The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Health Care Reform: It’s Not About Obama

Posted by Alan on July 21, 2009

Health care in America is complicated, pervasive and critical. There’s a lot that works well in the current system. There is much that needs to be fixed. Getting health care reform right will take patience, determination and constructive debate. That’s why it makes sense to worry less about deadlines and more about getting reform right.

Moderate Democrats and others have been driving this point home and President Barack Obama statement’s were beginning to recognize Congress was unlikely to meet his August deadline for passing health care reform legislation. (He continued to push for enactment this year, but seemed more open to a vote in the Fall).

Enter South Carolina Senator Jim DeMint. Speaking on a conference call organized by Conservatives for Patients Rights, Ben Smith on reports Senator DeMint as saying if Republicans can “hold [health care reform] back until we go home for a month’s break in August … Senators and Congressman will come back in September afraid to vote against the American people.” This may or may not be true, but it’s certainly a reasonable political analysis. However, the Senator then went on to say,  “If we’re able to stop Obama on this it will be his Waterloo. It will break him.”

And thus Senator DeMint undermines the efforts of responsible lawmakers to pass thoughtful health care reform legislation. Senator DeMint did not offer public policy differences with President Obama. He cast the issue as purely political. It was the essence of the “just say no” “I hope Obama fails” foolishness that Republicans spout from time-to-time. It’s the my ideology right or wrong philosophy that has made the GOP party a distinct minority in Congress. It makes the health care reform issue all about President Obama.

Regardless of whether you agree with Senator DeMint’s opposition to President Obama or not, this is inept politics. It undermines substantive reasons for taking more time to refine the health care reform package. Worse, it gives the Administration an opportunity for changing the topic and potent ammunition for calling for fast passage. Which is exactly what’s happened. Newsweek describes the scene: President Obama is speaking at a Children’s hospital. After quoting Senator DeMint’s remarks, he proclaims, “Think about that. This isn’t about me. this isn’t about politics. This is about a health care system that is breaking America’s families, breaking America’s businesses and breaking America’s economy. And we can’t afford the politics of delay and defeat when it comes to health care, not this time, not now.” In other words, on “their” side is the party of “no,” on your side, my fellow Americans, is me.

The Administration wants nothing more than to cast his health care reform effort as a battle against obstructionist conservatives. You may have noted that conservatives got pounded in the last election. They make ideal targets. Making Senator DeMint the face of the GOP anti-health care reform efforts is a gift to the White House. Even Senator DeMint realizes this. “Let’s be clear, there is no one in this debate advocating that we do nothing despite the president’s constant straw man arguments,” the Senator said yesterday. And he’s right, the Administration is using his remarks to create a straw man, an easy target to knock down. The reality is what Senator DeMint says to a group of conservatives who already agrees with him doesn’t really mean much. He was preaching to the choir. But when his language was given a wider audience, it was easily exploited.

Senator DeMint said today that “Republican have offered comprehensive health care reform solutions ….” Technically that’s true, but what the GOP has put forward is as misguided in their own way as any element of the Democrat’s proposals.

What’s needed, but won’t happen, is for everyone to take a deep breath and calm down. It will take 60 votes in the Senate to pass health care reform – President Obama knows this, the Congressional Leadership knows this and so do the pundits. There are not 60 liberals in the U.S. Senate. Nor are there 40 conservatives. The political reality is the reforms that emerge will reflect the views of the moderates that can provide the necessary votes. This doesn’t mean the reforms will be wise, but it probably means they will be less than extreme.

The Senate Finance Committee’s proposal will come the closest to reflecting this moderate approach to reform. They need more time to get their bill together and we should give it to them. In the meantime, let’s recognize that health care reform is too important an issue to play with solely to embarrass a political opponent. Doing so only makes the job harder.


5 Responses to “Health Care Reform: It’s Not About Obama”

  1. I agree with tour last statement that this is too important to play politics with. It will not only make the job harder, but also increase the chance of coming up with something that is worst than we already have.

  2. You are absolutely correct – it isn’t about Obama. It is about whether this country is ready to have such a system, or put another way, whether such a system can be “integrated” or “merged” into our way of life.

    We have a tendency in America to argue for or against a concept based on our own personal philosophy or view of the world, what advances our personal interests, or the interests of our party, family, organization, or region. Perhaps viewing the issue from a management or systemic perspective might result in innovative approaches to the issue. The American national mindset, citizen philosophy, lack of citizen motivation to be proactively healthy, and governance model make the socialization of health care in America very problematic, particularly at this point in time. A country needs to know its limitations.

  3. Bob said

    I appreciate the non-partisan, dispassionate analysis on this site.

    Can you explain why you think it will take 60 votes to pass health reform in the Senate? While I understand conservative Dems not wanting to sign their name to a bill they do not support, do you really think they would join a Republican filibuster effort? If the options are 1.)fail to pass any health reform at all, and 2.) pass health reform with 51 votes it seems to me we’ll see a bill pass with 51 votes.

    Also, I keep hearing about the procedural maneuver the Dems invoked which could make the bill “filibuster-proof”– can you explain that as well?

    • Alan said

      Thanks for the kind words Bob. I appreciate them. As for your questions:

      1. It takes 60 votes because a conservative Democrat could decide to let the bill fail rather than close a Republican filibuster. It does come down to game theory. If liberals hold out for too much will moderates walk away from the bill? If it comes down to having no health care reform or liberal health care reform, will moderates really doom the legislation? Until we get there and see the specifics, we won’t know. Personally, I believe the liberals will give the moderates enough to guarantee their support and elimiante the risk, but that’s just one scenario.

      2. The process you’re talking about is called reconciliation. It’s a process in which the majority can prevent filibusters of budget-related items. The problem for the Democrats is that not every provision of their reform package impacts the budget. Under Senate rules it probably is not possible to block a filibuster of those provisions. So to get their entire package approved, they’ll need 60 votes.

      Hope this helps.

  4. I absolutely agree with your conclusions. SFC is the one place where this will all have to come together. Above all we need honesty and integrity of the process. The quality, cost and delivery of health care is at stake. It will affect us all personally for years to come. Follow more of the debate at

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