dont seem to get is that ultimately this rest with the American people. Obama can be as tough as he want he can tell Congress some truths about themselves but the reality is if the Senator is in the pocket of the insurance company he can't do squat.

You said that he should draw a line. You think its that easy he can't even get all the democrats to sign on so I want to know what the heck kind of line you think can be drawn so that he can get enough votes and not have a watered down version of the bill.

Everyone has an opinion and frankly many are worth about two cents.

[dogwatch]

Somebody better get to work and learn how to use a sixty per cent majority in the Senate. This is sick.

[JBS]

Just like his feckless approach to reforming Wall Street and preventing future "too big to fail" crashes and bailouts. It's the other side of the same coin.

Where do you think Goldman Sachs stands on health care reform? Do they expect to profit from it? Or from killing it?

Where do you reckon the most obscene "profits" will come from? Universal health care? Or big insurance & big pharma?

What's good for Goldman Sachs is good for Goldman Sachs and screw the U.S.A.

If you need a doctor, go to the emergency room!

[Ben6768]

All this b.s. , when all they have to do is go to Europe and find out how its done there.
Of course they deliberately avoid this so that people dont find out that this health care reform is a scam, just lipstick on the pig.
In Europe there is a mature system that works, after decades of trial and error.

[Terry Riley]

"talk does not boil rice"
but a good talker makes people think the
cook is in charge

who is pulling the puppet strings of the smooth talking puppet
who sucks in the adulation of the masses and makes them submit to
a future of servitude and debt?

[nordstrom]

Lyndon Johnson didn't have to deal with a 24-hour cable news cycle fed largely by Twitter updates, so he could do a lot more things behind the scenes without having his every move put on instant blast.

Obama has to proceeed more cautiously, patiently and strategically in a world where right-wing politics has been normalized by a Republican­-compliant media ("Meet the Press," anyone?) that calls right-of-center "moderate" and left-of-center "left-of-center."

[jmpurser]

Well it's a feckless (generally incompetent and ineffectual) approach in a feckless direction. Obama killed real health care reform when he took single payer off the table. Now we've got a massive corporate welfare bill that actually makes the world's most expensive health care system MORE expensive while STILL not covering everyone.

[Lendall]

Thank you, jmpurser. I totally agree with your comments, and with Michael Brenner's article. This is in fact a corporate welfare bill -- yet another one from this nominally "Democratic" administration. I keep getting madder and madder the more I think about it. This is going to kill genuine health care reform for another generation. It's tragic.

[rssrai]

This will be a huge test for President Obama. Does he want to go down as being weak or strong? He needs to go out there and expose the democrats who want to kill health care reform. These democrats need to be exposed if they vote no on a bill, and for years to come democrats should go out and vote against them and quit sending money to them. For such an important bill democrats should vote lock and step. Gov Schweitzer will not get any support from democrats for what he is saying now about not support health care reform. If Gov Schweitzer runs for president some day, for what he is saying now about health care reform it will be remembered forever. We democrats will not forget.

[veracity]

Obama's heart simply is not in this fight - he is way too awed and subordinated to his Goldamn-Sachs "economics" team (Rubin, Summers, Emanuel, and their hired, perenniel goldman-sachs' errand-boy, Timmy Geithner) to understand the financial horrors facing MILLIONS of Americans -
NOT just the 50 million of us who DON'T have health-care, but the other ONE HUNDRED MILLION who KNOW that if their mom, their father, their sister, son, or daughter come down with a major disease, IT WILL MEAN FINANCIAL RUIN for the family - "health insurance policy" NOTwithstanding.

(No, Mr. President, giving that woman DENIED "health-care coverage" does NOT qualify as action on this vital issue.)

It is absolutely amazing that in his 4 years at Columbia, and 4 or more years at Harvard Law & pos-grad, that Obama has become so awed by the DC/NY financial system, that he can no longer see the woods for the trees.
Already, for past 15 weeks, Ed Schultz has been fighting this fight FAR harder than ANYONE in the Emanuel-obama White House.

Mr. Obama BUYS IN TO the notion that the FIRST priority of America's health industry is TO PROVIDE PROFIT for the tycoons who dominate it.

That - along with the TWELVE TRILLION DOLLARS of TAXPAYER MONEY (actually MORE DEBT accrued to taxpayers) he (and Bush-Paulson before him) have GIVEN to Wall Street, are already TORPEDOEING his presidency.

[Ben6768]

Very well, Veracity. This post should be engraved in stone as an epitaph for this administration.

[annis]

About your second-to-last sentence: reflect a moment - which of those two presidents has more regard by succeeding generations - Johnson or Kennedy? Is it the executive or the statesman who ultimately leaves more of a legacy? Is it someone who rams programs through an unwilling legislature or someone who takes the time or has the talent and intellect to raise the bar on discourse both with the public and with the Senate and the House.

On all the other issues - economy, and process of law for example - these vital issues are not solved either but we are being slowly but surely lifted out of our comfortable lethargy and apathy and our hypocrisy.

[TXfemmom]

Obama needs a spine and some old-fashioned rough and tumble, get in there and fight and threaten and take action and INTIMIDATE those people to institute those changes. One cannot change this country, and especially the things which need to be changed without ruffling feathers and being willing to take on the big, tough, entrenched powers and special interests of this country.

Obama is intelligent, he wnats good for the country, but he has to be willing to get in there and FIGHT, INTIMIDATE, THREATEND AND CARRY TROUGH WITH THE THREATES, and to FORCE his way down the throats of the people in Congress, within the financial system, and beyond. He has good ideas, but he appears to lack the toughess. He can remain calm, but now HE NEEDS TO BE ANGRY, AND TOUGH, AND MEAN AND A STRONG-WILLED, TOUGH-SPINED WARRIOR FOR THIS COUNTRY.

[annis]

Are you being sardonic?

[Ben6768]

Must be the heat

[Jodo]

A great article. Obama is a big time bust. He's all over the map on health care only talking around what real reform should look like. He's done the same thing on the economy. He jumps from one proclamation to the next reacting to what his staff deems to be politically correct that week. His leadership now amounts to attempting to obscure the fact that he has no intention of changing the corrupt status quo. If we get any public option at all there will be so many limitations and outright subsidies to the insurance companies the entire excercise will be useless. Then we hear from the media and the Obama administration about what a landmark piece of legislation was passed. The scary thing is this is not cynicism but a reality.

[PaxEterna]

The is the best opinion I have read, and sums up my sentiments exactly.

If this bill passes, it will be the death-knell to true reform, and BO will be a one-term President, which he will deserve, since he has betrayed the American people who elected him at every turn.

Disgusting, shameful, karmic ....