I’ll be back on Vermont Public Radio this Monday as a guest on Jane Lindholm’s Vermont Edition program. We’ll be discussing Obama’s first year in office. You can email questions to VPR in advance – as I recall, some of the best questions and phone calls during my last visit came from regular contributors to this blog, so I encourage you to participate again. The program begins at noon – send your questions in advance to: firstname.lastname@example.org
(As always, I’ll be playing our word game contest in which I try to incorporate three words chosen by a random word generator into my answers, just to keep the vast VPR audience on edge. Monday’s words will be: “accord”, “smoking” and “perpetual.”)
A good chunk of that discussion will undoubtedly focus on health care. In anticipation of that topic, I want to answer some excellent questions several of you asked regarding health care and Obama’s first year in general, and to pose one of my own. Health care is in the news again today thanks in part to this New York Times article in which Rahm Emanuel appears to indicate that passing health care has dropped down on the list of Obama’s legislative priorities. Emanuel’s comments are not surprising; those of you participating in the live blogging of the State of the Union will recall that I thought Obama clearly signaled that he no longer was willing to expend time or political capital in getting the current health care legislation through Congress.
In reading through the various blogs after the speech, I detected what I saw as a stubborn resistance among progressives to read the writing on the wall indicating that health care reform is dead, at least in the short term; more than one blogger insisted that Obama had stated in his speech his renewed commitment to pass the health care legislation now in play on the Hill. In their defense, he did renew his support for health care reform, at least in the abstract, by saying, “Here’s what I ask Congress, though: Don’t walk away from reform. Not now. Not when we are so close. Let us find a way to come together and finish the job for the American people.” And, as Chris A. argued in his comments on the election night blog, there may be good political reasons to pass the Senate bill. Chris suggests that Democrats in the House who voted for health care will pay a bigger political cost with voters in November if they appear to reverse themselves by not supporting health care reform, and that the best way to get legislation passed is for House Democrats to support the Senate bill. That may be true for most of those Representatives who supported health care, but I believe the aftershocks from Brown’s election, as interpreted through the media, changed enough votes in the House to make this strategy politically untenable. Simply put, I don’t believe there’s enough political support in Congress to pass health care legislation in either chamber in its current form.
The placement of Obama’s “support” for health care near the end of his speech, against the backdrop of the political calendar that shows midterms just around the corner, clearly told me that Obama had come to the same conclusion, and that he preferred to put further health care debate on the back burner. Emanuel’s comments add further credence to that supposition, as did Obama’s remarks during his open debate yesterday with Republican leaders. In that meeting Obama made no effort to provide a roadmap for ending the deadlock on health care and admitted that some of the closed-door dealmaking that led to passage of the House and Senate bills was “messy”.
With the midterms now less than a year away, time is working against those who support passing health care legislation. This raises the question: was pursuing health care reform a mistake? Yesterday, retiring Democratic Senator Byron Dorgan, now freed from the constraints of running for reelection, said it was; Obama, he argued, would have been better off focusing on the economy during his first year. Hindsight is 20/20 of course. But I said from the beginning of Obama’s election that he was unlikely to get Congress to pass sweeping health care reform, and that instead his best strategy was to lower expectations and focus on more modest changes, such as insurance reform and cost control within the context of the current fee-for-service, third-party payer health care system. My reasoning had less to do with the specter of Republican obstructionism and more to do with the inevitable drop in public support as health care moves from an abstract promise of “reform” to the specific legislative compromises that must inevitably be made to get reform legislation through Congress. Remember, in the end the public doesn’t consider health care legislation in a vacuum – they compare it to the status quo. For much of the public, the uncertainties associated with the reform proposals, particular on the cost side, outweigh their misgivings toward the current health care system.
I’m working on a longer post that examines why health care reform did not pass despite Democratic majorities in both chambers, but let me end this post by asking: Is Dorgan right? Did Obama make a mistake in signing on to health care reform? Or was the mistake perhaps in the tactics he used in trying to get Congress, and the public on board?
These are the questions I’ll try to address on Monday’s VPR show but I’m eager to hear your talking points beforehand.
Obama’s mistake was in not putting something like tort reform into the bill. Something it would be difficult for Republicans to vote against. Once this “red meat” was in the bill, Republicans might have started to seriously negotiate a health care bill. Right now, it looks as if Obama put the wrong bill on the table and has backed the Republicans into a corner.
Of course I realize that this is not “his” bill, so maybe his biggest mistake was to let Nancy and Harry hack it to death.
As I understand it, the main reason to support health care reform, assuming you already have insurance which is about 85% of the US, is to get costs under control. Had the focus of the bill been cost control…perhaps even means testing…the country might have rallied to the bill.