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At a fundraiser last night, President Obama laid out his vision for health care reform. This is interesting:
Mr. Obama said that once Congressional Democrats had worked out their differences and settled on a final bill, he would push for a vibrant, public debate over the health care legislation. He said he planned “to call on our Republican friends to present their ideas.”
“What I’d like to do is have a meeting whereby I am sitting with the Republicans, sitting with the Democrats, sitting with health care experts and let’s just go through these bills,” Mr. Obama said. “Their ideas, our ideas. Let’s walk through them in a methodical way, so that the American people can see and compare what makes the most sense. And then I think that we have got to move forward on a vote. We have got to move forward on a vote.”
Mr. Obama said that Americans were apprehensive about the health care legislation because there was too much misinformation that he would now work to clear up.
“They are certain that they would have to go onto a government plan, which isn’t true,” the president said. “But that’s still a perception a lot of people have. They are still pretty sure that they would have to give up their doctor. They are still pretty sure that if they are happy with their health care plan, that it’s bad for them. They are still positive that this is going to add to the deficit. So there is a lot of information out there that people understandably are concerned about.”
He continued, “That’s why I think it’s very important for us to have a methodical, open process over the next several weeks and then let’s go ahead and make a decision. And it may be that if Congress decides, if Congress decides we’re not going to do it, even after all the facts are laid out, all the options are clear, then the American people can make a judgment as to whether this Congress has done the right thing for them or not. And that’s how democracy works, and there will be elections coming up and they will be able to make a determination and register their concerns one way or another during election time.”
Is this wishy-washy capitulation? Greg Sargent is worried:
Maybe I’m misreading this. But if you look at the transcript of Obama’s remarks at a fundraiser last night, it seems like the President was at least raising the possibility that health reform may not happen.
To be clear, Obama didn’t say this was a desirable outcome — quite the opposite, in fact — but he did seem to suggest that it’s possible.
I don't think that's what's going on. I actually had to read Obama's remark twice to fully understand what he's getting at, but now that I have, it seems pretty clear. I think Obama sees the perception that the process is broken -- that it's backroom deals and "ignoring the will of the people" -- to be the biggest impediment to passage of the bill. So he's proposing a remedy to that perception.
The most important part is what Obama says should happen first: Democrats should settle their differences and work out a final bill. That's crucial. Then he wants to sit down with both parties, and health care experts, and walk through the details in a methodical way. I'd guess he's imagining a process that might look a little like his back-and-forth with House Republicans -- they present him with wild claims about a government takeover, and he calmly responds. They insist that their ideas are better, and he gets to show that they're not. Then you vote. In other words, a debate in which he gets to take center stage, on top of the kabuki theater of a House debate. That way Obama gets to demonstrate that the plan he has is the product of having considered all the alternatives and arriving at the best way to solve the problem, not just cooking up a backroom deal. The idea seems to be to use his wonky, technocratic style to counteract the process-based objections and sell the bill.
Another key element of Obama's remarks is his insistence that Congress actually have a vote. Let me repeat that section:
That’s why I think it’s very important for us to have a methodical, open process over the next several weeks and then let’s go ahead and make a decision. And it may be that if Congress decides, if Congress decides we’re not going to do it, even after all the facts are laid out, all the options are clear, then the American people can make a judgment as to whether this Congress has done the right thing for them or not.
He's saying that Congress can't just ignore the issue and let it die in quiet. It needs to have a vote, relatively soon, and make a decision, rather than decide by default to keep the status quo. This strikes me as enormously positive news.
Now, Obama's remarks are laying out what happens after Democrats have laid aside their differences and agreed on a final bill. As Jonathan Cohn writes, getting to that point is not going to be easy, and will probably require Obama's involvement, which to this point has been weak-to-nonexistent. But these remarks suggest a deep commitment to success and a pretty smart plan for making it happen.
COMMENTS (8)
The Democrats must have the courage to move ahead on health care reform. The real ironies in all of this are that:
1. The Bills in both Houses of Congress represent not a federal takeover, but rather the expansion of private sector health care to the vast majority of people who currently are not covered by health insurance.
2. Conservatives are screaming about this reform, while, for the first time in memory, the health insurance industry is supporting essentially universal health insurance. The industry wants this because these bills would restructure the insurance marketplace so that insurers can compete on quality, service and outcomes instead of on cherry-picking the healthiest subscribers ... view full comment
The Democrats must have the courage to move ahead on health care reform. The real ironies in all of this are that:
1. The Bills in both Houses of Congress represent not a federal takeover, but rather the expansion of private sector health care to the vast majority of people who currently are not covered by health insurance.
2. Conservatives are screaming about this reform, while, for the first time in memory, the health insurance industry is supporting essentially universal health insurance. The industry wants this because these bills would restructure the insurance marketplace so that insurers can compete on quality, service and outcomes instead of on cherry-picking the healthiest subscribers and denying people needed coverage or services. If you actually talk to CEOs of insurance companies, they would much rather compete on this basis because the vast majority of them care about making people healthy. It's why they got into health care to begin with. But they can't possibly remain viable as profitable entities if young people and healthy people are exempted from paying premiums and only sick people buy insurance. The reason Medicare and Medicaid exist is because private insurers have never been able to figure out how to make a profit covering the very poor or the elderly. The government had to step into this vacuum.
3. Insurance by definition is about pooling and sharing risk. It is actually a very efficient and effective market mechanism. If you want a private insurance market and you want private insurers to dominate it, and you want them to compete on the basis of helping people get the care they need (instead of by denying and delaying coverage and care), then you have to agree that there must be a viable market for private insurance. That requires that everyone participate. There's just no other way. The alternative is the current system where the people with real health care needs are treated as cost centers to be cut. (The other alternative is to give-up on the marketplace and to have the government provide this service. Clearly conservatives don't want that.)
The current insurance market is socially and economically dysfunctional. 90% of what's in these health care bills is simply to fix that and then set the insurance industry free to compete as vigorously as they can in providing people to effective and efficient health care. This should be a Conservative's dream outcome and instead it is being attacked as a government takeover because the cause of destroying Obama's Presidency by blocking any accomplishments has become Republican Party's main focus. It's a shame, especially for the millions of Americans who desperately need and deserve these reforms to keep them healthy and to keep them from economic disaster just because they get sick.
Obama thinks the way to pass health care reform is for the Democrats in Congress and the "experts" to give the American public more details about the legislation and to compare those details with the details of the Republican's alternatives. Because "that's how democracy works". He shows a great deal of respect for the American public. But he's also delusional.
Obama thinks the way to pass health care reform is for the Democrats in Congress and the "experts" to give the American public more details about the legislation and to compare those details with the details of the Republican's alternatives. Because "that's how democracy works". He shows a great deal of respect for the American public. But he's also delusional.
It was much clearer to me than to Sargent: "Congressional Democrats: Pass health reform. Period, no excuses. If you don't, your political careers are over, and I won't mourn you."
And raylward, I think that he may perhaps be expecting a bit much of the public, but isn't delusional. It may be as simple as "Make clear to the public that the Republicans are not just liars, but damn liars. Then make clear that their alternatives involve saving money by treating broken legs with duct tape and whiskey and grandma laying dead in the gutter in front of the hospital, her cold fist clenched around her long-empty bottle of heart pills."
It was much clearer to me than to Sargent: "Congressional Democrats: Pass health reform. Period, no excuses. If you don't, your political careers are over, and I won't mourn you."
And raylward, I think that he may perhaps be expecting a bit much of the public, but isn't delusional. It may be as simple as "Make clear to the public that the Republicans are not just liars, but damn liars. Then make clear that their alternatives involve saving money by treating broken legs with duct tape and whiskey and grandma laying dead in the gutter in front of the hospital, her cold fist clenched around her long-empty bottle of heart pills."
If I was looking for a demonstration of what's wrong with Obama's approach to change, I couldn't have found a better example. We HAD the debate. We now know that Republicans are not amenable to being convinced by the cogency of mere wonkery, and that many voters have bought into their incoherent counter-proposals. This reality will not be changed by a graduate seminar on health policy options, and only a naive intellectual would think that it could be.
We have the votes. Do it, and hope that we're right and that this will become apparent way out there in 2015 when this plan begins to bear fruit. We will never have this opportunity again.
If I was looking for a demonstration of what's wrong with Obama's approach to change, I couldn't have found a better example. We HAD the debate. We now know that Republicans are not amenable to being convinced by the cogency of mere wonkery, and that many voters have bought into their incoherent counter-proposals. This reality will not be changed by a graduate seminar on health policy options, and only a naive intellectual would think that it could be.
We have the votes. Do it, and hope that we're right and that this will become apparent way out there in 2015 when this plan begins to bear fruit. We will never have this opportunity again.
janus, selling public policy is no different from selling soap. Republicans get it, Democrats don't. Obama's speech last night has Emanuel's prints all over it. Emanuel was right for the job in January, when Obama (and everybody else) thought Obama's biggest challenge would be working effectively with a Democratic Congress. Obama's biggest challenge has changed, Emanuel hasn't, and most likely can't.
janus, selling public policy is no different from selling soap. Republicans get it, Democrats don't. Obama's speech last night has Emanuel's prints all over it. Emanuel was right for the job in January, when Obama (and everybody else) thought Obama's biggest challenge would be working effectively with a Democratic Congress. Obama's biggest challenge has changed, Emanuel hasn't, and most likely can't.
raylward, you made me laugh - you were also right about messaging stuff being frustratingly off on another thread about Rahm.
But I do give Obama credit for his courage and leadership in trying to model reasonableness, despite it all. That impulse is never a waste, and he can't change now. I think he's making respectable headway too. Its hard to imagine that the Republicans will have the support of the public to kill reform. Just a gut thing.
The problem with this statement at the fundraiser is that it is too bloodless, I think I fell asleep in the middle of it.
Obama has no problem hitting you right between the eyes in his speeches (some will kill, some will be killed, zillions of exampl ... view full comment
raylward, you made me laugh - you were also right about messaging stuff being frustratingly off on another thread about Rahm.
But I do give Obama credit for his courage and leadership in trying to model reasonableness, despite it all. That impulse is never a waste, and he can't change now. I think he's making respectable headway too. Its hard to imagine that the Republicans will have the support of the public to kill reform. Just a gut thing.
The problem with this statement at the fundraiser is that it is too bloodless, I think I fell asleep in the middle of it.
Obama has no problem hitting you right between the eyes in his speeches (some will kill, some will be killed, zillions of examples) with great beauty AND precision. He needs to be clear, bold, commanding in his message to the public
Or better yet: don't speak in code, pretty much ever.
Or better yet: don't speak in code, pretty much ever.
Give me a break -- if you want a vote tell the Speaker and Majority Leader to have a vote. The problem is that they don't have the votes to pass the Senate bill in the House or the magic reconciliation stratedgy in either body. My favorite part of you blog is the President sitting around with the members and health policy wonks and discussing the particulars of the bill. First, maybe the President will go on CSPAN and discuss the various deals that were made with Phrma, Hospitals, Device Indiustry, etc. We know that there is a bipartisan effort on the Energy and Commerce Committee to get to the bottom of the White House deals. I guess you bid time health care bloger forgot to attend tha ... view full comment
Give me a break -- if you want a vote tell the Speaker and Majority Leader to have a vote. The problem is that they don't have the votes to pass the Senate bill in the House or the magic reconciliation stratedgy in either body. My favorite part of you blog is the President sitting around with the members and health policy wonks and discussing the particulars of the bill. First, maybe the President will go on CSPAN and discuss the various deals that were made with Phrma, Hospitals, Device Indiustry, etc. We know that there is a bipartisan effort on the Energy and Commerce Committee to get to the bottom of the White House deals. I guess you bid time health care bloger forgot to attend that markup. But best of all maybe the President recount to the public how he made the deal with the Unions (SEIU, AFSME, etc.) to exclude labor unions and state government workers from the cadellac tax on health benefits. That would make a great CSPAN episode.