Did Obama Mess Up Health Care Politics?

Marc Ambinder: President's Strategy to Get Health Care Reform Passed May Cost Him

(CBS)  The "On The Marc" column is written by The Atlantic's Marc Ambinder, CBS News' chief political consultant.

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Did President Obama get the politics of health care all wrong? It's not an academic question.

Though the White House has been reluctant to offer too much guidance to Congress about what they should include in a health care bill, they've been clear from day one on strategy: 1) Don't put obstacles between Congress and the White House. 2) Lay out broad principles that everyone can agree on. 3) And try to do everything at once.

At the start of the Congressional recess, hindsight finds flaws with each of these tactics. Turns out that Congress produced too many bills too quickly, making it hard to produce one bill by the start of the recess.

Turns out that some specific guidance from the White House may have helped push things along in the Senate, in particular.

And it turns out that if the White House had split the various pieces of its reform into digestible chunks, it might already have a real victory to sell to voters.

I think the last criticism has the most merit. It's the one decision of the three that had foreseeable consequences, and it's the decision where those consequences weren't affected by outside factors, like the economic collapse.

Related: 10 Health Care Reform Myths
As Mr. Obama points out, the House and the Senate have agreed on the backbone of major reforms to the health insurance system. The industry, having been effectively courted by the White House, conceded to these reforms. The White House's above-the-fray sales pitch kept them on board. A bill could be passed today that includes a variety of new restrictions on insurance companies that will gainfully improve the system.

Instead -- and predictably -- Congress is haggling over the hardest part of health care to do quickly, which is how to fund an expansion of coverage for those who don't have it.

Blue Dog Democrats might not have revolted had the president assigned this task to a partially-binding Congressional commission at the beginning of the administration.

The "good" stuff in the health care bill is now indelibly linked to the "bad" stuff -- the inevitable rise in short-term costs and the ballooning deficit.

Had the White House split up the pie, one can reasonably assume that Mr. Obama might not have had to spend August traveling across the country, using his still considerable but continuously dwindling store of political capital to shore up what should have been an easy bulkhead: the health care status quo is NOT acceptable, and reform will improve the lives of everyone.

Mr. Obama is less popular than he was when this debate began. His attempt to link health reform to the economic recovery failed, and voters are anxious about endorsing a huge bill at a time when the government can't yet seem to fix the economy.

Mr. Obama's August strategy is probably the correct one, from the White House's perspective, and given the political landscape he faces.

Absent a direct case from the country's most popular politician -- a political who Americans like more than they favor and whose approach to government has won him sympathy from independents and moderates -- anxiety, magnified by conservative interest groups, will predominate at the town hall meetings that are used by members of Congress as a proxy for public opinion.

The White House remains confident that Mr. Obama can rally the Democratic base and snap Americans out of their funk by aggressively selling the quality component to his plan and by demonizing the insurance industry and Republicans as the status who.

Behind the scenes, his advisers will work with members of Congress to mitigate differences between the various stakeholders. And in some ways, they are tantalizingly close to a compromise: a majority on the House Energy and Commerce Committee have passed a modified "public plan" that reimburses doctors at Medicare rates plus five percent, doesn't require participation, and puts off the reimbursement mechanism for hospitals until later.

From a 30,000 foot perspective, if the White House can contain the panic that members will inevitably feel (and maybe a visit from the president to select cities can help) then its August recess will have been productive. Or at least, as productive as it could have been, given the choices made earlier in the year.

[coastx]

Obama is about to try and bag the freedom trophy by being the first US president to initiate legislation that will circumvent the constitution and set up the IRS to moderate health care reform so that PNAC can proceed unimpeded with it's overthrow mission.

[DavidFromWI]

The Dem's should worry less about the GOP and worry more about independent voters. Voters that do NOT vote along party lines.

As far as the angry mobs at the town halls go, Seniors make up a good portion of those 'mobs'. Seniors VOTE and VOTE CONSISTENTLY more than any other demographic. Seniors are also very internet and politically savvy. They have lived long lives and have been screwed by more than a few administrations. They have long memories and do not take kindly to being called names. If they are among the 'mobsters' than the leftists in congress and the Obama administration should LISTEN to that mob.

When you have the white house, the senate, and the houe the coninued harassment and name calling gives and appearance of bullying and kicking a dong when its down. The Leftists in DC are confusing winning an election with thinking they have carte blanc to do and say anything they fell like. Their continued elitist behavior and delusional apperance of superiority and snobbery is leaving a bad taste with many INDEPENDENT voters.

Americans also have long memories and most voters memories extend farther back than eight years. Keep up the cute snarky name calling and the leftists will have to learn the hard way that when they ARE in power it gives an entirely different impression than during the last eight years when they were not in power.

And yet, their game plan seems to be threaten and ridicule. Oh sure, that will work. Here is a little fact politicians forget'it is far eaiser to gain supporters the first time than LOOSE THEM than to get them back as supporters a second time'. Keep up the attacks on the GOP and 'right wing extremists'. That sure seems to be working so far. (the GOP are in a debacle of THEIR making not of the lefts attack machine)

CIA, law enforcemnt, middle and rual America, Republicans that DID vote for Obama, fellow Dems' that disagree and are attacked, angry seniors the leftists are making 'friends' fast.

[DavidFromWI]

As far as angry mobs of seniors (plenty of them at town hall meetings)

Don't believe everything you read on line or see on TV. There are plenty of independents that are angry too.

Seniors have been screwed by govt for a long time and many more election cycles than just the last few. They are also very internet and politically savvy.

They have long memories and do not take to being called a mob very well. They also do not care what know it all knee jerk defenders of ANY administration think.

If they are an angry mob then the administration and congress should listen because seniors have long memories and they have shown they do VOTE. THEY VOTE CONSISTENTLY more than other demographics.

Not an angry mob I would like to be on the other side of come election time.

[masonburdette]

I applaud President Obama for standing by his pledge to reform healthcare; for decades every politician running for national office has pounded the pulpit saying "We need to reform healthcare", but they never carry through. This nation is too wealthy to allow even one citizen to not have access to healthcare. I personaly have excellent coverage but it is disheartening to know the poor faces many health risks do to be left out in the cold. President Obama please keep pressing this issue all the way through!

[masonburdette]

Corrected:
I applaud President Obama for standing by his pledge to reform healthcare; for decades every politician running for national office has pounded the pulpit saying "We need to reform healthcare", but they never carry through. This nation is too wealthy to allow even one citizen to not have access to healthcare. I personaly have excellent coverage but it is disheartening to know the poor faces many health risks due to being left out in the cold. President Obama please keep pressing this issue all the way through!

[masonburdette]

I applaud President Obama for standing by his pledge to reform healthcare; for decades every politician running for national office has pounded the pulpit saying "We need to reform healthcare", but they never carry through. This nation is too wealthy to allow even one citizen to not have access to healthcare. I personaly have excellent coverage but it is disheartening to know the poor faces many health risks do to be left out in the cold. President Obama please keep pressing this issue all the way through!

[jbchitown]

Yes. When are people going to wake up. Congress and the dems are pushing their agenda on the rest of the US. While there are things that we need to do in ensure health care it does not require an overhaul. Why not fix Medicare? Why not fix Medicaid? Have you interviewed a Veteran lately about the care provided at VAs. The post office is $9b in the hole, not one state Medicaid program is in the black and Medicare is 7-8 times more costly than the government anticipated when this was enacted. By the way Medicare is not a health plan they simply pay claims someone needs to get this right!

If our fearless leaders can not properly managed Cash for Clunkers what do you think will happen to our health care system. In one week the blew through a billion dollars and they were not even smart enough to resrict our money to American car makers. The result 4 out of 5 are foreign cars, sure they have plants in the US but none of these companies were asking for a bail out so not only do we throw more money at the problem we send it out os the country. Sounds like shipping jobs overseas. Where is this outrage? Not likely because the demo's thought is was a good idea. How can anyone not see this!

I hope and pray that town hall meeting get even bigger and louder at least we are creating some noise. By the way, Nancy Pelosi was the first person to use the word Nazi when describing the attendees at the town all meetings not Rush, get your fact straight and present the truth. Not one station mentioned Nancy Pelosi. Go figure.

[aknideas]

Mr. Obama has not been very Presidential- with his comments or his ideas-

[cinci_citizen]

A CIGNA Executive gives an insider?s view on health care. This video is riveting and a MUST SEE! Please give it a minute or two of your time.

http://www.pbs.org/moyers/journal/07312009/watch.html

[jsd330]

cinci_citizen

If you are reffering to Wendal Potter, I would beleive him about as far as I could throw him. I would like to ask him how much from each insurance company he worked for is his Golden Parachute worth. I think he is looking to be Obama's insurance commisioner or czar. He sucked up all those big bonus's for years and it never bothered him then. So all of a sudden it bothers him now. Or maybe those insurance companies put a big hole in his golden parachute.

[gladyrmt]

Maybe......just maybe we have finally gotten someone in the White HOuse who cares enough about the poor and the middle class in this country to risk not getting re-elected if it will help the multitudes who have lost jobs because of our wonderful capitalistic previous administration who pushed....yes pushed, to send jobs out of the country. We are reaping the BENEFITS of that now.

This country is geared to look out for the rich. That was done the last eight years. It is now time to make life easier for the middle class. They have shouldered the burden long enough.

[RCC_Soldaten]

http://www.foxnews.com/politics/2009/08/06/fear-loathing-democrats-liken-health-reform-protesters-nazis/

[Stevenapoli7]

Recommendations to lower health costs. By the way, health care costs are only a bit more (i.e. 1%) than what we spend yearly on clothing and acessories.
1. Malpractice/ torte reform
2. Joint commission reform (i.e. control this beast)
3. Simplify reduce regulating insurers from state to state for consistency.
25% of the 46 million uninsured are not u.s. citizens. 6 of the 8 million uninsured kids are eligible for insurance, but parents did not sign them up. Is this even a crisis?

[JJJJackson]

Obama is trying to force feed people something that they do not want - he said he will pass this no mater what the cost! Noone trust our goverment - they would mess up a steel ball! They cannot even manage a cash for de clunkers - they refuse to go on this messed up gov Health plan for themselves - this is all for only a few million people and everyone's taxes will increase for less care and actually deficient care - we don't want your stinkin Obama not Care Program!

[jab232]

No, Obama did not mess up health care politics. There are billions of dollars involved here. UnitedHealth made over three quarters of a billion last quarter alone, and they are just one corporation. Cigna's CEO gets over twelve million a year and will receive seventy-three million in a golden parachute. Where does that money come from? Health care premiums, mostly from people who have been cherry-picked with the truly sick left out.

When you have a lot of money at stake, you have a nasty fight. And it is getting nastier. From what I read, the GOP and corporation-backed mobs are becoming violent now. Obama's approach is exactly right--keep on slogging through no matter what they throw at you. The uninsured and those of us who know we will lose health care insurance when we get an expensive illness deserve it.

[mooksie1]

I am really tired of the leftist media calling those who protest against the Obama proposed government take-over of healthcare, "a mob". They are concerned citizens who are voicing their opinions and protesting agains Obamacare. Furthermore, the White House is asking people to snitch or spy on citizens who dare opppose Obamacare. After they have collected the names of these so called snitchers, what will they do? Send them to Guantanamo? Call them domestic terrorists? I guess a citizen cannot oppose Obama or he will have hell to pay. Are we living in the former Soviet Union or in Nazi Germany now, where citizens are continually spied upon?

[earlysaid]

Bipartisanship is not going to happen when republicans have no shame and their base has no sense. I am disgusted with all the second guessing about Health Care Reform when the issue is still in the works. President Obama is doing a terrific job in spite of the rabid hate coming from republicans around the country. Republicans are acting like thugs, racists and seriously misinformed stupid people. Everything President Obama is working toward will help Americans. Everything republicans are doing is shockingly horrible and hateful. If anyone is doing everything wrong concerning Health Care Reform it is the Republican Party as a whole.

[drsuz]

Just WHAT are the Republicans doing now that has you so upset? Now that they are learning from their mistakes under the Bush Administration, and trying to get a grip on stopping wasteful government spending they are thugs, racists and seriously misinformed stupid people.

News Flash..The Democrats ARE the ones who are acting like spoiled rotten children who did not get their way and are constantly spending/giving away billions of dollars that WE DONOT HAVE to spend. Seems the Democrats DID learn one thing under the Bush Administration. HOW TO SPEND MONEY!!! You would have thought they would have put a end to WASTEFUL SPENDING..They are like little kids given free reign in a Candy Factory. I expected more CONTROL from them...silly me..

[robinspp]

Whatever Obama does, he does it for the future. Another excellent program is health care reform. The health insurance companies will not be able to cheat the people in future once it is implemented. The senate members and the congress will not get money from the private run health insurance companies. The CEO?s of the private run companies cannot swindle people?s money. The insurance premium will go down. The insurance companies cannot deprive needed treatment.

[drsuz]

I am totally happy with my heath care program. I pay around $4000/year with $1000 deductible for a family plan. In my $4000, it also covers optical and dental. (Does Obama's plan cover those?) When I see my doc, I only pay a $25 copay and before he does any tests, I always have his office check to see if it is covered by my insurance company and so far, I have not had to pay a penny extra out of pocket. I get certain xrays/exams free once a year.(Called prevenative medical checkups) I only have to pay $7 for my medication if prescribed. I get a free yearly eye exam and free glasses every two years or contacts once a year. I get free dental xrays and have to pay 50% for dentures/partials/crowns which I can go to a secondary and get for next to nothing. (I have dentures so no biggie there.) So now tell me, WHY should I give up all this and WHERE is my insurance company cheating me? If my premiums go up, it will be because of Obama's Health Care Plan.

[jsd330]

drsuz
You have a very good plan. And there are plenty of health insurance plans out there that are affordable. Who knows what the government plan is going to cover and how much it will the total cost be. What people aren't looking at is the cost of the premium and the additional taxes. You might end up paying more then you would for a private plan with the same coverage.

[drsuz]

by jsd330 August 6, 2009 11:09 PM EDT
drsuz
You have a very good plan. And there are plenty of health insurance plans out there that are affordable. Who knows what the government plan is going to cover and how much it will the total cost be. What people aren't looking at is the cost of the premium and the additional taxes. You might end up paying more then you would for a private plan with the same coverage.

Lets put it this way, I better not otherwise I will be visitng the ACLU. For if my insurance company has to compete with the Obama Plan which causes changes in my heath plan or how what type of treatment I can or cannot recieve, that according to the Constitution is interferring with my right of liberty. Read up on it.. If they want to raise taxes, go ahead. I don't work, my husband does and he has a good claim for disability but he rather WORK, support his family and live with the pain than be a government freeloader. But if push comes to shove, he said he would go the easy route just like all the other freeloaders.

[drsuz]

Yes we do need Health Care reform in this country, BUT NOT what this Administration is trying to push down our throats.

We NEED them to regulate the health insurance industry which would make health care AFFORDABLE to everyone including those with pre-existing conditions.

We NEED them to regulate the Pharmaceutical industry which would make medicine we need AFFORDABLE to everyone.

We NEED them to offer financial assistance incentives to our future physicians to enter into General Practice/Family Medicine instead of specialized fields. There is a shortage of Family Practioners in this country.

We NEED them to get control of Medicare/Medicaid to prove to us they can actually manage something.

If they want to make sure that those 'poor' people have health insurance, well design a program to cover THEM until they are gainfully employed and can pay their own way.

Do they tell you that alot of those without health insurance and who DO work ARE offered health insurance but refuse it because they donot want to pay the premiums? Nope.

Do they tell you that States offer medical assistance to people and that they include those in their so-called 'Millions of Americans' are without insurance? Nope.

Have they explain to you why only medical not dental or optical (which also contributes to illnesses) will be in this plan? Nope.

Have they explained to you just WHERE the money is going to come from to finance this program? Nope. (They still donot know)

Can ANYONE explain to me LOGICALLY why it is OKAY for Obama and the DNC to throw a hissy fit when people rise up and protest against this and start labeling people against it with names like Astroturfs, Tea Baggers, Commies, Nazi's? (Shows alot of class doesn't it)

Obama and the DNC are acting no better than Bush and the GOP when Bush ran for the Presidency and Gore was whooping the pants off of him and Bush ran around crying that certain Govenors PROMISED him he would take their States and they better make sure he does.

Obama stated he wanted 'Change' in this Administration and so far all I have seen is the same ole thing as the Bush Administration...Spend..Spend..Spend..and spend some more.

[robinspp]

Keeping the money in the safe will not do any good for the people. When the government spend, people get money by getting job.

[drsuz]

Okay, the Government is spending..Where's the jobs? Last I heard, unemployment is UP again..

[democracy1]

by drsuz August 6, 2009 10:01 PM EDT
Okay, the Government is spending..Where's the jobs? Last I heard, unemployment is UP again..

Any economist will tell you that employment ALWAYS lags behind other indicators in a recovery. Just sayin'.

[mattbfast22]

Come on is it really that bad now? It will be another govt program that gets abused by most. Chicago is a great city, but when it comes to politics it is the shadiest city ever. I was once confident and now beginning to see a resemblance. To much fat Joe. Just have an option for everyone else in one big pool they can choose to join or not to join. At the end of the day if someone is hurt and needs treatment they get it. It either gets better for a few for worse for everyone...

[reveal5]

After seeing the video of right wing protestors at Healthcare Reform meetings...After seeing these videos...When I look at this blog, I'll see some retired geezer, probably female, trying to get the last vitriolic words into their paragraph before they need to make their hourly bathroom run. Seems like it would be kinda' tough to get all revolutionary when y'all can't get more than about 30 minutes away from the nearest pooper. Revolution, sure...Y'all revolutionaries would just need an extra duffel bag though...You know, for Maalox and Depends.

[schotzy81]

jon wrote: "What we should consider doing instead is start thinking about confiscating some of their assets and using those to finance the costs of reform. "

Spoken like a true socialist! And you wonder why so many Americans are turning against the plan? Please, keep up that Chavez-like ranting!