Just Words?

The New Republic: What The Dem Platform Really Says About Health Care (And What That Says About Obama)

(The New Republic)  This column was written by Michael Sean Winters.

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The typical voter may not pay much attention to partly platforms these days, but activists certainly do. And at the Democratic Party platform hearings held in Pittsburgh just over a week ago, advocates for health care reform made their presence felt, proposing--and obtaining--revisions to the platform proposed by Obama and the party. The final platform proposal, which the full party will consider in Denver next week, now states that "every American man, woman, and child [should] be guaranteed affordable, comprehensive health care. ... with everyone in and no one left out." The word "guarantee" didn't appear in the previous draft; that was the activists' doing. The phrase "everyone in and no one left out" is also significant: It's a slogan liberal health care activists frequently use, and they're hoping that its adoption signals that Obama is serious about reform.

But while supporters of these positions were pleased with their victories, they weren't entirely satisfied. And it wasn't simply because the platform fell short of endorsing government-run, single-payer health insurance, which is the option activists strongly favor. The other source of concern was an uncertainty about Obama himself. Health care was never as central to his campaign as it was to Hillary Clinton's or John Edwards's. And since the primaries ended, the issue has virtually disappeared from his advertisements and broad messaging. "I'm not sure that Obama will actually pursue the same kind of idea that we had inserted in the platform," Donna Smith, spokesperson for Progressive Democrats of America, told columnist Marie Cocco.

It's a legitimate concern. High gas prices may have displaced health care in the public's mind, but the crisis remains as serious as it was six months ago. Last week, actuaries released predictions that health care costs would rise by 10 percent next year. That will mean more people struggling to pay for health care and more people giving up insurance altogether. Add to this the fact that even the most level-headed analysts now concede that addressing health care is essential to the country's long-term fiscal and economic health, and the case for health care reform remains as strong as ever.

Does Obama grasp this? There are good reasons to think he does--starting with the fact that the platform language was strong even before the activists introduced their amendments. The original platform, whose principal author was veteran Obama advisor Karen Kornbluh, specified that everybody should have health coverage on a par with what members of Congress have. That's no small matter, since members of Congress get relatively generous coverage. It's the right thing to do: without a promise of sufficient benefits, universal coverage is meaningless. But following through on this promise would require passing a bigger, more expensive reform. If Obama wanted to downplay his commitment to health care, he wouldn't have made this vow so explicit.

The same goes for another potentially controversial element of his health care proposal: Making sure everybody has the option of enrolling in a public insurance plan that looks something like Medicare. A viable public plan would help keep private insurance plans honest, by setting a benchmark for affordability, benefits levels, and responsiveness. And if a public plan proved to be more efficient than private alternatives, it might eventually lure most Americans as enrollees, effectively becoming a single-payer plan by acclamation. That's why liberals love the idea--and conservatives hate it. If Obama were going to back away from some of his primary-race promises on health care, that's another place where he might do so. But the public plan, like the promise of generous benefit levels, was always in the platform--again, even before the amendments in Pittsburgh.

Most striking of all, perhaps, is the sheer amount of attention--and apparent priority--health care gets in the platform. Health care is the first policy issue the document takes up in depth. No other platform in recent memory dealt with health care so prominently--or in such detail. Even in 1992, the last year in which a Democratic nominee seriously proposed universal coverage, the platform relegated health care to lesser status: It appeared ninth in a long list of measures to improve economic security. Priorities like deficit reduction, public investment, and agriculture all came before it.

Skeptics will note, correctly, that the whole point of party platforms, for Democrats and Republicans, is to appease the activist base. By themselves, they mean nothing. But conversations with people in and around the campaign suggest that the platform language is more than just rhetorical pandering. Several sources have told me that Obama has explicitly instructed staff to keep plugging away at health care reform, even though other issues may be dominating the polls right now, because, as one senior campaign aide put it, "it will be a top priority for him as president" and "we'll need to build support for it among the public in order to get it done if we win." Campaign insiders also insist that the promises of relatively generous benefits and a public plan option are meaningful. Heather Higginbottom, the campaign's policy director, has told me that Obama considers the public plan "an elemental pillar" of his proposal--one he is prepared to defend this fall even if, as expected, Republicans attack it (falsely) as a "government takeover" of medicine.

Of course, what Obama tells his staff (and what his staff tells reporters) is less important than what Obama tells the public. If he's serious about building support for health care reform, he has to give it a higher profile than he has already. But the political logic for emphasizing health care is almost as clear as the policy logic: As my colleague Nate Silver has pointed out, it would allow Obama to broaden the conversation about economic security, so that it includes an issue on which John McCain's philosophy and proposals are highly unpopular. And while I'm not sure David Axelrod and the rest of Obama's strategic advisors think this way, the platform is one sign that Obama does.

[kdelphi]

"Affordable" is code for "not everyone".EVERY CIVILIZED COUNTRY IN THE WORLD DOES IT--so dont tel me we CANT. You dont WANT to and you are selfish. Plus, Michelle made $950,000 from Univ of Chicago Hos Assn. for years, and Obama tooks GOBS of cash from Rx Cos., HMOs, and insurance--they are the enemy! We CANNOT afford natl insurance ALONG WITH insurance co CEOs GIANT salaries.As for tax cuts--we need to pay down our debt! How''d that $300 work out for you? Still got it? What will you do with the $1000? Pull yourself out of poverty? The prograMS WE need, need revenue! $250,000 a yr. is NOT a viable level for "wealth"! I believe to participate in the system anymore (as well as to advocate for it) is killing people as simply as the war and Blackwater---but there''s even MORE profit for the rich. You have to be really naive and yes, insane, to buy the DNC''s BS this time around. After 8 yrs of W--this shouldve been a landslide with progressive policies all around....instead, welcome to Third World status, unless youre rich. Like Obama and McCain and Pelosi. Death- mongers all.

[rytom64]

How insane do you have to be to vote along "party" lines ?

[broadwayphi]

The McCain camp is lying. Not exaggerating. Lying.

Example: a McCain TV ad claims that Obama would "raise taxes on middle class." In fact, Obama''''s plan would cut taxes for middle-income taxpayers and would increase rates only on families with incomes above $250,000 or with individual incomes above $200,000.

Is that you?

It isn''t me.

OBAMA 08

[Netterz]

I dont see why anyone would be shocked over Obama not speaking about the things that launched him to canidacy in the beginning. They all lie, and there is very little diffence in this campaign, than previous elections. The only thing these people want to become big political faces, is to insure themselves of a never ending HUGE retirment check, never ending 100% covered health insurance, and the other perks that come with it, like secret service, housing, a long list of staff to care for them, etc. They have known for years that they have been successfully running America into financial and global embarrassment for atleast 50 yrs now. Most people forget or look over that we have been living under a Democratically controlled Senate, Congress, and most state Governors for quite a few yrs now. They have done nothing good for the country, with President Pelosi behind the wheel, blaming anyone she can throw under the bus. Obama is no diff than any other, tho he has done his best to snow the public, with his elequent speeches.

[pdchapin]

"A viable public plan would help keep private insurance plans honest, by setting a benchmark for affordability, benefits levels, and responsiveness."

What government program do you know that''s a "benchmark for affordability .. and responsiveness?" Universal health care is great, but I''d rather work on making private insurance affordable and the companies competitive with each other that try building a new bureaucracy.

[siobama]

ENOUGH OF REPUBLICAN CORRUPTION !

VOTE DEMOCRATS !

[samthetvcat]

---"Add to this the fact that even the most level-headed analysts now concede that addressing health care is essential to the country''s long-term fiscal and economic health, and the case for health care reform remains as strong as ever. Does Obama grasp this?"---

I think in Barack-think so long as he''s doing more than the Republicans would ever do, he''s in better shape than them for the next election. And that there''s nothing to gain politically by sticking his neck out more than that. Meaning that peoples'' physical health is irrelevant to his career, and that the causal link between fiscal/economic health is to nebulous for him to get credit come election time (?)

Like, aren''t most people basically in agreement over Barack''s thought process by now - that it''s like that?

[wogerwabbit]

Last week, actuaries released predictions that health care costs would rise by 10 percent next year.


Gee, that''s all... what a break! My premiums have risen 20% per year for the past 3 years. Good news for a change. Not!

[solsenz]

People didn''t like McCain when he ran last time. Why now that he''s older and more mixed is he even being considered. He never talks about us, just other countries. Do you not notice?