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Mike Lux

Mike Lux

Posted February 27, 2009 | 03:16 PM (EST)

Next Big Change Up: Health Care Reform


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.

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 ...
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 ...
 
 
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02:51 PM on 03/03/2009
I don't worry that public health insurance would be abused. You have to remember who has been in power the last 20 years to realize how abused our self paid programs have been.

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.
03:40 PM on 03/02/2009
For instance, my mother (retired and on Medicare) goes to the Dr routinely and has several procedures (diagnostic & surgical) done every year (and has since she went on this medical coverage). It helps pay the Dr's, hospitals, & other providers bills! Many of the procedures she definitely didn't need BUT they were done anyway. On the other hand, I have a sister who doesn't have health insurance nor disability - yes, if you haven't paid enough into the system and you are under age 65 1/2 and married (even if your husband is permanently disabled in a truck wreck) you are not eligible for any benefits of any kind - income, food stamps or health care. She was taken to the emergency room with what would later prove to be sepsis, but they were not going to treat her in the emergency or admit her to the hospital until I arrived and pressed the point. She has diabetes, chronic cor pulmonale and congestive heart failure - on total life support 24/7! She did not receive free care - she was billed for the care and ultimately had to file bankruptcy because of a lack of the ability to work to pay it off. We have got to do better for our citizens! She worked all her life as a daycare provider in her home making under the minimum for paying into the system.
03:29 PM on 03/02/2009
(continued)
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!
03:28 PM on 03/02/2009
I hope and pray that someone, somewhere, will be able to cut through all the "noise" and clearly articulate the reasons why the US absolutely MUST have better health care coverage for all it's citizens. For those who object to "socialized" or "nationalized" health care, you really need to take a step back and take a good look at what you are objecting to! If you have health care coverage at all, then in some sense you have "socialized" medicine because NO ONE in the US now has individual coverage - EVERYONE is in some "group" in order to maximize the coverage while minimizing the costs - either through your employer, a coalition (e.g. National Association for the Self Employed, etc.), or a combination of local/state/federal government (poor relief, indigent care, Medicaid or Medicare). As such, healthcare is composed of a patchwork of "socialized" medicine - no true way of ensuring that all the care is quality or affordable. In this manner, those with (1) plenty of money, (2) jobs with employers who provide medical insurance, and (3) those who in some manner must depend upon our governments for their support (TANF, Food Stamps, etc) receive "quality" health care.
12:37 PM on 03/02/2009
Americans like to believe they live in the best country in the world. To pop your bubble, according to the UN WHO, the US ranks 37th in health care available to the average citizen in each, "average" being the key word. That means that 36 other countries in the world do a better job in providing health care to the average citizen and some at half the cost. To most American citizens, the US is just another third world country. True, we spend more dollars on health care than any other country even though our delivery system is a complete failure. Fixing the system is not difficult or magic or does it require a lot of original thinking, just be willing to open your eyes and take a look at what is working elsewhere where the quality of life is higher and healthier. Take the best from each of the other 36 and combine it into your own and whatever emerges will be better than what we have now. Mystery solved.
06:35 PM on 03/01/2009
I think the biggest impediment to health care reform is how the issue is being framed. Whenever we talk about health care reform we start with cost and speak of little else. That is the problem. Cost is not health care. That puts the cart before the horse. As I imagine Tom Daschle was hearing in the townhall meetings he had started around the country from patients, families and physicans alike was that cost was determining who got what and when. People have been inappropriately diagnosed, suffered and died ignobly for cost. Are the insurance companies to blame? Not really because they are for-profit business and cost is their life's blood.

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.
02:37 PM on 03/01/2009
Affordable healthcare is a classic conservative proposition. Bringing the costs down will conserve a significant amount of the 2.26 trillion we now waste on our current system. True conservatives support a massive overhaul of a system that's is the single biggest weight on business prosperity. We all pay a health tax in this country whether we want to or not. Healthcare reform will throw that tax off our backs.
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candyc
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candyc
08:03 AM on 03/01/2009
I am a sixty year old woman .Yesterday was the last day of my good health insurance. My 66 year old husband was laid off from his job. He is eligible for Medicare. I'm not.

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.
09:40 PM on 02/28/2009
Throwing money at it won't help; it's just buying a bigger bucket instead of fixing a leaking roof.

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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08:55 PM on 02/28/2009
I am not a big fan of Government run health care, I don't trust their judgement or even their ability to handle large sums of money (see Iraq, Social Security or Medicare).

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.
10:59 AM on 03/01/2009
So. Are you a fan of our current "system" of health care? Or lack thereof?
11:26 AM on 03/01/2009
Not at all but I have seen what Government has done to Social Security and Medicare. With SS they spent all the surpluses over the past 40 years and now those people that paid in will get the shaft. Medicare will lose billions every year from here on out.

I am not a fan of running up debt, left or right it is wrong.
01:23 AM on 03/02/2009
prove it. you probably made it up or confused median and mean.,

We have no reason to believe you.

Last calculation I made: doubling rhe top income tax over 250k would pay for the entire budget.
12:44 PM on 03/02/2009
In 2007, the Feds took in $2.6 trillion . . . $1.1 trillion from income taxes . . . doubling everyone's taxes may get us $2.2 trillion in income tax revenue bringing out income to $3.7 trillion.

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
07:31 PM on 02/28/2009
Right on, Mike! My gf is a nurse, and this is her major concern. She saw you at NNIYN outside Denver today, btw! Props for relatability.
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ProudLiberalDan
Standing up an fighting conservatives since 1987
07:12 PM on 02/28/2009
HR676, Single-payer Health Care, is currently before Congress. I have written both my Senators and my Representative to support it. Please ask your members of Congress to do so too.

If it were to reach his desk, I do believe Obama would sign it.
05:05 PM on 02/28/2009
I & the nation have been waiting for this since 1948. It's way past time to make Harry Truman's dream into a reality. We were so close but so far away when Hillary worked for it while Bill was POTUS. This has been a Democratic dream since 1948; now is the time for universal health care in America, with or without Harry & Louise.
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Linda Bergthold
Health policy consultant
05:01 PM on 02/28/2009
I totally agree with you, Mike, that health reform will happen this year. And when I wrote this post for Huffington almost two months ago about the prospects for health reform, I wasn't even as sure as I am now that it would happen. http://www.huffingtonpost.com/linda-bergthold/happy-health-care-reform_b_155403.html
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!
11:06 AM on 03/01/2009
I'm really tired of the shame on us spiel. It discounts the very well-organized conspiracy that the "republicans" have been waging on our government and our country over the last 3 decades. They've exhibited genuis, albeit evil, in their tactics and their accomplishments. The degree of their dishonesty and audacity took everyone by surprise. I remind you of the 2000 presidential election.

If we can't do it this time, it actually means that evil has prevailed, not that we didn't try hard enough.