Wednesday, November 12, 2008 at 5:23 pm
Moving Forward on Health Care
With the exception of what we're hearing from a few people like Jonathan Cohn, the rapidly congealing conventional wisdom of the Washington pundit class is that health care reform is a non-starter next year. The assumption taking hold is that Barack Obama simply can't afford to tackle it; he can't afford the money, and he can't afford the political capital. The way things generally work in Washington, the longer that idea stays out there, the more likely it is to become a reality.
That would be unfortunate, if recent history is any guide. In 1993, Bill Clinton decided to put off health care reform until his second year, focusing instead on putting some points on the board with his deficit-reduction plan and NAFTA. The hope was that these victories would add momentum that would aid the health care effort. The reality turned out to be the opposite: By the time Clinton finally got around to health care in 1994, his political capital had been drained and spent. Will Obama make the same calculation? As Hillary Clinton told me in an interview shortly before Election Day this year: "It's important to move simultaneously on several fronts, and I know how difficult that is. But a new president has a honeymoon period. ... I hope that we're going to really make progress on health care, right off the bat, with a new Congress. ... I think the bottom line is that Americans are voting for change, and by that they mean they want to see a better life for themselves and their families and their country—and we're going to have to produce that."
That's why the 87-page health care white paper that Senate Finance Committee Chairman Max Baucus released today--to much acclaim by unions and other groups interested in health care reform--could be so important. The policy details are not all that significant; the only real difference from Barack Obama's plan is that Baucus would put in a so-called "individual mandate," which is a requirement that individuals who do not get coverage from their employers buy it on the open market. Obama would make that decision voluntary, though his plan, like Baucus's, would strive to make it easier for people to afford it. The key thing is that this is a signal from the chairman of the Finance Committee--one of the biggest hurdles for any effort--that he is intent on moving forward. What remains to be seen is whether Congress and the new administration see health care reform as a priority that is secondary to an economic recovery, or one that is crucial making that recovery happen.
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Senior Writer Karen Tumulty has been TIME's National Political Correspondent since 2001, and has also covered the White House and Congress for the magazine. A native of San Antonio, she is a graduate of the University of Texas at Austin and Harvard Business School, where her career choice has significantly lowered the average salary of her graduating class. But she gets lots of free magazines. Read More »
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Joe Klein is TIME's political columnist and author of six books, most recently Politics Lost. His weekly TIME column, "In the Arena," covers national and international affairs. In 2004 he won the National Headliner Award for best magazine column. Read More »
Michael Scherer is the White House correspondent for TIME. He previously worked for Salon.com, Mother Jones, and the Daily Hampshire Gazette. A native of San Francisco, he graduated from U.C. Santa Cruz and Columbia University's Graduate School of Journalism. Read More » Follow Michael Scherer on Twitter
Jay Newton-Small is the congressional correspondent for TIME. Born in New York, she spent time growing up in Asia, Australia and Europe following her vagabond United Nations parents. A graduate of Tufts University and Columbia’s Graduate School of Journalism, Jay previously covered politics for Bloomberg News. And, yes, despite the misleading name SHE is a she. Read More » Follow Jay Newton-Small on Twitter
Amy Sullivan is a senior editor at TIME magazine, and author of the book The Party Faithful: How and Why Democrats are Closing the God Gap (Scribner, 2008). A Michigan native, she holds degrees from the University of Michigan and Harvard Divinity School. She writes about religion and politics for TIME, but no longer answers to the name "Bible Girl." Read More »
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Wednesday, November 12, 2008 at 5:31 pm
Is it believed that Baucus is plugged in and this is part of a coordinated strategy? Having witnessed the exactitude of Obama's planning, it's hard for me to believe this isn't part of a scripted initial playbook, even if it's only a loose collaboration.
Wednesday, November 12, 2008 at 5:32 pm
Mad Max is the Master of the Universe and will save the world.
Wednesday, November 12, 2008 at 5:35 pm
I think it could be done this year, maybe. Snowe, Collins, Specter, and Voinivich sign on. If Dems win Alaska, and or Minnesota it will be more likely. The Bush dog democrats have lost some power in the house because of the size of the margin there.
The blue dogs will be wallowing in Big Pharma and Big HMO money though. Good luck to any primary of GE challenger who tries to fund a campaign against them.
The leverage is going to come from big business who is getting destroyed by health care. I could see President Obama changing GM's mind in exchange for some bailout money.
Wednesday, November 12, 2008 at 5:37 pm
The thing about policy provisions in campaign promises is that they are not meant to be taken literally. They are signals. They say "This is where I will fall on the spectrum." Obama was saying "I will do what is possible." Clinton was saying "I'll fight to the edges of possibility."
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Mandates will not be a showstopper for Obama, unless he thinks he can't clear the Senate with them in place.
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I agree with Hillary here. Now's the time. Look to FDR's 100 days. With people losing jobs, and worried about losing jobs, the ability to not have to worry about health care coverage will resonate very well.
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It could even spur a burst of entrepeneurship.
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Stuff snowballs. Momentum builds. Make Mitchipoo stand up and say that Americans who are out of a job don't deserve health insurance.
Wednesday, November 12, 2008 at 5:38 pm
Having witnessed the exactitude of Obama's planning, it's hard for me to believe this isn't part of a scripted initial playbook, even if it's only a loose collaboration.
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Much has been made of the disadvantage of running for President from the senate. There may be some advantages stemming from being a Senator if you're gonna be President. Staff relations if nothing else.
Wednesday, November 12, 2008 at 5:41 pm
What remains to be seen is whether Congress and the new administration see health care reform as a priority is secondary to an economic recovery, or one that is crucial making that recovery happen.
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That's the question, isn't it? To me, the answer is clear. The American economy is operating with a huge burden that none of its industrialized competitors share: an extraordinarily expensive and inefficient health care system. Asking the economy to recover without seriously addressing this problem is not quite asking the impossible, but it is making things needlessly difficult.
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It's so important that people remember that the decline in real incomes over the past 8 years would be a gain if health care prices had not risen so dramatically; Health care costs are erasing gains in productivity.
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And thanks KT for writing about this.
Wednesday, November 12, 2008 at 5:44 pm
@jay - I see signs of Obama's influence on leadership in the Senate, House, and on the lame duck White House. What I find interesting is that I am seeing NO sign of any influence on Treasury. I understand there is only "one President at a time," but I expected to hear in Paulson's words today a sign or two that I recognized as Obama-like. Didn't see it.
Wednesday, November 12, 2008 at 5:45 pm
No way health care reform takes precedence over the current economic and financial crisis. Obama and the Dems can't take on their preferred agenda until the major crises are at least handled as some sort of token effort.
http://www.political-buzz.com/
Wednesday, November 12, 2008 at 5:45 pm
I think it could be done this year, maybe. Snowe, Collins, Specter, and Voinivich sign on. If Dems win Alaska, and or Minnesota it will be more likely. The Bush dog democrats have lost some power in the house because of the size of the margin there.
The blue dogs will be wallowing in Big Pharma and Big HMO money though. Good luck to any primary of GE challenger who tries to fund a campaign against them.
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Trifecta--
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The blue dogs are the issue here. I honestly don't think the Senate will stop anything like this even if filibusters are attempted. The "Oh my, we can't do anything without the republicans" bit was a plan to tie Bush around their necks if they continued to vote in bloc.
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To my mind, firing up the GG/FDL Accountability project, targeting Steny first, is the best thing to do. Make the folks in the safe seats fear primaries. This will force the Blue Dogs to stand alone in opposition to making sure their constituents can get health care after they are laid off.
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This brings Rahm back to mind. What are his real motives? LBJ was a pragmatic ballcutter who turned out to be an idealist when given the shot. Let's give Rahm a chance to shine.
Wednesday, November 12, 2008 at 5:51 pm
yeah, Rose, I think he should frame it that way. The negative thing is that people will lose health insurance when they get laid off, and we have to address it. The positive thing is that people who get laid off, or who think their current employer doesn't offer a bright future, can go for that business plan they've always had in the backs of their minds.
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Policy wise, this is a great time for a fermenting small business private sector. Much of what's wrong is related to powerless taxpayers and choiceless consumers funding companies that deliver crap products and services at high prices.
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Universal health care, tied to creating opportunities for actual plumbers with actual licenses hoping to get out of the wage slave treadmill is a really powerful message.
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Man, do I want preview right now. If this makes no sense, well, sorry.
Wednesday, November 12, 2008 at 6:01 pm
In terms of the blue dogs , another advantage to going for it early IS the economic crisis. No one I know understands where we are getting the gazillions to fund all the bailouts is coming from - there is a sentiment that we are already in Neverland and if we're taking things on faith let's let the guy we elected solve the problems we asked him to and not just fund AIG hand relief with happy endings. Now is the time. We are already in the booth, might as well look up and participate.
Wednesday, November 12, 2008 at 6:05 pm
Health care leaves people slaves in their jobs. I think some employers like this too much. There would be so many people starting small businesses except they have a family member with a pre-existing condition, so they are trapped.
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If health care was treated as a right, there would be people leaving dead-end jobs and creating companies that would help grow the economy.
Wednesday, November 12, 2008 at 6:25 pm
[...] Moving Forward on Health Care TIME - USA As Hillary Clinton told me in an interview shortly before Election Day this year: "It's important to move simultaneously on several fronts and I know how … See all stories on this topic [...]
Wednesday, November 12, 2008 at 6:55 pm
I'll repost here my comment to Joe Klein's post:
Wednesday, November 12, 2008 at 7:06 pm
[...] Moving Forward on Health Care TIME - USA In 1993, Bill Clinton decided to put off health care reform until his second year, focusing instead on putting some points on the board with his … See all stories on this topic [...]
Wednesday, November 12, 2008 at 7:11 pm
Stuart - nice to see you back. Hope the moderation fix brings others back too.
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Re the "rapidly congealing conventional wisdom": "rapidly congealing" is probably the operative state. Haven't seen a lot of evidence Barack worries overmuch about the CW.
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As he said re the first debate: A president should be able to do more than one thing at a time. My bet is he'll be addressing this in some fashion in the first year, dependent on how far south the economy sinks.
Wednesday, November 12, 2008 at 7:13 pm
Stuart - have you figured out a way to do a space between paragraphs without typing in a period, the way the rest of us are doing it??
Wednesday, November 12, 2008 at 7:14 pm
If this proves anything, it's that the committee chairmanships are crucial in getting progress moving forward. In that vein, could people please contact their reps and get that old fart Dingell out of the Energy chairmanship and Waxman in? Dingell, the stooge of the auto industry who's fought CAFE standards and fuel efficiency standards and has driven the industry to bankruptcy?
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We need real energy reform in this country, and Dingell will use all his power to stop it.
Wednesday, November 12, 2008 at 7:26 pm
Well let's first assume that Obama has a plan for his presidency. there is a reason that he ran with such urgency as opposed to waiting until he had more experience, more time in Washington or waited his turn. Thee is clearly something big he wanted to accomplish that couldn't be done in Illinois, or the Senate. My money is on big bold strokes. He's studied successful and unsuccessful presidencies and he is aiming for success.
Wednesday, November 12, 2008 at 7:51 pm
For the kids unfamiliar with Time magazine: When Time magazine announces "Moving Forward on Health Care", that's Time magazine's euphemism for socialized medicine.
Wednesday, November 12, 2008 at 7:54 pm
And for kids unfamiliar with the Swamp, when textee shows up that means his medication is wearing off.
Wednesday, November 12, 2008 at 8:01 pm
Teste and Rusty you just don't have your heart in it anymore. I get it, I felt that way in 2000.
No shame.
Wednesday, November 12, 2008 at 8:09 pm
the rapidly congealing conventional wisdom of the Washington pundit class is that health care reform is a non-starter next year.
KT, Can you name one time the Washington pundit class has been right about anything?
Wednesday, November 12, 2008 at 8:16 pm
The more I read about this the more I think having Baucus come out with a policy paper to get the health reform process going would be an excellent way for Renegade to buck up all of the hand-wringing, Pavlov-like Democrats who can't help but respond to the rights's desperate pleas to take it slow and act like Republicans. I would think that this would be the perfect play of a president-elect who is really good at chess and has to wait for the current president get off stage. And it ought to keep the punditry class in check because they have been wrong so often they ought to be fearful of continuing to pooh pooh health care.
Wednesday, November 12, 2008 at 8:17 pm
For the kids unfamiliar with Time magazine: When Time magazine announces "Moving Forward on Health Care", that's Time magazine's euphemism for socialized medicine.
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Um, high fives all around for socialized medicine?
Wednesday, November 12, 2008 at 8:18 pm
I have a fear about this upcoming debate. Everybody sit down and stop eating. Three words: Joe The Proctologist.
Wednesday, November 12, 2008 at 8:43 pm
Cliff, if this be socialized medicine, sign me up. Having just walked away from a job with extreme prejudice, I now pay COBRA premiums for my health insurance. For my little family, that comes to $1,300 a month - and the costs go up 3 percent next year. I could use the chance to buy into something like Baucus proposes.
Wednesday, November 12, 2008 at 8:57 pm
That's funny. I could have sworn that "socialized medicine" was the euphemism!
My bet is he'll be addressing this in some fashion in the first year, dependent on how far south the economy sinks
Obama has mede it clear that he intends to build the economy from the "bottom up." In that regard his health plan is one plank in the whole platform. Businesses need customers and customers need to have money (the real kind, not the plastic variety.) Removing health care as a worry will aid spending in other areas.
Wednesday, November 12, 2008 at 9:22 pm
textee, hahahahahahaha. Go read some Bill Kristol. He will show you the way out of the darkness.
Wednesday, November 12, 2008 at 10:19 pm
Thank you so much for your kind words, Kathy!
Wednesday, November 12, 2008 at 10:51 pm
From Wikipedia:
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"The term [socialized medicine] is often used in the U.S. to evoke negative sentiment toward public control of the health care system by associating it with socialism, which has negative connotations in American political culture. As such its usage is controversial. A 2008 poll indicates that Americans are sharply divided when asked about their views of the expression socialized medicine, with a large percentage of Democrats holding favorable views, while a large percentage of Republicans hold unfavorable views. Independents tend to somewhat favor it." (from http://en.wikipedia.org/wiki/Socialized_medicine)
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So, socialized medicine is a wedge-issue phrase. Got it.
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texte, how many kids do you have? Any dependents on your health care plan? Any medical bills? If so, then what's the problem with government trying to even out the crater-blasted playing field of what passes for health care? (And if you don't have kids or dependents or medical bills, then what's your beef?)
Thursday, November 13, 2008 at 3:03 am
[...] found it both startling and heartening that someone had either the guts or the foolishness to put forth such a plan even before Obama [...]
Thursday, November 13, 2008 at 3:59 am
[...] friend site: read here Tags: baucus, clinton, committee, health, obama, [...]
Thursday, November 13, 2008 at 12:44 pm
This writer worked in health care finance for 27 years.
The game is afoot. Big bucks are at stake. The ethics of Corporate Accountants is tied to their employer - not to the government. Be careful with those regulations. .......
http://thefiresidepost.com/2008/11/13/the-job-of-the-corporate-accountant/
Thursday, November 13, 2008 at 2:19 pm
"Rapidly congealing conventional wisdom." Yeah, that and $2600 bucks will get you a night in the Lincoln bedroom at the invitation of President Hillary Clinton. Or is that what Cokie Roberts was serving Ms. Quinn at tea the day after the election?
Friday, November 14, 2008 at 8:39 pm
The Call to Action/Health Care Reform 2009 proposal released 11/13/08
(http://www.finance.senate.gov/) by Senator Max Baucus is a disaster.
The Baucus plan is an expansion and continuation of the status-quo
mixture of a government subsidized ineffective private health
maintenance insurance industry operating parallel to and within Medicare
Insurance.
7 Specific Reasons Why the Baucus Health Reform 2009 Plan Fails.....
1) The Baucus plan fails to enroll all Americans in a single payer
National Health Insurance such as the most efficient health insuranceplan (Medicare) which is already contracted with most doctors, hospitals and clinics in the Country. Medicare has the lowest operating expenses and the best morbidity (sickness rates) and mortality (death rates) compared to all other insurance companies. The Baucus plan will therefore divert $700 Billion to $1 Trillion per year away from patients, hospitals, doctors, clinics, nurses, pharmaceuticals, therapist and researchers into the overhead pockets of health private insurance company administrators and executives.
2) The Baucus plan fails to technologically upgrade, integrate and
centralize medical billing and records systems in order to optimize
examination of clinical outcomes, pharmaceutical efficacies and monitor fraud and abuse. In addition, by failing to centralize and
technologically upgrade billing and records systems within a single
National Health Insurance plan, America will be unable to instantly
monitor disease outbreaks and instantly respond to natural and man made disasters or bio-nuclear terrorism..
3) The Baucus plan fails to control drug costs by failing to allow a single efficient national health insurance company such as Medicare to bid on pharmaceuticals. In addition, the Baucus plan by failing to put all Americans on a National Health Insurance Plan such as Medicare does little to shrink the 'risk pool' of insured, thereby failing to decrease insurance premium expenses for all Americans.
4) The Baucus plan fails to provide funding for scientific, clinical and epidemiological research and development by allowing private private insurance companies to divert funds from medical research and development to instead support their massive and profitable administrative and executive bureaucratic overheads.
5) The Baucus plan fails to provide physicians with the same legal
protection from malpractice lawsuits which have been established for
commercial health insurance corporations during the last 3 decades.
6) The Baucus plan fails to explain where to find the 1.5 million new health care workers which will be needed once 100 million new Americans obtain health care insurance. Health care workers can be found easily by shutting down the wasteful and inefficient private health insurance companies, putting all Americans on National Health Insurance such as Medicare. The 1.5 million former private insurance company bureaucrats can then be remployed to actually deliver health care in hospitals,clinics, nursing homes, assisted living facilities, pharmacies and home
health services such as Alzheimer family assistance.
7) The Baucus Plan fails to address this problem of disenfranchised
physicians. Many physicians in this country have left the practice of medicine, or downsized their practices due to private insurance company abuses, malpractice threats and direct pharmaceutical marketing. A recent national poll of physicians based on the AMA database demonstrated that 60% of physicians support a single payer National Health Insurance such as Medicare. A continuation and technological upgrading of our most fair Medicare Health Insurance for all based on the concepts outlined above, would undoubtedly motivate those disenfranchised physicians to return to the profession and bright younger physicians to invigorate the field.
The Baucus plan is wasteful, inefficient, fragmented, creates a new
redundant bureaucracy and will continue to provide no potential future health improvements for America. Only an efficient National Health Insurance carrier such as a technologically upgraded Medicare Insurance company will be able to provide low cost health insurance and pharmaceuticals for all Americans while maintaining the quality of private physician practices and Hospitals.
H. Green, MD, FACP, FAAD, FACMS
Monday, November 17, 2008 at 6:56 pm
[...] Time [...]
Thursday, November 20, 2008 at 3:44 pm
[...] Moving Forward on Health Care [...]