For good or for bad, and hopefully for good, this is a big week for the future of health care reform. On Thursday, President Obama will hold his bipartisan health care summit, during which he will certainly seek his ever-elusive goal of bipartisanship. The president will also have an opportunity to further isolate his Republican obstructionist opponents--provided he takes the opportunity, and the GOP takes the bait. And just days before, the president unveiled his own health care plan, signaling his willingness to provide some direction and leadership on his signature campaign issue.
If health care reform legislation eventually passes, this week may well have been the reason. Either way, the Obama administration's strategy up to this point, or lack thereof, provides a valuable lesson in how not to promote a health care plan.
The president unveiled his own 11-page health care plan, which is available online. The plan would extend coverage to 31 million people, ramp up regulations on the health insurance companies, and replace the Senate's proposed tax on high-cost insurance plans with a tax on the wealthy. Other highlights of the Obama plan include the following:
-An end to discrimination based on pre-existing conditions
-Extension of Medicaid, but the elimination of Sen. Ben Nelson's $100 million Medicaid funding deal for Nebraska
-State-based exchanges, as opposed to national, would allow consumers to purchase and compare insurance plans
-A national insurance authority would help states fight unreasonable insurance rate hikes
-The plan would close the "donut hole" gap in the Medicare prescription drug plan
-Penalties if people do not buy insurance, with income-based subsidies if they cannot afford coverage
-An end to anti-competitive practices by drug companies that keep cheaper generic drugs off the market
-A voluntary, long-term insurance option for people with disabilities
-Scholarships, loan repayment and other incentives to promote the expansion of the health care workforce
-Reauthorization of the Indian Health Care Improvement Act will improve health care for 1.9 million Native Americans
In addition to the plan, the President supports legislation removing antitrust exemption for the insurance industry.
For the first time in a while, Obama is taking the lead and seizing the reins in the health care debate. But it took a long time to get here. The administration has been criticized for over-learning the lessons from the failed Clinton health care plan. President Clinton's attempt at universal health care failed because they kept Congress out of the loop. Obama, on the other hand, took a step back while a dysfunctional, lobbyist-loving Congress shaped the legislation on its own, with no guidance from the White House. The congressional sausage-making process turned people off, and Obama lost popularity with his base for not acting like the agent of change he was in the 2008 campaign.
Conspicuously absent from the Obama plan is the much beloved and ever-popular public option. The president chose to pitch his proposal as a foundation that legislators can amend and build upon. However, the administration has risked alienating its base of Democrats and Independents by announcing it ditched the public option because of a concern the votes are not there in the Senate. This comes despite 23 senators signing onto Sen. Michael Bennett's (D-Colorado) letter to Senate majority leader Harry Reid (D-Nevada), calling for a public option through reconciliation.
Critics charge that the President has made too many concessions in order to attract Republican support he will never win over. Progressive Change Campaig co-founder Adam Green said in response that "The White House obviously has a loser mentality -- but America rallies around winners. Polls show that in state after state, voters hate the Senate bill and overwhelmingly want a public option, even if passed with zero Republican votes."
Green's group is targeting seven lawmakers who have not yet signed on to the Bennett letter, as insurance giant Wellpoint is poised to hike rates by double digits in at least 11 states, including the lawmakers' respective states. Susan Bayh, Sen. Evan Bayh's (D-Indiana) wife is a Wellpoint board member, and has made millions of dollars in that capacity.
Republicans will likely use the summit to brand the President's plan as expensive and more government expansion, and push for a private-sector alternative to reduce costs and increase coverage--as if the private sector has served Americans so well when it comes to health insurance.
GOP reactions to the Obama plan were predictable. House minority leader John Boehner, who criticized the House health bill as too long to read, criticized the President's plan for being too short. House Minority Whip Eric Cantor rejected the President's proposal, calling the bill a "non-starter" and expressing little hope for a bipartisan agreement. "The president insists on bringing back a bill that the American people have resoundingly rejected," he said. The White House challenged the Republicans to offer their own proposal.
Conservative radio entertainer Rush Limbaugh provided the most controversial reactions to health care reform, characterizing the reform effort as "a civil rights bill" and "reparations." "The rich are going to stop getting all the good stuff, we're gonna take -- this is income redistribution, this is returning the nation's wealth to its quote-unquote rightful owners," Limbaugh said. "This is a civil rights bill. This is reparations, whatever you want to call it."
Limbaugh's opposition to health reform on racial grounds mirrors both the racially-charged, anti-health care tea party movement, not to mention the traditional conservative resistance to taxes and social programs. Through the use of the race card and a Southern Strategy, Republicans won over white voters by opposing social programs on the grounds that they would benefit African-Americans. It was a strategy perfected by the late GOP strategist Lee Atwater.
Accounting for one-sixth of the U.S. economy, health care is an important issue. Prohibitive medical costs literally cripple struggling families that cannot afford to get sick. A Harvard Medical School study found that 45,000 people die each year because they lack health insurance. "I'm most concerned about the 47 million people in the nation who are uninsured," Roslyn Brock, the new NAACP chair, recently said. "I would hope that our Congress, working with the [Obama] administration, would recommit themselves to ensure comprehensive and affordable health care for all Americans."
In 2008, 7.3 million African-Americans were uninsured. Patients of color are less likely to receive the same quality medical care as whites, and blacks die of cancer at a higher rate than whites, even with equal care. Further, black doctors are underrepresented, accounting for under 8 percent of first-year medical students, although African-Americans are 15 percent of the population.
At the same time, the health care debate has sucked all of the air out of the political room, and the Congressional Black Caucus has expressed frustration of late that high unemployment in black and low-income communities received little attention in the latest jobs legislation.
Hopefully the time spent on health care reform will translate into rewards for the American public, and a second political wind for the Obama White House. We should find out soon. What happens next will be a crucial test as to whether the President can get the job done, and successfully promote big legislation on other pressing issues in the future.