Barack Obama and Health Care Reform
Did Barack Obama overlearn the lessons of 1994? The President has made a deliberate effort to stay out of the health care negotiations that are taking place on Capitol Hill, because he doesn't want to repeat the mistakes that the Clintons made of sending up a plan and telling Congress to pass it--only to realize too late that they had created something for all sides to attack. But now, up against a tight deadline to get this legislation passed, some Democrats say (mostly privately) that they wish the President were more of a presence in the talks, and that he would spell out more clearly what is and isn't acceptable to him in a final product. For instance, does it have to include a government-run public plan like Medicare for the uninsured? Here's a story I wrote on this dilemma for TIME.com.
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Can't blame him for being somewhat cautious after the stimulus fight and moderates essentially shooting down much of his plan.
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he would spell out more clearly what is and isn't acceptable to him in a final product.
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Why? What he going to do? Veto it?! -
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PD: That's sort of the point. A lot of Democrats believe, for instance, that it won't work without a public plan. (See my post last week on that letter from Rockefeller and Brown.) But if that isn't part of what comes to Obama's desk, is he going to veto it? Hard to imagine.
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With people like Max Baucus and Ben Nelson around I can understand the President's cautious approach. He needs to flush out the opportunists, the fingers to the wind wallahs and others with their hands deep in HealthCare's pocket before he enters the fray.
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Bitter: From what I'm told by the White House, Obama (like Baucus) still hasn't given up on the hope that it can win GOP votes, even after they decided to put health care in reconciliation. Please read my story for an interesting anecdote on that subject.
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Seriously, Obama isn't interested in investing any 'political capital' until he actually has product to sell. He probably figures that limiting lawmaker's perogatives at this point would lower the odds of passage.
I doubt he'd be willing to veto any bill that results. -
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PD: That's the argument that Axelrod makes. (Again, see my story.) But I can tell you that some very key Democrats are getting nervous. Most won't say it publicly, but they are.
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Here is a thought, maybe President Obama doesn't want to give the Republicans a line of attack by coming out for how he wants the bill to be only to hear them say they weren't consulted. Right now the more he takes a hands off approach the more it shows he is giving the Republicans every opportunity to come ot the table and for compromises to be made. Now I don't understand the concern trolling because honestly President Obama is working with a stacked deck now that reconcilliation is on the table. What I expect you will see is that after maybe a month or so has passed and Republicans aren't offering anything of substance President Obama will take ownership of the bill and then he will convince Dem leaders in Congress to swing his way by and in large and when the obstructionists object he will point out that when they had a chance to be constructive they chose not to be. Whether Obama is cominig out strong in the media or even to some of the rank and file I would be shocked if he hadn't spoken with Nancy Pelosi and Harry Reid about how he wants the bill to look ultimately. For now I don't think he loses anything by being hands of. Instead in fact I think it burnishes his bipartisan cred and it takes away a target for the right wing smear machine. With the political climate being what it is I think its the right way to go.
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SG: I'm not concern trolling. I am reporting. I am talking to people who are in the room, and telling you what they are saying. This is my job as a reporter. It gives me access to sources who are working on the legislation, and the responsibility to report to my readers what I discover.
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Dodd is the only one willing to be quoted on the record, but he is Ted Kennedy's closest friend in the Senate, and the second-ranking Democrat on the Health Committee. He brought this up at a breakfast with reporters -- even though he hadn't been asked about it. And I can tell you I heard similar sentiments from a number of other very senior Democrats on this issue, including from at least one who told me he has conveyed this opinion directly to the President.
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I have also asked these questions of the White House, and have reported to you their response. Again, this is my job. Sausage-making is never pretty, but the process does shape the final product. -
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K Tizzle
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I actually wasn't talking about you, I was talking about the unnamed Dems you keep referring to. -
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SG: They are not trolls, either. They are people who feel very passionately about this issue, and who have devoted decades of their lives trying to see health care reform happen. I'm not sure they are right here, but I thought the intensity of this fear is newsworthy. Also, I'm told by three officials at the White House that Obama will be stepping up his game shortly, but they refused to give me any details as to how. I delayed writing this story for five days trying to get those details, but finally gave up and wrote it.
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Where's the upside for Obama getting involved early? Is he calculating that he'll have more influence coming in late to resolve stalemates than he would have had investing in a particular approach early on?
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I'm wondering if he would have been more involved early if he didn't have so much else on his plate. On the other hand, this has been his consistent approach, hasn't it - including with the stimulus bill? -
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that last post was probably more than you wanted to know about the sausage-making on my end.
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If Obama doesn't stand up for a public plan, it will be considered a betrayal of his campaign promises.
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Lets not forget that Obama was just about the last candidate to come up with a health care proposal -- and he, like all the other Democratic candidates, included a "public plan" option. Had he not done so -- had he said "well, I think that we can leave it in the hands of the private insurance companies", he would likely have lost the nomination, because health care was the domestic issue in the primary.
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Not that I'd be terribly surprised if Obama does betray the people that elected him.... but its crucial to note that if he doesn't use his political capital to ensure that there is an effective public plan that he is betraying his promises. -
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One other impression I get is that Obama is significantly more pro-business than either his opponents OR his allies let on. I think that when he says, "I recognize that there's that concern. I think it's a serious one and a real one. And we'll make sure that it gets addressed." he's just being straight up honest. The folks who are crying 'socialist' and such are reacting to a cartoon, not to the actual man.
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Kathy: I'm not sure he should be involved. But some of the people I talked to are afraid that what is going to emerge from these committees, especially in the Senate, will not be good. Also, they are afraid that the whole thing may fall apart. I've even heard one scenario where Reid and Pelosi may have to come in at the last minute and write a bill. People are nervous, in part, because health care reform only comes around every 15 years or so, and they don't want to blow it again.
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K Tizzle
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Describe a situation for me where health care doesn't happen this year with reconcilliation that doesn't involve President Obama making a big overt mistake. Right now the biggest threat to healthcare as far as I can tell is Obama making a move that Republicans can successfully paint as an overreach and that will give conservative Democrats cover to also vote against it. Keeping in mind that hopefully if it gets to where we have to use reconcilliation to push it through Franken will be seated. Its ok to be concerned but its not ok to be freaking out over smart political moves by the President. I imagine that if President Obama was very hands on the same people would be worried that he was too hands on. Either way like I said before the deck is stacked this time in a way that it never has been in the past and while nobody should be taking victory laps, they also probably shouldn't be expressing to a reporter (no offense) that they think the President should be doing more. That gives the impression that either it isn't important enough to him or that he doesn't know what he is doing. Democrats are notorious concern trolls which is always problematic but this is one time where I think if they have any concerns and they want health care to pass they should keep those concerns between themselves and the WhiteHouse. Especially when we are this early in the game. -
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"One other impression I get is that Obama is significantly more pro-business than either his opponents OR his allies let on."
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Its not just Obama that is more pro-business than they would like people to believe. There are a whole host of democrats who will wail, preen and pander in front of the cameras but, in the end will find some lame excuse on why they just couldn't vote in favor of the American people. Just like they did with the cram down. But the beauty is we rubes will reup these same clowns without batting and eye. Because maybe next time. -
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Was Specter's defection being embraced warmly by the Democrats all about health care? He's already gotten a pile of money for NIH, so I'm not sure what he still wants out of a health bill.
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KT - it sounds like you're saying that Kennedy no longer has the primary hold on the debate. Is that because he's lost some clout on the issue or that others have equally strong pov's. -
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"But now, up against a tight deadline to get this legislation passed, some Democrats say (mostly privately) that they wish the President were more of a presence in the talks."
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Please explain to me what "deadline", and why there is such a rush?
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Is this going to be another example of rushing a bill to vote which was never read by any of the congressmen or women?
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Do you sense that the President's favorability ratings are falling like a rock?
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Or, do you think the American people will see this for what it really is, more democrat bull-crap, and a way to totally destroy our health-care system? -
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rusty: a way to totally destroy our health-care system?
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What health care system? -
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KT: I read your column before posting. I am sceptical about Democrats who are beholden to healthcare money. After reading several posts mentioning Kennedy I wonder whether his own health problems means he will not be leading the push for a new plan. Overall I have less confidence in the Senate to get the people's business done. But when it comes to monied interest groups the Senate finds it can expend the energy needed given how well they are lubricated with cash.
I guess I don't see the Senate in stark Republican, Democratic and Independent terms.
Which may be why members want the President to provide aggressive leadership.
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Either way like I said before the deck is stacked this time in a way that it never has been in the past and while nobody should be taking victory laps, they also probably shouldn't be expressing to a reporter (no offense) that they think the President should be doing more.
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there is an excellent reason why people like Dodd are saying the President should be doing more -- Obama's absense from the debate is allowing the insurance companies and their factotums to dominate the discussion to the point where the there will be no real health care reform, just a bill that enhances health insurance company profits. Obama needs to stand up for a public plan -- and make it clear that such a plan is necessary because insurance companies are in the business of denying care to maximize profits. -
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sgwhite: i'm not nearly as confident as you are that something comprehensive will pass. right now, i'd give it 50/50. i asked a longtime hill aide, who had worked on this before in 1994, what the definition of success is. he described a bill that would cover an additional 10 million people, which still leaves 37 million without coverage. one big reason, which i wrote about last week, is the difficulty in coming up with a bill that meets the CBO scoring requirements.
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kathy: ted kennedy's illness has made it impossible for him to play the kind of role he would be playing if he were healthy. baucus is in the drivers seat. -
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Obama offered to curb malpractice awards, a subject near and dear to the republicans, and expected them to offer something in return? Political theater. He knows they're not going to cooperate under any circumstances. He knows they have no interest in bipartisanship and are going to do anything they can to derail anything he wants to accomplish. They'll sit on their hands during the entire process and then whine about being excluded again. When the bill is finished they'll bring out their own comic book length alternative and act like it's a viable alternative. The right wing knows meaningful healthcare reform is another nail in their coffin. Personally, I can't wait for the RW to flatline so that we can pronounce them dead and bury the carcass. Maybe whatever emerges to take the place of their party can use a few of the organs, but the body has to be disposed of.
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