Where Hillary Clinton failed, the team of President Barack Obama and HHS Secretary Tom Daschle is determined to succeed—and the political momentum is all on their side.
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WHILE CONSERVATIVES HAD MANY allies in the private sector during the last health-care fight, this time around they may find themselves more alone than Gary Cooper in High Noon. Many businesses struggling with high health care costs are happy to have the government step in, while doctors and insurers have their own issues with the current system and have put out reform proposals.
The American Medical Association, for instance, was once a leading opponent of efforts to expand the federal government’s role in the health care system. Ronald Reagan famously recorded an LP on the group’s behalf in 1961 titled “Ronald Reagan Speaks Out Against Socialized Medicine” to protest the creation of Medicare. But the AMA is now promoting its own universal health care plan, and expects to work closely with the Obama administration to help reform the system. (Daschle reached out to the group shortly after the election.)
“The status quo is not good,” said Nancy Nielsen, president of the AMA. “It’s not good for patients and doctors are not happy. Doctors are discouraged, they’re dispirited, sometimes they’re angry, and it just isn’t working well for anybody.”
Specifically, Nielsen explained that doctors are irritated by the difficulty of getting reimbursements and frustrated by the “hoops they have to jump through to get the care they think their patients deserve.”
She said that all the parties involved share the goals of making sure that everybody has health insurance and that medical care is affordable, but the debate will be over how to get there. The AMA does not favor a government-run health care system, she repeatedly said, and the group’s own plan—which would move away from employer-based health care and toward individual tax credits—actually has a lot more in common with the one offered by John McCain during the campaign than it does with Obama’s. At the same time, the nation’s largest physicians’ group sees health care reform as inevitable, and it wants to be part of the process, because doctors will have to work within whatever system gets created.
“The important thing for us is that we are part of the solution,” she said. “If we are on the outside looking in and just complaining without being part of the solution, that’s not a good place for physicians to be.”
The last time around, the insurance industry played a crucial role in derailing Clinton’s health-care proposal, and its efforts are epitomized by the “Harry and Louise” television ads featuring a typical American couple living in a health care dystopia ushered in by the legislation, struggling to make sense of the changes. But America’s Health Insurance Plans, the largest insurance industry trade organization, has recently stated that it would be willing to offer coverage to those with pre-existing conditions as long as there was a mandate requiring all Americans to purchase health insurance, thus ensuring that healthy people get brought into the risk pool.
“Our industry is taking a drastically different approach than it did 15 years ago,” said AHIP spokesman Robert Zirkelbach. “[We] play an integral part of the health care delivery system and we felt we had a responsibility this time around to put forth solutions and contribute to the health care discussion.”
Expressing a sense of urgency that echoed Obama’s, Zirkelbach said, “We cannot afford to not take action. We have got to address the health care concerns that are facing the nation.”
WHILE DASCHLE AND OBAMA may consider health care an emergency, the reality is that any plan to overhaul the nation’s health care system will take some time to put together.
In a December conference call sponsored by the liberal group Institute for America’s Future, Rep. Pete Stark (D-CA), who serves as chairman of the health subcommittee of the House Ways and Means Committee, said that Democrats were unlikely to vote on a comprehensive health care reform proposal until early in 2010. Stark said that there was still a lot of “deferred maintenance” on the current health care system that would have to be completed prior to a total overhaul, including expanding SCHIP, dealing with Medicare compensation for doctors, and promoting health information technology.
Rep. John Shadegg (R-AZ), one of the few well-versed Republicans on Capitol Hill when it comes to health care, expressed optimism about the position of conservatives going into what he acknowledges will be a difficult fight.
“I see this shaping up as a tremendous opportunity for Republicans to make clear their vision of the future versus the Democrats’ vision of the future and to do it on very favorable turf,” Shadegg said. He insisted that Republicans can win the fight by articulating that they are in favor of giving choice to consumers and patients, by, among other things, extending the tax-preferred treatment enjoyed by employers to all Americans so that they can pick the plans that they want.
The government-run aspects of the Democrats’ plans will be exposed once it is opened up to more scrutiny, according to Shadegg. “I don’t think that Americans are going to base their views of the health care proposals in Congress in the next two years on the debate that went on during the last election,” he said.
Specifically, Shadegg said that it would become pretty obvious to most Americans that the health care exchange that is a feature of standard Democratic proposals does not represent genuine choice.