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The Democratic Strategist

Political Strategy for a Permanent Democratic Majority

Health Care Reform Strategy Taking Shape, Part II

A few addenda to my Tuesday post on healthcare strategy: Sam Stein reports at HuffPo that advocates of a single payer system will have representation at today’s White House Summit on health care reform. Rep John Conyers “a known single-payer advocate,” along with an advocacy group, Physicians for a National Health Program will participate in the summit. The group had put out a press release earlier in the week complaining that,

“Groups representing physicians, nurses, and consumers who advocate for a single-payer system of national health insurance have thus far been excluded from the summit,” says the release. “The Clinton task force on health reform made a similar mistake of excluding the voices of those who support a single-payer system… At a time when public support for single-payer is greater than ever – more than 60 percent in recent polls – we urge President Obama not to make the same mistake.”

Obama “has generally shied-away” from outright endorsing a single-payer approach, although he has made favorable comments about the single-payer concept, according to Stein. Conyers and the progressive physicians group undoubtedly will provide a strong voice at the summit, although there will be 150 participants clamoring for attention.
In yesterday’s New York Times, Sheryl Gay Stolberg’s article “Obama Taps Clinton Ideas but Not Clinton Herself” discusses some possible ways Secretary of State Clinton’s expertise on health care reform could be tapped and notes major differences in the strategy deployed by Presidents Clinton and Obama:

To begin with, the Clinton plan was drafted in secret and delivered to lawmakers as a fait accompli; Mr. Obama is articulating broad principles and leaving the details to Congress…President Bill Clinton waited 11 months after taking office in 1993 to roll out his plan, a delay many Democrats say was deadly. Mr. Obama is forging ahead after six weeks. Mr. Clinton focused heavily on access to care; Mr. Obama is framing the debate in terms of cost. The Clinton plan left Americans worried that they would be forced to switch doctors. Mr. Obama’s message, Mr. Axelrod said, is, “If you are happy with what you have, you can keep it.”
Once the stimulus bill was enacted, Mr. Obama moved quickly to include money for health care changes in his budget, something Mr. Clinton did not do because his economic advisers wanted to focus on deficit reduction first, said Chris Jennings, who was Mr. Clinton’s senior health policy adviser. “That’s really key,” Mr. Jennings said. The delay, he said, “probably was the reason why we were unable to sustain interest and support.”
Mr. Obama, by contrast, made a conscious decision to tackle deficit reduction and health care, for which he set aside $634 billion in his budget, at once. “We’re 16 years later,” Mr. Axelrod said, “and I think the imperative is even greater because of the budget. Health care reform is a fiscal imperative now, not just a moral imperative.”

Thus far, President Obama’s initiatives have received a generally positive response from some sectors of the health care industry, as Ceci Connolly and Dan Eggen report in today’s Washington Post. Eggen and Connolly explain that Obama’s “modest approach” was favorably received by the pharmaceutical industry and “could save the drug companies billions a year compared with price controls,” and,

The lure for the industry is the prospect of tens of millions of new customers: If Obama succeeds in fulfilling his pledge to cover many more Americans, those newly insured people will get checkups, purchase medicine, undergo physical therapy and get surgeries they cannot afford today.

Progressives will be happy to note that Obama’s health plan is not all good with the drug lobby. The authors quote W.J. “Billy” Tauzin, a former congressman who now heads up the Pharmaceutical Research and Manufacturers of America (PhRMA:”There are things we don’t like about it. But there’s time to discuss all that.” The authors quote other health industry groups that have significant misgivings.
Obama’s Almost Perfect Strategy” in TNR‘s “The Treatment” blog by Jacob Hacker, co-director of the Center for Health, Economic, and Family Security offers four strategy reccomendations for the Administraton. Hacker, editor of “Health at Risk: America’s Ailing Health System–and How to Heal It,” also advises Obama reform team thusly:

It makes sense to keep the targets for political attacks hidden for as long as possible, but that does not mean that Obama and his advisers should start dropping key priorities-priorities that they have already articulated and defended-before the debate begins. For if there is a final lesson from the Clinton reform debacle, it is that the President’s power is greatest as an agenda setter rather than a legislator. Obama should make sure the agenda is set correctly.
So when the administration presses its agenda to leaders in Congress, it shouldn’t sweat the details. But it should make clear that the big three-employer contributions, an Exchange, and a public health insurance plan aren’t details. They are the essence of Obama’s vision of a transformed system.

Stolberg notes that “Experts say the political climate for passing major health care changes is more favorable than ever, with business leaders, pharmaceutical and hospital executives, insurance officials and advocates for patients all agreeing the need is urgent.” Stolberg’s point about Mrs. Clinton’s influence being felt as the battle lines are drawn is duly-noted. Long before Mrs. Clinton, however, Senator Ted Kennedy lead the charge, and the reforms that pass will bear his imprint and reflect his tireless leadership on the issue.

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