What if I told you that less than four years ago, and alliance of Liberal-Medical Groups, Unions and Progressive organizations did a study about how to shape a universal healthcare plan and that many of those organizations are deeply involved in Obama’s health care initiative today?
What if that study reported that Americans worried that such a plan would boost costs, or reduce care, for those who were already insured and that any fancy verbiage the researchers used to allay those fears were grossly unsuccessful?
Would you call this scenario a fantasy? Would you say that even Barack Obama isn’t arrogant enough to think that he could turn around such deep-seeded distrust of a government health plan?
The scenario is not a fantasy, and the Alliance described above is called the Herndon Alliance, its membership includes most of the groups supporting Obamacare. The study was conducted, and the results were ignored by the Arrogant-in-Chief:
WASHINGTON — A group called the Herndon Alliance — a coalition of liberal health-care groups, unions and patient-advocacy groups created in late 2005 — was only a few months into its work planning a health-insurance overhaul by the time it asked focus groups what they thought of the idea of a government-run plan to compete with private ones.
The public-option was an article of faith for many in the alliance, but the focus groups’ reactions were sobering. Skepticism ran high. The chief worry: Giving access to inexpensive government insurance to America’s 46 million uninsured would boost costs, or reduce care, for those who were already insured.
When pollsters told the advocacy groups the public option probably wouldn’t fly, they were told to paper over the problem with a better “message,” according to a participant in the project.
“We tried to do our best to come up with some fancy words to help talk about this,” this participant said, but in the end, he said, marketers and pollsters involved in the Herndon Alliance may have told their advocacy group clients what they wanted to hear.
It was an early warning of the trouble that was to engulf President Barack Obama’s most ambitious legislative effort despite years of careful groundwork laid by supporters.
Two overarching problems have bedeviled the Democrats’ health-care push. One is the difficulty of persuading people who already have health insurance that the plan offers something for them. Polls suggest many Americans are happy with the coverage they have.
The other is the cost, estimated at $1 trillion over a decade. While Democrats say the plan will be budget-neutral, Republicans say the cost savings and tax increases being used to fund new programs would better go toward reducing the fast-growing federal budget deficit.
Mr. Obama has had trouble making the case that his health push would carry teeth to elimimate the waste that he blames for driving up costs. A key moment in the debate came July 16, when Congressional Budget Office director Douglas Elmendorf told a congressional committee, “We do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount.”
A look back suggests the president and his allies may have “overlearned” the lessons of President Bill Clinton’s 1993-1994 health-care defeat. They expended great effort to line up the support of health-care insurers, pharmaceutical makers and care providers, believing that by keeping them around the table, they could win over Republicans and stop the kind of industry-led attacks that helped sink the Clinton plan. But this strategy left out the wooing of public opinion, which was being affected by broader events, including the economic crisis and anger over bank bailouts.
Some Democrats say the president exacerbated the message problem by being too distant from the legislative process and too vague to the public about his aims. (The White House says it was right to stay aloof from the process but is now ready to wade in.) Democrats also say that for all their preparations, they never anticipated Republicans and their allies rolling out incendiary accusations that the Obama plan would empower “death panels,” help illegal immigrants and raid Medicare.
By the time Congress turned to health care in earnest this spring, lawmakers had just approved more than $1 trillion to support financial firms and signed off on $787 billion in stimulus spending. Many Americans were feeling overwhelmed, some lawmakers say. “What the president has asked of the American people is a lot to absorb,” said Rep. Ron Kind, a Wisconsin Democrat.
Officials such as Nancy-Ann DeParle, head of the White House health-reform office, spent hundreds of hours wooing organized groups and members of Congress. But top Democrats underestimated the power of small, conservative groups to stir public opposition. In May, little-known groups like Americans for Prosperity Foundation and Conservatives for Patients’ Rights began airing television spots likening the proposed changes to the government-controlled health systems in Canada and the United Kingdom.
When the Senate Health, Education, Labor and Pensions Committee began drafting a bill, partisanship quickly arose. This soured Republicans who served on the Finance and health panels, including Sens. Orrin Hatch, Pat Roberts and Michael Enzi. What had started as 11 negotiators on the Senate Finance Committee dropped to seven, then six. Republican leaders increasingly felt emboldened to oppose any overhaul of the health system.
The Journey So Far
In June, Sen. Max Baucus, the Montana Democrat who heads the Senate Finance Committee, told the negotiators they had gone through all the big issues and it was time to draft a bill. But the resistance didn’t just come from Republicans. Democratic Sens. Kent Conrad and Jeff Bingaman said they weren’t ready. A planned June bill “mark-up” slipped to July, then to September.
Conservative Blue Dog Democrats and the leadership of the House Energy and Commerce Committee held a marathon meeting with the president two weeks before the August recess. White House Chief of Staff Rahm Emanuel and Ms. DeParle spent 8½ hours in the speaker’s suite trying to reach a deal that would allow the committee to complete its work. Lawmakers pleaded with the president to take a more forceful stance and define his positions better.
But Mr. Obama was being pushed in two directions — by liberal Democrats who wanted him to embrace the public option and by Republicans, such as Sen. Grassley, who told him they needed him to renounce it, if a bipartisan bill that emerged was to be acceptable after final negotiations. President Obama told him he couldn’t give such assurances, according to a senior Republican Senate aide, leaving the Republican feeling he had no defense against leaders opposing his efforts.
Sen. Tom Coburn (R., Okla.) got a call at home from Mr. Obama on a Saturday morning in late July. The two have been close since the president was a senator. “You need to take what you want to do and really spell it out,” Mr. Coburn says he told the president. “You need to see if you can get some of us to come across the line, and accomplish 80% of what you want to do.”
“I understand what you’re saying,” Mr. Coburn says Mr. Obama told him, “but I don’t think we’re there yet.”
The president’s focus on wooing groups often brought fewer benefits than he expected. The seniors’ lobby AARP backed him, but that prompted loud complaints from AARP members worried about Medicare cuts. The American Medical Association’s cautious backing was countered by state doctors’ groups opposed to a public health plan.
Lawmakers, as they disbanded for the August recess, were shocked by the level of discontent they found bubbling at home. Rep. Peter Welch, a liberal Democrat from Vermont, had his epiphany during a meeting in a Mini Mart parking lot in Derbyline, a small town on the Canadian border. Over 50 people crowded around a couple of Dumpsters to berate him. “It was stunning,” Rep. Welch said. “They came with talking points” gleaned from talk radio.
Many Democratic lawmakers say they remain resolved to push ahead on an overhaul, even if in a reduced form. Republicans plan to portray the overhaul as part of a Democratic agenda of heavy spending that threatens to increase the deficit. “We don’t want a health-care plan that will break the bank,” said Rep. Eric Cantor, the second-ranking Republican in the House.
What Democrats want now, they say, is a big assist from Mr. Obama. “There is no way we are going to get this passed without the energetic, concentrated attention of the president,” said Rep. Welch. “He is going to have to weigh in on the details, and do so loudly.”
President Obama is using so much political capital on a program that he knew went against the vision of health reform acceptable to the American people. This is a reflection of how important it is for him to move the entire structure of our economy away from the capitalism that made the US great.