Political Physics: Dying for Reform While Democrats Kick their Own Ass


a blogumn by Monique King-Viehland

Way back when, you know in January, I posed a question in Political Physics: The Unexpected Democratic Snag, “Is the Democratic Party the Biggest Threat to a Successful Obama Presidency?”  At the time I was discussing Obama’s economic stimulus proposal, but as I sit on the sidelines and watch the health care discussion I think the question remains relevant.

Health Care ReformDuring his presidential campaign, Obama made health-care reform a central theme and according to CNN Politics.Com, “promised not only to achieve universal health care in his first term, but also to cut the average family’s health care health-care costs by $2,500.” In his speech last Tuesday, Obama said, “an estimated 45.7 million Americans are uninsured, and for those with coverage, health care costs have been rising four times faster than wages.” According to a 2009 Institute on Medicine Report, the average cost of family health-care coverage more than doubled from 1999 to 2008, from $1,543 annually to $3,354 annually.

But even with rising costs, do Americans really want universal health care?

A recent poll by CNN found that 72% of respondents favor increasing the federal government’s influence over the country’s health care system in an attempt to lower costs and provide health care coverage for more Americans. In addition, 6 in 10 believe that the government should provide health insurance or take responsibility for providing health care for all Americans. Moreover, in an extensive ABC News/Washington Post poll, Americans by a 2 to 1 margin, 62 to 32%, prefer a universal health insurance program over the current employer-based system.

The Business Roundtable issued a recent report entitled “the Health Care Value Comparability Study.” The author of the report noted, “In many important respects, the American health care system is among the best in the world. When it comes to scientific advances, medical technology and the quality of our best doctors and medical institutions, the United States is without peer. But this country’s health care system, in its average performance, is becoming increasingly expensive and burdensome to businesses and families – costs that, without some restructuring of the system, will put the benefits of this amazing medical expertise beyond the reach of an increasing number of Americans.”

Clearly the majority of Americans want health care reform that includes greater accessibility and reduced cost. So President Obama has proposed health care reform measures that center on the following set of eight principles:

* Guarantee Choice. The plan should provide Americans a choice of health plans and physicians. People will be allowed to keep their own doctor and their employer-based health plan;

* Make Health Coverage Affordable. The plan must reduce waste and fraud, high administrative costs, unnecessary tests and services, and other inefficiencies that drive up costs with no added health benefits;

* Protect Families’ Financial Health. The plan must reduce the growing premiums and other costs American citizens and businesses pay for health care. People must be protected from bankruptcy due to catastrophic illness;

* Invest in Prevention and Wellness. The plan must invest in public health measures proven to reduce cost drivers in our system—such as obesity, sedentary lifestyles, and smoking—as well as guarantee access to proven preventive treatments;

* Provide Portability of Coverage. People should not be locked into their job just to secure health coverage, and no American should be denied coverage because of preexisting conditions;

* Aim for Universality. The plan must put the United States on a clear path to cover all Americans;

* Improve Patient Safety and Quality Care. The plan must ensure the implementation of proven patient safety measures and provide incentives for changes in the delivery system to reduce unnecessary variability in patient care. It must support the widespread use of health information technology with rigorous privacy protections and the development of data on the effectiveness of medical interventions to improve the quality of care delivered; and

* Maintain Long-Term Fiscal Sustainability. The plan must pay for itself by reducing the level of cost growth, improving productivity, and dedicating additional sources of revenue.

So Americans want health care reform, right?

And the Presidents has proposed reforms, right?

Democrats have a 60 to 40 majority in the Senate and an even bigger margin in the house.

So this should be a no-brainer right? Wrong.

According to Reuters, “Obama’s hopes for passing an initial version of healthcare reform by August are dead in the Senate and on life support in the House of Representatives — and his fellow Democrats played a big role in their demise.”

Specifically a core group of 52 democrats, referred to as “Blue Dogs,” are proving to be formidable opposition to what should be a slam-dunk for a “Democratic Super Majority.” These Blue Dogs are fiscally conservative democrats who come from traditionally Republican states. Their positions are more tenuous than their colleagues. As Bonnie Erbe noted in US News & World Report, “the Blue Dogs come from shaky, as opposed to safe Democratic districts, where a wrong step on federal spending or taxes could whisk them out of office easily. When the public starts to realize how much healthcare reform will raise taxes, they’ll vent their anger on Blue Dogs first and foremost.”

With an estimated $1.75 trillion-dollar price tag and a preliminary plan to pass that cost along to higher income Americans in the form of a tax increase, the Obama plan is far too costly for Blue Dogs.

So between Republicans and Blue Dog Democrats, the Obama plan is all of a sudden facing an uphill battle and the August deadline set by the President is posed to come and go.

The worst part as the clock continues to click away, is the real people who will suffer are the 45.7 million Americans who are uninsured. In 2002, the Institute of Medicine released a groundbreaking report, “Care without Coverage: Too Little, Too Late,” which estimated that 18,000 adults nationwide died in 2000 because they did not have health insurance.

In 1994, universal health care was a key priority of the Clinton Administration. For a variety of reasons, the measure failed and that failure triggered a series of events that led to huge Democratic losses in the 1994 midterm elections which paved the way for a GOP takeover of Congress. What would failing to reform health care mean for the Obama Administration and for the “Democratic Super Majority?”

If the Blue Dogs remain at odds with their colleagues and the President, we will have an answer.