At Summit, President Obama Says He’s Open To Compromise On His Health Care Proposal, New York Times Reports

Medical News Today, March 9, 2009

President Obama on Thursday during a White House health care summit “indicated for the first time that he was open to compromise on details of the proposal he put forth in the 2008 campaign,” the New York Times reports (Pear/Stolberg, New York Times, 3/6). Obama at the summit reiterated his goal “to enact comprehensive legislation this year, an ambitious undertaking many say is further complicated by the nation’s dismal economy,” according to the Washington Post (Connolly, Washington Post, 3/6). Obama also expressed “a pledge to include Republicans and consider opposing views,” according to USA Today (Wolf, USA Today, 3/6).Obama said, “During the campaign I put forward a plan for health care reform. I thought it was an excellent plan. But I don’t presume that it was a perfect plan or that it was the best possible plan” (New York Times, 3/6). He said, “I just want to figure out what works,” adding, “We don’t have a monopoly on good ideas” (Washington Post, 3/6). “Every voice has to be heard. Every idea must be considered,” Obama said (Sidoti, AP/Philadelphia Inquirer, 3/6).Obama said, “When times were good, we didn’t get it done. When we had mild recessions, we didn’t get it done,” adding, “There’s always a reason not to do it. Now is exactly the time for us to deal with this problem” (Washington Post, 3/6). He said, “The status quo is the one option that is not on the table,” and “those who seek to block any reform at any cost will not prevail this time around” (Marks, Christian Science Monitor, 3/6).Obama also cited the need to address health care costs in conjunction with efforts to expand health insurance to more residents (Washington Post, 3/6). He said, “If we don’t address cost, I don’t care how heartfelt our efforts are, we will not get this done,” adding, “If people think we can simply take everybody who is not insured and load them up in a system where costs are out of control, … we will run out of money” (Condon, CongressDaily, 3/6).

Summit Details

About 82 health care policy stakeholders, 32 House members, 23 senators and eight “everyday Americans” attended the summit, CongressDaily reports (Condon, CongressDaily, 3/5). According to CQ HealthBeat, the summit “was an attempt by President Obama to get the health overhaul debate off to a markedly different start than the one that many analysts say marred the attempt by President Clinton to enact universal coverage” (Reichard, CQ HealthBeat, 3/5).

The summit included five “breakout” sessions that addressed “sticky issues,” such as proposals to finance health care reform, plans to reduce health care costs, whether to establish an individual health insurance mandate and whether to develop a public health plan that would compete with private plans, USA Today reports (USA Today, 3/6). The sessions sought to “show a variety of lessons learned in the 16 years since the Clinton effort,” according to the Wall Street Journal (Meckler, Wall Street Journal, 3/6). Secretary of State Hillary Rodham Clinton did not attend the summit, but “she was very much a presence” at the event, which involved a “gathering of allies and foes of Clinton’s failed effort 15 years ago,” The Politico reports (Budoff Brown [1], The Politico, 3/5).

“Though there was ample talk of bipartisanship and plenty of praise for the president’s initiative in bringing everyone involved in health care together to discuss the problem, this issue of government-run care was one of the major fault lines exposed during the day’s events,” the Washington Times reports (Lengell/Ward, Washington Times, 3/6). Some Democratic lawmakers, such as Senate Finance Committee Chair Max Baucus (D-Mont.) and House Ways and Means Committee Chair Charles Rangel (D-N.Y.), also raised concerns about a proposal by Obama to limit itemized tax deductions for higher-income residents to help finance the health care reserve fund (New York Times, 3/6).

Obama also “gently sparred” with Senate Finance Committee ranking member Chuck Grassley (R-Iowa) about his “campaign proposal to offer a government-sponsored insurance option to people who do not have coverage,” the Post reports. Grassley said that the “public option” would make the federal government “an unfair competitor” to private insurers. “The thinking on the public option has been that it gives consumers more choices and helps keep the private sector honest,” Obama said (Washington Post, 3/6).

Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.) also “made a dramatic appearance” at the end of the summit, Roll Call reports (Koffler [1], Roll Call, 3/5). According to the Washington Post, Kennedy attended “to make the case that it is possible to expand health coverage in America while bringing soaring medical bills under control” (Washington Post, 3/6). Kennedy said that past health care reform efforts “haven’t been the kind of serious effort that I think we’re seeing right now.” He added, “This time we will not fail” (New York Times, 3/6). The summit concluded with tributes to Kennedy (New York Times, 3/6). Kennedy and Baucus will lead health care reform efforts in Congress (USA Today, 3/6).

Comments

During the summit, America’s Health Insurance Plans President and CEO Karen Ignagni told Obama, “You have our commitment to play, to contribute and to help pass health care reform this year” (Washington Post, 3/6).

American Medical Association President Nancy Nielsen called the summit a “very auspicious beginning.”

Families USA Executive Director Ron Pollack said of the summit, “It creates an aura of inevitability” for health care reform (USA Today, 3/6).

In addition, Federation of American Hospitals President Chip Kahn said that Obama has “successfully launched the process we need to achieve health reform, which we all want, and brought together congressional Democrats and Republicans with stakeholders to begin to forge a consensus” (Washington Post, 3/6).

Roger Hickey, co-director of the Campaign for America’s Future, praised Obama for his proposal to establish a “public health insurance option,” which he called “key to expanding coverage, controlling costs and improving quality in health care” (Washington Times, 3/6).

U.S. Chamber of Commerce President Thomas Donohue said, “We know where everyone stood. But they don’t stand there anymore,” adding, “We’re going to get some kind of an agreement here, whether it’s two-thirds of what everybody wants or three-quarters of what everybody wants or who knows. If you don’t get in this game … you’re not on the menu” (Washington Post, 3/6).

Congressional Efforts

Before the summit, Baucus on Thursday met with members of the Senate Finance Committee to discuss the process for the development of health care reform legislation. He said that in late April the committee will host a series of public “roundtables” and private “walk-throughs” on the legislation (Wayne/Armstrong, CQ Today, 3/5). The committee will divide the legislation into three areas — improvement of health care delivery, expansion of health insurance and reduction of health care costs. Baucus hopes to work with Kennedy on the legislation and plans to meet with him on Friday. According to CongressDaily, “Baucus and the administration are likely to clash in some areas,” such as the proposal to finance health care reform (Edney, CongressDaily, 3/5). Baucus said that he hopes to begin to mark up the legislation in June to allow a Senate floor vote in July (Drucker, Roll Call, 3/5). In the House, Waxman said that he hopes for a floor vote on health care reform legislation before the August recess (Budoff Brown [2], The Politico, 3/5).

Meanwhile, a group of fiscally conservative House members on Thursday introduced a bill (HR 1321) that seeks to provide all residents with “quality, private health insurance,” Roll Call reports. The legislation — sponsored by Reps. Mike Castle (R-Del.), Jim Cooper (D-Tenn.), Jo Ann Emerson (R-Mo.), Anna Eshoo (D-Calif.), Jane Harman (D-Calif.) and Debbie Wasserman Schultz (D-Fla.) — includes portable health insurance; a focus on prevention and wellness; and provisions designed to require health insurers to compete on cost, benefits and quality. The bill is budget-neutral, according to the Congressional Budget Office. In a statement, Cooper said, “The Healthy Americans Act is bipartisan, it saves us money and it lets every American choose a plan with the same level of benefits I get as a member of Congress. Americans can’t wait for us to study the issue any longer. We should build off of this consensus bill and pass health reform now” (Bendery, Roll Call, 3/5).

Also on Thursday, House Majority Leader Steny Hoyer (D-Md.) said that House Democrats might use the budget reconciliation process to move health care and other proposals by Obama to prevent a filibuster in the Senate, CQ Today reports (Clarke, CQ Today, 3/5).

Editorials

• Financial Times: Obama “intends health care reform to be the signature innovation of his time in office” and “[i]f he succeeds, it will do for his place in history what the creation of Social Security did for FDR,” according to a Financial Times editorial. The editorial continues that the “worst single blow” to the Obama administration was the “failure to secure the appointment of Tom Daschle to head” HHS and as the “chief White House adviser on health care reform,” as Daschle “was uniquely qualified to lead the health reform effort because he combined many years of experience in the Senate with a detailed understanding of the issue.” The editorial continues that Kansas Gov. Kathleen Sebelius (D), whom the administration has named as its HHS secretary nominee, “lacks [Daschle’s] particular strengths.” According to the Financial Times, “the fact that [Sebelius] will not serve as Mr. Obama’s leading adviser on health care reform will subtract from her influence” (Financial Times, 3/4).
• The Hill: Obama’s “goal of health care reform is no certainty, but it probably has a much better shot than Bush’s stab at Social Security,” according to an editorial in The Hill. The editorial continues, “For starters, there is a widespread belief that the health care system is sick. Various remedies are proposed, but no policymaker is making the case that the status quo is fine and dandy.” In addition, “Whatever reforms Democrats pursue, major consumer and business associations may come together to back them,” according to The Hill. The editorial continues, “It won’t be easy, of course,” but “Democrats are experienced in fighting Republican health care bills and crafting their own,” adding, “They know what works and what doesn’t” (The Hill, 3/5).

Opinion Pieces

• David Brooks, New York Times: Members of the Obama administration believe that “Republicans should welcome the … health care ideas” in the president’s budget proposal, New York Times columnist Brooks writes. The piece continues that, according to the White House, the budget includes “Medicare reform” that “represents a big cut in entitlement spending,” as well as “means-testing” and “more competition and cuts [to] corporate welfare,” which are “all Republican ideas.” In addition, Obama has said that, in the long term, health care reform will be deficit neutral, which many experts say will force Democrats to reduce the tax exemption for employee health coverage to raise revenue, an idea that is “at the core of most conservative reform proposals,” according to Brooks. He continues, “I’m still convinced the administration is trying to do too much too fast and that the hasty planning and execution of these complex policies will lead to untold problems down the road,” but “I’m more optimistic” that if Senate moderates “can get their act together and come up with their own proactive plan,” they can “help shape a budget that allays their anxieties while meeting the president’s goals” (Brooks, New York Times, 3/6).
• Morton Kondracke, Roll Call: Obama has “laid out a breathtakingly bold agenda” that may be “more than he, Congress and the American political system can possibly accomplish — especially so fast,” Roll Call Executive Editor Kondracke writes in his “Pennsylvania Avenue” column. Kondracke adds, “Universal health care and indexed Pell Grants for college promise new entitlement obligations before existing ones are brought under control.” According to Kondracke, “More bailouts, a big budget, new tax cuts and tax breaks, health care down payments and energy changes will jam Congress at the same time, with each a possible bargaining hostage for another” (Kondracke, Roll Call, 3/5).
• Brad Bannon, U.S. News & World Report: “Now that the Obama planning process” for health care reform “is beginning, it’s a good time to examine what went wrong with” former President Bill Clinton’s attempt at a health care system overhaul, Democratic pollster Bannon writes in a U.S. News & World Report opinion piece. He adds, “Hopefully, Barack Obama’s plan will avoid the secrecy, bureaucracy and obstinacy of the Clinton effort.” According to Bannon, “Obama has already avoided the secrecy problem” encountered by Clinton “with his promise to hold a number of ‘conversations’ on the issue and also with his summit.” In addition, “Supporters of health care reform trust Barack Obama will design a plan that is simpler and easier to explain than the Clinton Rube Goldberg contraption.” Bannon adds, “We shall also see whether President Obama is more flexible than President Clinton.” While the “Clinton approach to reform” included a “stubborn streak,” the “Obama approach” has been “a lot more subtle.” Bannon writes that, “while we have been talking about what kind of health care reform President Obama will introduce, he has been producing health care reform,” including “resuscitat[ing]” CHIP and adding billions of dollars to increase health care spending in the economic stimulus package (Bannon, U.S. News & World Report, 3/5).
• Sally Pipes, Wall Street Journal: “The Democrats’ case to expand government health care is so full of holes that passing it quickly is their only hope” because if “Americans slow down and ask questions, they will be hard-put to come up with answers,” a Journal opinion piece by Pacific Research Institute President and CEO Pipes states. Pipes writes that many of the “slogans [Democrats] use to justify government intervention are false,” including: that providing coverage for employers hinders the competitiveness of U.S. firms; that the uninsured shift costs to the insured when they “avail themselves of the health care safety net”; and that preventive care, disease management and electronic medical records hold the potential for large-scale savings (Pipes, Wall Street Journal, 3/6).
• Charles Krauthammer, Washington Post: Few presidents “undertake the kind of brazen deception at the heart of Obama’s radically transformative economic plan, a rhetorical sleight of hand so smoothly offered that few noticed,” syndicated columnist Krauthammer writes in the Post. He writes that Obama was “intellectually dishonest to the core” in saying that a “‘day of reckoning’ has arrived” and that he “has come to redeem us with his far-seeing program of universal, nationalized health care,” among other proposals. According to Krauthammer, there are numerous causes for the economic recession, but they do “not include the absence of universal health care, let alone computerized medical records.” Krauthammer writes, “The fraudulent claim that” health care, energy and education “are both cause and cure is the rhetorical device by which an ambitious president intends to enact the most radical agenda of social transformation seen in our lifetime” (Krauthammer, Washington Post, 3/6).

Broadcast Coverage

• ABC’s “World News Tonight” on Thursday included a segment that addressed the proposal by Obama to limit itemized tax deductions for higher-income residents to help finance the health care reserve fund (Gibson [1], “World News Tonight,” ABC, 3/5). In addition, ABC’s “World News Tonight” on Thursday included comments from ABC News Medical Editor Tim Johnson about the tone of the health care summit (Gibson [2], “World News Tonight,” ABC, 3/5).
• American Public Media’s “Marketplace” on Thursday reported on proposals by Obama to reduce health care costs. The segment includes comments from John Shields, a health policy analyst at the Lewin Group, and Joseph Antos, a health policy expert at the American Enterprise Institute (Henn, “Marketplace,” American Public Media, 3/5).
• CBS’ “Evening News” on Thursday examined the cost of a proposal by Obama to expand health insurance to most residents (Reid, “Evening News,” CBS, 3/5).
• CNN’s “Anderson Cooper 360” on Thursday reported on the summit (Cooper, “Anderson Cooper 360,” CNN, 3/5). A transcript of the segment is available online. CNN’s “Lou Dobbs Tonight” on Thursday also reported on the summit (Dobbs, “Lou Dobbs Tonight,” CNN, 3/5). A transcript of the segment is available online. In addition, CNN’s “The Situation Room” on Thursday reported on the summit (Lothian, “The Situation Room,” CNN, 3/5). A transcript of the segment is available online.
• MSNBC’s “1600 Pennsylvania Avenue” on Thursday reported on the summit (“1600 Pennsylvania Avenue,” MSNBC, 3/5). In addition, MSNBC’s “Hardball with Chris Matthews” on Thursday included a panel discussion about whether Obama can reduce health care costs (Matthews, “Hardball with Chris Matthews,” CNN, 3/5).
• NBC’s “Nightly News” on Thursday reported on the summit (Todd, “Nightly News,” NBC, 3/5).
• NPR’s “All Things Considered” on Thursday reported on the summit (Liasson, “All Things Considered,” NPR, 3/5). NPR’s “Day to Day” on Thursday also reported on the summit (Horsley, “Day to Day,” NPR, 3/5).
• PBS’ “NewsHour with Jim Lehrer” on Thursday reported on the summit. The segment includes comments from Pollack; Nielsen; and Helen Darling, president of the National Business Group on Health (Brown, “NewsHour with Jim Lehrer,” PBS, 3/5).
• WAMU’s “The Diane Rehm Show” on Friday reported on the summit. The segment includes comments from Susan Page, Washington, D.C., bureau chief for USA Today; Jake Tapper, ABC News senior White House correspondent; and Jackie Calmes, national correspondent for the New York Times (Rehm, “The Diane Rehm Show,” WAMU, 3/5).

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