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Thursday, July 23, 2009

President Obama Needs to Embrace Wyden/Bennet or Health Care Will be His Waterloo

I believe that Bill O'Reilly did sum up the president's health care plan the best. He simply couldn't understand how any of it will work. That's because the president is either misguided or disingenuous. He makes outlandish claims about how everyone will be covered, costs will go down, services will stay robust, and no one will lose the health care coverage they currently have. At the same time, while this plan means a massive expansion of government control, he actually claimed that government won't get in between the doctor and patient. You can see why O'Reilly was so confused.

The Democrats face a serious political problem. Democrats control all levers of government. At the same time, the conservative ideology controls the House and in the Senate the ideologies are very close. Certainly, there are NOT 60 liberal votes in the Senate if they are needed to avoid a filibuster.

Now, when the president was popular, Nancy Pelosi could whip up the Conservative Blue Dogs and put them into line with liberal bills. Now, the president's popularity is in question. The popularity of the current health care bill is NOT in question. The public doesn't like it very much.

Yesterday, the Speaker proclaimed that she had the votes to get the current house version of health care reform passed. Today, the key committee again delayed its mark up session. Here's the bottom line. The Blue Dogs are NOT going to get on board with anything near what is currently in the House. Now, Senator Reid says that no bill will be created before the break and that echos thoughts by Senator Durbin.

The president needs to come to terms with reality. The current vision for health care reform doesn't have the votes. No matter what he does going forward will not suddenly reverse the momentum against it. His plan has been exposed as little more than a massive expansion of power and government scope. In a battle of party versus ideology, ideology won.

If the president wants to pass sweeping health care reform, he should look at a bill that has been stuck in committee. That bill is jointly sponsored by one Democrat and one Republican, Ron Wyden and Robert Bennett. The president wants universal coverage, lower cost, and to allow all those happy with their coverage to keep it. This bill would do the first two and can do the third. Here are some highlights.

All employers, along with individuals and the government, will share the responsibility of financing health care. During a two-year transition period, employers who provide employee health benefits would be required to convert their workers' health care premiums into higher wages. Employers who don't currently offer health benefits would have to make phased-in "Employer Shared Responsibility Payments," which would be used to provide financial assistance to individuals and families of modest income. After two years, all employers would make "Employer Shared Responsibility Payments." These payments would reflect the relative ability of small and large employers and low- and high-wage industries to make such payments, and would have no direct impact ON the coverage that is available to their employees.

Employees, in turn, would be required to purchase private health coverage with their higher wages. To ensure that it's affordable, the plan would fully subsidize the premiums for those who live below the poverty line. Those people between 100 percent and 400 percent of the federal poverty line would also receive subsidies on a sliding scale to help pay their premiums.

Individuals would choose from a variety of private plans offered in their state. State-based Health Help Agencies (HHAs) would guide individuals through the enrollment process. These agencies would also provide consumers with unbiased information about competing private health plans and determine premium reductions that will ensure every American can afford their health plan. HHAs would ultimately lower administrative costs by coordinating payments from employers, individuals and the government.

As for the insurance companies, they would no longer be allowed to "cherry pick" their customers. Under the current system, insurance companies can pick and choose which customers they sign up -- typically the healthy ones -- and send those in fragile health to government programs more fragile than they are. The Healthy Americans Act stipulates that insurance companies be required to cover every individual who chooses to enroll and that they be prohibited from raising prices or denying coverage if individuals are sick or are at risk of becoming sick. Previous and existing health problems, occupation, genetic information, gender and age could no longer be used to determine eligibility or the price paid for insurance.

I don't want to make it seem as though I endorse this plan. I don't though there is a lot that I like in it. Instead, I want to point out that right now the dynamics of the legislature mean that any plan that would pass would look much more like this plan than what the president is trying without hope to get passed. This bill would mandate coverage of everyone. This plan would move much of our population from employer funded health insurance to individually funded health insurance. It would convert health insurance into higher wages. Both employers and employees would share in the cost of health insurance. This is the sort of idea that would get enough votes to pass.

The basic political problem is that while the president claims that his plan will lower costs, the public, and enough of the legislature, don't believe him. He can either continue to push forward hoping that somehow if he continues to say the same thing people will suddenly see "the light". On the other hand, he can take a step back and realize that the current path simply will not work. If the president were to embrace something like the Wyden/Bennett bill, that is something that could pass and he would get his sweeping health care reform. Now, we will see if President Obama is an ideologue or a shrewd politician. If he pivots and moves toward something like Wyden/Bennett, he'll get sweeping health care reform. If not, health care reform will fall apart and his presidency will be significantly damaged with it.


Both Pelosi and Reid have now backed away and health care reform doesn't look to move forward prior to the August break.
Also, check out this video on the topic.


Anonymous said...

I can see how you think the only way Obama has to salvage his agenda is to team up with the Blue Dogs to pick off some of the Republicans, leaving the rest to look like they're not serious about health care reform.

But at the same time, this isn't 1994. Distrust of the conservatives is extremely high in the Democratic base. They don't think the Blue Dogs care about 2010 because if the Democrats lose the House they'd just switch parties anyway.

And Max Baucus isn't helping on the Senate side, either. He's already defied his party leader who told him to stop undermining the house bill because his fellow Senate Democrats won't vote for his. He's criticized the President in public by saying he "hasn't been helpful", allowing the Republicans to claim Obama's all about his ego and his legacy. And he refuses to let his own party know what he's working on while keeping the Republican leadership consistently informed.

In any case, voting for a bill the conservatives "allow" the Democrats to pass would essentially be like conceding the 2010 election. On the other hand, as Charles Grassley pointed out yesterday, polls show that if health care reform failed to pass, voters would put 3 times more blame on the Republicans and the Health Insurance Industry than they would on the Democrats and Obama.

In short, Obama can still choose to let the Republicans have their Waterloo, but don't be surprised if Obama is the one who comes out looking like Wellington at the end.

mike volpe said...

Let me see if I understand you correctly. The Democrats have veto proof majorities in both chambers but if health care doesn't pass you're saying that polling claims that Americans would blame Republicans. Where is this ludicrous polling. I know that Grassley is a bit eccentric, but he isn't that eccentric.

Let's get something straight. If health care doesn't pass, it will be blamed on the Democrats. That's what happens when you are in charge. You need to go back for some basic lessons in politics.

Anonymous said...

From the Quad City Times.

And he has a point. The one thing Obama has going for him is that the Republicans are seen as not having a credible alternative.

Americans see that when they watched the Republicans destroy Clinton's health care program and then take control of Congress and sit on the issue for 12 years.

They see that whenever they think of that execrable excuse for a Medicare prescription drug bill the Republicans wrote.

They see that whenever Inhofe and Demint talk about using this to destroy Obama's presidency.

They see that when Roy Blunt announced this morning that the Republicans have no intention of releasing a competing plan.

They see that whenever Rush Limbaugh and Larry Elder claim there is no health care crisis.

Do you really think the American people are going to give control of Congress to a party that acts like their every move is dedicated to overthrowing a President they voted for by over 8 million votes and to who they are still giving a ~60% approval rating?

Have you looked at the 2010 Senate races lately? The Democrats are more likely to expand their majority than they are to lose control of the chamber!

mike volpe said...

I don't know what Roy Blunt said but both Robert Bennett, Tom Coburn, and John Shadegg have competing plans.

I don't know what this article says and I don't know what the current Senate races look like because neither matter. The election is November 2010 and it's July 2009. If the president doesn't pass health care reform, it will be the he and his party that takes the hit. There is no two ways about it.

If people think Republicans have no alternatives it is because they aren't looking. Republicans have offered alternatives to every policy Obama has offered and they will pound that home come time for the elections.

Anonymous said...

I'm sure they will, but the trick will be how do they make their plan sound like something other than just another excuse to pass a tax cut? And how to do it without out-gaffing Joe Biden like they did in 2008.

helloitsme said...

Anonymous, please be careful when you use the word "Americans", because:
1. I am happy that the Clinton's didn't get their health care plan
2. I wish there wasn't a Medicare prescription plan at all
3. I agree that there is no health care crisis. I run a company and see how many people deny coverage for health insurance but choose to carry dental insurance, because they know they can go to the emergency room to get health care for free, but they can't do the same for dental.

Americans don't unilaterally agree with your position, but liberal Democrats like you do. So next time you think about using the word "Americans" don't!

Doctor David said...

Maybe now would be an excellent time to repost this article, as well as call your representative and demand that Wyden/Benett get its day in the sun.