The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Obama Should Focus on Getting Health Care Reform Right, Not Fast

Posted by Alan on July 17, 2009

President Barack Obama, as expected, has launched a full-court press on health care reform. For the fourth day in a row he spoke out on the issue, his tone becoming increasingly impatient. He consistent message is for Congress to pass comprehensive health care reform passed in August, which is a shame. His passion should be focused on what reform Congress passes, not when.

President Obama’s passion for health care reform is sincere and clear. Fixing America’s health care system was central to his campaign. Reform is critical to his economic recovery strategy. As moderates and others question the cost and approach to reform, the President’s tolerance is wearing thin. Here’s how CBS News reported on a speech he gave in New Jersey yesterday: “We have finally reached a point when inaction is no longer an option," Obama said, his hoarse voice rising in volume and anger. "I will not defend the status quo." Obama brushed off his opponents as naysayers who expect a different outcome with the same-old approaches to a decades-old challenge. "It’s a path where our health care costs keep rising. … That’s not a future I accept," Obama told the friendly audience.

The ramp-up in rhetoric is tied to an increase in concern about the legislative proposals moving through Congress. Take the preliminary analysis of the health care reform package being considered in the House of Representatives by the Congressional Budget Office. (The analysis does an excellent job of summarizing that bill as well). In his blog, CBO Director Douglas Elmendorf described the findings: “enacting those provisions by themselves would result in a net increase in federal budget deficits of $1,042 billion over the 2010–2019 period. “ His office also estimates that it would reduce the number of uninsured in the country “by about 37 million, leaving about 17 million nonelderly residents uninsured (nearly half of whom would be unauthorized immigrants).” That would increase the number of Americans under the age of 65 with coverage to an impressive 97 percent. But that trillion dollar plus price tag is causing sticker shock in Washington, causing widespread hyperventilation among lawmakers and pundits. (It is important to emphasize that the CBO analysis was preliminary and did not take into account all of the provisions of the bill).

Then there were the meetings President Obama held with moderate Senators Republican Olympia Snowe and Democrat Ben Nelson – both of whom urged him to slow down the process and let negotiations take their course. Add to the mix a letter to Congressional Leaders signed by Senators Snowe and Nelson, along with Senators Susan Collins, Joe Lieberman, Mary Landriu, and Ron Wyden (two Republicans and four Democrats) asking for additional time to find a compromise on health care reform, and you can see why the White House is pushing hard to keep the August deadline alive.

But that’s the wrong focus. The President’s need for speed is a political one. The longer the debate goes on  the greater the possibility outside events or internal political fighting will derail the effort. Passing legislation as complicated and controversial as comprehensive health care reform requires momentum and a sense of urgency. The August deadline, especially in the context of legislation passed by Congressional Committees so far, create both.

Legislation as complicated and controversial as comprehensive health care reform also requires careful consideration and broad support. The careful consideration minimizes the unintended consequences that will surely result from changes of this nature. The broad support assures increases the odds of the new law being enacted smoothly and with a minimum of interference by a future Congress.

By calling those who want to delay passage of health care reform obstructionists implies that the President supports the versions currently before Congress. Yet when asked about specifics the President and his spokespeople note that the details need to be worked out by lawmakers and everything is still on the table. In other words, President Obama wants Congress to hurry up and pass something. He’s outlined what he’d like in it (a public plan, exchanges, a host of cost control measures) and what he doesn’t like (taxing high-end benefits), but he’s not pushing for any specific bill. He’s just pushing.

The problem with this approach is that the President is putting his political capital and prestige into play for a timeline, not a policy. If Congress fails to enact a bill by August the President will be seen as having lost, even if they return from their summer recess and pass a sound bill. Worse, from his point of view, he’s giving opponents another argument for voting against reform if it’s brought to a vote next month: that the process was rushed.

The President would be far better served politically to have the Senate Finance Committee continue to work toward bi-partisan health care reform even if it means pushing back passage of a bill by a couple of months. The nation would be far better off with this outcome, too. The resulting legislation would be more likely to make America’s health care system better, more efficient, more fair and more broadly accepted.

Arm twisting lawmakers into enacting health care reform by an arbitrary date is politics as usual. President Obama promised something different. He should keep that promise and focus on getting health care reform right, not just fast.


5 Responses to “Obama Should Focus on Getting Health Care Reform Right, Not Fast”

  1. KenK said

    The only rationale I can come up with for the tremendous urgency with which the President is pushing the health care reform bills is to limit the ability of the public to critically read and digest the enormous tome of legislation. One not-so-hidden agenda is to drive the private insurers out of business via the public plan, rather than to declare the for-profit insurance business model to be unacceptable from a public health standpoint and make the necessary changes to the private insurance market. Maybe this in itself is not such a bad thought, but the the soundness of the business model of the public plan seems to be a non-priority to the Democrats pushing pace of the legislation.

  2. Dede K-S said

    One only needs to look at the examples of MediCare reform on the national level, and MRMIP reform on the California state level, to find proof that health care and financing reform, once passed, stays on the books without keeping up with the times and the pace of change. Government programs are ponderous and exceptionally slow to innovate. I find status quo unacceptable, just as our President has stated. We must move forward with change. However I don’t agree for a moment that any legislation is better than none, and that we can count on passing clean up legislation. I am not aware of any examples of this being the case in the past for health care and health insurance reform, and there are many examples that demonstrate that health legislation fraught with problems sticks far beyond its intended effectiveness. This is too critical an area to do poorly. My line in the sand: my legislators will lose my vote if they don’t slow down. I am vocally letting them, and everyone I know, this position and why.

  3. Mark Goodman said

    I am touring around New England with my wife and had a stop in Montpelier VT. It was an amazing afternoon in democracy. In front of the main post office near the capital building was a town hall type meeting on health care reform. Two of senator Leahy’s aides were there taking notes and moderating the conversation.

    New England is historically anti tax and that sentiment was very pervasive at this meeting but one thought really echoed at this meeting and that was to slow down. It is better to get it right than hustle through a half baked bill that is both costly and ineffective.

    There was some gripes about the insurance industry but a greater fear of the government running healthcare. There was also a lot of concern that if the government offers a plan to compete with the private sector every taxpayer would have to contribute in an increased tax.

    The senator’s aides were very non-committal and told the dozen or so assembled that anything is a long way off.

    I would have liked to stay to the end but Ben & Jerry’s was calling me to Waterbury. I was pleased to hear from strangers not in the insurance industry that the majority of these people shared my views. Now it’s about convincing people who have their hand on the yea/nay button will listen.

  4. Paul said

    Couldn’t agree more. The 1,000 page legislation is being pushed way too fast, before they can even figure out all the consequences and before the CBO can analyze it. This is no way to reshape 1/6th of the economy.

  5. momintheusa said

    Thank you for posting this excellent article. I agree that this is being pushed too hard too fast, common sense be damned. I fear we will all live to regret this rush to ill considered action.

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