The politics of healthcare in America

Obama might be down, but don’t count him out just yet


The politics of healthcare in AmericaPresident Obama will be conducting another prime-time television news conference to address healthcare reform. His strategy of letting Congress initiate policy in this sector has encountered some serious snags. As a result, some Democrats, the so-called Blue Dog Democrats, are opposed to the project. We can also expect the Republicans to stay the course and oppose any attempts at reform, though a few moderates might endorse a proposal that includes some GOP initiatives. But it is the Democrats’ support that is crucial to the success of Obama’s healthcare plan. If Obama cannot keep the Democrats onside, then he too will go the way of President Bill Clinton and lose the centerpiece of his potential presidential legacy.

In an earlier blog, I referred to these Blue Dogs as Storm Cloud Democrats because they have been known to ditch the party line when storm clouds start to form and mid-terms are on the horizon. Many of these Democrats are elected in red districts (Conservative Republican areas), which explains their vulnerability around mid-term elections. In Congress, they have been known to join Republican initiatives and block policies from a president of their own party (JFK in the 1960s, Clinton in 1990s). For instance, they were the Democrats that failed to support Hillary Clinton’s healthcare proposals back in the early days of the Clinton presidency.

The Obama White House has done all it can to avoid falling into the Clinton trap. Letting Congress take the lead was part of that strategy. The problem now is that the momentum behind the reforms is beginning to stall as the GOP has joined forces with the Blue Dogs to raise the spectre of out-of-control costs and a government takeover of healthcare, prompting fears the project will result in higher taxes. That Obama has chosen a mid-week July evening to conduct a national press conference is indicative of how much the White House is worried the project is going off the rails.

If the election campaign is any indication, it seems the president performs best when there are others on the playing field. When adversaries push, he pushes back—and push, they have! Ads attacking the healthcare reforms are airing daily, and while some of them are raising legitimate questions, others are dealing in misinformation. The commercial blasting the Canadian healthcare system is especially revealing, in that it shows how conservatives will stop at nothing to prevent any government presence in the reform package. Those who voted for Obama and strongly backed his commitment on healthcare are about to hit a critical point. After all, the goal behind this reform is to cover the 47 million American who are uninsured, and the proposals currently circulating on Capitol Hill may not succeed in doing that. The latest report by the Congressional Budget Office has only fed the panic over costs and coverage.

Congress must continue to play a role in the debate, but presidential leadership involves more than respecting other branches of government. It means pointing the way forward, forcing the compromises, and pushing for results. Unlike much of his initiatives on the economy and on national security, the president seems to have lost the advantage on healthcare. His recent poll numbers show the honeymoon is indeed over and while his personal popularity ratings are still strong, his policies on healthcare no longer have the favor of a majority of the voters.

Obama found himself in a similar situation after his primary losses in Pennsylvania and Ohio, and when dealing with the Pastor Wright controversy. Back then, he appeared to be off his game. Now, it is obvious Obama is reaching back into the playbook for yet another rebound strategy. Expect Obama to shift from the defensive “let Congress do its work” line to one inspired by President Lyndon Johnson and start to show presidential leadership as the latter did in delivering medicare and civil rights legislation in the 1960s.

Restoring America’s image abroad, rediscovering economic stability and growth, dealing with climate change with an eye on global efforts, and reforming healthcare to cover all Americans is what will make this presidency a truly transformative one. So far, healthcare reform is the one priority that has tested the president’s legislative abilities and leadership the most. Success in the healthcare arena would go a long way in setting the tone for his presidency and establishing a template for future legislative initiatives—just like the New Deal did for FDR. Declaring a deadline is a good first step, but his goals must be clearly understood and pursued: lower costs, universal coverage and quality care. A public healthcare option must also be considered or else an important competitive component would be missing. Obama has the numbers. In the days to come, we will see if he has the will.


The politics of healthcare in America

  1. Live in US for 9 years (200-2009). Horrible state of health care for those who HAVE health insurance. Don't forget, it's only those who have "benefits" that have it. In Canada "benefits" are contributions to add-ons: drugs, private rooms, mental health etc. In the US health care, the very basic variety, is a "benefit". It's scary and frustrating and difficult to navigate. And as any freelancer will attest, don't live in the US if you're an artist, writer, journalist, entrepreneur, because if you are, then you're going to face "social" assistance and barriers that will cut into your mortality. If I were to handle Obama's spin, the focus would be on those who "have" health care, or who "think" they have, and present their risks, not those of those who currently don't have anything since they are already listed as those who haven't achieved the American Dream and who in hell would want to bail them out! No one has the perfect solution, but I am home again, and glad to be here! Kathleen E. Kamping

  2. With Independents split 40% for and 55% against his handling of healthcare it would likely be severely career limiting for many Blue Dog Democrats to support Obama's healthcare reforms.

    • It would be repeating the mistake of 1993. THe GOP won the mid terms . People want healthcare and it will good for their careers to have an accomplishment tto their names. Doing Republican agenda only gets republicans elected . Not more Democrats .

      • If your constituency is against healthcare reform (which is likely the case for many Blue Dog's with these numbers), then being against it isn't "Doing the Republican Agenda", it's doing your constiuents agenda. And while I don't deny that the Democrats campaigned on healthcare reform, most of those Blue Dogs know they were elected because there wasn't an (R) beside there name, not because of a wholesale change in the philosophy of their district.

        • Have you not heard about voting one`s conscience and doing the right thing ,sbt…….Ever heard of Edmund Burke ……..

  3. How much do you want to bet that he is pulling off that old famous move by Presidents past where he punts the issue to congress (step # 01 done) – then – as time goes by and the year deadline becomes real he goes over the head of the blue dogs and straight to the people and uses some of this captial he has for real …watch for townhall and or fireside chats with one important one in his office and nice brand new flag right behind him and a stern look on his face … just a thought!

    • hilarious lol – the capital is already gone, the majority of the public oppose the plan.

  4. Just listened to the commercial on Canada . How our Prime minister or health minister say nothing about this is beyond me . harper is a walking sleeper . Unless he agrees with it . That would not surprise me . Right wingers like Harper are nostalgic for Cheney and Bush . For years ,the Alliance-Reform party has tried to transform our Medicare system to something close to America`s brand . So say nothing HARPER or Clements because the American is speaking for you and doing your work.

  5. What isn't getting any attention in Canada, especially Ontario, is the educational reforms underway by the Obama administration. For example on average-remember America has 300 million people, Americans are not scoring as well as they would like on international tests. But in some jurisdictions they're cleaning up.

    Charter schools in Massachusetts are doing exceptionally well. here is a basic outline of their program: , high-performing charter schools, like those in the Knowledge Is Power Program (KIPP) network, combine more class time with a rigorous curriculum and exceptionally devoted teachers. A typical KIPP school day runs from 7:30 a.m. to 5 p.m., Monday through Friday, with four hours of class every other Saturday and three weeks of mandatory summer school. More hours and days are key, says Steve Mancini, KIPP's public affairs director.

    Now in Ontario, parents don't have any choice. The education system is highly liberalized, slack and failing it's citizens. Some would argue differently from this, but their is a mountain of good evidence, which can be expressed as a mountain of a thousand red flags.

  6. "Restoring America's image abroad, rediscovering economic stability and growth, dealing with climate change with an eye on global efforts, and reforming healthcare to cover all Americans is what will make this presidency a truly transformative one"

    Wow, this blog reads like an Obama campaign ad.

    What garbage.

  7. I'm not a physician, but this site (… ) claims that Shona Holmes, the Canadian woman in the healthcare commercial, actually had a non life-threatening cyst, and not a terminal brain tumor as suggested by the ad. Anyone out there with more knowledge of this area want to comment?

  8. Approx. 6 years ago I was diagnosed with Stage IV cancer. With my type of cancer (bladder) that meant a 12-18 month survival time. I was operated on within a week of diagnosis (a 7-8 hour operation) & received chemo as soon as I was fit to do so. I received exemplary care throughout my treatment. About 18 months ago, following a regularly scheduled scan, the one and only remaining tumour had increased. I then immediately had another round of chemo. As my body has not been able to withstand the treatments for the normal durations, I still have the remains of a tumour, but it has diminished in size. I am still alive, and I can attest to the marvelous & speedy treatments I have received both times. I live in the Maritimes rather that one of the major cities in Canada.

  9. The commercial on Canada's system is a sham . I hope Obama succeeds and takes on the health for profit lobby . It is disgusting to see the Republicans resist any change. As for the Blue dogs , they are are gutless and will pay a price if they drop Obama.

  10. Sure, Canada's healthcare system is not the best. In fact, no system works perfectly. The advantage with the canadian system is that EVERYONE gets treated. No matter how wealthy you are. Right now, the american system is the opposite. The more money you have, the fastest and the best services you'll get. This is nonsense.
    The Obama administration has given back the ''international power'' the United States used to have. He now needs to give back the American Dream. That everyone has the same chance.
    If Obama succeeds, he will be known as a ''transformative'' president. If not, he will be a ''transaction'' president.

  11. I hear tell that he wanted a prime time slot last night to push his agenda but the TV Networks had Susan Boyle on and didn't give him the slot – OUCH!

  12. …the GOP has joined forces with the Blue Dogs to raise the spectre of out-of-control costs and a government takeover of healthcare, prompting fears the project will result in higher taxes.

    Nice turn of phrase there, John. The "spectre" of out-of-control costs? "Fears" of higher taxes? Do you seriously believe the blow-the-lights-out costs of this plan to present and future US taxpayers are just a fairy tale? Please…

  13. The fact is that realpolitik has hit Obama on the way to his being transformational. Everyone with an inkling of intelligence in the US knows that the current health care system is merely a money-making machine with little care given to actual patients. Indeed, that Harper and the Conservatives sit idly by while Canada's system is being so maligned is a complete shame. In certain cases here in Canada, you ask yourself whether there isn't a conspiracy underfoot to convince people that the system is so bad that they end up buying into the myth that the current US system is actually what we should have here.

    Rather than meeting the challenge head-on, and having majority government control, with the general population paying, as much of the developed world does, Obama has no choice but to deal and "negotiate" with Republicans, thereby making the system so convoluted that it ends up being ridiculously self-defeating. My cousin in Minnesota, who has a wife and 2 kids, is paying 1100 dollars A MONTH in health insurance charges. And how much do you want to bet that if he happens to find himself or any of his family members sick, that they just might not be covered.

    It just doesn't seem right that in the richest country on the planet, people will be going bankrupt for the crime of having fallen ill.

    • this is so typical . my heart goes out to you Eric K.You are right on Harper .

  14. Regardless of the need for reform of the American health care system, the speed at which he is trying to ram this through is completely reckless. You can't just wave a magic wand and come up with a bill that transforms your entire health care delivery model in a couple of weeks. What is he thinking? Especially in the middle of this economy, facing the kind of deficits he is facing…I just don't see how you get there from here.