His hopes for fundamental reform to America’s troubled health-care system endangered by a revolt from within his own party, Barack Obama Wednesday night staked his presidency on an ultimatum.
Americans “are looking to us for leadership, and we must not let them down,” the President vowed in a prime-time press conference.
“We will pass reform that lowers cost, promotes choice, and provides coverage that every American can count on. And we will do it this year.”
With that stark declaration, Mr. Obama threw down a gauntlet to his Republican opponents and to nervous Democrats worried about what reform might cost.
With opposition growing and Mr. Obama’s popularity slipping, hopes that legislation could be passed before Congress rises for its August vacation at the end of next week are fading.
By nonetheless imposing an end-of-year deadline for final passage of a bill, the President is gambling all of his political capital on success. If the year passes without his signature on a bill, the political costs of such failure will be enormous.
Negotiations to craft a reform bill have been complicated by so-called Blue Dog Democrats in the House of Representatives. They are alarmed at projections from the Congressional Budget Office that the current plan would increase the deficit by $239-billion (U.S) over 10 years, the very opposite of the administration’s goal of expanding coverage while reining in spiralling expenses.
Conservative Democrats in the House energy and commerce committee are holding up passage of the bill until their cost concerns are met.
Representatives and senators, especially those in the Senate finance committee, are negotiating non-stop in an effort to craft legislation that extends benefits without increasing costs.
Dick Durbin, Senate Majority Whip, predicted Wednesday that the Senate would fail to pass legislation before the August break. “We’re going to take a little longer to get it right,” he told The Hill newspaper.
By nonetheless imposing an end-of-year deadline, Mr. Obama is warning Congress that it can talk, but it must also ultimately act.
“If you don’t set deadlines in this town, things don’t happen,” he told reporters. “The default position is inertia, because doing something always creates some people who are unhappy.” But he maintained, “The stars are aligned and we need to take advantage of that.”
At the heart of Mr. Obama’s proposal is a public health-insurance program that would compete with private insurers and that would, in theory, drive down costs over time.
The Republican opposition in Congress has warned that people would be forced out of their existing plans and into some statist monstrosity (the word “Canadian” is often invoked) in which faceless bureaucrats decide what treatments patients would receive.
“If they try to fix our health-care system like they’ve tried to rescue our economy, I think we’re in really, really big trouble,” House Minority Leader John Boehner told reporters Wednesday.
The GOP attacks are working. The President’s approval rating has dropped to 55 per cent, according to a new Associated Press-GfK poll, down from 64 per cent in late May and early June.
Although half of those polled approve of Mr. Obama’s handling of health care, 43 per cent disapprove, a number that has risen sharply since April.
In response, the president reminded his critics of the 47 million Americans who have no coverage at all, of the millions more whose coverage is inadequate.
“This is about every family, every business and every taxpayer who continues to shoulder the burden of a problem that Washington has failed to solve for decades,” he said.
Beyond the question of the legislation itself is the question of Mr. Obama’s political skills. By imposing a no-excuses deadline, the President has gambled that he can manage congressional opposition from Republicans and from members within his own party.
If he fails, and health-care legislation does go down in defeat, the President’s agenda on the environment, immigration and education will lie in shambles.
Earlier this week and again Wednesday night, Mr. Obama quoted Republican Senator Jim DeMint, who said, “If we’re able to stop Obama on this, it will be his Waterloo. It will break him.”
But though some conservative commentators are predicting that Congress will never pass a bill Mr. Obama can sign – William Kristol of the Weekly Standard urged Republicans this week to “go for the kill,” as Mr. Obama noted – it would be risky to bet that Mr. Obama will fail.
Those conservative Democratic representatives holding up the legislation will have to compromise at some point. Otherwise, they will have to explain to voters in their district during midterm elections next year why they torpedoed the most important priority of their own party leader and of most Americans as well.
The White House, similarly, will be prepared to make trades to ensure that legislation of some kind or other sees the light of day.
One significant breakthrough came Wednesday, when the Blue Dogs and House energy-and-commerce-committee chairman Henry Waxman agreed that an independent panel should be given the power to set fees and make cuts.
Also in Mr. Obama’s corner are industry associations, such as the American Medical Association and the American Nurses Association, who have opposed previous reforms. Business groups are also onside, as corporations struggle to meet the ever-escalating costs of insuring workers.
And reasonable legislators of both parties know that government simply must reform a health-care system that costs almost twice as much as that provided by other industrial countries, and that is expected to soon envelop one-fifth of the American economy.
Mr. Obama took pains to remind viewers of those truths Wednesday night.
“If we do not control these costs, we will not be able to control our deficit,” he maintained. “If we do not reform health care, your premiums and out-of-pocket costs will continue to skyrocket. If we do not act, 14,000 Americans will continue to lose their health insurance every single day.
“These are the consequences of inaction. These are the stakes of the debate we’re having right now.”
His success or failure as a president is at stake as well
Tags: Obama
