Tuesday, June 23, 2009
President Obama has a green light and open eight-lane highway for health-care reform. But somehow the guy can't put his foot on the gas.
He hedges in neutral while some fellow Democrats muck up policy and Republicans demagogue them into mush.
A commanding 85 percent of Americans want "fundamental changes" in American health care, according to a recent New York Times-CBS News poll.
On the allegedly controversial "public option" -- a government-run plan that would compete with private insurers -- 72 percent are in favor. And that includes half of self-identified Republicans.
What is Obama afraid of? He apparently dreads repeating the mistakes of the Clinton health proposal. One was letting wonks create a mostly finished health-reform product. Neither lawmakers nor health-care interests liked being kept out of the kitchen.
Obama wanted to avoid, as he recently put it, "my way or the highway" on health care. But that needn't mean sitting stalled on the interstate as friends and foes alike run a demolition derby over coherent policy.
Remember how the Clinton plan was ridiculed for being too complicated. Hillary's 1,400 pages became the big ha-ha.
And so what are so-called moderate Democrats, fearful of supporting a public plan, suggesting in its place? Fifty separate cooperatives, each run by a board of directors managing its own risk pool, cutting its own deals with doctors and hospitals.
This proposal push by Sen. Kent Conrad, a North Dakota Democrat, has the support of some Democrats from fairly conservative states. Conrad says he wouldn't mind one national cooperative but is concerned it would run into the same opposition as the public-plan idea. (Again, see the poll numbers above.) Does he worry that a Republican will call him a "collectivist" on Fox? That's going to happen anyway. He can bank on it.
By the way, the Clinton plan also envisioned regional cooperatives. They were panned as "too much government control."
Some House Democrats have come up with a plan to pay for health care through a tax on soda. The thinking goes that sugary sodas contribute to obesity, and the tax would make people think twice before popping a can of Coke. Mamma mia -- and silence from Obama.
The real worry about Obama's steering ability will come when the discussions grow really hot over paying for the plan. The Congressional Budget Office recently estimated the cost of a Senate health-care draft bill at $1 trillion over 10 years. South Carolina Republican Lindsey Graham immediately pronounced the number "a death blow to a government-run health plan."
The problem isn't the $1 trillion. It's that the legislation would leave too many Americans uninsured. Even the $1.6 trillion earlier estimate is not an outlandish amount to spend on a decade's worth of high-quality health-care for all Americans. The Bush tax cuts will cost $200 billion more than that.
In 2007, the Medicare drug benefit weighed in at an estimated $964 billion over 10 years. And it covers only one health benefit for one slice of the population. Nonetheless, Republicans congratulated themselves that the number was down from an earlier projection of $1.08 trillion. The decline showed that "competition among private plans had effectively held down costs," Bush's secretary of health and human services, Michael Leavitt, announced.
Yet Montana Democrat Max Baucus, who heads the Senate Finance Committee, now insists on getting the 10-year cost of comprehensive health-care under $1 trillion.
Obama has to pick whom to disappoint and what to fight for.
Above all, he should drop the obsession with winning wide Republican support for health reform. Time to stop idling and gun it out on the road.
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