Health care, Obama, and the perils of post-partisanship

By Kathy G.

Jonathan Cohn has an interesting article up on health care in the Democratic Party platform. The good news is that the language of the platform is very strong. It states that:

[E]very American man, woman, and child [should] be guaranteed affordable, comprehensive health care. ... with everyone in and no one left out.

[. . .]

Coverage should be made affordable for all Americans with subsidies provided through tax credits and other means.

[. . .]

Health insurance plans should accept all applicants and be prohibited from charging different prices based on pre-existing conditions.

[. . .]

Families should have health insurance coverage similar to what Members of Congress enjoy.

The text is much stronger than in previous platforms; as Cohn notes, the language urging that health care be "guaranteed" to all, "with everyone in and no one left out," is especially notable. Moreover, says Cohn, "the sheer amount of attention--and apparent priority--health care gets in the platform" appears to be significant.

So far so good, right? But the platform isn't a problem -- the health care section is even better than many activists had hoped. The real question is the extent to which Obama is committed to following through on comprehensive health care reform. The Obama aides Cohn speaks to all assure him that health care will be "a top priority for him as president," but so far, Obama himself has placed little emphasis on health care in his speeches and at his campaign events. And unless he makes it clear to the public that health care is an important part of his agenda, how will he win public support for comprehensive changes in our health care system? How will he be able to claim a mandate for health care reform?

How he's handled the health care issue is symbolic of the bigger problem I have with Obama. He's running on vague promises of "hope and change," but he's not making any kind of robust case for the specific policies he stands for. Nor is he drawing strong and clear contrasts between his agenda and priorities and those of McCain and the Republicans. I'm at a loss to explain this, because Obama's position on health care and many other core issues is far more popular than the Republicans' approach.

Maybe the campaign has simply made the strategic decision that extreme caution and airy, bloodless, post-partisan rhetoric are more likely to get Obama elected than a more populist and frankly ideological campaign emphasizing economic security and core liberal, Democratic principles would be. And who knows -- they may be right.

But I fear that if Obama is elected, the kind of campaign he's run will make it much harder for him to govern. Republicans would be able to claim, with some justice, that people voted for him because he promised an end to partisanship, and not, for example, sweeping changes in our health care system that Democrats strongly support but Republicans just as strongly oppose.

Who knows, maybe after the convention we'll see some important changes in the kind of campaign Obama has been running. But I fear Obama may already have boxed himself in so thoroughly that, even if he wins, he will have an exceptionally hard time getting anything done -- even those things that the public by and large strongly supports.

Nothing would please me more than if he proves me dead wrong about this. But so far, I don't see it happening.

UPDATE: In his column today, Paul Krugman says a variation of what I just said -- only he says it better.

Comments

[Shane Taylor]

While we're trading impressions we want falsified, it seems to me that Democrat progblogs are neglecting a crucial How? Specifically, how to compel Obama to act for change?

http://tpmcafe.talkingpointsmemo.com/2008/08/12/politics_under_the_predator_st/

David Sirota, as you have noted before, is a model exception with his emphasis on building independent institutions.

http://www.huffingtonpost.com/david-sirota/the-difference-between-mo_b_118494.html

[Annie]

I have a different perspective about the strength of the platform. It supports access not to health CARE, but to health Insurance, and this isn't a sustainable model from which to build health CARE system change.

It also assumes that cost savings will be aimed at fleecing the pockets of providers (individuals and institutions) instead of via better patient relationships resulting in preventive, less costly care; achieving better patient compliance with basic health management actions such as eating nutritious foods in better amounts, being able to engage in safe and effective exercise; being able to access timely, appropriate and affordable health care; and being able to spend health CARE dollars on actual health CARE services and necessary infrastructure instead of to parasitic industries such as for-profit insurers, marketers, services and infrastructures which are duplicative and geared toward high end reimbursements and clientele and administrative/sales services.

As reimbursements are restricted from providers, the physician and nurse shortages grow ever more critical and acute. The Dem. platform as it stands provides no incentives to attract and retain more physicians and nurses. It doesn't aim to provide mechanisms to retrain workers from parasitic industries to providers and needed healthcare workforce skill acquisition.

Without a paradigm shift, this platform is just as downstream and finger-in-the-dyke as any other.

Whether Obama makes any real commitment to enacting any or all of it is really moot.

[Batocchio]

"But I fear that if Obama is elected, the kind of campaign he's run will make it much harder for him to govern. Republicans would be able to claim, with some justice, that people voted for him because he promised an end to partisanship, and not, for example, sweeping changes in our health care system that Democrats strongly support but Republicans just as strongly oppose."

Yup. I hope during the convention, the debates, and the last months we hear more of the key policy points you're talking about. There's no reason he can't provide some nice rhetoric but also at least a few key details.

[Paul]

Theyare blowing it, if all they are offering is health insurance. Health insurance isn't healthcare. The insurance companies have amply demonstrated that they are unfit to participate in healthcare delivery. The plan is nothing more than another corporate mega-welfare program. It will give the insurance companies 45 million more chances to say, "That's not covered. Go away.".

Universal single payer healthcare is the only way to go, and it has got to be billions cheaper with the parasitical, for-profit middle-man excised from the loop.

HR-676 is the only way to go. Instead, what the party platform is offering is just one more corporatist sellout/betrayal of the public's best interests.

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