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Barack Obama on Health-Care Reform: Trust Us.


At about 5:30 p.m. today, President Obama held a conference call on health-care reform that included, in his closing remarks, an unusually thorough glimpse at the White House's legislative strategy:

The House bills and the Senate bills will not be identical. We know this. The politics are different, because the makeup of the Senate and the House are different and they operate on different rules. I am not interested in making the best the enemy of the good. There will be a conference committee where the House and Senate bills will be reconciled, and that will be a tough, lengthy and serious negotiation process.

I am less interested in making sure there's a litmus test of perfection on every committee than I am in going ahead and getting a bill off the floor of the House and off the floor of the Senate. Eighty percent of those two bills will overlap. There's going to be 20 percent that will be different in terms of how it will be funded, its approach to the public plan, its pay-or-play provisions. We shouldn't automatically assume that if any of the bills coming out of the committees don't meet our test, that there is a betrayal or failure. I think it's an honest process of trying to reconcile a lot of different interests in a very big bill.

Conference is where these differences will get ironed out. And that's where my bottom lines will remain: Does this bill cover all Americans? Does it drive down costs both in the public sector and the private sector over the long-term. Does it improve quality? Does it emphasize prevention and wellness? Does it have a serious package of insurance reforms so people aren't losing health care over a preexisting condition? Does it have a serious public option in place? Those are the kind of benchmarks I'll be using. But I'm not assuming either the House and Senate bills will match up perfectly with where I want to end up. But I am going to be insisting we get something done.

After that quote, it seems almost redundant to say that this is the clearest indication we've gotten that the White House sees conference committee as the focal point for its efforts. But that's the message. The audience for this call -- which I was not originally invited to, but was able to listen in on -- was mainly progressive bloggers, and so the underlying argument was that liberals should have some faith that a disappointing draft out of the Senate Finance Committee is not the end of the process, and they should not lose heart.

But it's also a risky strategy: The plea for progressives to avoid making "the best the enemy of the good," and instead remember that flaws can be fixed in conference committee, is, on some level, the White House saying, "Trust us." Conference committee, after all, is a closed-door negotiation that is hard to influence. What emerges will be very hard, if not impossible, to change. If the White House does not hew to the same bottom lines as the progressive bloggers, or is not able to persuade the congressional negotiators to honor its preferences, the product could diverge quite sharply from what some liberals are hoping for.

On the other hand, actually getting health-care reform to conference would be further than any president has gotten ever. If the White House can shepherd this effort that far, maybe it will deserve some trust.

Photo credit: AP Photo/Pablo Martinez Monsivais.

By Ezra Klein  |  July 20, 2009; 6:47 PM ET
Categories:  Health Reform  
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"trust us" would be easier to do if the President had not already spit in the eye of the progressive community over several issues, including gay rights.

Posted by: JonWa | July 20, 2009 6:56 PM | Report abuse

And let's not forget the illegal and expanded secret bombings in Pakistan that kill women and children as they sleep.

Posted by: georgejones5 | July 20, 2009 7:47 PM | Report abuse

I wish that the President would stop talking down to us. When he says that 80% of the two bills will overlap, and that "only" 20% will be different, he knows perfectly well that the 80% is safe, noncontroversial stuff and that the 20% includes everything that matters. I am not comforted by hearing that all of the important issues are up for grabs. Nor am I reassured by what sounds like preparation for a White House defense of the final product: "OK, it doesn't cover everybody, it doesn't tame the outrageous profiteering of the health care industry, it doesn't have a serious package of insurance reforms, and it doesn't have a public plan, but, hey, we still got 80% of what we wanted, and that's pretty darn good!"

Posted by: lydgate | July 20, 2009 7:54 PM | Report abuse

So anything missing from both bills will be added in conference? If the Senate can't get past Ben Nelson, conference will happen anyway?

It sounds to me that Obama mainly wants to take credit for winning the war without having fought any of the battles.

This would be easier to swallow if we had climate change legislation that would actually work, even a little bit, a Justice Department that was interested in punishing crimes committed in high places, and a President who showed that his background as a constitutional lawyer had taught him to actually believe in the constitution.

So far, I've been sadly disappointed what passes for integrity on all those issues.

Posted by: pj_camp | July 20, 2009 8:04 PM | Report abuse

Unfortunately Obama can not be trusted on the important issue of health care. He has shown he lacks strong principes on health care reform in the following ways:

1) refusing to consider a single payer system

2) reversing his campaign rhetoric, criticizing Senator Clinton's mandate, which was the only significant difference between the two in domestic policies

3) being wishy-washy on whether a public option must be in a health care bill for him to sign it

4) being open to taxing employer paid benefits, which would break another campaign promise, if included in a health care bill

5) not insisting upon higher taxes on the wealthy to pay for health care reform

6) seeking to finance health care expansion substantially on the backs of the elderly, poor with reductions in Medicare and Medicaid spending

7) insisting any health care bill be deficit neutral, while allowing other spending, on his wars in the Middle East, high military spending in general, the "stimulus," increased education aid, etc, be added to the national debt

Posted by: Aprogressiveindependent | July 20, 2009 8:16 PM | Report abuse

"The audience for this call -- which I was not originally invited to, but was able to listen in on -- was mainly progressive bloggers"


The White House didn't figure the WaPo's liberal healthcare blogger should be in on that call?

Posted by: generic_ | July 20, 2009 8:23 PM | Report abuse

I want my free health care and I want it now! Obama is just another excuse machine. Why can't the American people see through all his empty promises??

Free health care for everyone! Come one, come all. Punish all the greedy doctors and greedy corporations (don't forget Haliburton!!), and greedy banks and greedy CEOs and greedy, well just about everybody in this god forsaken country needs to be punished except the Progressives!!

Free health care for liberal progressive bloggers, make it an entitlement, and let's get on with it!!

Posted by: Curmudgeon10 | July 20, 2009 8:31 PM | Report abuse

Imagine a young married couple heavily in debt. They've run up multiple credit cards to the tune of tens of thousands of dollars, and are near bankruptcy. They have overextended first and second mortgages on their home, and are being threatened with repossession. They do not live within a budget - they just spend as they go and call it a budget. They spend way beyond their means, month after month and year after year.

At this point of crisis, the husband announces that they are going to buy a gigantic second home, a vacation home of their dreams, and then celebrate it by going on an expensive around-the-world trip.

Would you conclude that he is deluded, blinded, ignorant, or insane? Or of some combination of these conditions?

This is precisely the situation with Barack Obama and his Democratic Party allies in Congress, who wish to spend trillions more to insure the 35 million uninsured in this country, right now! And with no clear idea what the total cost over ten years or how much further this will weaken our nation's teetering finances.

Posted by: votewithyourfeet | July 20, 2009 8:43 PM | Report abuse

Do we know who would be the players on the conference committee? Are they appointed by the congressional leadership, or is there some kind of established process? I'm getting the impression that O and Rahm are confident that they can get exactly what they want - if they can get to conference.

Posted by: john7 | July 20, 2009 9:06 PM | Report abuse

If a year ago, while running for president, Barack Obama had said, "The way to get out of our economic troubles is by burying ourselves under a mountain of debt," John McCain would be president today.

Yet just this week, Vice-President Biden said just that: "And folks look, AARP knows and the people with me here today know, the president knows, and I know, that the status quo is simply not acceptable. It's totally unacceptable. And it's completely unsustainable. Even if we wanted to keep it the way we have it now. It can't do it financially.

"Now, people when I say that look at me and say, 'What are you talking about, Joe? You're telling me we have to go spend money to keep from going bankrupt?' The answer is yes, that's what I'm telling you."

This is why I've started buying mutual funds that invest in China. These jerks are deliberately trying to bankrupt our country.

Posted by: gilbertbp | July 20, 2009 9:19 PM | Report abuse

Ezra, this is where I come after reading all the other chattering houses to get the 'bottom line' on healthcare.

Listen to the whole call here, its great

Posted by: FebM | July 20, 2009 9:19 PM | Report abuse

Years ago my mother bought an item and told my dad how much money she had saved. He said, "Think how much money you would have saved if you bought a train load!" Guess Good Ole Joe didn't know my dad!!!!

Posted by: PalmSpringsGirl | July 20, 2009 9:34 PM | Report abuse

I'm sorry but this is retarded. Maybe throwing out a draft and then fixing problems during committee might have worked in the good ol days but this is 2009. With the way technology and the 24/7 media cycle works Obama can't seriously expect to turn in a crappy rough draft and then fix the mistakes an hour before the "paper" is due.

First impressions are important in politics, especially when it comes to major legislation. Democrats have their priorities ass backwards on this. We should have framed the discussion around cost controls and instead deficit spending. History has shown us that people are willing to ignore deficits if they think the money is money well spent. The framing should have gone:

A Problem : Health Care costs are spiraling out of control. Crippling economy. Hurting businesses. Bankrupting families.

B. Cause: A fracture health care system run by private insurance companies that inflates health care costs, anti market restrictions on medicare. Inefficient and ineffective health care service. Lack of adequate competition in health care market because of limited consumer choice.

C. Solution: A health care plan that fixes medicare by allowing it to employ free market principles and bargain for cheaper medication. Providing cost effective preventive treatment instead of expensive ineffective treatment. Ensuring a truly competitive market by creating a non profit public option. Pooling the purchasing power of 300 million Americans to increase their market power and lower health care costs.

Granted I just wrote this in 5 mins off the top of my head so some of my details are off. But still, hell of a lot more persuasive framing of the health care debate compared to the current democratic rhetoric.

Posted by: TheChairman66 | July 20, 2009 10:02 PM | Report abuse

Trust the A-hole B.S. artist when he wants to add trillions to the already astronomical debt? And, the dumbo wants to give free health care to twelve million illegal aliens?
That's a pile of money for us to pay for the incompetent in the White House to buy illegals' votes.
What a disgrace this incompetent leftist liar is..

Posted by: LarryG62 | July 20, 2009 10:09 PM | Report abuse


The healthcare reform bill released by the House Of Representatives is an excellent bill as I understand it. It's a bill with a strong, robust, government-run public option, and an intelligent, reasonable initial funding plan to cover almost all of the American people. It is carefully written, and thoughtfully constructed, informed, prudent and wise. This bill will save trillions of dollars, and millions of your lives. It is also now supported by the AMA.

This is the type of bill that all Americans can feel good about. And this is the type of bill that has the potential to dramatically improve the quality of healthcare for all Americans. Rich, middle class and poor a like. Democrats, Republicans, Independents, and all other party affiliations. This bill has the potential to dramatically improve the quality of life of every American.

The house healthcare bill should be viewed as the minimum GOLD STANDARD by which all other proposed healthcare legislation should be judged. All supporters of true high quality healthcare reform should now place all your support behind this healthcare reform bill released by the United States House Of Representatives, as the minimum Gold standard for healthcare reform in America.

You should all now support this bill with all your might, and all of your unrelenting tenacity. This healthcare bill is a VERY, VERY GOOD! bill for all of the American people. Fight tooth, and nail for every bit of this bill if you have too. Be aggressive, creative, and relentless for this bill.

From this time forward, go BIGGER and DEEPER with the American people every day until passage of healthcare reform with a robust, government-run public option.

FIGHT!! like your life and the lives of your loved ones depends on it. BECAUSE IT DOES!


Senator Bernie Sanders on healthcare (

God Bless You

Jack Smith — Working Class

Posted by: JackSmith1 | July 20, 2009 10:42 PM | Report abuse

what about the fact that this doesn't bend the cost curve does he not understand?

He continually talks out of both sides of his mouth.

We need to fix healthcare but that doesn't mean throwing trillions at it.

How about the fact that he arbitrarily delayed the updated report about the economy until Mid August when its normally out in mid July? YOu wonder why? When people see how really bad it is they'll all say we can't throw trillions at a system that won't work, that won't bend the cost curve.

you want answers Mr president? Tax YOUR UNIONS above the cadillac threshold of $17,000. I am in NJ (one of the most expensive states for healthcare and no reasonable plan is that expensive.

You want answers, TORT REFORM.

But you wouldn't want to upset those that voted you into office. Why doesn't the Washington Post bring these issues up???

How about when Mass. puts in its new legislation changing the way docs are paid we study it to see how it works over a short time (year to 18 months) before we throw our entire system into his public option.

In the meantime we can enact what we can all agree on now, an end to pre-ex, an individual mandate as a trade off to that and small tax increases and reallocations to be able to offer subsidies to those that can't afford it because when we decrease what Medicaid and Medicare are paid by $500 BILLION and add 11 MILLION people to the Medicaid and Medicare rolls we aren't bending the cost curve we are CONTINUING the ever growing shift of costs from public plans that are inefficent to private plans.

Posted by: visionbrkr | July 20, 2009 11:26 PM | Report abuse

On both questions, shifting views among political independents add an additional challenge for the president. Since March, independents have taken a decidedly negative turn on stimulus spending (56 percent now prioritize avoiding a deficit over increased spending), and confidence that Obama's economic plan will work has fallen 20 points since just before his inauguration.

Independents are no longer trusting you Mr Obama. You said we'd have time to read bills and you've renig'd on that promise. You said unemployment would cap at 8% and its now 9.5% and growing. You're holding back bad economic data from us to avoid telling us the truth about your spending programs.

Mr Obama when you hold yourself out to be "above the fray" you actually have to be above the fray. Your constituents did not believe it to be a political line but how they expected you to truly act. Many of them now as the polls regarding independents are showing are turning against you. They know that your spend spend spend ways are no good for our country and as I've said we need to find ways to cut costs in this time when states are cutting programs to survive, furloughing workers to save a couple pennies. During their struggles you're spending TRILLIONS.

Posted by: visionbrkr | July 20, 2009 11:36 PM | Report abuse

Progressives were thinking at the beginning, or at least hoping, that Obama has a "rope a dope" approach to his opposition, giving ground only to come up later with the winning "punch". It has seemed lately, though, at least from my perspective that this weakens his bargaining position and that Ali-like ability to finish has not emerged. Furthermore, at some point, when legislation becomes law or policy gets enacted, there are real world consequences that political actors on one side or another of a debate did not see. These consequences feedback on politics and if they are negative, weaken the people responsible for that policy. I'm afraid Obama and the Clinton veterans in the Administration are so focused on the politics that the policy is, in the end, going to be sacrificed. I hope to be proven wrong.

Posted by: michaelterra | July 21, 2009 12:46 AM | Report abuse

Not much focus has been on the part of this reform that is financed by cutting the Medicare budget. Isn't the Medicare Trust Fund having serious solvency problems which start much, much earlier than the Social Security Trust Fund solvency problems that we hear so much about.

I am doubtful that it makes sense to direct money out of the Medicare program at a time when that program is rapidly moving to insolvency. Those savings that President Obama creates by having this reform should be used to improve the solvency of the Medicare program. Health care reform should by fully financed without going into the soon-to-be insolvent Medicare account.

Posted by: lancediverson | July 21, 2009 10:55 AM | Report abuse

it would be interesting if you could respond to this wall street journal oped

Posted by: americawondc | July 21, 2009 12:05 PM | Report abuse

Millions of life-long Democrats like myself who were screwed over continuously by Obama in the last 18 months learned one thing:

Obama simply cannot be trusted. Obama cannot be trusted on any issue. Obama cannot be trusted by his friends. Obama cannot be trusted by his enemies. Obama cannot be trusted. --Hillary is 44

Remember this. It is always true. Single payer or nothing. If other nations can do it, so can we.

Posted by: donna_darko | July 21, 2009 12:41 PM | Report abuse

Since single payer advocates have been excluded and censored in a process that was supposed to be open and transparent, why should we trust the Democrats?

Indeed, after the betrayal of FISA [cough] Reform, the betrayals on Gitmo, state secrets privilege, and torture, and handing the banksters $700 billion NOW NOW NOW through TARP on top of everything else, why should anybody trust the Democrats?

Posted by: lambert_strether | July 21, 2009 2:38 PM | Report abuse

Jack Smith — Public Option Shill.

The entire thing is a bait and switch operation:

130 million: Public option enrollees as sold to the American people in the "progressive" blogosphere

9 million: Public option enrollees as scored by CBO.

That's going to keep the insurance companies honest? Puh-leeze...

Posted by: lambert_strether | July 21, 2009 2:43 PM | Report abuse

We need govt reform as much as healthcare reform. Passing legislation without reading and allowing billions of unnecessary spending is inexcusable. And now they want to rush thru a 1000 page health bill without reading. I've seen how Medicare and Social Security operates when I was taking care of my mom. They actually spent $1750 for wheelchair that I could have purchased for $450...they spent $600 for a 10 pack box of Depends that I could have purchased less than $300. I reported it as fraud or price at least price gouging and was told to contact my congressman or senator as these were not fraudulent. Suggests political kickbacks to me.
With all of the takeovers and appointment of czars who have given political favors to Obama.
Spending billions to the auto industry to 'help them avoid bankruptcy' when even I knew they would have to file bankruptcy. Talk about political kickbacks to the unions. Very clever on Obama's part. Spend billions of taxpayer money to make it look like he tried to help them, so when the inevitable happened and people got laid off it made him look like he tried to help.
Creating millions of tax payer money on 'czars' who are nothing more than campaign supporters. How is all this fiscally responsible? And he wants me to believe that he and the Democratically controlled Congress know how to devise a plan for a more improved and cost efficient health plan! AND it needs to be done NOW. Really scary stuff. Yes we need reform, but his approach to everything is sounding more and more like socialism. Not the kind of change I want.

Posted by: weinerdog01 | July 21, 2009 3:56 PM | Report abuse

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