Optimism Grows Among Experts That Obama Will Act Quickly On Health Care
After an earlier round of hand-wringing about whether President-elect Obama would push off health care reform out of fear of its economic and political costs, some experts and advocates in the field are increasingly optimistic that the incoming president will in fact act decisively and ambitiously to pursue reform in his first year.
These experts point to several very recent rapid-fire developments to justify their hopes, first among them the announcement today that Obama has tapped Tom Daschle as secretary of Health and Human Services.
Richard Kirsch, the national campaign manager for Health Care for America Now, a leading umbrella group of health care advocates, unions and providers, points out that Daschle has repeatedly talked about the imperative of acting fast on health care reform lest Obama's mandate be spent in other areas.
"Daschle has talked for awhile about the need to do this early," Kirsch tells me, recounting that Daschle stressed this in a meeting with him as long as a year ago. Kirsch adds that there are mounting signs that the Obama team "understands that because of the enormity of doing health care, because it's the hardest thing to do, they need their mandate the most for it."
Dem Rep. Pete Stark, a longtime advocate for universal health care, hit a similarly sunny note in a statement today.
The Daschle pick "speaks volumes about the importance the Obama Administration places on working with Congress to enact comprehensive health reform," Stark said, adding that it "bodes well for all."
Daschle isn't the only thing that has these folks cheered. Incoming White House chief staff Rahm Emanuel has been promising ambitious action in striking terms.
Experts also say it's unlikely that Senator Max Baucus would have released his recent plan, or that Senator Ted Kennedy would be planning to release one himself so soon, without a tacit go-ahead from the Obama team itself. What's more, these Senators are casting health care reform as a crucial component of any economic revival plan, an argument that the pro-reform forces have been pushing hard.
"Baucus and Kennedy wouldn't be moving as aggressively as they are, and wouldn't be making the case so aggressively that health care reform should be a critical element of an economic recovery plan, without a signal from Obama himself," says Gerry Shea, the lead health care organizer at the AFL-CIO, which along with other unions is pledging huge upcoming efforts on behalf of reform.
Obama's transition team has indicated to advocates in the field that they would be holding their first meeting with them on the topic soon. Separately, as noted below, frequent writers on health care are also cheered by the Daschle pick, stressing Daschle's talents for navigating Congress and his belief that health care reform must be comprehensive and not incremental.
Hey, look!! Government that actually works, and not just for the connected few! Whouda thunk it?
November 19, 2008 3:30 PM | Reply | Permalink
Kind of scary and obama is getting handed a gift on iraq as well. The agreement signed by the king mandates all troops out within 3 years. Wow, what a good day.
November 19, 2008 3:33 PM | Reply | Permalink
fingers crossed...
November 19, 2008 3:38 PM | Reply | Permalink
If this is what complacency looks like, I could get used to it! Think I'll go for another walk in the park...
November 19, 2008 3:49 PM | Reply | Permalink
So, in other words...all that speculation about him not moving fast on healthcare was just...speculation?
In other words, we all have very little to go on so we're trying to create stories?
November 19, 2008 4:22 PM | Reply | Permalink
Health care immediately and then the car companies won't have to be bailed out.
November 19, 2008 3:42 PM | Reply | Permalink
Ditto, it would be a huge help for all businesses and industries. HUGE! Every car's price is increased by about 2k for healthcare costs. Talk about being more competitive. Healthcare reform would be a huge, huge benefit to the economy.
Now the downer is this:
http://news.yahoo.com/s/ap/20081119/ap_on_go_co/auto_bailout_what_s_next
What in God's name are republicans thinking???? Bankruptcy of the big three would cost the government much, much more than a bridge loan. They really don't get it. I think the republican party really has a death wish at this point.
November 19, 2008 3:45 PM | Reply | Permalink
No, they don't have a death wish. You had it right in the previous sentence. The Republicans simply DON'T GET IT. If their ideology says up is down, then by golly, up must be down.
November 19, 2008 4:03 PM | Reply | Permalink
You would think that the Lehman fiasco would scare the sh*t out of them. If they would have slowly unwound this financial garbage internally and dealt with Lehman differently, we would not be in this disaster spinning out of control and spending hundreds of billions of dollars on paper. What does it take to get through these buffoons' thick heads? I really don't understand.
November 19, 2008 4:12 PM | Reply | Permalink
Ideology trumps reality. It's like someone running into a brick wall, deciding that the wall really shouldn't be there, then running into it over and over again because they're convinced that the wall can't really be there.
I don't get it, either.
November 19, 2008 4:22 PM | Reply | Permalink
I'm supposed to be working and I am screwing around here and listening to the tv. There was some republican talking head on this auto industry thing saying incredible things. First he said that they wouldn't go bankrupt, than he said that they would go chapter 11. Last I heard Chapter 11 was bankruptcy. Then basically his point was that they could then renege on the labor contracts and cut wages. Gee, that's a marvelous idea.
The problem is that the industry could never get debtor in possession financing because the credit markets are frozen solid as a rock. Sooo, they go chapter 11 and in order to avoid liquidation the federal government would have to give them debtor in possession financing, ie a loan. Soooo, why let them go into bankruptcy in the first place. It really is kafkaesque.
November 19, 2008 4:33 PM | Reply | Permalink
It all makes perfect sense. All you have to do is throw reality out the window.
See, first we have known knowns, then we have unknown knowns...
November 19, 2008 4:39 PM | Reply | Permalink
As long as we're being optimistic ...
On most domestic issues, it boils down to "us" (consumers & taxpayers) against "them" (corporations and lobbyists), but as you say, why can't healthcare be an issue that splits "them" into two warring factions? Obviously Blue Cross will fight against it like a cornered rabid polar bear, but a company like GM or GE has to spend gazillions on health care. Why wouldn't they turn their legions of lobbyists loose to fight FOR healthcare reform? When I worked for a large software company, my HMO cost me $15/month and went I got laid off and went on COBRA, it went up to $350. So that (failing) company had to pay $335 a month per employee. If government took over and that company could abandon its HMO program, it would save that $335 per employee per month or $4020 per year.
Now, if the companies that would go under if GM goes down employee 3 million people, government healthcare would provide that industry with a 12 billion dollar bailout EVERY YEAR GOING FORWARD!!
And by cutting Blue Cross out of the deal, it wouldn't cost tax-payers anywhere near 12 billion to do it.
Devil's Advocate: If my rosy little calculations were true, then why the hell did healthcare reform fail so catastrophically in 1993???
November 19, 2008 4:02 PM | Reply | Permalink
It wasn't handled properly in 93. That was the problem. We have a totally different situation now and it will be handled properly.
November 19, 2008 4:04 PM | Reply | Permalink
Exactly. It was a policy written by wonks for wonks. It was so complex they never could satisfactorily explain it to people, so Harry and Louise won by default.
November 19, 2008 4:06 PM | Reply | Permalink
And it was written in secret by clinton and they tried to shove it down the throats of a democratically controlled congress. Won't happen again. It will be totally transparent and gradually sold to the american people and it will make sense. We have a super great and intelligent awesome communicator at the helm of the ship of state. Look out. The sky's the limit.
November 19, 2008 4:14 PM | Reply | Permalink
Assuming that the Clintons made big mistakes in 1993 ...
I'd still like to hear the arguments against my thesis that major corporations outside of the healthcare industry should logically lobby for government provided or subsidized health insurance.
In other words, regardless of the technical and psychological failings of the Clintons, why didn't the lobbyists for companies like GM and GE apply tremendous pressure to pass their plan anyway? Any government health care is a complete positive for General Motors, no?
I know this is overly simplistic, but I don't see why.
November 19, 2008 4:31 PM | Reply | Permalink
Ok, I would have to go back and research what happened in 93. I am going from memory. However, I don't think that business was behind it in 93, because their financial situation wasn't like it is today and, surprise, surprise, they were being short sighted. Same thing with the healthcare industry.
In the last 5 years or so, big business and small businesses alike have been totally behind universal healthcare, as has the healthcare industry. The healthcare industry is tired of the costs and aggravation of dealing with insurance carriers. For businesses, it would get a huge cost off their books and would allow them to compete on a more level playing field with the other industrialized democracies. None of the other industrial democracies have healthcare costs directly built into their products that are exported. The costs are more widespread through their economies. Soooo, the costs of our exported products and domestic products would be less and therefore more competitive. That's why it's beneficial to both business and the american people.
Also, another point is that the US economy subsidizes the pharmaceutical industry worldwide. We pay substantially more for drugs in the US, which in turn feeds the profits of the pharmaceutical industry so that they can sell the drugs cheaper overseas. Is that fair? Of course not.
I hope that maybe this explains some of the issues. I'm sure that I didn't cover all of them.
November 19, 2008 4:41 PM | Reply | Permalink
I think there were two reasons. First, the 91-92 recession was over and the problem was less acute. Also, this was when managed care came into vogue, and as a result, the rate of increase in healthcare costs was abating. They all thought managed care was going to be the answer. They were wrong.
Second, most big corporations are managed by Republicans, and the Republicans were scared to death that Clinton and the Democrats might actually pass a plan that worked and that people actually liked.
November 19, 2008 4:48 PM | Reply | Permalink
So we know that the health insurers will be lobbying their Republican representatives to filibuster the health bill, but can we hope that the majority of OTHER large corporations will be lobbying Republicans not to block it? And factoring in the fact that the Republicans want to see Obama fail, do we expect a health bill filibuster or not?
November 19, 2008 5:11 PM | Reply | Permalink
I would gamble no, but I like the strategy of putting the reform in the budget process so that you only need 50 votes to get it passed if necessary. Also, it has to be a gradual process. I really feel confident on this one. Also, business is desparate for healtcare reform, because the costs are killing them.
November 19, 2008 5:15 PM | Reply | Permalink
HA!! I just saw a description of GM as a healthcare provider selling cars to defray costs. It's not that far from the truth, and they're not the only ones.
November 19, 2008 5:30 PM | Reply | Permalink
Don't get me laughing too! I'm already on happiness overload!
November 19, 2008 6:05 PM | Reply | Permalink
I'm not sure what to expect. Health care costs are again spiraling, but this time without an illusory solution available. For sure the insurance industry will come out with guns blazing. But I think businesses are going to look at their costs for insurance and look at GM and if they don't actively lobby for it, at least they might not stand in the way.
But make no mistake, this is going to be a tough fight. There will be plenty of obstructionism.
November 19, 2008 5:23 PM | Reply | Permalink
It was not the "handling" of it that left this problem get worse and worse. It has been 15 years since Clinton gave it her best shot. Please quit with the blame Clinton for everything theme. There has been complete opposition by business and doctors since Harry fucking Truman. The absolute fierce and greedy folks who make tons of MONEY off the sick and dying are what stands in the way of Americans having the simple human right to healthcare. The whole civilized world does this and we let billionaire profiteers steer us into the MOST EXPENSIVE least efficient system ever. Sadly things need to get to disaster in this "democracy" for progress to be made in the interest of average people.
November 19, 2008 8:16 PM | Reply | Permalink
She admitted that it wasn't handled properly during the primary. Don't you remember?
I agree to a certain extent with the balance of your statements. However, I submit that if it was handled properly in 93 we would have universal healthcare now and the dems wouldn't have gotten slaughtered in 94. Sorry.
November 19, 2008 10:09 PM | Reply | Permalink
Thank God my heart is strong - this is so much hopeful news - after so many dreary years of wanting to tear my hair out day after day - I can hardly stand it!
I'm glad the TPM staff is young and hardy. It will take toughness to get through all this good stuff!
November 19, 2008 3:44 PM | Reply | Permalink
It really is amazing to get some good news for a change. The last 8 years have been so depressing. Wow, in just one day! Awesome.
November 19, 2008 3:49 PM | Reply | Permalink
It's almost as if he had a sixth sense of what was going to happen so he been planning accordingly. Ya think its' that vision thing Bu$h was always afraid of coming to grips with?
November 19, 2008 3:46 PM | Reply | Permalink
Obama really is a genius. Look out change is a coming big time! I was listening to Tribe on NPR today and he said the most amazing things about obama. He thinks that obama is the smartest person that he has known and he was referring to obama as a conlaw scholar. Wow!!!! We have a bright future for a change.
November 19, 2008 3:51 PM | Reply | Permalink
Can I just point out that not long ago, this very space was speculating about how Obama wasn't going to act quickly enough on HC....
My, the difference a day makes.
November 19, 2008 3:57 PM | Reply | Permalink
That "HC" is for Healthcare, not Hillary Clinton, though the hand-wringing has been equally fierce regarding her.
November 19, 2008 3:59 PM | Reply | Permalink
I was here to note the exact same thing. That clicking sound you hear is my eyeballs rolling.
November 19, 2008 4:23 PM | Reply | Permalink
If you haven't already, you should sign up for emails from the change.gov site. I just got a cool one from Podesta asking to review a video and submit ideas on energy and the environment. IDK if they would actually take into consideration anything but the idea of giving people an opportunity to get involved is pretty damn cool if you ask me.
November 19, 2008 3:59 PM | Reply | Permalink
I sincerely hope that Obama finds a way to expand healthcare in a way that is both efficient and smart.
Like the complete opposite of the whole Medicare Part B thing.
November 19, 2008 4:01 PM | Reply | Permalink
First thing he could do is get rid of medicare part b. It's corporate welfare for the pharmaceutical and insurance industries. It's a complete and utter waste of taxpayer dollars and an outrage. First program to be cut and a new program employed.
November 19, 2008 4:24 PM | Reply | Permalink
You both mean "Part D" - D for drugs. Yes, get rid of D. But keep Part B - that is outpatient care.
A = inpatient
B = outpatient
D = drugs = failing grade
November 19, 2008 4:29 PM | Reply | Permalink
and Part M = me = impatient!
November 19, 2008 4:30 PM | Reply | Permalink
Really? I thought it was B and the other stuff was already in medicare.
November 19, 2008 4:49 PM | Reply | Permalink
I swear to God. A and B were always there. And D was added by the bush cabal. Google it if you like.
November 19, 2008 5:00 PM | Reply | Permalink
My bad. All this time I thought that I was hearing b and I guess they were saying d. I should pay better attention.
November 19, 2008 5:05 PM | Reply | Permalink
Hate to say this, but maybe you need a hearing eval. With the new health care, you could get one. Reason I say that is that I have the exact same problem. Often mishearing consonants - and even with the two hearing aids (for hearing loss) I still get mixed up!
Forgiveness extended. But do have your hearing checked.
November 19, 2008 6:04 PM | Reply | Permalink
Maybe this will make Lynn Sweet STFU.
Fingers crossed....
November 19, 2008 4:05 PM | Reply | Permalink
Fat chance, that.
I was just going to mention Lynn (Have you consulted living ex-Presidents?) Sweet...Guess these events sort of reflect on her credibility, don't they?
November 19, 2008 4:08 PM | Reply | Permalink
Lynn Sweet's credibility (much like the writer herself) has no shadow and no reflection.
November 20, 2008 10:42 AM | Reply | Permalink
Oh man! I was hoping Cheney could have that 5th heart attack, before we go investing money into curing people and stuff!
November 19, 2008 4:30 PM | Reply | Permalink
Well, when we all rush to seek care, hopefully others will get there before a guy with a bad heart! (shame on me for saying that!)
November 19, 2008 4:31 PM | Reply | Permalink
I want Cheney to live long enough to see his legacy ... preferably from a jail cell.
November 19, 2008 4:36 PM | Reply | Permalink
Given the criticisms of the 1993 healthcare debacle, do you think there's any chance that installing Hillary at SoS is a way of distancing her from the healthcare initiative? I noticed that Ted Kennedy slotted her for a major role - who would take over that position were HRC to leave the senate?
November 19, 2008 4:35 PM | Reply | Permalink
See earlier threads today - that was much discussed. All speculation of course. But God forbid you miss any jot or tittle of it!
November 19, 2008 4:43 PM | Reply | Permalink
which thread? couldn't find it
November 19, 2008 5:14 PM | Reply | Permalink
Sheepish look.... well, apparently that one thought never got mentioned. Just the whole topic discussed... including all sorts of theories. Go back and add yours... just for the record!
November 19, 2008 6:02 PM | Reply | Permalink
Her role was to deal with the health insurance industry, which hopefully will cease to exist as we know it, unless someone wants to piss their money away on some type of umbrella coverage to get a solo suite in a hospital or something, so it was really a non-role.
November 19, 2008 4:47 PM | Reply | Permalink
It's not like 92, where Hillary botched her opening moves. The economy and the overall zeitgeist have already set the board for Obama to have HCI checkmate in several moves.
I don't think Hillary ultimately matters much, but yes it probably would be good to have her on board for Obama's plan which doesn't attempt to mandate universal immediately, but which combines regulation, tax/cost breaks, and open enrollment to Medicare/Medicaid. Better than floating her own plan in Congress just to be a PITA.
***
btw
In 92 the country was still enchanted by Reaganomics and laissez faire generally, and the insurance lobbies weren't yet the political equivilent of syphilis.
Now, even GM is begging for more efficient healthcare, phrases like "cherry picking" are commonplace and already decided issues against BIG HCI, premiums have skyrocketed for over a decade while real wages have been stagnant, and it's pretty clear present HCI will never be efficient or universally affordable without a major kick in ass.
On top of it all we're facing a recession and possibly another Great Depression if things go badly, which will deny a lot of families employee HCI.
Oh, and we need more medical care than ever in our history because chronic obesity, diabetes, and other developed nation diseases are making us less healthy than we were a century ago.
November 20, 2008 5:43 AM | Reply | Permalink
Did you see the new button that just appeared? It says "report abuse." wow!!!!
November 19, 2008 4:59 PM | Reply | Permalink
Don't get me laughing too! I'm already on happiness overload!
November 19, 2008 6:00 PM | Reply | Permalink
If true, this is a very hopeful set of developments. We'll have to wait and see. The most important part of the information in this post is the recognition of the importance of making this the top priority right away and of moving quickly on passage. They cannot let this get bogged down even by competing Democratic proposals. They must push the basic package hard and quickly or else the opposition will be able to gut or derail the entire effort. And the truth is that by establishing national health care, we will be taking an enormous burden off the hands of business which will be a great source of relief for the economic problems we now have.
November 20, 2008 12:26 AM | Reply | Permalink
Never seriously doubted it. The people who said he wouldn't be able to do HealthCare reform because of the economy, are really confused. Not even able to read writing clearly on the wall.
Healthcare has been not only a moral issue, but an issue of economic efficiency, for a long time, but widely recognized as such for several years at least. For example GM has bemoaned Japanese cost advantages in healthcare for years.
During a time of crisis is when people are most likely to reprioritize and seek efficiencies. With our struggling economy and the need for stimulus, current HCI costs so burdensome to industry, and with the potential for large layoffs and loss of HCI, now is exactly when HCI reform is most needed.
***
I expect to see Obama continue with his plan to pass middle class tax cuts, some of which being targeted at HCI.
Regulation will end cherry picking and other predatory practices, while raising a floor of regulated coverage, especially preventative.
Electronic records regulation will streamline medical records keeping for cost efficiency, better care, and interoperability/portability. That will create a one-time IT boom with some lasting job growth in medical IT while cutting down on nursing paperwork, allowing more medical care.
That will radically change the existing business model for HCI, forcing them to compete on upselling service and supplemental, and stop predatory practices.
Most importantly he'll offer open enrollment into a medicare/medicaid type system for all adults, and mandatory for children with costs offset by tax-cuts or sliding scale. Medicare/medicaid having an order of magnitude less overhead than for-profit HCI. That'll help a lot of people losing HCI due to layoffs or unaffordable premiums.
Additionally he'll allow Medicare/Medicaid to negotiate drug prices for the first time.
All of which is going to make medical insurance more cost efficient and provide coverage to tens of millions who otherwise wouldn;t have it.
(In the 2nd term, the popularity of the program due to happy customers and increased efficiency will allow it to be expanded much further, really putting the squeeze on for profit insurers, who will eventually retreat almost fully to supplemental upsells. )
November 20, 2008 5:28 AM | Reply | Permalink