The Trail: A Daily Diary of Campaign 2008


Dan Balz's Take

Health Care Reform Outlook Clear? Don't Count on It

By Dan Balz
The gathering of industry leaders standing with President Obama in the White House pledging to cut up to $2 trillion in health care costs over the next decade suggests a gathering of momentum behind one of the president's signature domestic initiatives. The train is leaving the station. All aboard!

Perhaps. While 2009 may not be 1993-94, the truth is that it still may be too early to declare that the constellation of forces in favor of reform is cohesive and strong enough to weather the battle that will surely come. Whatever goodwill Obama can create now he will need later this year to persuade the House and Senate -- and the array of special interests involved in health care -- to enact a comprehensive reform package.

The story line is developing that the political climate is dramatically different today than it was during the Clinton administration, when health care reform ultimately crashed and burned without ever coming to a vote on the floor of the House or Senate. There is some truth to that, but not so much as people might assume.

Consider public opinion. In September 1993, 48 percent of Americans surveyed by CBS News and the New York Times said that fundamental changes were needed to fix the nation's health care system. Last month, when the same question was asked, a virtually identical 49 percent agreed with that statement. In 1993, a slightly higher percentage than today said the system was in such bad shape that it needed to be completely rebuilt. On balance, then, there has been no real change in public opinion.

Or take expectations. In January 1993, 68 percent of Americans surveyed by The Post and ABC News said they believed Clinton would make substantial progress in improving the cost and availability of health care in this country. When the same question was included in a poll last December, an identical percentage said they believed Obama would make substantial progress on the front. Again, no real change there.

For those with short memories, the sight of health industry leaders pledging to cut costs voluntarily reminded veterans of the health care fight of two parallels. Going back to the Clinton days, most industry leaders were pledging support for comprehensive health care reform in the early days of that new administration. They only turned against Clinton's plan when the details were unveiled much later. The details of Obama's plan are not yet known.

More than a decade before the Clinton experience, then-President Jimmy Carter called for legislation to impose cost controls on hospitals as a way to rein in rising medical expenses. The industry came forward and said don't bother with legislation, we will cut costs voluntarily. "Congress never passed cost controls and six months later there was no sign of voluntary cost controls," recalled Robert Blendon, professor of health policy and political analysis at Harvard.

Still, veterans of the Clinton battle believe there is a better chance of enacting health care reform this year. "The sense of momentum and commitment to change is powerfully stronger this time," said Judy Feder, a fellow at the Center for American Progress and a former Clinton administration health care policy adviser.

Her conclusion is based on the belief that the deep recession on top of the already sizable burden of rising health care costs has hit everyone -- businesses, middle-class Americans with insurance, the uninsured, government -- harder now than it did coming out of the recession in the early 1990s. That has gotten everyone's attention and, if managed skillfully, could help Obama do what Clinton could not.

Obama also is looking to avoid missteps that cost Clinton. He began his push for health care reform in the first months of his presidency. Clinton waited until much later in his first year and by the time he was in the middle of the health care debate he had been weakened by earlier battles. Obama starts in a stronger position.

Clinton's process shut out Capitol Hill as a plan was developed. Obama has turned over development of a plan to the Hill. He also is prepared to use the reconciliation process to win passage of a plan, something Clinton never tried.

Obama is not talking about a massive government solution, although conservative critics say that's what he wants. He is talking more about cutting costs for everyone who has insurance as he is about expanding access to those without.

Obama also has avoided demonizing potential opponents at this stage of the fight. By the time the Clintons unveiled their plan in the fall of 1993, the health insurance industry, small business and for-profit hospitals already were dug in against it.

A lobbyist who works for business groups on health care issues pointed to the industry leaders standing with Obama on Monday. "Everyone who showed up at the White House has something they're terrified of," he said. "But they decided to take a chance because from their point of view, the president hasn't openly painted a bulls eye on their back."

Translation: It's easy to be for health care reform as long as the toughest issues aren't yet front and center. To date there has been more controversy created over whether a reform package should include a government-run health insurance package than by potentially more significant questions of whether Obama will try to achieve universal coverage and, if he does, what it will cost.

The most difficult issue will be paying for health care reform. Obama outlined some measures in his budget in February, but already some of those ideas have been shot down by Congress. Even with effective cost containment measures, revenues will be needed.

While Obama was holding his second health care event in two days at the White House on Tuesday, the Senate Finance Committee was holding a hearing on possible ways to raise revenues. One idea raised again was to limit the tax breaks afforded to individuals with high-end health insurance plans offered by their employers. Health care experts concede there are no easy ways to raise the revenue for health care reform.

Blendon believes the economic forces that may be creating urgency to act on health care could, in the end, frustrate efforts for truly comprehensive reform. Businesses may well target a reform plan as one that will kill jobs in a recession. Asking people to pay more in taxes in this economic climate also could be politically difficult. "The climate makes it harder to talk about all these issues," he said.

In the end, Obama may have to settle for far less than he envisioned during the presidential campaign, though some of his advisers believe anything that advances the cause of expanding coverage or controlling costs would count as a victory. They seem to have no illusions about the fight ahead. What happened at the White House this week should not be underestimated as a sign of potential, but the president is far from a victory lap on health care.

Posted at 5:18 PM ET on May 12, 2009  | Category:  Dan Balz's Take
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The first REAL reform needs to take place at the Corporate level of Insurance/Health Care Providers,since there one in the same.To undersdtand the complexity of how medical billing is siclical,billing oneself for services rendered to his own client, who in turn pays him for his services,Etc,Etc,Etc.This is the real area where our Government needs to step in and put some reality into our health care "System" as it is named.The "System" is currently loaded to make you think twice about seeking health care, even if you have insurance,and if you dont you are assumed a Beggar and Sloth for not having the capacity to afford insurance in the first place.
Funny thing,even with all the un-insured or under-insured,the Medical-System is the only region of our Economy still untouched by the recession we are in.And yet, if you've been to a doctor in the recent past, all most doctors are allowed to do is prescribe a drug for this, a drug for that.If that doesnt work, you need a specialist, and if this one doesnt find someting you go to another one.All to create billable hours,just to add to the bottom line.
Our health "System" has been socialised for the past 25 years,but it has'nt been made so by the Government, it's been handed to us by our great "Free Market" capatalist society,those who really control our health.All incorporated into an allmost perfect profit making storm
Ever hear of a Health care provider loosing money(other than through a lawsuit)?How about the so called "Not For Profits",ever seen one of em break even at the end of the year???Never,and not likely.
I've paid for insurance for 15 years to date.Some with emloyer provisions, some direct single payor,its all the same.If i lever what ive paid into for insurance vs. what i have used, im at a loss for thousands,and if i keep myself healthy,ill never break even from the money spent just to feel, Healthy?????

Posted by: mullett | May 15, 2009 6:24 PM

I truly hope that Obama will propose a government option in coverage, to force competition into the health care system.

Whenever competition is robust, consumers benefit from lower costs that result. In contrast, the absence of competition (for essential services, as opposed to discretionary purchases) sets up a situation where the market participants are able artifically fix prices. Those who have the money to pay do, because there's no alternative. Those who don't have the money do without, because they have no alternative. That's the health care system we have now.

Injecting real competition into the process will tend to get all participants to moderate their pricing by trimming their profits. The increase in affordability that results, combined with some mandates like no exclusions for pre-existing conditions, should get everybody covered.

Most of the debate that has occured to this point is based on an assumption that too much is being spent currently on health care, and that somehow that has to be reduced. That is true, but only to a point.

The idea that insurance companies ahould be encouraged to cut costs is just plain wrong. Left to their own devices, they will cut costs by upping the number of coverage denials -- that is their concept of cutting costs. And, the money saved will simply go to their profit margins, which will not expand coverage. We need to look at policies that will reduce their profit margins and restrict their ability to deny coverage.

The underlying assumption that health care financing is a zero-sum game must be challenged. We need to spend MORE on health care, not less. The only costs that should be cut are from the margins charged by private insurers. We should not reduce the level of quality care. We should not attempt rationing under the guise of "comparative effectiveness." And we should not attempt to pay for the expansion of care by taxing employer-paid health insurance.

How do we pay for it? We need a serious discussion in this country about our priorities. In the end, we should adjust our priorities by reducing the defense budget and using the savings to finance health care and other items that improve our quality of life. And we need to raise taxes.

Posted by: tedb1 | May 14, 2009 10:21 AM

Responding to post by mgd1 (below), actually the cap on medical oxygen was enacted in the Deficit Reduction Act of 2005. It was proposed by a Republican (Bill Thomas), passed by a Republican Congress, and signed into law by a Republican President (Bush). So blaming Obama for that bone-headed 36-month oxygen provision in Medicare is 100 percent wrong.

POST BY mgd1:
Obama has begun to reform Medicare. Effective January 1, 2009, every Medicare recipient can only have 36 months of oxygen support in their life. That way all seniors with chronic heart and lung conditions will be deprived of their life supporting access to oxygen. Medicare has set up a toll free number for oxygen providers to call to verify how many more months of their "lifetime benefit" are left. Got to love Obama's reforms! Posted by: mgd1 | May 12, 2009 9:12 PM

Posted by: michaelr1 | May 13, 2009 5:41 PM

So, you don't want socialized medicine? (The last dozen Republicans in existence seem to keep saying this).

Fine, then to satisfy your pointless negativity, we'll also get rid of the "socialist" fire department, police, roads, and schools. Happy now?

Posted by: fluxgirl | May 13, 2009 11:29 AM

Republicans want to prevent their fellow American men, women, and children, from having access to doctors and medical care and medication, including pain medication, when they are sick and dying of Cancer.

How can such people exist?

Posted by: AmericanDemocracy | May 13, 2009 9:54 AM

More Pay-offs when is this "Savior" going to stop . He is not the "Messiah", He is more like the "Anti-Christ". He is going to bring us all down! "Change"? into what? We will be starving by the time his 4th year ends. And he will have exhausted the USA resources squandering it away with his "advisers"(?) and supporters.

Posted by: amapola11 | May 13, 2009 5:45 AM

Just like Old Faithful, someone erupts with the "socialized medicine" dodge. OK, champ, riddle me this: if our free-market system is so much better than all those "socialized" countries in "Old Europe" then why does it cost us so much money? And why does it manage to leave so many uninsured? Are you proud of that? Of paying twice what anyone else does?

Employer-paid care made sense when medical care was a lot cheaper and most people worked at the same job for 35 years. It doesn't make sense now.

Stop seeing Lenin and Stalin and get over it. Medicare has 1% overhead costs and private insurance has 25%. The free market approach is a shuck and jive.

Posted by: chrisfox8 | May 13, 2009 12:22 AM

Linda: I am not rich, Iam not selfish, I am not a DR, I am not ignorant, I am not the insurance or pharmacutical business .. I am and American and I am aginst socialized medicine. President Obama and the socialist democrats WILL distroy the best health care in the world if they are sucessful in nationalizing American medicine. That is the naked truth.

Mark A. Wright

Posted by: markandbeth | May 13, 2009 12:00 AM

Kids who have cancer don't need health insurance they need health care. The people who could provide them health care are who you should direct your question to.

Posted by: rpatoh | May 12, 2009 11:53 PM

Therre has allways been one particularly annoying glitch in providing health insurance for those who don't receive the benefit from their employers. It is that employer paid insurance is tax free while self paid insurance is not. The plan gaining momentum in Congress now is to quit or limit the tax free status of employer paid insurance, and use the new revenue to provide government insurance for those who can't afford to buy their own while their premiums are taxed. Congress would never think to just allow all insurance premiums to be tax free, or even just have all payment for medical/dental/psychological care be tax deductible. Instead Congress is leaning hard toward increasing the cost of medical insurance/care by taxing it more.

Posted by: rpatoh | May 12, 2009 11:42 PM


Both my kids are MD's and what you've stated just isn't true.

But the more basic question is this --

Why do you want to prevent sick and dying Americans, especially kids with Cancer, from getting health insurance?

Why should you live and they die?

Posted by: AmericanDemocracy | May 12, 2009 11:24 PM

"Health care experts concede there are no easy ways to raise the revenue for health care reform."

This is dead wrong. Actually there's a way we can have better universal health care at no more than we are now paying (see 5. below). Here are the facts (cf.

1. We waste $100 - $200 Billion a year on the high overhead of insurance companies.
2. We waste 200 - $400 Billion a year on doctors filling out forms for insurance companies.
3. I don't know the compliance cost of patients fighting with insurance companies, but it must also be in the 100's of Billions.
4. We pay the highest drug cost in the world to drug companies that spend twice as much on profit and three times as much on "marketing" as they spend on research. This is about another $100 Billion each year.
5. Because of the above, we could give Super Medicare (few limitations, no co-pays, no deductibles and complete drug, mental & dental coverage) to everyone at no more cost per person than we are now paying.

Other countries with single payer systems get better health care as measured by all the basic public health statistics and they do it at less than half the cost per person. If we build on our rotten system, we will get a health care system with rotten foundations.

Posted by: lensch | May 12, 2009 11:18 PM

Poor thgirbla, your desperation really scared me. What an unhappy soul.

Posted by: ExpressReader | May 12, 2009 10:58 PM

Well, to raise more revenues for health care you could just increase the interest rates on patient account balances retroactively.

So say you got an appendix removed and owe the hospital ten thousand after insurance, for which you agreed to pay 500 dollars a month until the balance is paid off with 10 percent per year accuring in interest.

So the hospital could just send you a new bill increasing the interest on your bill from 10 percent to 20 or 30 percent per year, thus increasing its revenue stream.

If you question their increasead rates on balances, they would proabably explain that their credit analysts have looked at your account and determined that you are a high risk for default as people who've had their appendix removed are often later conflicted about why they had to spend so much money on their hospital stay. This they will tell you allows them to unilaterally change the terms of your account.

Sound bogus and unbelieveable.

Have you talked to a credit card company lately?

Posted by: secretscribe | May 12, 2009 10:54 PM


Both my kids are MD's and you're just plain wrong.

Every hospital and every doctor has a set of guidlines and proceedures for how each disease is handled.

Treatment is based on best medical practice not ability to pay.

Its not the case that you keep on throwing treatents at the disease until you run out of money.

Only Republicans think it works that way.

The bottom line is that Republicans can't wait to kill other people or put them to death.

Its too bad that they'll get the compassion when they get sick that they deny others.

Republicans are vile people.

The Republican Party can't disappear quickly enough for every decent person on the planet.

Posted by: AmericanDemocracy | May 12, 2009 10:33 PM

It's going to be a battle, true. That's why the Dems were very happy to get Specter, who does not bring them a whole lot except for a sure-fire vote on health care. Every vote will be needed.

Nobody ever said it was going to be a cake walk. But comprehensive health care is going to pass, this year or next -- a critical mass of support has been reached.

Posted by: mypitts2 | May 12, 2009 10:23 PM

Single payer? we already are! Insurers overall insure the healthy and dump the sick. Then medicare/taxpayers pay the bills.

So again the question is... why do we need insurers? Duh!!! - Because the congress needs lobbying money from insurers!

Posted by: ryan_heart | May 12, 2009 10:14 PM

Republicans --

Do you really think you're going to turn anyone against President Obama?

Don't you realize that all you do is turn people against you and the Republican Party?

Posted by: AmericanDemocracy | May 12, 2009 10:06 PM

Just remember what POTUS Hussein's campaign chant was............

............."Yes We Can...., Yes We Can...., Yes We Can............"

Little did the voters realize it at the time, but once elected they are finishing their chant back at the voters..............

.............."Yes WE Can and YOU can't stop US, Yes WE Can and YOU can't stop US, Yes WE Can and YOU can't stop US............."

Mr. and Mrs. Taxpayer, just remember this chant in 2010 and 2012 when they, Congress and POTUS Hussein, come to YOU wanting to be re-elected!!!

Posted by: thgirbla | May 12, 2009 10:06 PM

Looks like another wash-out, with Obama already laying the groundwork to take credit for TRYING ... and of course blaming the failure on Republicans.

In other words, it will come to nothing but a partisan political exercise.

I predict the same kind of foozle on the "cap-and-trade" environmental bill.

I only wonder how many on the Left will realize they're being snookered.

Posted by: gitarre | May 12, 2009 9:38 PM

For Obama's philosophy on health care reform, you only have to look at his record of bailing out the banking industry at the expense of the middle class.

It will be the same thing with health care "reform." All the billions the big insurance companies are pledging to "save" means they will cut way back on benefits while raising premiums. How else do you think they are going to "save" all this money?

And of course, Obama the corporate shill will enable them all the way.

Posted by: solsticebelle | May 12, 2009 9:33 PM

Obama has begun to reform Medicare. Effective January 1, 2009, every Medicare recipient can only have 36 months of oxygen support in their life. That way all seniors with chronic heart and lung conditions will be deprived of their life supporting access to oxygen. Medicare has set up a toll free number for oxygen providers to call to verify how many more months of their "lifetime benefit" are left.

Got to love Obama's reforms!

Posted by: mgd1 | May 12, 2009 9:12 PM

Dan's absolutely right. I give it less than a 50% chance and that's bad news for lots of Americans that will suffer and die if Universal health care doesn't pass.

I'm always amazed at how low a value Republicans put on human life compared to lucre. They claim to serve God but are the most Godless group of folks the world's ever seen. Republicans only "God" is money.

I wish President Obama had put Hillary Clinton in charge of health care.

She viewed it as her life work and wanted a "re-match" with the bad guys.

Hillary's a real fighter and she and Bill know how to defeat the Republicans and did it over and over when Bill was President.

Its hard to believe the the Repubican Party is pulling out all the stops to prevent uninsured Americans, including Kids with Cancer, from getting health insurance.

One thing's for sure.

Republicans are going straight to Hell.

God's nobody's fool and Repubicans position on abortion is just a fig leaf to cover up the fact that they have no moral standing on any issue, including abortion because Republicans are such hypocrites about it.

Posted by: AmericanDemocracy | May 12, 2009 9:04 PM

The REAL dynamic behind escalating health costs is this...

Person A is told she or he has only 6 months to live. But with an expensive, new treatment, there is a 50-50 chance of person A living another 3 months, and a 10% chance of living 24 more months. The new treatment costs $100,000. Should the doctor do it? And the family says..."Yes."

Let's face it, the ONLY way to effectively rein in costs is to curb the last ditch life extension efforts. Now who has the will to do that?

Posted by: CarolGBOS | May 12, 2009 8:52 PM

Reportedly, in this paper, Hillary told the One that her biggest mistake in her health care solution was to spell it all out in detail. You see, if people actually know what's planned for them, they become vocal about whether they like the legislation or not. In her case, they did not.

So I would be aware of any health care "reform" that lacks details, those to be filled in later by some "commission," or "board," or even "blue ribbon panel." Congress has already shown a willingness to pass legislation without actually reading it. It's not that far a stretch to believe they would pass a bill with huge funding but without any actual laws within it, just to avoid that bothersome public scrutiny.

I believe Obama could generate more interest in his ideas if he actually had some. I've yet to hear anything approaching an actual idea other than "reform," or "universal coverage," or some other panacea. Do we think that the taxpayers are going to be soaked for coverage for 12 million illegals? Obama opposed a "mandate" in the campaign. Does this mean we'd also be soaked for providing care to those who can afford it (perhaps if they purchased private insurance they might have to forgo a trip or two to Cancun or Maui each year) but don't? (See: half the single people under age 30).

How is whatever it is that is being discussed behind closed doors to be paid for? If you look at the deficit projections by Obama's own people, there is no way the country can afford this without a significant tax increase on the middle class --- that dwindling group of folks in this country that actually pay income taxes.

Posted by: Curmudgeon10 | May 12, 2009 8:36 PM

Health care reform is a very unusual issue in American politics because almost EVERYONE will benefit from action: doctors, patients, rich, poor, sick, well. The current system is SO inefficient and benefits SO FEW that it's just amazing it still survives.

There are countries in which health care isn't up to US standards. But there are NO other countries in which people pay as much for health care as poor as ours. ALL OF US are getting ripped off, on a matter of life and death.

THE ONLY beneficiaries of the current fiasco are the companies that currently ration our health care. Not us. Not our doctors. Huge companies that decide which procedures they will and will not allow, that tell our own doctors what they can and cannot do to help us live well and prosper.

For this "service," these companies bill us trillions of dollars every year, making our health care the worst deal in the world, bar none. The amazing "deal" they offerred yesterday promises they will bill us $2 trillion LESS over ten years.

No other country in the world would allow these vampires to suck trillions of dollars out of our pockets. It's just plain suicidal, both for society, and for our parents, out childrem, and ourselves. Our political system INSISTS that we pay these people. They INSIST that our doctors can't take care of us without paying them off. What's up with that?

Sure, the vampires have a lot of money (duh, how'd that happen?!) to advertise against disngaging them from the public trough. But why oh why do the sheep on this forum line up for this abuse?

Wake up and smell the chloroform!


Posted by: airscott | May 12, 2009 8:35 PM

Obama cannot be namby bamby about reform- FDR did not go far enough in 1935 to reign in the corporate monsters.

Basically Obama should simply force real reform down the throats of the republicans and conservative democrats- plus the Insurance & drug companies.

Health care reform is the signature issue of Obama- he cannot retreat from it now.


I agree with you, but ultimately, I'm not sure this is what he wants.

Remember, so much of our modern politics is tainted by corporate money and their politial lackies and they unfortunately still hold sway.

And the thing will fall until they figure it out.

Difference between now and then though, or maybe not, is the budget.

They all seem to be caught in void where they don't understand really what the American, or world economy is, and how it can be manipulated.

How is this stock market today? What about the wars, and the future implications to the our budget, particularly given any losses, and the reluctance to prosecute the criminals, those who torture?

Cheney's guys can't run a war, or a budget -- why hasn't Obama dumped them, publicly, kooks like Brennan?

I mean, it doesn't build a lot of faith in America in terms of investment, and you really can't create a viable system when the world sees you as an enabler of corrupt mediocrity.

And at that point, amid the ruin, it's about taking care of the country and the people, and they can't do that either, so bereft of talent they are.

But it's just run of the mill mediocrity...

Posted by: thegreatpotatospamof2003 | May 12, 2009 8:33 PM

Obama cannot be namby bamby about reform- FDR did not go far enough in 1935 to reign in the corporate monsters.

Basically Obama should simply force real reform down the throats of the republicans and conservative democrats- plus the Insurance & drug companies.

Health care reform is the signature issue of Obama- he cannot retreat from it now.

Posted by: vercingetorex | May 12, 2009 7:44 PM

Non supporters include: the rich, the covered, the insurance business, doctors, pharmacuticals, greedy, selfish and ignorant. Everybody knows the health care in this country is inadequate, outrageously expensive, and greedy. Those that don't support reform, have no concern for any body else in their lives. Greed and selfishness is what is bringing this country down. If the shoe fits???

Posted by: linda_521 | May 12, 2009 7:35 PM

Could Obama please take care of an issue without spending more and more money?
And dont give false promises on what you can save. 2 trillion? Why not say 20 trillion in make believe money!?

Please stop with the new Amtrak.

Stop with the entitlement programs that the Democrats are drooling over.

Stop stop stop it Obama!

Then maybe you can turn to a real problem like Social Security!

Posted by: jabberwolff | May 12, 2009 7:13 PM

President Obama's single most cost cutting strategy that could be implemented w/o affecting the quality of care of patients/consumers of health care should be to make the advertising of pharmaceuticals illegal. This could be followed by the taxing of glossy mailings to patients/consumers. The elimination of these ads could diminish the cost of health care w/o diminishing the quality of health care patients/consumers receive.
Congress has a role in diminishing the cost of health care as well. It should
find a way to eliminate insurance companies as brokers of our health care system. We don't need to buy insurance for education; why should we need to buy insurance for health: For those Republicans/and others who say government should not be involved in providing health care, as a person who had to pay my own premiums at a time when the insurance premiums went up by double-digit rates several years in a row, wake up; we are paying a tax, not to the government, but to an insurance bureaucracy. Now that the insurance industry feels threatened they are eager to offer 1.5 percent rates (much less than the rates of their increases) so they won't be cut out of their ludicrous industry charges, they want a voluntary commitment to pass as a way to cut costs?
What do they take the public for, completely uneducated? (I am a product of the public school system; it works.)

Posted by: nkelly1 | May 12, 2009 7:04 PM

The reality is that the solution is staring us right in the face.

Single payer nationalized health care.

For HALF the money we waste in America, where our lifespan is 8 to 10 years SHORTER, we could provide single payer health care to every single American.


All the rest is sound and fury, signifying CEO's looting the public to line their pockets.

Posted by: WillSeattle | May 12, 2009 6:58 PM

Straddling between the boat and the pier much? So many vested interests... so little time. The problem might be the amount set aside for profit. Who does decide the profit margin?

Posted by: deepthroat21 | May 12, 2009 6:56 PM

Prediction: those executives standing behind Obama yeserday will soon become the leaders fighting him every step of the way for one simple reason: to "reform" health care, i.e. to make it more affodable and to expand coverage to the uninsured will require the various stakeholders to take a haircut economically.

When it becomes clear that reform means a reduction in profits or in coverage for individuals the battle will begin in earnest and the photo ops will be replaced by behind the scenes lobbying and urgent negotiations between politicians and the industries which support them with campaign contributions. Guess who is going to come out of that one on the short end?

Sad fact is that the health care, pharma and insurance industries have purchased a high degree of profit protection in the current health care model by insinuating themselves into the political process and becoming indispensible to elected officials. They will use this influence to prevent any erosion of their profit margins and, once again, health care reform will either fail outright or be sold to us in a slightly modified form which preserves the economic status quo.

Citizens who believe health care reform
is necessary not only to expand coverage but to reduce the burden health care expenses are imposing upon personal and national budgets, should correspond with their elected representatives and let them know they will not accept the status quo and will vote against them if they do not take a stand for the people and not health care companies.

Posted by: bobfbell | May 12, 2009 6:43 PM

Just take away the health care benefits provided to our lawmakers for a year, you can bet a fast solution to this problem will be taken care of quickly.

Posted by: shipfreakbo214 | May 12, 2009 6:23 PM

I am not sure why Mr. Balz is citing public opinion polls to suggest that maybe health care reform will not be so easy. Does he think the public is going to fix the healthcare system? For that matter, does he think Congress or the president even cares what the public thinks? Most Americans opposed the bank bailouts. That didn't stop it from happening. Most Americans, back in 1993, supported a requirement that employers provide insurance. That didn't make it happen. Truthfully, the public has had little say about anything that's happened in this country in the past 20 years. The corporations have been running the show for at least the past two decades. That part is what has not changed, and in the end is the only part that is relevant.

Posted by: crashprevention | May 12, 2009 6:15 PM

It all comes down to how much profits those involved in providing the healthcare are willing to forgo. It's really that simple in principle, but hard as heck in practice.

Posted by: TalkingHead1 | May 12, 2009 6:15 PM

When has the government successfully ran any program? Do we hold up Social Security and Medicare as shining examples of a job well done by our government? These programs are both bankrupt at this point in time. The same will happen with any single service program run by the government. The government cannot help themselves by opening up programs to expand entitlement programs and this will become another black hole money pit with more trillion dollar losses.

Look at the news today. Social Security and Medicare are going over a cliff. Until we solve Social Security and Medicare we do not need to change horses in mid-stream on health care. Let the government say how they are going to fund Social Security and Medicare.

Here is a start. Stop paying out Social Security to anyone that has not paid into it. If there are people that need assistance then send them to other programs. Social Security has been the piggy bank for the government too long. The government has now borrowed all of the funds to phony up their books over the years.

Posted by: Bubbette1 | May 12, 2009 6:10 PM

Don't be fooled by Obama's stealth. LBJ stuck us with Medicare when we had a surplus back in 1964.The lies that were used to sell it to the Doctors- no price-fixing by the government etc. still STINK.
The left's goal of CONFISCATING 16% of the US economy-healthcare- is still there,still lurking.
In face of the debacle of Canadian & UK nationalized healthcare, the marxists in the White House want to cement in a Democratic benefit program that will make all Americans beholden to them for evermore. TAXES & RATIONING your care to follow.
Ninety percent of Americans are content with their Doctor's care. But, they want 'the government' to pay for it.
Financial suicide ! Taxes will turn the US into a lost state like Britain.
Keep the government OUT of your most personal life. Keep your freedom to CHOOSE, your own Doctor. Freedom to CHOOSE if you even want to buy insurance.
Keep your medical reords out of the hands of the Washington bureaucrats. Keep America , America, land of liberty.

Posted by: wilfredknightex-brit | May 12, 2009 6:07 PM

The question is whether Obama and Congress will take care of the needs of the health insurance industry, or whether they will take care of the needs of the American people.

I see no reason to believe that they care about the American people. So far they've taken care of only American corporations.

The health insurance industry is evil and needs to be abolished and replaced by universal single payer.

Posted by: geezjan | May 12, 2009 5:53 PM

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