While the work on stabilizing the banking system, passing the Obama budget, and working on the other big issues the president has prioritized will all continue steadily along in the coming months, it is clear that health care reform is the next big debate on the President's mind. The first big signal of this was the way he deftly, and rightly, turned the fiscal responsibility summit into mainly a discussion on health care reform, and then announced on the spot that there would be a health care summit next week. Then, in his speech to the nation Tuesday night, he made a push for fundamental reform this year. And finally this week, his budget includes a $634 billion "down payment" on the money needed for health reform. Clearly the president is gearing up for a big battle.
As one of the earliest members of the Clinton White House health care team, I am very encouraged by the early strategic signs coming from President Obama. As I discuss in my book, The Progressive Revolution: How the Best in America Came to Be, we made some big mistakes in the Clinton drive for health care reform that doomed our chances for victory, and President Obama's early decisions suggest that they are learning at least some of the right lessons from that experience. Here are some things I am encouraged about:
1. Obama said we needed to do serious reform this year. In early 1993, President Clinton got convinced by Bob Rubin and other corporate Democrats to delay pushing for health care until 1994, after the first budget fight and after they could push their beloved NAFTA through. President Obama set a great tone in his speech Tuesday night: We're going to go big, and we're going to do it this year.
2. Putting a down payment into the budget. Rubin and his allies also convinced President Clinton that reducing the deficit was more important than health care, and that money for health care should all be done later. It was a huge mistake, making the budget numbers for health care reform politically unpalatable. While President Obama hasn't put in every dollar needed for health reform in this budget, he has sent a budget that does have a significant $634 billion down payment.
3. Leaving the details to Congress. Another major mistake was to take the first year of Clinton's term to write an excruciatingly detailed piece of legislation. The result was that we spent a year being lobbied by every outside group imaginable on every detail of the bill (I personally met with over 1,500 different groups on the bill that year) and then as soon as it got sent to the Hill, that same lobbying process began with Capitol Hill. In the meantime, we lost momentum and passion, and the insurance industry picked us apart by focusing on the tiny details of the bill in their infamous Harry and Louise ads.
Obama is sending clear signals that he is going to leave the details of the legislation up to Congress.
We have a long way to go to pass a serious health reform bill, and the obstacles are big to getting it done. Teddy Roosevelt, FDR, Truman, LBJ, even Nixon all tried before President Clinton's plan went up in flames. But Barack Obama knows how messed up our health care system is, and he knows we need big change. I'm glad he has the guts to take it on, and I'm glad to see his early strategic moves on it are smart ones.
Mike Lux is the author of The Progressive Revolution: How the Best in America Came to Be.
Now that we are aware of what they are capable of, we can have regulations preventing their greedy little fingers from touching a good plan for the people.
No health plan the government can create will be as bad as the mess we have now that we call insurance. The insurance companies suck up the money we pay into Medicare, Medicaid, VA, and for the Federal and State government, Schip and many in the Judicial system, firemen and policeman and others.
Even Nixon was concerned that health care cost would ruin this country and how many years ago was that. I don't know, but I know it was many many premiums ago and many many high copays ago.
Obama is going to help those who are recently laid off to pay for Cobra, but there are many who won't get covered with that.
We need a health care system where if you lose your job you don't lose coverage especially if you have a pre existing condition. Once you lose coverage and have a preexisting condition no insurance company will cover you. It isn't profitable.
Millions of working Americans neither have the money nor work for a company who can afford to provide the coverage. Because they work to support themselves and their families, they are ineligible (excluded from) for the "welfare" programs. They are the backbone of federal and state budgets because they pay more of the taxes collected in our country than any other group! Yet, they are excluded from the medical care system until they become so sick they have chronic, incurable and possibly terminal conditions which may then qualify them for the state/federal programs. Their care is much more expensive than if they were offered preventive care in the first place through a quality "universal" program. When they remain healthy, they also remain employed and contributing to the budget through their taxes! It's time for us to put ideologies aside and concentrate on the greater good for ALL Americans and for the health & well-being of our country!
What is broken is our health delivery system. It will continue to be broken as long as we look at it in terms of cost. This conversation needs to start with what it means to be healthy and how can/is health delivered. (Is it reasonable to expect that a doctor can effectively work with a patient in tem minutes? What are the patient's roles and responsibilities in his recovery?) Once we've determined what a health system should be, then we can start talking about cost.
http://www.nytimes.com/2009/03/01/us/politics/01lobby.html?pagewanted=2&_r=1&hp
There must be thousands of Americans in the exact same situation as me. At sixty, I really need health care. But there is NO way we can afford Cobra.
We both got glasses the other day while still insured. The optometrist was swamped with customers. When I asked why they were so busy, they said it was because health/vision insurance was ending on the 28th due to lay-offs.
The people who pontificate about this are NOT uninsured. Health insurance is a HUGE problerm. It keeps people enslaved to jobs they hate. The uninsured put off seeing doctors until things spin out of control. Then what are we supposed to do? Die?
It also seems very clear that the cost of insuring employees is the most serious impediment to all businesses, especially small ones. Instead of dithering around, why not take a good look at Universal Health Care- NOT provided by employers, but provided by our government? My husband was paying $300 a month for our insurance, and his company was paying a lot more. It makes no sense to continue on this road.
For all of you who have good insurance through your jobs?
Don't get too comfortable.
This is reality, folks. If it can happen to us, it can happen to you.
The problem is that Health care is not a market economy that is self-regulated by supply and demand! Think about it: if it were, drug companies would not be able to increase the price of their drugs without demand going down.
Changing the model from a free-market system to a universal health system will eliminate the middle profit-taking insurance companies that compromise the quality of health care by being an economic drain on the system.
The solution must be more systemic than insurance coverage and it must go beyond a simple single-payer system. You must first get over the fact that health care is not a free-market economy; only then can a proper solution be formulated.
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Also, we really need to try to justify Mr. Obama's massive budget by just saying the rich will pay for it because they can't, there isn't enough money there.
Even taking every taxable "dime" of everyone earning more than $75,000 in 2006 would have barely yielded enough to cover that $4 trillion.
I am not a fan of running up debt, left or right it is wrong.
We have no reason to believe you.
Last calculation I made: doubling rhe top income tax over 250k would pay for the entire budget.
There is ZERO chance the top 2% can support everyone else, sorry.
http://www.publicagenda.org/files/charts/ff_fedbudget_revenue_sources.png
http://online.wsj.com/article/SB123561551065378405.html
If it were to reach his desk, I do believe Obama would sign it.
However, I think we do not dare underestimate the power of the opposition in the coming months. In the Clinton times, there was not nearly enough attention paid to framing the message and getting in front of the attacks, thus Harry and Louise really took over. This time reform will be characterized as "socialism" and a "government takeover", even by those who ironically support bank nationalization! During the campaign, the Obama people were very adept at fighting the smears, anticipating the attacks and de-fanging them by comments just like Obama made this week -- "some will say" or "the critics will tell us..." Obama himself sells his ideas better than anyone, and I hope he will use his bully pulpit to frame the message early on. And this time we have the blogosphere and a much more engaged citizenry to support reform. If we can't do it this time, with the economy in such desperate shape and the Republicans in disarray, shame on us!
If we can't do it this time, it actually means that evil has prevailed, not that we didn't try hard enough.