Health Politics

During his campaign, President Obama called on our nation to work together to solve great challenges. But was the president's health reform speech in Congress this week partisan, as some critics charge? Or did he leave the door open for bipartisan compromise?

Certainly the president "called out" those who distort the truth. Who can blame him? But he was not partisan. I am more sensitive to partisanship than most. In 2006 I watched my boss, former Sen. Lincoln Chafee (R-RI), fall to his Democrat challenger. Sen. Chafee voted against the war in Iraq, against drilling in the Arctic National Wildlife Refuge, and against amendments to ban gay marriage. He did not vote for President George W. Bush in 2004. Yet, Democrats ran countless ads linking the Senator to President Bush and his policies, particularly the Iraq war. Smart campaigning or not, it was partisan politics.

In contrast, President Obama did not cast aspersions in his address. He did not portray positions inaccurately. None of that. President Obama in his speech drew only one line in the sand. It was a very big and very nonpartisan line: we are going to address our health care coverage problems and we are not going to add to the deficit to do it. He made clear he is looking to solve our nation's health care crisis with anyone -- Republican, Democrat, or Independent -- who wants to solve it with him. He was also unambiguous, however, that he will not stand silent while people perpetuate misinformation to score political points.

Bipartisanship does not require silence in the face of unfounded rhetoric. The president was right when he said Congress already agrees on about 80 percent of his plan. Exchanges, insurance market reforms, subsidies, deficit neutrality, and tackling waste, fraud, and abuse are all initiatives that enjoy broad bipartisan support. In addition, President Obama left the door open for bipartisanship on more contentious aspects of reform:

The dominant story in Friday's papers was that President Obama's speech had united Democrats and reenergized the push for health reform. But what about the rest of America?

Overnight polling of Americans over 45 from the AARP shows independents are more in favor of reform after watching the president's speech and, furthermore, that a majority of Democrats, Republicans, and Independents all agreed reform must be a priority for this year. Remember earlier polls had shown that older Americans had been more apprehensive about reform, particularly after hearing lots of distortions about how it was supposedly going to harm Medicare, 

Key findings from the poll include:

• 70 percent of respondents had questions and concerns about reform before the speech
• Of those who had questions, three-quarters said their questions and concerns were talked about or addressed during the speech.
• Of those who felt their concerns were brought up, close to seven in 10 respondents and 63 percent of Independents were supportive of the proposals discussed.
• 95 percent of Democrats, 70 percent of Independents, and even 56 percent of Republicans wanted reform to be a priority for our leaders.

As New York Times columnist Charles Blow argued the other day, while "Conservatives speak in bumper stickers," the President, on the other hand, "speaks in thesis statements."

But last night, the President forcefully and effectively took on the catch-phrases spread by health care reform combatants -- death panels, government-takeovers. He cut through the confusion that grew this past summer about the true meaning of health care reform.

President Obama encouraged Americans to listen closely to facts and pay no heed to the "partisan spectacle," "bogus claims" and "scare tactics" that interfered with an "honest debate."  And he implored Republicans to take part in that debate. "l continue to seek common ground in the weeks ahead.  If you come to me with a serious set of proposals, I will be there to listen.  My door is always open."

A recent report from the Urban Institute is a useful guide to the facts.

We've already posted some of our initial reactions to the President's speech last night. You can read the full text here of the president's remarks here, as well as the letter from Sen. Edward Kennedy.

Here are some more highlights and reactions from around the web:

• CNN snap-poll of people who tuned in for the address found that: "Two out of three Americans who watched President Barack Obama's health care reform speech Wednesday night favor his health care plans -- a 14-point gain among speech-watchers."
• Kaiser Health News interviews eight Americans who watched the speech: "Was it persuasive? How would the proposals he outlined affect you and your family?" Jeff Goodman, 52, an uninsured owner of a small business in Los Angeles said:

[My recent heart attack] was just another secret shopping mission God sent me to evaluate the health system. It's very challenging. I am more optimistic than I was an hour ago that the bill he finally signs will actually be genuine reform, that this won't be watered down. ...

If everything he said tonight comes true, my situation will be really improved. The group plan I could pay into would become much more affordable. Or I could join a co-op. And I really want to be able to offer coverage to my employees. I'm really optimistic both as a small business man, and an individual.

I shared my initial reactions to President Obama's address to Congress last night on the National Journal's Health Care Experts Blog and the The New York Times' Prescriptions blog.

From the National Journal:

President Obama made two key points tonight.  Number one, and most practically, he is still willing to compromise with those who still have an open mind, despite the way implacable ideological opponents have behaved this August (and before, and still tonight, Mr. Joe Wilson (R-SC), and no doubt tomorrow and forever).  He signalled this through his willingness to implement malpractice reform, taxes on high-end benefit packages, and linking the pace of coverage expansion with realized system savings.  The latter in particular signalled both his commitment to fiscal responsibility and his confidence that so many experts we can all name are correct, we can reduce cost growth while improving quality. 

Some excerpts from President Obama's primetime address on health care reform, via The New York Times.

...Another woman from Texas was about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne. By the time she had her insurance reinstated, her breast cancer more than doubled in size. That is heart-breaking, it is wrong, and no one should be treated that way in the United States of America.

...our health care system is placing an unsustainable burden on taxpayers. When health care costs grow at the rate they have, it puts greater pressure on programs like Medicare and Medicaid. If we do nothing to slow these skyrocketing costs, we will eventually be spending more on Medicare and Medicaid than every other government program combined. Put simply, our health care problem is our deficit problem. Nothing else even comes close.

We're not sure where Betsy McCaughey will show up after the President's speech tonight, but we'd be surprised if we didn't hear from her... The Health Care Blog had a nice piece last weekweek. Here's a taste:

Betsy McCaughey's extravagant claims of eager Democratic euthanasiasts hiding behind health care reform have been exposed,  eviscerated, and enshrined as just plain evil.  

Of  course, that's the kind of behavior you'd expect from Bad Betsy, the hyper-partisan political pit bull. But what about Good Betsy, the founder and chairman of the non-profit Committee to Reduce Infection Deaths (RID)?

As someone who's been involved in the patient safety movement since the mid-1990s, I've admired her pugnacity and plainspokenness. Unfortunately, when I decided to look a lot more closely at RID, it turned out that Good Betsy was not quite "the real McCoy" either. The assertions she makes about herself and her organization teeter at the border between exaggeration and being deliberately misleading....

(Reposting this to correct a typo -- it's age 18-64, not 19)

One political obstacle to health reform is that most Americans say they lilke their current health care (although I've never been clear whether that means they like their doctor or their insurer.) But in reality, their insurance may be a lot more precarious than they realize..

Half of all working age Americans -- a whopping 88 million people between ages 189 and 64 and their families -- have at least one risk factor that makes their health care insecure, according to a new report from the Third Way (And that's not even taking into account the rising cost of insurance).

• 46 million Americans have serious pre-existing conditions, such as diabetes or cancer, which makes it harder or more expensive to get coverage.
• 20 million skipped a doctor's visit because of the cost.
• 37 million had a gap in their insurance coverage.
• 23 million Americans had very high health care costs (spending more than $1 out of every $8 on premiums, or having high out-of-pocket expenses).

So when people say they like what they have, they need to ask themselves: will "what they have" be there when they need it? And will it be there tomorrow? With health reform, the answer will be yes. Without it -- cross your fingers.

Statement from Baucus's office:

"The time has come for action and we will act.  We must move forward if we are going to get this bill done by the end of the year. 

I just met with my Finance Democratic colleagues and laid out the path for moving forward.  I will put out a Chairman's Mark [a draft legislation] early to mid-next week and I will move the Finance Committee to mark-up health care reform the week after next.

This is our moment.  We have spent many weeks and months on this crucial issue.  Now is the time to move forward."

Speaking to a big enthusiastic crowd of workers at the AFL-CIO's Labor Day picnic in Cincinnati, President Obama looked to regain the momentum on health reform by recapturing some of the magic his campaign. (Full text here)

"In every debate there comes a time to decide, a time to act," the president said. For health care reform, "[T]hat time is now."

Responding to cries of "Yes we can" with "Yes, we will," the President prepared for what may be the biggest speech of his administration before a joint session of Congress on Wednesday.

Laying out the goals of reform, Obama sounded confident in our nation's prospects for achieving them.

"We've never been this close. We've never had such broad agreement on what needs to be done," he said, "And because we're so close to real reform, the special interests are doing what they always do -- trying to scare the American people and preserve the status quo."

He hit back against those who would derail the debate with deceits and misinformation, asking "all those folks who say we're going to pull the plug on Grandma. What's your answer? What's your solution? And you know what? They don't have one. Their answer is to do nothing."