Rahm Challenges Business Leaders: Let's Do Real Health Care Reform
Here's some very good news for those who are hoping that Obama moves quickly and ambitiously on health-care reform:
President-elect Barack Obama's incoming White House chief of staff challenged chief executives and other business leaders Tuesday night to join the new administration in a push for universal health care, saying incremental increases in coverage won't be acceptable."When it gets rough out there, a lot of business leaders get out of the car and say, 'We're OK with minor reform.' I'm challenging you today, we're going to have to do big, serious things," Rahm Emanuel said, speaking to The Wall Street Journal's CEO Council, a conference convened to elicit corporate opinion on the challenges facing the new president.
Rahm also promised that the new administration would "throw long and deep" on major issues, health care being only one. While the devil will of course be in the details, the fact that Rahm himself is setting the bar very high for the incoming administration's expected health care reform efforts is welcome.
Late Update: Ben Smith has video of Rahm's speech.
As much as I hate sports analogies, sounds good to me...
November 19, 2008 10:44 AM | Reply | Permalink
Wow. Talk about fearlessly entering the lion's den...
November 19, 2008 10:46 AM | Reply | Permalink
heh -- yep
November 19, 2008 10:52 AM | Reply | Permalink
It's also good news for those of us who like to look at Rahm. I like the picture on the front page.
November 19, 2008 11:47 AM | Reply | Permalink
This one's an easy bomb down the middle because GM's long-standing crisis has taught everyone that employer-based health care is literally destroying business.
If GM can't afford to provide health care, nobody can.
Believe me, every CEO with the sense FSM gave a goose gets this.
November 19, 2008 10:54 AM | Reply | Permalink
Exactly. There's no one with a bigger stake in solving this problem than employers. Spiraling health insurance costs are eating them alive. They're trying to pass as much as they can onto their employees, but they're having to pay much of it themselves. Plus, they all know they're also paying part of the freight for the Wal-Marts of the country who don't provide health insurance.
I'm still skeptical that there's enough political tailwind to be able to achieve major reform, but I'd love to be surprised.
November 19, 2008 11:22 AM | Reply | Permalink
Well GM has the most generous, most expensive health plan out there and their car-selling business is going to pot. So, no GM is proof that you can run your business into the ground if you don;t sell your products and you don't control health care costs.
I would find an example of a very successful and profitable firm that provides good but not ridiculously expensive benefits, and look at how much financial pressure they are under (and/or their employees are under) because costs are rising so fast. Then you can make the statement if Firm X can't provide decent HC benefits then no one can.
November 19, 2008 11:54 AM | Reply | Permalink
I own a small business and my costs are going up 7% for Medical and 12% for dental next year. I'd welcome a reasonable universal healthcare plan.
November 19, 2008 4:02 PM | Reply | Permalink
Now I'm in 7th Heaven!!!!
Yes!!!
November 19, 2008 10:54 AM | Reply | Permalink
I think this is where Obama is going to burn most of his political capital. Other big issues are pretty much bi-partisan issues for the most part with the issue being how to get there.
This is also why Lieberman was welcomed back into the caucus, as he will vote for the Obama health care initiative and it will be a close vote. Obama will likely ask for as much as he can to get a 51-49 senate vote, anything more in the Dems favor means they could have asked for more.
November 19, 2008 10:57 AM | Reply | Permalink
Kennedy has huge political capital. And so does HRC. Obama won't necessarily have to do such heavy lifting if you use Kennedy's capital - before it's gone! And the capital of a memorial to him.
I see it as a win-win.
November 19, 2008 11:16 AM | Reply | Permalink
There are returns to capital you know. Why do we talk as if all you do is exhaust it. HC reform will help in a real and concrete way not just people without HC, but those who will see cost reductions, including conservative business-men. If there is a broad coaltiion for change then the investment will yield positive returns
November 19, 2008 11:56 AM | Reply | Permalink
How true.
November 19, 2008 12:58 PM | Reply | Permalink
Absolutely, but maybe not in time to benefit Obama in four years, which is what makes it courageous.
The reason Gingrich's crowd fought tooth and nail against universal healthcare was not because they thought it wouldn't work, but because they were afraid it would, and it would become another pillar of Democratic support like Social Security.
November 19, 2008 1:01 PM | Reply | Permalink
In many ways reducing cost is more important than coverage. In fact it is what makes universal coverage possible. A larger medicare system that is growing in cost at unsustainable rates is a big problem.
November 19, 2008 1:26 PM | Reply | Permalink
You know, Obama annoys me from time to time (Lieberman, FISA...)without a doubt. I am a squeak on the cynical side, too.
Even so, I am convinced this guy is the real deal and he will try to pull off just about every single thing he promised.
I love it.
November 19, 2008 10:57 AM | Reply | Permalink
take care of? sure. but will it be water-down crap- that's the question.
November 19, 2008 11:09 AM | Reply | Permalink
It seems that concern trolling isn't just for elections...
November 19, 2008 11:19 AM | Reply | Permalink
I'd give a bit of a pass to our friends in MN. Their Coleman-Franken anxiety must be debilitating.
It's what we all went through in 2000 with FL. This time it's they who are biting their fingernails to the flesh. Symptoms can also include outbursts of unabated cynicism. And those are just some of the visible signs!
November 19, 2008 11:35 AM | Reply | Permalink
The Obama Administration is probably looking to "Big Bang" because if the chaos of the Republican Party right now. With no leadership they can't really put up a central front or develop a concerted counter-push to the initiatives.
November 19, 2008 11:02 AM | Reply | Permalink
Or else there are really huge problems out there and if we don't do something about them we are all in some really deep doo doo.
Why does the motivation have to be political?
If you think Obama is looking for political victories rather than materially changing the circumstances of the American people for the better then you don't understand him.
November 19, 2008 12:06 PM | Reply | Permalink
A corporate sponsored universal healthcare bill? Shyeah, right. Dump the corporations and pass legislation that's good for the PEOPLE.
November 19, 2008 11:04 AM | Reply | Permalink
I wonder if your objection here (to which I am natively sympathetic) does not hang on an equivocation. To my mind "corporate sponsored universal health care" could mean "universal health care predicated on private insurance corporations managing the care for everyone"; in other words, this could be about insurance corporations. It could, however, also mean "industrial, technological, financial and other corporations pushing for single payer as a means of getting health care costs off of their own books"; in other words, this could be about the non-insurance corporations realizing that their interests run more in line with the peoples' interests than with the insurance corporations' interests. If the latter, then this is not really such a bad thing. It remains to be seen what Emmanuel's words mean (if anything), but I would not be too quick to assign them the worst possible meaning.
November 19, 2008 11:36 AM | Reply | Permalink
Corporation are consumers of health care. They pay insurance companies. They are getting creamed by rising costs, and eventually there only choice is to pass tha ton to their employees. Employers total compensation is going up even while workers cash wages are not growing.
Employers are natural allies here. If they can be convinced that they will pay less under universal health care then they will be for it.
November 19, 2008 12:09 PM | Reply | Permalink
What I REALLY want the Obama administration to do is CREATE JOBS and change our economy to a GREEN ECONOMY.
As a physician, I have to see what is being proposed as "universal healthcare" before I would sign on on it.
November 19, 2008 11:05 AM | Reply | Permalink
Huge co-sign!
November 19, 2008 11:18 AM | Reply | Permalink
And as a geologist, I'd like to see the new direction in energy policy we are going to take. Now we have the big brushstrokes, the preparation, the lead up.
But it looks like health care is where the first major push is going to happen. Even if Obama didn't get any other thing done (which would be catastrophic), a legacy of creating successful universal health care would be huge.
November 19, 2008 11:56 AM | Reply | Permalink
Maybe as a physician you can explain why the cost of your services has increased faster than virtually any other in our economy year after year.
Then can you explain what is the most cost effective treatment to reduce high blood pressure according to the evidence and under what circumstances is it ethical to prescribe a treatment that is more expensive than that? Does it give you pause that there is little empirical evidence about the most effective treatment for patients in many many cases and that therefore you with some unknown frequency treat people with too little effect for too much money.
November 19, 2008 12:01 PM | Reply | Permalink
Maybe as a physician you can explain why the cost of your services has increased faster than virtually any other in our economy year after year.
Then can you explain what is the most cost effective treatment to reduce high blood pressure according to the evidence and under what circumstances is it ethical to prescribe a treatment that is more expensive than that?
Does it give you pause that there is little empirical evidence about the most effective treatment for patients in many many cases and that therefore you with some unknown frequency treat people with too little effect for too much money.
November 19, 2008 12:02 PM | Reply | Permalink
This is why we need a single payer system. Cut out the middle men. Cut out big pharma as an intruder on best medical practices. Etc.
November 19, 2008 1:01 PM | Reply | Permalink
I favor single payer, but it does not solve the problem. You actually have to invest significant resources in evidence based practice. Then you have to re-educate doctors who think they know what is best without sufficient empirical foundation. And then you have to have a structure of compensation/payment that leads to the most efficient delivery of medical services: best outcomes for the lowest price. right now we have worse outcomes for a higher price.
November 19, 2008 1:31 PM | Reply | Permalink
Except in psychotherapy.... where it's worse outcomes for a lower price - due to so many "carve-outs" for mental health care. But that will have to change when parity comes through.
November 19, 2008 3:22 PM | Reply | Permalink
This is so American. This is the only industrialized country without universal healthcare. All the work has already been done in other countries. Let's just copy one of them!
Instead, as with the repeated redesigning of the dollar coin so it still (except in full sunlight) is indistinguishable from a quarter, we'll set a bunch of experts to work and come up with something approximating what we have now, and then send them back to do it again.
November 19, 2008 3:46 PM | Reply | Permalink
Yeah, me too. I'm feeling pretty cynical after the Lieberman lovefest, but the real tests for me will be: a real national health care system, a real withdrawal from Iraq on a 16 month timetable, and a complete repudiation of torture by any agent of the US. If the Obama admin delivers on these, I will gladly put aside my cynicism.
As an aside, it doesn't bother me a bit that Obama appears to be bringing in old Clinton admin people for some key jobs -- even Hillary at SoS (though she wouldn't be my first choice necessarily).
November 19, 2008 12:05 PM | Reply | Permalink
I feel exactly the same way, 714. I bitch and moan about BO moving to the center and being too conciliatory but I think it's from habit, more than anything else. His ability to look at a situation from 20,000 feet when others are viewing it from 10,000 is amazing. Which is good -- when you look at Iran, Iraq, Afghanistan, Israel/Palestine, Russia, Healthcare, Economy, Climate Change, Immigration, Nukes, Africa -- yikes. I don't remember a time when the list has seemed so daunting. I'm thrilled we elected him and I wish him luck. He'll need it -- just like he understands he needs Lieberman on his side. I don't like it, but I bow to his broader view. For now.
November 19, 2008 11:15 AM | Reply | Permalink
I've given Obama my trust here. Unless he proves otherwise, I'm gonna give him all the benefit of the doubt. His campaign was brilliant. He, along with his team, has shown himself to be a brilliant tactician. And ethical. For the Constitution and Rule of Law. I'm loving it so far. It's good he still wants to take the high ground. And pull us along with him.
I'm hopeful - but realistic.
November 19, 2008 11:21 AM | Reply | Permalink
That's one reason I haven't been around. Of course I'm up to my eyebrows in alligators since I got back to Dallas, but I don't feel like bitching about Obama's choices.
Not until they prove to have been bad choices. Then I'll bitch. Right now, I can't see it. I'm still on my honeymoon with President Awesome.
;)
November 19, 2008 11:49 AM | Reply | Permalink
lol, but we miss you, Tena. Join us in our endless speculation!
November 19, 2008 11:59 AM | Reply | Permalink
Endless Speculation, Inc. We need a logo!
November 19, 2008 1:04 PM | Reply | Permalink
Crisis creates opportunity for big change.
President Elect Obama gets this. Carpe diem.
November 19, 2008 11:31 AM | Reply | Permalink
Hm, color me pleasantly surprised here. I thought for sure that a week after the election we would already be hearing a series of throat-clearing statements meant to lower expectations. Instead even the usual obstructions (Baucus, for instance) are sounding a note of more aggressive reform. This is indeed good news. Not a sure thing yet by any stretch of the imagination, but a good sign nonetheless.
November 19, 2008 11:31 AM | Reply | Permalink
Somehow I suspect Rahm's being prodded by his big brother -- though it is interesting to me that Ezekiel Emanuel's proposals differ in some key respects from the Obama plan.
Regardless, this IS great news. Carpe diem indeed!
November 19, 2008 11:52 AM | Reply | Permalink
Because how else would a guy like Rahm know that reforming health care is a really really important issue if his brother didn't tell him?
November 19, 2008 12:11 PM | Reply | Permalink
Carpe annum?
November 19, 2008 12:16 PM | Reply | Permalink
Awesome, now that is what I want to hear. Universal healthcare would solve a host of economic problems virtually over night. We would instantly be much more competative internationally without businesses having to absord the legacy costs associated with healthcare. It would be a boon for business and just might be responsible for saving the big three. That's why by and large, businesses are totally on board with it as is the healthcare industry. The only ones against are the insurance carriers and right-wing republicans.
Long and deep is the way to go. I like it.
November 19, 2008 12:19 PM | Reply | Permalink
That's the spirit I'm looking for. Makes me feel considerably less pessimistic that Holy Joe's survival could portend do-nothing business as usual. Go Rahm!
November 19, 2008 12:25 PM | Reply | Permalink
This is beyond outstanding. I am just loving the selection of Rahm Emanuel more and more each day. He's fearless and he's on the same page as the PE. Let's go out there and work hard for change!
November 19, 2008 1:18 PM | Reply | Permalink
Throwing long is the same thing and throwing deep, isn't it?
November 19, 2008 4:48 PM | Reply | Permalink