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Obama Set to Engage on Health Care


“We’re entering a new season,” senior presidential adviser David Axelrod told Politico. “It’s time to synthesize and harmonize these strands and get this done." That will begin as early as next week, when President Obama puts his full weight into health-care reform. It will begin, as these things often do, with a speech. Not a town hall, or a press conference, or a Q&A, but a speech. Early word is that it will happen either in the Oval Office or before a Joint Session of Congress. It will be the first time Obama has the full force and symbolism of the office to define the debate on health care.

On some level, this was always the plan. Bill Clinton exhausted his political capital early. He began health-care reform by giving a speech and developing his own bill. That meant he had no capacity to change the dynamics once Congress got hold of the legislation. The Obama administration, conversely, has purposefully avoided a major address or an articulation of specifics. That way, they hoped, they could keep Obama's political capital relatively separate from the first phases of the reform fight, and then use it to push whatever Congress developed across the finish line.

The problem is that Obama hasn't managed to wall himself off from health-care reform. Since he didn't propose a bill, he got tied to the House bill. Since he didn't forcefully enter the debate, the media reported on his news conferences and town hall meetings as if they were the White House's failed attempts to set the agenda. Obama's popularity has fallen and support for "his" bill — a bill that doesn't exist — has plummeted.

Objectively, the fact that he hasn't given a speech on health-care reform or defined his own bill or begun to really pressure the Congress means, in practice, that he has a lot left of tools left in his toolbox. What's not clear is whether he has the political capital left to use them effectively, or whether the last few months saw him robbed of something he hadn't even had a chance to use.

Photo credit: By Charles Dharapa — Associated Press

By Ezra Klein  |  September 2, 2009; 11:26 AM ET
Categories:  Health Reform  
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Obama does need to give a speech that outlines exactly what these terms mean in ways that ordinary people (and even sopme journos) can understand. Something like:

"In this country we have the VA that proides health care for veterans. The hospitals are owned by the federal gov't and the doctors are government employees. That is real "government-run health care" and no one, absolutely no one, is currently proposing that we expand that to the whole population. So what we are proposing really is not "government-run health care" or a government takeover of health care.

"For people over 65 we now have Medicare, where people enroll in different private health plans. The doctors and hospitals are private but they all send their bills to the federal government, and the gov't pays. That is a "single-payer" system. We have a similar program for low-income people (Medicaid). We are not proposing that for the rest of the population, although some people do advocate letting younger people buy into Medicare.

"The rest of the population is either uninsured or has private health insurance, either through their employer or through an individual plan. The doctors and hospitals are private, and the bills are all sent to the different insurance companies, who decide whether or not or how much to pay. If the employer is the government, this is "government-funded" but not single payer. This is the model we are proposing, not single-payer or government-run health care. The difference is that the insurance companies would be more regulated so that they couldn't deny coverage or treatment to make more money and there would be subsidies for people who didn't qualify for Medicaid but still couldn't afford insurance so more people would be covered.

"To have more choice, we might also have a non-profit or publicly administered plan that still uses private doctors and hospitals but keeps costs down with lower administrative costs. And we have various means to analyze which treatments work best in which situations and which don't so we don't waste money.

"But no one is proposing restricting or denying care for Medicare patients because of age or disability or anything like that. Not going to happen, period."

Posted by: Mimikatz | September 2, 2009 12:24 PM | Report abuse

Persuasion of the public was never part of the plan for passing this. Hence the amazing statement of Specter at his town hall: we have to make decisions very fast. The lack of an attempt to sell this or persuade people of its merits, rather than muscle it through, is the bottom cause of the public outcry. This is what has to be backtracked -- if it still can, given the nature of the senior advisors around the president.

Posted by: truck1 | September 2, 2009 12:33 PM | Report abuse

That's a very good summery of the whole dynamic, Ezra.
Obama was robbed by the astonishing stupidity of the America people and the even more astonishing cynicism and evilness of the Republican party. Sadly, this combination was just too effective, which left me with some really somber thoughts about the future of this country.

Posted by: impikk | September 2, 2009 12:38 PM | Report abuse

Getting a health care bill has LESS to do with Obama's political capital than it has to do with the Congress's FEAR of NOT getting a health care bill done. Congress KNOWS that if they FAIL to get a bill then in 2010 that MANY Congressional seats WILL be lost. Thus FEAR rather than Obama's perceived (or lack there of) political power will get a health care bill done.

However, I do believe that Obama DOES have political health care left even if he has falling poll numbers. Americans want reform but they don't like what is perceived as the Obama health care plan because of all the misconceptions. However, once a bill is passed than it will look like the Democratic Congress ACHIEVED something that no other Congress had been able to achieve and their poll numbers will INCREASE.

Posted by: maritza1 | September 2, 2009 12:52 PM | Report abuse

It's good to see Democrats finally getting some discipline on keeping their powder dry. Never know when you might need it for an important fight.

Posted by: jackiebinaz | September 2, 2009 12:56 PM | Report abuse

Ezra Klein writes, "It will begin, as these things often do, with a speech."

Just what America needs, another condescending lecture from the Black Messiah.

All this backtracking, all this backpedaling, this complete failure to present a cohesive and coherent health care package begs a question,

"Why did not Obama get this right the first time around?"

A rhetorical question, of course. Reason for this failure at health care and failure at his presidency is quite simple: Obama lacks experience and is incompetent. This is well reflected by his surrounding himself with Chicago thugs.

Beyond my understanding why Obama approached his presidency believing he could be successful using his community organizer thuggery ways.

Americans do not much cotton to being bullied around by Chicago thugs. Rather foolish of Obama to believe he could bully America into submission.

"All the king's horses, And all the king's men...."

Okpulot Taha
Choctaw Nation
Puma Politics

Posted by: PurlGurl | September 2, 2009 1:22 PM | Report abuse

maritza1: Getting a health care bill has LESS to do with Obama's political capital than it has to do with the Congress's FEAR of NOT getting a health care bill done.

I'm not sure it's such a straightforward calculation. Vulnerable Congressmen will have to weigh whether the potential reward for accomplishing something/anything on health care reform would outweigh the potential backlash from those who are unhappy with what is (or they believe to be) in the bill. The August recess has shown that there is more intensity amongst the opponents of the current reform bills, so that may factor into their calculus.

maritza1: "Americans want reform but they don't like what is perceived as the Obama health care plan because of all the misconceptions."

impikk: "Obama was robbed by the astonishing stupidity of the America people and the even more astonishing cynicism and evilness of the Republican party."

Don't fool yourselves, many Americans have legitimate concerns with the bills and supporters of the bills have been dissembling, too.

Posted by: tbass1 | September 2, 2009 1:31 PM | Report abuse

Despite all the bravado, I completely reject the notion that the President has somehow changed his position. Instead, I assert that Lance Bass, Bob McDonnell, and the President have something in common: to some degree, we made them all cloud their positions in order to gain our favor. It is unremarkable today to hear Lance Bass say that he is gay, but had he said it ten years ago, he would never have been able to take the podium and say it today. To hear Bob McDonnell say he's not opposed to women having jobs is today unremarkable, but had he said it ten years ago, he would not be able to take the podium and say it today. The President is in a similar position: had he not acquiesced to some wildly socialist, addictive agenda some time ago, he would not today have the podium to propose a plan -- perhaps even a fair, reasonably conservative, bipartisan plan -- for health care reform that's as much a success and a loss to each political party.

I'm not saying "Good for him" or even "Give the guy a chance". I guess I'm saying listen to what he's saying compared to what we've been saying and see if it makes any sense.

The headline read "Why wasn't this the year of Lance Bass?" in part because we all had hoped he would have trusted his public more, and sooner. Anyone with political aspirations should know by now that courage doesn't go unnoticed even it involves a moment of suffering and loss.

Posted by: rmgregory | September 2, 2009 2:27 PM | Report abuse

From a marketing point of view, you don't introduce new products in August.

Posted by: infirm | September 2, 2009 3:46 PM | Report abuse

Are you suggesting he hasn't already been engaged all along? Who do you think you're fooling?

Posted by: whoisjohngaltcom | September 2, 2009 3:48 PM | Report abuse

Think, if you will, a moment about the term "Health Care Industry". Do you sense a juxtaposition, between Health Care and Industry. Where does "health care" fit into "industry"? How can the care of the sick ever be considered an industry? The only way this can happen is when we turn our backs to the sick, wounded and dying as human beings and consider them to be quantities added to or subtracted from profit and loss columns. It is absurd, even on the surface, that there is a "debate" regarding this societal right. Is anyone immune to sickness? Do accountants have some special invisible guard about their bodies which turns away illness? Any person who bothers to exercise any wit realizes not just that no one leave the world alive but also no one escapes the ravages of illness, disease and accident. There is no argument, beyond so called cost, to water down health care reform. What is the price of this "reasonable" argument to the child suffering a chronic illness, the mother whose baby is stillborn or the father whose leg was lost because the care needed was not available. We are the so-called greatest nation on earth, due mainly to the heroic efforts of our fathers and mothers during World War 2. How much longer will the world hold us in this high esteem? How much longer will we be able to hold ourselves there? I have written the President and received a form letter response. If any Senator or Representative reads this will you pay me and the rest of the citizenry you represent the same sort of "lip service" or will you, like the late Senator from Massachusetts, stand up for this right which is in fact the difference between a society and a collection of drones ? As I respect all humanity, I respect my Representatives, but as a Representative you occupy a position which does not automatically demand respect. You, like any of the rest of us who toil at our work, earn our fellow humans respect. For what it is worth my "Representatives" can earn mine and no doubt millions of others by standing up to the vested interests and if need be standing up to our President by demanding health care for every citizen of our nation. If any Representative has read this far, Thank you. Ian MacFarlane

Posted by: imacfarlane | September 2, 2009 6:07 PM | Report abuse

I am sure Obama thinks this is just a messaging problem.

All that FOX news and negative adds have filled the heads of the American people.

He remembers all the applause and warm reception of his town hall meetings.

This will simply be a rehash of his town hall speeches but in front of an applauding congress and on nationwide tv.

If he actually does make some news ... like give up on the public option, I will be surprised and very very disappointed.

Posted by: cautious | September 3, 2009 3:37 AM | Report abuse

"Objectively, the fact that he hasn't given a speech on health-care reform or defined his own bill or begun to really pressure the Congress means, in practice, that he has a lot left of tools left in his toolbox."

No speeches yet on health care reform? Seriously? No really, seriously? What next, Obama has never posed for a magazine cover?

Posted by: permagrin | September 4, 2009 9:35 AM | Report abuse

Mickey Kaus pwns Klein on his delusions that Obama somehow has not yet angaged on health care. He cites CBS News:

"Our CBS News tally shows that Mr. Obama has given 27 speeches specifically on his health care objectives. Add in other remarks, events and statements in which he mentioned health care and the number soars to 119."

These people will say anything to put the nanny state in charge of an even bigger portion of our lives.

Posted by: harkin1 | September 4, 2009 1:04 PM | Report abuse

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