Results tagged “health care” from David Corn

The 80/20 Rule: A Question for Obama?

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On the run--again--today. And I'm prepping for President Barack Obama's press conference tonight. There are usually two hundred or so reporters in the room, and he tends to pick about a dozen (from a prepared list) for questions. Thus, the odds are not good. Nevertheless, you have to have something in your notebook--in fact, a few queries, in case someone chosen before you are asks that pearl you had spent days composing.

I'm certain many of the questions tonight will focus on health care. And on NPR this morning, Julie Rovner, the public radio network's reporter covering health care, made an intriguing point about the legislation now being produced (or processed?) on Capitol Hill. She cited what she calls the 80/20 rule: every stakeholder (that is, interest group) may like or tolerate 80 percent of the health care reform legislation under construction, but also cannot abide by 20 percent of the bill. The problem is that this 20 percent is different for each group. Example: the insurance industry may support mandates but absolutely despise the public option. Business groups, though, hate mandates. And so on. Which means that each of the key components of the package enrages a powerful player. Total up all those 20-percents, Rovner says, and it adds up to 100 percent. Maybe more! So how to navigate all this?

Hey, maybe that's a good question for Obama.

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Why McCain Is Bonkers on Iran

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Jim Pinkerton and I were together again for another Bloggingheads.tv diavlog. We mainly agreed on Iran, with Jim sort of concurring with my assessment that John McCain is "bonkers" for pushing Barack Obama to embrace the Iranian opposition. Nothing would hurt the opposition movement's credibility within Iran--where it counts most--than a big wet-kiss from Washington. We then moved on to health care, with Jim suggesting both Ds and Rs are wrong to preach austerity to the American public when it comes to health care dollars. Perhaps, but I challenged his solution: freeing the health care industry from government regs so it can produce the sort of products and services that can be exported abroad a la McDonald's. Finally, our big topic: whether the remaking of the cheesy 1984 anti-commie movie Red Dawn--high school kids in Colorado beat back Russian and Chinese invaders--is of any cultural significance. Jim: yes and hooray! Me: no and yawn.

Also, at Thursday's White House press briefing, I asked press secretary Robert Gibbs about an earlier McCain tweet, in which the senator again urged Obama to declare an explicit alliance with the Iranian opposition. Here's the exchange:

Q: Thanks, Robert. A question about Iran again. Earlier today, a few hours ago, John McCain, on his Twitter feed, said -- and it's short, as it has to be -- "Mass peaceful demonstrations in Iran today; let's support them and stand up for democracy and freedom!"
MR. GIBBS: Was it that vociferous or are you --
Q : "The President and his administration should do the same." Do you think that it is helpful, or not helpful, for members of Congress to be making declarations like this, and putting pressure on the White House to do and say more?
MR. GIBBS: Again, I'm not going to get involved into commenting on the motivations that other members may have. I know some people agree with what Senator McCain said; some people agree with what other Republicans have said that's very much like the President's position. The President strongly believes that we should and have spoken out to ensure that demonstrators have the universal right and principle to demonstrate without fear of harm. But at the same time, we have to respect their sovereignty.

Gibbs did not use the opportunity to call McCain "bonkers" or anything else. But with a crunch time coming in Iran, we can expect McCain and other Rs to turn up the rhetoric and try to intensify the pressure on Obama. That might be good politics for them, but it's not likely to help the Iranian opposition.

On Health Care, Is Obama Passive or Wily?

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It's become almost a daily ritual in the White House press briefing room. Reporters ask press secretary Robert Gibbs what President Obama will fight for regarding the health care reform bill now under construction in Congress, and Gibbs refuses to discuss details. Will Obama oppose a move to tax employee-based tax health care benefits, per his campaign position? Gibbs won't say. What does Obama want to see in a public health insurance option? Gibbs won't say.

At Wednesday's briefing, NBC's Chuck Todd tried to push Gibbs on the taxing benefits issues. Gibbs wouldn't give. Then Todd asked, when it comes to the health care bill, what is Obama "inflexible on?" Gibbs replied,

On the run, at the moment. But please check out this piece below I posted at MotherJones.com. The point of the vignette: it must be damn difficult these days to be working for the Obama administration and trying to contend with the multiple crises at hand. And the conversation I describe below occurred before the news came out that 651,00 jobs were lost in February. How would you like the first item in your job description to be "miracle worker"?

On Thursday afternoon, as the White House summit on health carereform was ending, a parade of Washington pooh-bahs moved from the Old Executive Office Building, past the outside of the West Wing, to the front entrance of the White House for a final meeting, where President Barack Obama would hold a seminar-like session. ("Senator Mitch McConnell, got any thoughts to share?") As I watched Sen. Chris Dodd, Sen. Jay Rockefeller, Rep. Henry Waxman and others strolling along, I spotted a senior administration official who handles economic issues. He, too, was heading to the East Wing, and he was holding a collection of thick briefing books.

"Having fun?" I asked.

"Any time I'm not working on AIG and Citibank, it's a good day," he said. "Health care is fun compared to that. Believe me, I'm glad to be out of the office doing this."

How encouraging, I thought.

"You know what makes everything so hard?" he asked me. Before I could answer, he stepped closer to me.

Barack Obama wins. Mitch McConnell is talking nice about the president-elect. And Henry Waxman bounces John Dingell from the chairmanship of the all-powerful House energy and commerce committee.

It's a good time to be a liberal in Washington.

Sure, Clintonites are scoring well in the Obama administration sweepstakes, and the Clinton years are remembered by liberals for the exasperating triangulations of Bill, Hill and their crew. But the combo of Obama's triumph and the far-from-over economic meltdown has provided liberals with their best opening since the days of the Great Society, or even the New Deal. Forget--for the moment, only for the moment, I promise--Hillary Clinton's possible appointment as secretary of state. There's something larger going on and it's truly a fundamental change: the market is dead. It cannot even take care of itself. So how can anyone rely on--or call for--market-driven solutions for the challenges that face the nation: the economy, the health care crisis, and global warming?

My take on the second debate, first posted at MotherJones.com....

Last Thursday, during a McCain campaign town hall meeting in Denver, one participant stood up and challenged the GOP presidential candidate: "When are you going to take the gloves off?" His fellow McCain supporters in the downtown hotel roared with approval. "How about Tuesday night?" John McCain replied, referring to his second debate with Obama.

How about not? The McCain campaign in recent days has pumped up its effort to delegitimize Barack Obama, with its top strategist apparently calculating that McCain cannot vanquish Obama if the election is about issues. At a recent rally in a California suburb, GOP vice presidential nominee Sarah Palin declared "Our opponent...is someone who sees America, it seems, as being so imperfect, imperfect enough, that he's palling around with terrorists who would target their own country." (This was a reference to Obama's past association with Bill Ayers, the former Weather Underground radical who became an education expert). And on Monday, McCain delivered a blistering attack on Obama that was loaded with inaccuracies and distortions. So one expectation among the politerati was that McCain would continue swinging--or thrashing--at the second debate. Work in Bill Ayers. Refer to Jeremiah Wright. Depict Obama as shifty and untrustworthy.

That did not happen. McCain, trailing Obama in the polls, mainly trained his fire on policy matters. He did continue to hurl misrepresentations at Obama. (As the debate proceeded, I received 40 emails from the Obama campaign making this point.) For instance, McCain once again claimed that Obama has voted 94 times to raise taxes, a charge that has been widely debunked by various factchecking outfits. But there was no frontal assault on Obama's character--and only one or two slight digs on his qualifications. The debate was more high-minded than anticipated. But it demonstrated a tough reality for McCain: he is out of sync with his own campaign. He cannot pull the trigger, when his advisers seem to believe a machine gun blast is needed.

Obama and his campaign are fully integrated. He calls for a break from the past eight years on both domestic and foreign fronts and famously urges fundamental change. As a new face--and a black man--he sure does represent change. He is his message. And his campaign for over a year and a half has not had to go through any strategic lurches or had to reconfigure either its candidate or its core pitch. That's not true on the McCain side. His campaign has been nothing but lurches. And the most recent one--a turn toward even more negative campaigning--undercuts his old and now practically worn-out reputation as a straight-talking maverick. So come Debate II, McCain was confronting a tough choice: damned if he does (go negative) and stalled if he doesn't.

Deciding to forego the nasty stuff, McCain relied on policy differences to hammer Obama. The problem: Obama's policy prescriptions are not unpopular.

When Hillary Didn't "Get the Job Done"

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Quick--name an official task that was Hillary Clinton's responsibility last time she was in the White House? The answer is obvious: health care. It was a top priority for the Bill Clinton administration in the first years of his presidency. And he handed the mission to his two-for-the-price-of-one First Lady.

What happened next? We all know: an unmitigated disaster that set the cause of health care reform back for years. Hillary Clinton and her top advisers--in proceedings marked by secrecy and we-know-best arrogance--cooked up a plan that no one could understand. They bent over backward to accommodate the corporate community and miscalculated: Big Business ended up opposing the plan. And the common folks who the plan was supposed to help couldn't comprehend it--which meant they (and their elected representatives) could not fight effectively for it.

Flash forward to 2008. Clinton is fighting for her political life in a fierce battle with Barack Obama. She's pandering on gas prices, she's suggesting that Obama is not ready to be commander in chief, she's pouncing on a remark he made to suggest he's an elitist, she's making a big deal out of his past relationship with a onetime 70s radical, she's accusing him of not being committed to withdrawing from Iraq, she's pushing reporters to dwell upon Obama's friendship with a developer indicted on corruption charges, she's pondering how to game the delegate system. And her latest ad in North Carolina, which holds an important primary on Tuesday, she repeats her claim that she is the candidate who can make change happen.

In the ad, North Carolina Governor Mike Easley, a Clinton supporter, says:

These are tough times in America and I think that Hillary is the one we can count on to get the job done. She's going to turn the economy around, she's going bring new jobs, she's going to get some tax cuts for the middle class for a change. She's going to make health care available to everybody in this country, and she's going to do everything she can to help every child reach their full potential. She is so resilient, so determined. She knows how to deliver.

To which anyone with a skeptical view (and a memory) might say, "Hillarycare." Sure, she's racked up a few accomplishments as a senator. But she failed miserably on the biggest task she has ever assumed. She didn't get that job done; she botched it. True, it was a tough assignment, and the odds were against her. But if she's making promises now, her first attempt to "make health care available to everybody in this country" is relevant. (More relevant than the issue of her laugh.) Well, maybe she can get the job done on the second time around. Older and wiser, and all that. But her early-90s failure was one reason why health care disappeared as a political issue for so long. That's a reality that present-day campaign rhetoric can be measured against.

McCain to Elizabeth Edwards: I Got Nothing For You

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On Tuesday, John McCain's silly-named "Call to Action" tour hit health-care-land, and he traveled to Tampa to tout his Bush-like health care proposal. At the center of his plan is a proposal to provide tax credits to individuals ($2500) and families ($5000) that they can use to buy insurance.

A few weeks ago, Elizabeth Edwards blasted McCain's plan for not covering preexisting conditions, including illnesses experienced by Edwards (breast cancer) and McCain himself (melanoma). McCain, in his remarks on Tuesday, tried to address Edwards' criticism:

Critics argue that when my proposed tax credit becomes available it would encourage people to purchase health insurance on the current individual market, while significant weaknesses in the market remain. They worry that Americans with preexisting conditions could still be denied insurance. Congress took the important step of providing some protection against the exclusion of preexisting conditions in the Health Insurance Portability and Accountability Act in 1996. I supported that legislation, and nothing in my reforms will change the fact that if you remain employed and insured you will build protection against the cost of treating any preexisting condition. Even so, those without prior group coverage and those with preexisting conditions do have the most difficulty on the individual market, and we need to make sure they get the high-quality coverage they need. I will work tirelessly to address the problem. But I won't create another entitlement program that Washington will let get out of control. Nor will I saddle states with another unfunded mandate.

Translation: Edwards is right, and I now have no concrete proposal for addressing her criticism. Folks with preexisting conditions are just going to have to tough it out while McCain works "tirelessly."

What I'm curious about is how far those tax credits will go in helping individuals and families obtain decent coverage. Democrats routinely slam this level of assistance as insufficient. And that's what you'd expect them to say. What about a less partisan source? In February, on The Health Care Blog, Robert Laszweski, the president of Health Policy and Strategy Associates and former top executive at Liberty Mutual Insurance Company took a look at McCain's plan, and here's what he wrote about the tax credits:

The real question is, will McCain's plan give you enough to buy health insurance? With the average cost of employer-provided family health insurance at $12,000 a year a $5,000 tax credit will often come up way short--especially for higher age people and those who don't have the benefit of an employer contribution. High deductibles and [Health Savings Account] plans will help but families who don't have employer contributions should be prepared to pay at least a few thousand extra dollars.
He calls for the states to develop a "risk adjustment" bonus for high cost and low-income families to supplement tax credits and Medicaid funds. But just who will pay for this (the states alone?) and how it would close the cost gap is not explained....How will he deal with age rating, medical underwriting, and preexisting conditions? If McCain does not develop an individual health insurance market everyone can access, no matter how old they are or how sick they are, his scheme will fall way short.

In other words, no. McCain's plan offers too little for too many. So if your budget is tight or you've already been smacked by a bad disease, McCain's Call to Action tour will pass you by.