March 8, 2010--Obama's Plan B or C or D
Last week's speech on health care reform was vintage Obama. As we have come to see, he made a pretty good case to split the difference. This time primarily between his own Democrats because he will need them to deliver enough votes to pass reform and they are quite divided over a number of tough issues. But he also pitched the Republicans since some of the ideas in his final, final plan do in fact come from them. Criticize him or them as you will, but we do need to begin to do something about tort reform (nothing resembling the draconian thing the GOP wants to do to virtually eliminate malpractice law suits, but something sensible) and tax-exempt health care accounts, which benefit the middle class more than anyone else. Both Republican ideas and both good ones.
But basically it was Obama-being-Obama and he's entitled to that. After all, he's the president. Being Obama meant that he had to go the extra mile and then some with Republicans in the hope that a little bipartisanship would break out (though he probably should have pulled the plug on this six or eight months ago), but this is the way he is. It's the good news/bad news of what he learned as a community organizer--work hard to achieve consensus. All things being equal, it's the preferred way to proceed.
But all things are not equal. Far from it. The Republicans have shown that they plan to block everything, every last thing he proposes and thus with health care he's now fully out of the closet. Either as the result of brilliant 15-moves-ahead strategizing or through the art of finding one's way without a roadmap.
Having said this, when he takes the speech he delivered the other day on the road it needs a little work.
Primarily he needs to do a little work at the blackboard because though in the spirit of transparency he said it will cost more money--about $100 million a year to cover another 31 million currently not insured--at the same time he claimed it will save money and this sounded like, well, double-talk. It seemed as if he were saying that on the one hand we will spend a lot but then on the other we will save even more. This is intellectually confusing--it sounds like spin or worse--and is politically harmful to his cause.
I think I understand how it will work but he has not yet been either fully clear, or honest. My read of his plan is that though it will cost more to include the 31 million, we will save more than that will cost by, among other things, cutting emergency room costs, reducing waste from Medicare, taxing Rolls Royce health insurance plans, and controlling the amount insurance companies will be allowed to charge. I think that's what's in his proposal.
If he says this in a clearer way than he did last week, he could also help defuse the Republican lie that Obamacare will "cut Medicare benefits." He needs to say in simple sentences that all benefits will be preserved, actually extended by working to close the prescription drug donut hole scam, but what will be cut from Medicare is the money being stolen by the health care industry.
He needs to clean up this part of the stump speech, take it on the road so he can stay politically in front of it, and do everything he can to help round up the votes needed, emphasizing along the way and as often as possible that the final bill will not have any special deals to "buy" single votes. He mentioned this the other day but in too muted a way. He should proclaim this and make sure he doesn't back down when they need someone like Nebraska Senator Ben Nelson's vote to make reconciliation work. These kinds of back room deals are the very kind of things that make Americans justifiably crazy.
If he does all of this, and the Democrats in Congress discover their backbones, we will have a major heath care reform bill. Not a perfect one but a significant step in the direction of solving this daunting problem. It will also be an important political victory for those involved, which may be the only way to convince quivering Democrats to vote for it. But if they do not act it will be the effective end of the Obama presidency and by November the end of Democratic majorities in both houses of Congress. Something they will well deserve.
But basically it was Obama-being-Obama and he's entitled to that. After all, he's the president. Being Obama meant that he had to go the extra mile and then some with Republicans in the hope that a little bipartisanship would break out (though he probably should have pulled the plug on this six or eight months ago), but this is the way he is. It's the good news/bad news of what he learned as a community organizer--work hard to achieve consensus. All things being equal, it's the preferred way to proceed.
But all things are not equal. Far from it. The Republicans have shown that they plan to block everything, every last thing he proposes and thus with health care he's now fully out of the closet. Either as the result of brilliant 15-moves-ahead strategizing or through the art of finding one's way without a roadmap.
Having said this, when he takes the speech he delivered the other day on the road it needs a little work.
Primarily he needs to do a little work at the blackboard because though in the spirit of transparency he said it will cost more money--about $100 million a year to cover another 31 million currently not insured--at the same time he claimed it will save money and this sounded like, well, double-talk. It seemed as if he were saying that on the one hand we will spend a lot but then on the other we will save even more. This is intellectually confusing--it sounds like spin or worse--and is politically harmful to his cause.
I think I understand how it will work but he has not yet been either fully clear, or honest. My read of his plan is that though it will cost more to include the 31 million, we will save more than that will cost by, among other things, cutting emergency room costs, reducing waste from Medicare, taxing Rolls Royce health insurance plans, and controlling the amount insurance companies will be allowed to charge. I think that's what's in his proposal.
If he says this in a clearer way than he did last week, he could also help defuse the Republican lie that Obamacare will "cut Medicare benefits." He needs to say in simple sentences that all benefits will be preserved, actually extended by working to close the prescription drug donut hole scam, but what will be cut from Medicare is the money being stolen by the health care industry.
He needs to clean up this part of the stump speech, take it on the road so he can stay politically in front of it, and do everything he can to help round up the votes needed, emphasizing along the way and as often as possible that the final bill will not have any special deals to "buy" single votes. He mentioned this the other day but in too muted a way. He should proclaim this and make sure he doesn't back down when they need someone like Nebraska Senator Ben Nelson's vote to make reconciliation work. These kinds of back room deals are the very kind of things that make Americans justifiably crazy.
If he does all of this, and the Democrats in Congress discover their backbones, we will have a major heath care reform bill. Not a perfect one but a significant step in the direction of solving this daunting problem. It will also be an important political victory for those involved, which may be the only way to convince quivering Democrats to vote for it. But if they do not act it will be the effective end of the Obama presidency and by November the end of Democratic majorities in both houses of Congress. Something they will well deserve.
posted by Steven Zwerling at
5:23 AM
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