After six months in office, the Obama Administration has arrived at a defining moment: the battle over healthcare reform. The outcome will shape future White House initiatives, the 2010 mid-term elections, and the future of the Republican Party.
Since the Roosevelt presidency, Democrats have tried to reform America's Byzantine healthcare system. Healthcare costs too much, isn't available to everyone, and drags down the economy, thereby limiting US competitiveness.
While four components comprise the system -- patients, doctors, hospitals, and insurance companies -- most Americans understand the key problem is the role of insurance companies. Many observers want a single-payer plan, similar to Medicare, which would eliminate insurance companies and the for-profit nature of the system.
In 1993 then President Bill Clinton proposed a solution to the healthcare crisis. His plan was defeated because the Clinton Administration had not coordinated effectively with their Congressional allies. Sixteen years later, the Obama Administration hopes to avoid the fate of the Clinton healthcare proposal by working closely with House and Senate Democrats.
In his effort to build consensus within the Democratic Party, Obama has sketched out broad objectives for healthcare reform and relied upon Congress to fill in the details. Obama wants universal coverage. The dueling congressional plans come close to this, but fail to cover roughly three percent of Americans. Obama also wants a healthcare plan that reduces costs and the federal deficit. So far, the competing congressional plans fall short of accomplishing this objective.
Because healthcare reform is a complex and contentious issue, some members of Congress have suggested the entire process slow down. On July 23rd, Senate Majority Leader Harry Reid indicated that while committees would complete legislation, the full Senate would not vote on it before its August 7th recess. This delay will work to the Republican's advantage, give them a month to chip away at Obama's plan and popularity with a coordinated death by a thousand cuts campaign that distorts the nature of the President's healthcare program.
While Obama's plan has the support of the American Medical Association and the American Nurses Association, insurance companies are spending $1.4 million per day to defeat Obama's initiative and employ an army of former government staff workers and retired Congress members to lobby against it.
Healthcare reform opposition has two conceptual faces. One is economic. Insurance companies realize their profits will diminish if the Obama plan becomes law; the rules of monopoly capitalism will be set aside and they'll have to charge competitive fees. In Obama's words, "I don't believe government can or should run health care. But I also don't think insurance companies should have free reign to do as they please." Desperate to continue their iron grip on the system, insurance companies falsely claim the Obama plan would reduce Americans' access to healthcare.
The second face of opposition is ideological. Most Republican members of congress are deeply conservative. They recognize that passage of the Obama plan would be more than a policy setback, it would deal a mortal wound to American conservatism. Shortly after Obama's election, a leading Cato Institute Conservative writer, Michael Cannon, wrote, Blocking Obama's healthcare plan is key to the GOP's survival. His point was that Democrats could win over Republican voters by improving the social safety net. "National health care... will bring reluctant voters into the Obama coalition." Desperate to hold onto power, Republicans falsely argue that the Obama plan would insert a Federal bureaucrat between patients and their doctors, ignoring the reality that in the current system insurance companies place a bureaucrat between a client and his or her doctor.
Republicans see healthcare as the decisive battle of Obama's first term. They are throwing millions of dollars into their anti-Obama campaign and are lying about the consequences of healthcare reform. If Obama's healthcare plan becomes law, it will not only guarantee affordable healthcare to all Americans, it will fatally discredit the Republican Party and severely damage their chances in the mid-term elections.
At his July 22nd press conference, Obama linked healthcare reform to America's long-term economic recovery. He reiterated his programmatic objectives --expand coverage, improve quality, lower costs, honor patient choice and hold insurance companies accountable - and pledged his plan will not add to the federal deficit.
Congress will not vote on healthcare reform until after Labor Day. During the next six weeks expect the unholy alliance of Republicans and insurance companies to rain down withering fire on the Obama healthcare proposal. They will lie about every aspect of the plan, deny the need for change, and attack the President.
Obama must fight back, joined by everyone who supported his Presidential campaign. This is the defining moment for healthcare reform. The President has to continue to explain his plan to the American people. He must use his political capital to rein in wayward Democratic legislators. He has to pull out all the stops.
Obama became President because he trusted voters to act like adults. The campaign for healthcare reform tests this belief. Americans must see through the virulent Republican propaganda campaign and support the President's plan.