Clinton-Era Aides Watch Health Care Debate In Horror

RICARDO ALONSO-ZALDIVAR | 02/ 8/10 03:24 AM

 

WASHINGTON — Shock and awe. That's what survivors of the Clinton-era health care collapse are feeling as President Barack Obama's overhaul legislation wobbles in Congress.

Aides who shaped Bill and Hillary Rodham Clinton's 1990s plan to cover all Americans, then labored in vain to pass it into law, are adamant that the Democrats can't afford another health care disaster. But they're divided on whether scaling down Obama's plan would be an acceptable solution.

The Clintonistas – now in think tanks, universities, serving in the Obama administration or lobbying – are a potent voice in the furious debate within the Democratic Party over how to salvage health care. Listened to because they're the veterans of the last health care policy war, they carry the scars of intense striving reduced to utter futility.

"If Bill Clinton couldn't get it done, and Barack Obama can't do it, no Democrat will ever try again," said economist Len Nichols, health policy director at the New America Foundation. A Clinton White House health budget aide, Nichols has been operating as an unofficial adviser to lawmakers and administration officials wrestling with details of the current legislation.

"History is written by the victors, not the vanquished," said Chris Jennings, congressional liaison for then-first lady Hillary Clinton during the 1990s debate. "Failure would serve as the ultimate judgment as to whether this effort was worth doing." Jennings, now a lobbyist, replaced Ira Magaziner, principal architect of the Clinton plan, as White House health policy adviser.

The former first lady, now secretary of state, says "it's really hard" watching the travails of Obama's plan. Hillary Clinton has been giving advice, as requested, to lawmakers in Congress and administration officials, and says she's still hopeful. "I'm not sure that this last chapter has been written," she told CNN's "State of the Union" on Sunday.

For most of last year, the health care debate was among Democrats. Republicans were left heckling from the sidelines. That changed when Republican Scott Brown pulled off a Senate upset in Massachusetts, winning the seat held by the late Sen. Edward M. Kennedy and depriving Democrats of the 60-vote majority they were counting on in the final push.

"Many of us thought we were really at the 1-inch line, then literally it was like being hit by a freight train with about 10 seconds' warning," said Ken Thorpe, a senior Health and Human Services official during the Clinton-era debate. Now a health policy professor at Emory University in Atlanta, Thorpe has proposed a scaled-back alternative in case Obama's plan can't get unstuck.

The mere mention of settling for less is causing consternation among former Clinton aides. Obama's health care plan – denounced as a government power grab by critics – is already scaled back from the ambition of the Clinton years.

Clinton-Era Aides Watch Health Care Debate In Horror

Let’s see if Obama can work effectively on Healthcare Reform going forward.

Obama to Hold Bipartisan Summit on Health Care

By JEFF ZELENY

Published: February 7, 2010

WASHINGTON - President Obama said Sunday that he will convene a half-day, bipartisan health care summit at the White House on Feb. 25 to be broadcast on television, so Americans can see Democrats and Republicans try to break the deadlock on health care legislation.

The president made the announcement in an interview on CBS during the Super Bowl pre-game show. The meeting would mark the first time in the long health care debate that leaders from both sides would be allowed to air their ideas publicly and see if they can find agreement.

Mr. Obama did not say what he was willing to give up in the negotiations or chart a specific legislative strategy for moving a bill through Congress.

“If we can go step by step through a series of these issues and arrive at some agreements, there’s no reason we can’t do this faster than it took last year,” Mr. Obama said in an interview on Sunday afternoon from the White House Library.

Mr. Obama made the move after recently conducting a televised brainstorming session with House Republicans that drew praise as a rare, candid exchange between a sitting president and the opposition party.

He added that he would not be supportive of starting the health care debate from the beginning, but rather would try to work from the existing proposals that passed the House and Senate to find agreement. It remained an open question whether this would be possible, given the hardened views of Democrats and Republicans alike.

But the bipartisan health care meeting on Feb. 25 is the latest example of how the White House is attempting to draw in the opposition party and highlight their ideas in the midterm election year, hoping that the Democratic proposals look better when compared to the Republican ideas.

“What I want to do is to look at Republican ideas that are out there,” Mr. Obama said. “How do you guys want to lower costs?”

Senator Mitch McConnell of Kentucky, the Republican leader, said he welcomed the bipartisan meeting on health care and called on the president to begin the dialogue “by shelving the current health spending bill.”

“The fact is Senate Republicans held hundreds of town halls and met with their constituents across the country last year on the need for health care reform, outlining ideas for the step-by-step approach that Americans have asked for,” Mr. McConnell said in a statement. “And we know there are a number of issues with bipartisan support that we can start with when the 2,700-page bill is put on the shelf.”

The president said he did not regret pursuing health care during the first year of his presidency, even though he intends to place a higher priority on job creation this year.

“It was the right thing to do then,” Mr. Obama. “It continues to be the right thing.”

The president spoke to CBS News’ Katie Couric in the hours leading up to the Super Bowl. Mr. Obama said he believed the Indianapolis Colts would defeat the New Orleans Saints, but acknowledged that the Saints were an emotional favorite.

“The Colts have to be favored,” Mr. Obama said.

Obama to Hold Bipartisan Summit on Health Care - NYTimes.com

Just received from OFA. Right now the uninformed Tea Party crowd is raising a lot of noise about not wanting healthcare reform. Their media attention is far from consummate to their numbers. One of the reasons this is the case is that many progressives tend to be timid about admitting to their progressiveness. When asked people individually what they want it is clearly closer to progressives than to Conservative yet many are hesitant to call themselves liberals. Let yourselves be heard lest we lose our country to those who do not understand their own positions and ultimately lose a prosperous country.

Egberto --
An alarming new study shows that health care costs increased last year at the fastest rate in more than a half century.
Health care spending rose to an estimated $2.5 trillion in 2009, or $8,047 per person -- and is now projected to nearly double by 2019. If we don't act, this growing burden will mean more lost jobs, more families pushed into bankruptcy, and more crushing debt for our nation.
The conclusion is clear: This isn't a problem we can kick down the road for another decade -- or even another year. We need to pass health reform now.
We're incredibly close. But too many in Washington are now saying that we should delay or give up on reform entirely. So we need to make it crystal clear that Americans understand the stakes for our economy and our lives, and that we want action.
Can you write a letter to the editor of your local paper right now?
In just five minutes of your time, you can tell thousands of readers about this new report on spiraling costs, and why abandoning reform is just not an option.
You can also help by posting this note on Facebook, letting your friends know about the new costs study and asking them to join you in writing a letter to a local paper.
President Obama and many allies in Congress are working hard to finish the job -- but we can't rest until it's done. Your note will help break through the Washington spin and show members of Congress and the media what local voters really believe. Click here to get started:
http://my.barackobama.com/FinishTheJob
It's clear that we're in the fight of our lives to pass real reform. But after a century of trying, the finish line is finally in sight. As President Obama reminded us all in his State of the Union address, we're fighting for our families and our country -- and we don't quit.
Thanks for making it possible,
Mitch
Mitch Stewart
Director
Organizing for America

As a Canadian living in the United States for the past 17 years, I am frequently asked by Americans and Canadians alike to declare one health care system as the better one.

Often I'll avoid answering, regardless of the questioner's nationality. To choose one or the other system usually translates into a heated discussion of each one's merits, pitfalls, and an intense recitation of commonly cited statistical comparisons of the two systems.

Because if the only way we compared the two systems was with statistics, there is a clear victor. It is becoming increasingly more difficult to dispute the fact that Canada spends less money on health care to get better outcomes.

Yet, the debate rages on. Indeed, it has reached a fever pitch since President Barack Obama took office, with Americans either dreading or hoping for the dawn of a single-payer health care system. Opponents of such a system cite Canada as the best example of what not to do, while proponents laud that very same Canadian system as the answer to all of America's health care problems. Frankly, both sides often get things wrong when trotting out Canada to further their respective arguments.

As America comes to grips with the reality that changes are desperately needed within its health care infrastructure, it might prove useful to first debunk some myths about the Canadian system.

Myth: Taxes in Canada are extremely high, mostly because of national health care.

In actuality, taxes are nearly equal on both sides of the border. Overall, Canada's taxes are slightly higher than those in the U.S. However, Canadians are afforded many benefits for their tax dollars, even beyond health care (e.g., tax credits, family allowance, cheaper higher education), so the end result is a wash. At the end of the day, the average after-tax income of Canadian workers is equal to about 82 percent of their gross pay. In the U.S., that average is 81.9 percent.

Myth: Canada's health care system is a cumbersome bureaucracy.

The U.S. has the most bureaucratic health care system in the world. More than 31 percent of every dollar spent on health care in the U.S. goes to paperwork, overhead, CEO salaries, profits, etc. The provincial single-payer system in Canada operates with just a 1 percent overhead. Think about it. It is not necessary to spend a huge amount of money to decide who gets care and who doesn't when everybody is covered.

Myth: The Canadian system is significantly more expensive than that of the U.S.Ten percent of Canada's GDP is spent on health care for 100 percent of the population. The U.S. spends 17 percent of its GDP but 15 percent of its population has no coverage whatsoever and millions of others have inadequate coverage. In essence, the U.S. system is considerably more expensive than Canada's. Part of the reason for this is uninsured and underinsured people in the U.S. still get sick and eventually seek care. People who cannot afford care wait until advanced stages of an illness to see a doctor and then do so through emergency rooms, which cost considerably more than primary care services.

What the American taxpayer may not realize is that such care costs about $45 billion per year, and someone has to pay it. This is why insurance premiums increase every year for insured patients while co-pays and deductibles also rise rapidly.

Myth: Canada's government decides who gets health care and when they get it.While HMOs and other private medical insurers in the U.S. do indeed make such decisions, the only people in Canada to do so are physicians. In Canada, the government has absolutely no say in who gets care or how they get it. Medical decisions are left entirely up to doctors, as they should be.

There are no requirements for pre-authorization whatsoever. If your family doctor says you need an MRI, you get one. In the U.S., if an insurance administrator says you are not getting an MRI, you don't get one no matter what your doctor thinks — unless, of course, you have the money to cover the cost. CONTINUED

Debunking Canadian health care myths - The Denver Post

It is imperative that we do not allow the GOP and their insurance company cohorts to change the true narrative. Keep getting the truth out.

Following the surprise victory of Sen.-elect Scott Brown (R-MA) in last week’s special election, conservatives have attempted to paint the election as a rejection of healthcare reform and progressive policies more generally.

Appearing on ABC’s This Week yesterday, Sen. Jim DeMint (R-SC) said, “what happened in Massachusetts” shows that “people are alarmed and angry about the spending, the debt, the government takeovers [including health care].” Conservative Washington Post columnist George Will said on This Week that Massachusetts “really was a health care election.” “This was a referendum on a particular piece of legislation that is the signature legislation of the administration, and the people of Massachusetts and the country are hotly angered over its substance,” Will said.

Senate Minority Leader Mitch McConnell (R-KY), on Meet the Press yesterday, said, “the message in Massachusetts was absolutely clear. The exit polls that I looked at said 48 percent of the people in Massachusetts said they voted for the new senator over health care.” McConnell added: “The people are telling us, ‘Please don’t pass this bill.’”

This “referendum” on health reform meme has become near-conventional wisom, with the media and even some Democrats echoing it. But a new Washington Post/Kaiser/Harvard poll undermines this assertion. The poll suggests that while the election was a “protest of the Washington process,” it was not a rejection of progressive policy. Only 11 percent of voters, including 19 percent of Brown voters, want Brown to “stop the Democratic agenda:”

- 70 percent of voters think Brown should work with Democrats on health care reform, including 48 percent of Brown voters.

- 52 percent of voters were enthusiastic/satisfied with Obama administration policies.

- 44 percent of voters believe “the country as a whole” would be better off with health care reform, but 23 percent believe Massachusetts would be better off.

- 68 percent of voters, including 51 percent of Brown voters approve of Massachusetts’ health care reform.

- 58 percent of all voters, including 37 percent of Brown voters, felt “dissatisfied/angry” with “the policies offered by the Republicans in Congress.”

A different poll, from Rasmussen Reports, cast doubt on the notion that Brown voters were primarily motivated by opposition to health care reform. The poll found that 52 percent of Brown voters said health care was their top issue, while an even greater percentage of people who voted for state Attorney General Martha Coakley (D) — 63 percent — placed it first.

And as the Wonk Room’s Igor Volsky noted, Brown “doesn’t make a very convincing messenger for opposing the policy behind health reform,” considering he voted for his state’s health reform legislation in 2006. “He promised to be the 41st vote against reform because Massachusetts had already passed its own health reform bill, arguing that the state shouldn’t pay for the national effort,” Volsky added.

More at the WonkRoom here, here and here.

Think Progress » Poll Confirms Massachusetts Election Was Not A Rejection Of Health Care Reform

I continues to amuse me that all those opposing healthcare reform when confronted with what it would actually look like actually like it. If these guys were not so dangerous I would feel sorry for them.

But the work is just beginning!

Although it's Christmas Eve, I wanted to share some exciting news: The Senate just passed a historic health reform bill. In all the back and forth, it's easy to lose sight of what this incredible breakthrough really means. But consider this: This Christmas, there are millions of Americans without health insurance who risk losing everything if they get sick. There are mothers and fathers who wonder how they'll provide for their children because an illness has wiped out their savings. There are small business owners who worry that they'll have to lay off a long-time employee because the cost of insurance is rapidly rising. If we finish the job, all this can change. We will have beaten back the special interests who have for so long perpetuated the status quo. We will have enacted the most important piece of social policy since the Social Security Act in the 1930s, and the most important health reform since Medicare in the 1960s. In Decembers to come, millions more will have access to affordable coverage. Parents will have the security and stability of knowing their insurance can't be revoked at a moment's notice. And the skyrocketing costs plaguing our small businesses will be brought under control. When you make calls, write letters, organize, this is the change you're making -- a better life for your family and for men and women in every state. There is still more to do before I can sign reform into law -- a last round of negotiations and final votes in the Senate and the House -- and I'm counting on your help every step of the way. But for now, I hope that as you celebrate this holiday season, you remember that the work you are doing is making our union more perfect, one step at a time. For that, I am grateful to you. Merry Christmas and happy holidays, President Barack Obama P.S. -- Organizing for America supporters are signing a note of appreciation to all the senators who have worked so hard to make this possible. I hope you'll join them: http://my.barackobama.com/SenateLetter

I received this letter from SEIU. The letter should have also stated that all of us who truly understand this issue has the duty to explain to all our neighbors, acquaintances, and everyone we come in contact with the reason why healthcare reform as being constructed by this Congress is essential and in their best interest.

"We may not cure this crisis today, but we must start toward that end," said Sen. Harry Reid moments before a vote on the Senate floor. The Senate just passed their health care bill on a 60-39 party line vote. With this historic vote, we stand closer today than ever before to delivering the type of health insurance reform our members and every American across this country deserve. The Senate has taken the first step towards passing its health care bill. Now, the Senate, the House and the White House have an opportunity to deliver real reform, worthy of every American's support. The next two weeks will be our last chance to fix the final bill. Start by signing onto an open letter. The House and Senate bills will shortly head into "conference," where Speaker of the House Nancy Pelosi, Majority Leader Harry Reid and President Obama will hammer out a final bill by merging the two. Conference is an opportunity to fix what's wrong with the Senate bill. It is also, in no uncertain terms, our last chance to do this right. Send a letter to Speaker Nancy Pelosi, Majority Leader Reid and President Obama, telling them to finish reform right. The final bill coming out of conference requires passage in the Senate and House, but no changes are allowed, so conference is the last chance we have to make things better. Today is the beginning of an aggressive campaign to put a good bill on the President's desk. Two major issues must be addressed in conference: Health care must be affordable: Low and middle income families must be able to afford health insurance if they do not get it through work, and employers must be asked to provide good health coverage for their employees so health care is affordable on the job. We should not finance reform on the backs of middle and lower income Americans - but should instead incorporate provisions in the House bill that ask the wealthiest 5% of Americans to pay their fair share. We must hold insurance companies accountable: If the insurance companies win, we lose. Insurance companies must be held accountable with strong regulations and consumer protections, and we must be given the choice of a national public health insurance option available on day one. We must finish reform right. Sign now. Happy holidays, Jessica Kutch Online Campaign Manager SEIU.org P.S. Members of Congress use personal stories from constituents to decide their votes and illustrate why certain provisions are important. We're looking for stories of financial hardship that illustrate why health insurance must be affordable. Do you or a family member have a story to share with Congress? Click here.

 Two telling statements:

• "Nowhere has there been a bigger gap between the perceptions of compromise and the realities of compromise than in the health-care bill."
• "Every single criteria for reform I put forward is in this bill."

Together, he said, these bills, many of which are highly popular among his party's left wing, "will make life better for many Americans."

On taking office in the midst of a severe financial crisis, Obama, a former U.S. senator whose senior staff includes many Hill veterans, settled on a legislative strategy that departed from those of his predecessors.

He decided that, rather than pursue big pieces of legislation one at a time, his administration would seek health-care reform, a cap-and-trade bill, financial reform legislation and other measures simultaneously.

"In some ways, we just didn't have an option," Obama said. "Because of the financial crisis, we had to make a series of decisions that, back in 2007 when my presidential campaign began, were not at the top of our list."

"What I thought was very important not to do was further delay work on some of the big-ticket items that I had been elected to achieve and that were critical for our long-term economic growth," he continued.

Obama said he "could have put off" health-care reform, adding that "there are some people who would say that wouldn't be such a bad thing -- the opponents of reform."

But he said delaying on that issue, which has been tied to the country's future fiscal and financial health, would have continued the "double-digit" rise in health-care costs and increase the burden on businesses paying for employee coverage.

"Given how difficult fighting the special interest has been on Capitol Hill, it's clear that, if we hadn't decided to make a bold step forward this year, we probably wouldn't have had the political capital to get it done in the future," he said. "Sooner or later we had to take that on, even though we knew it would be politically difficult."

[CONTINUED] 

Obama rejects criticism on health-care reform legislation - washingtonpost.com

Email from Organizing for America on what is at stake.

Any day now, health insurance reform will come up for a vote in the Senate. We're hearing a lot about what's at stake with this vote for President Obama, the Democrats who are fighting alongside him, and the Republicans who have lined up in opposition. But let's talk about what's really at stake for America. The Senate health reform bill will: Extend coverage to 31 million Americans, the largest expansion of coverage since the creation of Medicare. Ensure that you can choose your own doctor. Finally stop insurance companies from denying coverage due to a pre-existing condition. Make sure you will never be charged exorbitant premiums on the basis of your age, health, or gender. Guarantee you will never lose your coverage just because you get sick or injured. Protect you from outrageous out-of-pocket expenditures by establishing lifetime and annual limits. Allow young people to stay on their parents' coverage until they're 26 years old. Create health insurance exchanges, or "one-stop shops" for individuals purchasing insurance, where insurance companies are forced to compete for new customers. Lower premiums for families, according to the non-partisan Congressional Budget Office especially for struggling folks who will receive subsidies. Help small businesses provide health care coverage to their employees with tax credits and by allowing them to purchase coverage through the exchanges. Improve and strengthen Medicare by eliminating waste and fraud (without cutting basic benefits), beginning to close the Medicare Part D donut hole, and extending the life of the Medicare trust fund. Create jobs by reining in costs -- fostering competition, reducing waste and inefficiency, and starting to reward doctors and hospitals for quality, not quantity, of care. Cut the deficit by over $130 billion in the next 10 years. It's a long list. But that's only because this bill represents the most significant health reform our nation has seen since the creation of Medicare. And it's important that every American knows what's really at stake this holiday season. So please pass this email along to friends, family, and neighbors today -- or click below to share this list on Facebook and Twitter, or print out a copy to share with others: http://my.barackobama.com/SenateReformBill We wouldn't be this close to enacting these powerful reforms without all your hard work. Now, we're in the final stretch -- let's keep it up. Thank you, David Plouffe