President Barack Obama’s stated goal is to pass comprehensive health care reform by the end of this year. With a Democratic Congress and muted opposition (relative to those that opposed President Bill Clinton’s similar effort) President Obama has a good chance of succeeding. It won’t be easy, especially given the cost and the state of the economy, but the stars seem to be aligning.
Consider: Health care costs are a huge burden on America’s struggling manufacturing base. Health care reform would ease this burden. The public supports substantive change. Previous opponents to reform (doctors, hospitals, drug companies, insurance plans and the like) have lined up to promise to reduce health care costs by $2 trillion dollars by 2019. Voluntarily. Harry and Louise would be so proud. And President Obama has perhaps the most potent grass roots political organization ever assembled.
Hold that last thought.
One of the most controversial elements of the President’s health care reform package is the creation of a government-run health plan to compete with private carriers in the traditional market place. I’ve written on the controversy several times, so to oversimplify: liberals tend to think a public plan is essential to assure fair competition in the marketplace. Conservatives see it as the first step toward a single payer system. Many moderates, including centrist Democrats who appear to hold the balance of power on health care reform plan, seem skeptical about the idea.
Then candidate Obama campaigned strongly on the need for a public health plan. While he’s always expressed a willingness to compromise on the issue, in the past it has usually been about how a public plan would operate, not whether there would be one.
Hold this thought, too.
Now, let’s bring those two held thoughts together. Ben Smith over at Politico.com is reporting on an email sent out by President Obama’s grass roots organization, Organizing for America, on the issue. The letter urges supporters of the President to pledge to support three broad principles for health care reform. These principles are:
- reduce costs;
- guarantee choice; and
- ensure all Americans have quality affordable health care.
That’s it (the full email is printed on Mr. Smith’s blog). No mention of a public health plan. Zip. None.
Organizing for America’s call to action is focused on the right principles, too. Some of commented that the Administration’s emphasis seems to be more focused on health insurance reforms than on containing medical costs. I confess, I write more about the former than the latter, but that’s in part due to the nature of this blog and it’s because market reforms have been more controversial — so far. The reality is that President Obama has consistently worked to emphasize the need to rein in the escalating cost of health care in this country. In many ways he’s been successful in gaining consensus on those aspects of his plan.
Which means the question becomes whether he’ll fight to keep a government-run health plan in the mix even if it means jeopardizing the progress he’s made along other fronts. I don’t want to read too much into one email. But the fact that Organizing for America’s call to arms doesn’t mention public health plans may, just maybe, mean the Administration is willing to deal on the issue — or may be recognizing that the votes for a public plan just aren’t there. It’s too early to tell.
But look at it the other way: if the email had included the creation of a public health plan as a core principle, it would be very hard for the Administration to later back down on the issue. By side-stepping the opportunity to make such a plan a core principle of reform, at the very least President Obama is leaving the door open on whether a public plan needs to be part of the final package.
That’s the kind of flexibility he’ll need to pass comprehensive health care reform. And it’s why I personally believe meaningful reform is indeed likely to pass this year.