Obama Mounts "Aggressive" Health Care Push

Washington Post: As Skepticism Rises, White House Launches New Strategy to Increase Pressure on Congress

(Washington Post)  This story was written by Michael D. Shear and Shailagh Murray

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Six months into his presidency, Barack Obama may have no greater test of his ability to translate personal popularity into a successful legislative agenda than the upcoming two weeks.

With skepticism about the president's health-care reform effort mounting on Capitol Hill -- even within his own party -- the White House has launched a new phase of its strategy designed to dramatically increase public pressure on Congress: all Obama, all the time.

Senior White House aides promise "an aggressive public and private schedule" for Obama as he presses his case for reform, including a prime-time news conference on Wednesday, a trip to Cleveland, and heavy use of Internet video to broadcast his message beyond the reach of the traditional media.

"Our strategy has been to allow this process to advance to the point where it made sense for the president to take the baton. Now's that time," said senior adviser David Axelrod. "I don't know whether he will Twitter or tweet. But he's going to be very, very visible."

Another senior White House aide added: "It's time to raise the stakes on this."

But even as Obama returns to full-time campaign mode, he is facing increasing calls to show that his presidency can manage the tough, nitty-gritty of lawmaking by cutting deals with his allies to keep his health-care legislation moving in the House and Senate committees.

Conservative Democrats in the House are promising to vote against reform as it now stands, and are preparing two dozen amendments, including measures aimed at lowering the effort's long-term cost. In the Senate, members from both parties are urging the president to break his campaign promise to preserve the tax-free status of health benefits. And a chorus of weary voices from Capitol Hill is urging him to abandon his demand for passage of bills in the House and Senate by Aug. 7.

"I don't think we should be bound by a timetable that isn't realistic," Sen. Olympia J. Snowe (R-Maine), a key swing-vote on health care, told Obama last week as she reminded him that President Lyndon B. Johnson took 1 1/2 years to pass Medicare.

Obama has not officially budged on the timetable, although he and aides notably have not mentioned the August deadline in recent remarks. But he is quietly working with conservative, Blue Dog Democrats in the House on an amendment to create an independent panel to govern Medicare reimbursement rates that could help reverse crippling health-care inflation.

Most difficult for Obama is the pressure to accept a tax on health benefits as a way of financing the massive insurance reform he wants.

Speaking on "Fox News Sunday," White House budget director Peter Orszag would not rule out support for the benefits tax, but he continued to promote Obama's preference for limiting deductions for wealthy taxpayers.

Some Democrats close to the negotiations say they think it is only a matter of time before Obama backs off. One proposal that has emerged would tax insurance companies, as opposed to beneficiaries, and is considered a potential compromise approach that he may be able to embrace.

Aides said Obama and his team plan a rapid response to new developments, as they did Thursday with a quickly arranged conference call to rebut assertions by the Congressional Budget Office that health-care costs would go up, not down, if the Democratic bills pass.

The effort began Friday with impromptu remarks by Obama from the Diplomatic Room, even as groups allied with the White House launched political ad campaigns this weekend aimed at wavering lawmakers. On Monday, his advisers say, he will do a round of interviews to drive the narrative for the week. Private meetings with lawmakers will become more frequent and urgent.

The decision to vault Obama to the front carries huge risks.

The decades-long drive to reform the health-care system now rests largely on Obama's ability to quell revolts among Democratic allies, many of whom have spent the past several weeks picking at pieces of his proposals.

If conservative House Democrats succeed in sowing fear of rising deficits, it will be seen as Obama's fault that he could not rein them in. If Democrats in the Senate do not agree on financing, Obama must explain the failure despite his party's majorities in both chambers.

The health-care debate was at the center of private discussions at the annual summer meeting of the National Governors Association over the weekend. The health-care legislation under consideration in Congress envisions a significant expansion in eligibility for Medicaid, whose costs are shared by Washington and the states. Their budgets squeezed by the recession, governors fear a costly mandate to cover the newly eligible. The governors devoted most of a private lunch to the issue Saturday and earlier voiced objections to Senate Finance Committee Chairman Max Baucus (D-Mont.) over funding plans.

Obama's top strategists, including Axelrod and Chief of Staff Rahm Emanuel, have repeatedly defended the administration's ambitious agenda by saying that success breeds success -- each legislative victory makes the next one easier to accomplish, they insist. The flip side, then, is that a health-care failure could doom the rest of Obama's agenda.

Obama's advisers express confidence that the setbacks of the past week can be overcome, and they insist they have spent "no time" discussing the impact on his political fortunes if health-care reform does not pass this year.

"We don't do doom-and-gloom," Axelrod.

But the president's top advisers also recognize that the sense of optimism about health-care reform that existed in Washington several months ago has largely evaporated.

Cable news programs repeatedly declare the president's health care program is "teetering" or "embattled," despite a week in which Obama's proposals were endorsed by the doctor and nurses associations and committees in both legislative chambers passed major bills.

"We're swimming upstream against a culture of failure on health care in Washington," said one adviser, who spoke on the condition of anonymity to discuss the administration's strategy.

The White House decided early in the year on a hands-off approach to health-care legislating.

"Had we put a plan out, the entire debate would have been changes to the plan," said Emanuel, a veteran of the failed Clinton health battle. "It would have been how the president is failing or succeeding."

But even as he shifts into a more active role, Obama must be mindful of his legislative allies. Rather than strong-arming these old bulls, the White House must tiptoe around them.

Baucus was a veteran lawmaker in 1994 when the Clinton plan ran aground. House Energy and Commerce Chairman Henry A. Waxman (D-Calif.) is a leading health-care expert. Senate health committee Chairman Edward M. Kennedy (D-Mass.), who is battling brain cancer, voted to create Medicare in 1965.
For health-care reform to succeed, Obama will have to carefully navigate between paying the appropriate respect to those men while exerting the leadership that many are demanding.

"It's getting hotter, and there are bumps, but we are closer to health-care reform than ever before," Emanuel said.


Staff writer Alec MacGillis contributed to this report

[Yfkilleen]

Health Care Reform- just FYI
Just to make you aware of why I believe that the Health Care System needs to be reformed and why there is plenty $ been wasted. I am a healthy female so far. I used to be in the US Army. I used to be 20 lbs lighter and toned and I used to have better ?bad cholesterol?. Now I am out of the Army. I have a great Insurance plan that I am very happy with, as happy as I was with TRICARE.
I go to see my Doctor 4 X a yr because my ?bad cholesterol? has been inching up. I see my Doctor; he orders labs 4x yr to check my cholesterol and a full chemistry panel, sometimes he does my urinalysis to make sure that I am not breaking down. It costs my Insurance about $1000.00 total for the visit + labs. He also not too long ago sent me to a Specialist which I requested to check my heart because I am always tired. While at the Cardiologist, he ordered about $2000.00 worth of tests excluding his bill. My insurance this year has paid about $3500.00 for me. The verdict, I need to exercise more, that is why I?m tired and that is why my cholesterol is going up.
I knew that much and when I called my insurance earlier I asked for them to get me in a gym. They said no, that is not an option. I am used to working out with other people. I am not getting on my treadmill because it?s boring. I asked for them to hook me up with a couple of people with similar issues. It costs $30.00/month to get me in a gym. It will cost my insurance company $100.00/month to get me and my three friends who have the same insurance in the gym to lose the extra weight we gained when we got out of the Army. That is $1200/year for 3 people plus maybe a $600.00 for yearly labs.
My math tells me that if my friends are getting the same care as I do? My insurance company could save about $6000.00/yr for the three of us. Now, I live in a military town and there are a lot of ex-military here. We all are getting fatter for obvious reasons. If BCBS had a gym in my town, they would be saving tons. I don?t know why the Insurance Companies are not bankrupt yet; maybe my employer pays them well for my health care. By the way, my employer is the US Government.

[noloyalisti]

It is time to ignore any concerns of the Republicans. They had their chance and proved yet again they stand for big corporations interests. These greedy, uncaring corporations are standing between the American people and quality health care.

[noloyalisti]

It's time to stand up to these greedy, uncaring big corporations who are standing between you and your doctor. And time to stop the middle class and poor paying for the rich to have good health care while we don't. America, the land of corruption and corporate welfare.

[noloyalisti]

It's about time a Democratic grew a pair. I think he should completely ignore the Republicans, they have proven again and again they don't car about the American people.

He should call out all the DINOs too and then expose them as Republicans before they leave for vacation. Then they can face the majority of people who want and need significant health care reform (including public option).

[sjc_1]

They need to define the proposed plan to the public. The tax payers do not one "put over" on them. They need to see the details and decide for themselves. As long as you keep it vague and cryptic, the fear mongers will have a field day distorting and scaring everyone.

[Dest_0]

I guess if everything will be performed correctly some critical changes in the healthcare are waiting for us. Good changes, I guess.

<a href="http://www.city-of-hotels.com/">City of Hotels</a>

[jschmidt27]

Flexible spending accounts which can shield money for health expenses from taxes would be gone. Is that a tax increase for everyone who takes part in those?If the public option is included, will the public plan be subject to insurance rules in each state or exempt from such oversight? If they are then that is an expense that every insurance company has and the public plan would save that money. The plan is to lower payments to hospitals. Has anyone heard of a profitable hospital and would more go out of business resulting in rationed care? The same would hold true for doctors?

[wdh3007]

This fraud of a president is doing everything he can to control Americans by destroying this country that his father was not a true citizen of. In essence he stands for everything that is against what America truly stands for so therefore cannot possibly represent our interests, views, and beliefs that truly that make this country great. Terrorists and Dictators across the globe may hate America but Obama can do more damage from within over time.

[bondsman_dotmac]

We have reached a point that we can no longer afford all the spending that is being done and to yet be done, Enough all ready.

[jab232]

I found the Washing Post-CBS poll numbers interesting. According to the Post's analysis, among those opposed to the way Obama is handling health care, there is a substantial number who think he is not going far enough.

The GOP will use the numbers to say that people hate the health care plan because they think it is socialist. Michael Steele even used that word.

In fact, a portion of the opposition comes from those who don't like what is being done precisely because it is not socialist. It is not a single payer plan. It offers people choice.

Many of these people may finally support a more moderate plan. They will almost certainly vote against those who vote to trash health care reform.

[olyboy]

The president is trying to end private health insurance in this country. For those of you who believe him when he says you can keep your current coverage, wake up! The bill would require private insurance to accept people with existing conditions; that is, people with conditions that cost far more than they pay in premiums. That means that congress and the president want us regular folks to pay for the healthcare costs of people who didn't buy insurance and now find themselves in need of it. The pre-existing conditions requirement will make the cost of your current coverage unaffordable forcing you to accept the rationed care provided by the government. Look to Canada and the UK -- their citizens come here for healthcare they can't get at home. Where will we go when Obama says we are too old and worthless to have a knee replaced or get cancer treatment???

[cs4466]

Where will we go when Obama says we are too old and worthless to have a knee replaced or get cancer treatment???
by olyboy July 20, 2009 6:41 PM EDT

Oh, hey, I can tell you where to go right now. I can even tell you what to do when you get there.

Poor bitter neocons, LOL.

[hankiii]

Why do you ask for opinions on your evening news, and ask for response to surveys and not make it convenient for anyone to respond. I suspect because you are only interested in in responses that agreee with your liberal attitude. I watch the CBS evening news because I am interested in the liberal opinion, (I can't respond unless I understand your side)but it disappoints me that you are really not interested in hearing from the average US citizen that really cares about this country and where it's headed. When are you going to hire some journalists to air the news? I'm tired of watching someone hired for their good looks and the ability to read from a monitor in front of them.

[cs4466]

The thing that irks me is ... well wait.

The Witch of Wasilla quits and shows her true colors to the voters in Alaska.
Republican senators and governors and other government officials simply tripping over themselves in a competition to see who will be the next to publically humiliate themselves and their party in a sordid affair with their mistress, their mister or their pet goat.
President Barak Obama
Secretary of State Hillary Clinton
Solid Democratic majorities and complete ownership of both the Senate and the House.

Nope. Nevermind, it's all good. ;)

[lovegetpeace]

Hey Mortarman29,

Who paid for your mother in law had knee replacement? Medicare or some Private Insurance? Medicare is a Right for all Americans and Private Insurance is for the Privileged very few.

[beaumuff]

Nobody has problems with vets getting what they need. The problem is paying for a bunch of Oprah lover do nothings.

[nextgenman09]

I have a problem with it. freeloading Vets. And some of them watch Oprah. They were PAID to do their job - just like me.

[nextgenman09]

The thing that irks me is the VA Socialist Health Care System. Paying my tax dollars to provide free lifetime care for Vets. Talk about socialist.

[Mortarman29]

Not socialist. They earned it.

If I pay the healthcare for vets, that is for a job they did.

If I pay the healthcare for some person in society who has not rendered one service for me to earn that...THAT is socialism!

[nextgenman09]

Nope. Socialist. They got PAID all the time they were in. They were compensated. I work for the DoD, I serve, should I get free healthcare for the rest of my life? You just approve of socialist medicine as long as it fits your politics.

[jschmidt27]

Obama always says that the rich should pay their fair share. Well what is that? The majority of the rich exceptions are those who inherit, have worked long hours and took advantage of any risk they could manage to build companies, employee a lot of workers, and pay a lot intaxes due to their elevated income. SO what is fair. Do they use more fuel that is not taxed, or buy more possessions that are not taxed. Or use more air than anyone else? No. So what is fair? maybe they already give alot to charity. So who decides what it is fair? Looks like it is those that are in power who decide. And if the nightmare of 57% tax rate on top income earners as in NY becomes the norm if this bill goes through, then you are going to have a lot of people not employing other, not giving to charity, maybe cutting spending resulting in less taxes, or maybe even relocating to states that have less taxes to counteract the increase in Federal taxes. I'm not one of them but if you like punishing businesses that employ a lot of people than you will suffer the consequences. So why just call it a redistribution of wealth like Obama wanted to do in the first place and be honest about it. When you have more than 50% of the voters either on the payroll of govt or receiving checks from govt, it becomes pretty hard to roll back that bloated govt because they'll always vote in those that keep the money rolling. The rich are great targets until there are none.

[beaumuff]

Good post. I am not rich by no means but why try to be? Obama has us covered with all of his community organizer experiance. Like you said, he has one real big problem, what happens when they leave or become broke? Does Obama think Sam the town drunk will take up the slack or just wait for more?

[Mortarman29]

Okay Reveal, here are some more...staright from the Canadian Institute for Health Information, on 2008 wait times.

_____________

2008 Reporteed wait times (by provinces) for joint replacement

N.L. - 182 days
N.S. - 540 days (89%)
Quebec - 6 months
Ontario - 210 days
Sask - 4-12 months


You want more?

[lovegetpeace]

In America, there is no wait time because if we do not have insurance or are underinsured, then just go to the Emergency Room for treatment. One reason record number of hospitals have filed for Chapter 11.

In other words, 48 Millions without Insurance plus 68 millions uninsured never get to the waiting line since there is no waiting line because they refused treatment for you.

[Mortarman29]

68 million? Wow, the numbers keep changing!

[lovegetpeace]

This is what American's get for $3.6 Trillions a year from our current No-Wait Private Health Care system:

America ranks #42 worst in Infant Mortality Rate in the modern world:
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html

America ranks #47 in Life Expectancy Rate in the modern world:
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html

America got the #1 Highest Healthcare Cost (over twice (2X) 2nd place Sweden) in the modern world:
http://dll.umaine.ed/ble/U.S.%20HCweb.pdf

Americans have the only Private Health Care system in the world. When you are ill or injured and especially in an emergency, nobody shops around for the clinic or hospital with the best value care. The fact is that there cannot be Competition when it comes to an emergency.

Half of all personal bankruptcies filed in the U.S. every day are because of medical issues.

As long as you have mega pharmaceutical and hospital profits that are based on prolonged treatment rather than quick cures, the incentive is not to cure things such as cancer and AIDS. There's far more money in slowly killing a person for a number of years while bleeding them, their families and their insurance dry, as opposed to curing them with a quick, one-time treatment.

In American, if you do not die from your illness, then you will die from the by-product (side-effects) of the prescriptions.

All Foreign Capitalists have a Huge Competition Advantage against all American's Capitalists because they never pay Private Health Insurance.

What good is it to have the most advanced/high-tech Health Care in the world if nobody can afford it?

[Mortarman29]

By the way, my mother in law had knee replacement and she has insurance. She had her replacement surgery 30 days after seeing the doctor.

[Mortarman29]

CT and MRI Scan Wait Times Reported by Provinces*

Ontario - 126 days
Sask - 133 to 182 days (urgent 21 days)

[Mortarman29]

My son, who is a baseball pitcher, got an MRI of his hurt elbow in 10 days! And that wasnt even urgent (except we wanted to get him back on the mound!).

[quidam56]

As a former health care giver, I am shocked and saddened to see what has become of health care in America. $ 1. 4 million is being spent per day in DC by the health care lobbyists so your elected representative is getting taken care of and has quality health care we pay for and can't afford ourselves for our families, I know what is deemed, defended and supported in Tennessee and Virginia as quality health care and clearly profit care comes ahead of patient care. http://www.wisecountyissues.com/?p=62 MRSA ( methicillin resistant staphylococcus aureas ) is infesting our communities because filthy, uncaring hospitals and emergency rooms are breeding them and spreading them into our schools, homes, restaurants. How many more Americans' will be diseased or die while 74 % of Americans' are begging for health care reform ? More people died in America last year from MRSA complications than AIDS. When MRSA and a flu bug start mixing, it won't be pretty and we are being infected by the very health care system we depend on and trust to keep us safe and healthy. If we had "the best health care" in the world then why does RAM ( Remote Area Medical ) come to Wise County, Virginia year after year so people can go to the fairgrounds and stand in a line like cattle in the hot July sun just to see a health care provider ??? America's health care system is a disgraceful sham !

[Mortarman29]

I am concerned. But, they shouldnt get government run healthcare. The Federal government is prohibited by the Constitution from even getting ivloved in healthcare. Also, those 50 million can do a lot better than the government can give.

Fixing healthcare does not mean making people wards of the state.

[lovegetpeace]

Hey Mortarman29,

Sorry, you are absolutely correct...there is real actual competition in our current Private Health Care system.

The Health Care industry competes to see who removes the most benefits and high risk customers from their policies.