Rating the Obama Presidency and Chances of Health Care Reform

In the October 22, 2009 issue of The New York Review, Elizabeth Drew provides an assessment of the Obama presidency to date, particularly as Obama’s strengths and weaknesses are revealed in his handling of health care reform. Here are some of her points with my additional elaboration and interpretation, some of which Drew might well reject. You will want to read her article yourself at http://www.nybooks.com/articles/23183 .

It is clear now, and has been for some time, that the Republicans have zero interest in any bi-partisan approach to any policies. There one goal is to defeat Obama regardless of the consequences to the country.

The species of politician known as “moderate Republican” is nearly extinct.

Race is now an issue.

Obama’s search for consensus, desire to listen to all sides, refusal to take firm positions, cautiousness, and desire to please has been taken by his opponents as a sign of weakness they can exploit.

People who have medical insurance now have no interest in helping their fellow Americans who don’t have insurance if it means they have to shoulder any additional financial burden. Essentially the message to the uninsured and underinsured is “you’re on your own buddy; don’t look to us to help.”

Forget the cost projections when it comes to health care reform. The fact is no one can project what doing health care reform (or not doing it) might cost. Drew cites Joseph Califano, Johnson’s advisor: “It’s preposterous, “ Califano told Drew, “to project ten-year costs. When we passed Medicare no one foresaw MRIs, CT scans, transplants, or the explosion of life expectancy. And now we’re on the verge of a revolution in neurology and in genetics, stem cell research, and multiple transplants.” The future might be one in which everyone will be healthier and that chronic diseases will be easier and less expensive to treat and cure. It also might be one in which life expectancy increases dramatically and the demand for cutting edge medical care skyrockets causing an historic spike in costs. No one knows which of these scenarios might play out.

Any talk of getting savings from Medicare to pay for covering the uninsured scares the hell out of Medicare recipients who are not prepared to suffer the slightest decrease in their benefits to help out those who are uninsured or underinsured.

You can not cover forty-five million more people and cut costs, at least in the short term.

In spite of all of the Republican and conservative talk show orchestrated yelling and screaming at town hall meetings about a “government takeover of health care,” “death panels,” and so on, support for health care reform actually stopped trending downward as it had been before August and went back up in September. The Repubs and Cons lost that battle.

At least two of the Republicans—Grassley of Iowa and Enzi of Wyoming—now admit that their real reason for negotiating with Max Baucus on the Senate Finance Committee heath plan was to delay, delay, delay. They never had any attention of reaching a bi-partisan agreement. It makes Baucus look pretty naïve.

The co-op idea is a red herring. There is very little chance that co-ops will ever be established across the country and even if they are they will be too small to offer large insurance companies any real competition.

Some kind of health care reform will likely pass but with support from only one Republican, Senator Snowe and her support is not at all certain. Democrats will pass health care reform even if they have to go the route of “reconciliation” for the simple reason that losing the battle for health care reform this time would be devastating not only to Obama but to Democrats in general. For a number of Democrats the choice will be voting for health care reform and perhaps being defeated versus not voting for health care reform and definitely being defeated.

If Obama gets a health care reform bill to sign, even if it falls far short of what he wants and the country needs, he will have achieved an historic victory and one that has eluded all of his predecessors. It will be an achievement that will define his presidency and secure him a place in history as the president that achieved something that such men as Roosevelt, Truman, Kennedy, Johnson, and Clinton combined could not.

One final thought that Drew did not discuss. If Obama pulls health care reform off, the Sarah Palin wing of the Republican Party will turn on the Republican leadership with a vengeance. They hate Obama and will blame the current Republican leadership for failing to bring him down. If that happens, the party will splinter and the ultra nutty right wing conspiracy theory bigots will take over completely. The party might just move so far out of the main stream that only a small fraction of the country would want to be associated with it. The party might just fade into obscurity. Wouldn’t that be great?