Pulpit Bulls

Policy, Politics, and What's In Between

Posts Tagged ‘Health Care’

Should Obama NOT Do More On Health Care?

Posted by Eric on June 23, 2009

So says Ezra Klein. Yesterday I worried that Obama needed to get out there and make the case to Senators and the American public about the necessity of reform and a public option, but Ezra thinks this type of argument is misguided:

For now, the White House should have as little to do as possible with the various legislative products. Let the committees absorb the blows of the bad weeks. Let the early coalitions present themselves. Let the Republicans show their strategy in the mark-up sessions. Let the CBO score all the different options. Let the legislature familiarize itself with different revenue options. Wait. Wait and wait and wait. Wait until Congress has pushed this as far upfield as it’s able.

Then open up the White House. Then have Obama on TV. Then have Rahm on the phone with legislators. Then take Olympia Snowe for a ride on Marine One. The White House can exert explosive force on a piece of legislation, but it can only do so effectively for a short period of time. That was the mistake Clinton White House made in 1994. By the time their legislation was near reality, administration officials were so deeply involved that they couldn’t add external momentum. It is not a mistake that Rahm Emmanuel, who watched it all happen firsthand, means to repeat.

That’s a reasonable argument, but I’m not entirely convinced. Though the mistakes of 1994 aren’t being repeated, I worry that the administration may be so jittery about Clinton’s failure at reform that they are making the inverse of Clinton’s errors. Whereas Clinton tried to push a very specific package and froze out many Democrats and the entire Republican caucus, I fear Obama will leave all specifics to congress and yield too much to an obstinate and deeply unpopular Republican caucus. And if the legislature comes to a consensus for a weak and toothless health care package, it may not matter how hard Obama drums support for deeper reforms. Once enough Senators come out on the record against a public plan, it will be an excruciatingly difficult task to force them to back down. And that’s a very real possibility.

This isn’t to say that the administration shouldn’t save a trump card or two for the end, but it would be reassuring if the White House was doing and saying more now.


Posted in Health Care, Politics | Tagged: , , , | Leave a Comment »

Obama, the Public Plan and the Bully Pulpit

Posted by Eric on June 22, 2009

Obama Health CareSweeping health care reform looks to be faltering. The public option, a government-run insurance plan that competes with private insurance, may be nixed in the final bill altogether. This would ostensibly be the time for Barack Obama to champion the public option as he makes his way across the country touting the necessity of health care reform. He could forcefully make the case for a public plan and ask the crowd (and TV viewers) to call their senators and demand action. But he isn’t doing that. As Paul Krugman notes, “centrist” Democratic Senators like Blanche Lincoln from small states where “one or at most two private insurers dominate the market” have been wary of the public plan. And this makes sense since powerful insurance companies can raise lots of money for a  candidate. But you know who else can raise a lot of money? Barack Obama. Obama and Joe Biden could spend a couple hours calling major bundlers for each of these Democrats and, I suspect, raise as much or more than the insurance companies would. That, along with a public crusade for a public option could conceivably go a long way. But neither seems to be occuring.

Obama is a clear-cut pragmatist, sometimes to a frustrating degree. Some liberals are starting to wish there was more truth to the “socialist” and “leftwinger” labels that conservatives have been hurling at the president. But there’s never been any real reason to believe that Obama harbors any radical impulses. Even the fake reasons, like Jeremiah Wright, are probably just twisted evidence that Obama has always been as cautious and pragmatic as he is today. He had a radical black reverend when he was a state senator from a heavily black district in Chicago. When he was running for president in what’s still a heavily white country, he severed ties with Wright.

The conventional wisdom is that Obama has been dismissive of gay rights and willing to bend to conservative framing on matters like deficit reduction because he was stocking up on the political capital to ram through the big issues. But this is the big issue! And Obama is staying almost entirely out of the specifics of reform. That may change, or maybe his cautious approach has some justification I am missing. We will look back years from now and truly reflect on the wisdom (or lackthereof) of that strategy. But right now, it’s very worrying.

Posted in Health Care, Politics | Tagged: , , , | 1 Comment »

Is Howard Dean Relevant?

Posted by Eric on June 15, 2009

Howard DeanHoward Dean has been an important player in understanding how Democrats ended up with majorities in both chambers of congress and even to Obama’s landslide victory in November. Dean’s tenure as DNC chairman saw the Democrats take back the House and Senate in 2006 and comfortably pad their majorities in 2008. His “50-state-strategy” laid the theoretical and material groundwork for Obama to compete in traditionally red states like Indiana, North Carolina, and Montana. Dean’s innovative online outreach and fundraising operations were an inspiration for Obama’s own internet success.

But since Obama’s victory, the White House’s relationship with Dean has been unambiguously icy. This was perhaps most visible when Dean’s successor at the DNC, Tim Kaine, was publicly selected for the job in a press conference with the president while Dean was on vacation.

Now the good doctor fights for political relevance by injecting himself in the ongoing health care debate. Dean is releasing a new book on health care which will forcefully argue for a “public option” as an element of reform — a policy that both the VP and HHS Secretary Sebelius seemed alarmingly uncommitted to in their media appearances over the weekend. Dean has also soundly rejected Sen. Kent Conrad’s compromise proposal of health care “co-ops” as an alternative to the public option, by quipping that “insurance companies will be licking their lips.”

It will be interesting to see how much political power Dean still holds. He can’t command the spotlight the way he could when the Democratic Party lacked an annointed leader. The young and liberal voters who were Dean’s base are now solid Obama supporters, and even Dean’s grassroots organization Democracy for America has larginally been supplanted by Obama’s Organize for America. Dean is right about health care but I’m skeptical that he will matter much at all when everything is said and done.

Posted in Health Care, Politics | Tagged: , , | Leave a Comment »

Get Gov’t Away From Health Care and Leave My Medicare Alone!

Posted by Eric on June 11, 2009

517-43It’s almost certain that we are going to get some form of health care reform this year. The Obama budget triggers health care reform to automatically move to the reconciliation process if it doesn’t get passed by summer. So if the Republicans and centrist Democrats filibuster or squash health care reform, the budget reconciliation process allows legislation to get passed with only 50 votes (rather than the 60 necessary to end a filibuster).

Of course insurance companies, BigPharma, free marketers, and just about anyone with entrenched interest in the current broken health care system will mobilize to water down reform as much as they can. One of the first steps will be to try to turn public attitudes against “government intervention” into care. You know, stopping big government from interfering with the “doctor-patient relationship” and making sure that “hospitals aren’t being run like DMV.” Considering that the American health care system is very badly broken and knowing that popular president Barack Obama won a landslide election campaigning (in part) on fixing health care, you’d think the public would be in pretty fervent agreement with the president’s positions. Right?

Not exactly. According to Pew’s recent survey, public opinion about health care reform is decidedly mixed. While 86% of people told researchers they thought “the government needs to do more to make health care affordable and accessible,” 46% answered (see the table on the right) that they were “concerned that the government is becoming too involved in health care.” In other words, a significant number of people really have no clue what they think.

What’s pretty striking is, when broken down by age, the only segment of the population in which a majority fears the government is becoming too involved in health care is the over 65 crowd. This hit me as pretty weird since most of these old people are on Medicare and old people love their Medicare! Or so I thought. But maybe these folks have to deal with government-sponsored health care and know first hand of the evils that a governmental insurance plan holds. So I looked up the numbers and decided to bake up this delicious pie chart:

Medicare Satisfaction Chart

Medicare Satisfaction Chart

As you can see, old people really do like their Medicare. So where are their worries coming from? Are they scared this will somehow negatively impact their Medicare? Do they just not want others to have the wonderful services they do? Are they confused?

If anyone has any ideas, fill me in, because this doesn’t make any sense.

Posted in Health Care | Tagged: , , | 3 Comments »

Antibiotics in the Animals You Eat

Posted by Eric on June 10, 2009

Swine Chicken Feed
A couple of days ago we discussed the environmental consequences of cattle farming, specifically how corn (rather than grass or grain) diets fed to cows leads to increased levels of methane released into the air. One of the repercussions of corn-based feed for cattle that I didn’t mention before was that cows are pumped with antibiotics to help ease their unnatural digestion of corn. Antibiotics are also fed to swine and poultry to promote growth and to mitigate infections contracted from the inhumane and often filthy conditions in which farm animals are raised. This comes from the Union of Concerned Scientists who my fellow Washingtonians will recognize as being responsible for the recent ad campaign on the DC Metro (see the pictures above). The UCS writes that 70% of antibiotic drugs are used on animals and notes:

Antibiotic-resistant illness causes tens of thousands of premature deaths in the United States annually and drives up medical costs. Restricting the inappropriate use of antibiotics in both the medical and the agricultural sector can save lives and money.

Since everyone is talking about how to bring health care costs down, this might be a good place to start. But really what should be most troubling isn’t even current antibiotic-resistant illnesses, it’s the future of antibiotic-resistant illnesses. Overuse could potentially lead to a catastrophic disease outbreak and — though I have know idea how likely that is — it is a possibility that many scientists take seriously and policymakers should take it seriously as well. You should head on over to the UCS’ SaveAntibiotics website to find out what you can do.

Anyway, I am pretty sure I wrote a paper in middle school about antibiotic overuse so my warnings are clearly informed.

Pictures snapped by my versatile and multifunctional Verizon smart phone.

Posted in Food Policy | Tagged: , , , | 2 Comments »