Fixing health care
By David S. Broder
The Washington Post
Friday, November 28, 2008 10:40 AM PST
Things are looking up for substantive reform of America’s troubled health-care system.
No one who knows the history of such efforts, from Harry Truman’s administration through Bill Clinton’s, needs to be reminded of the difficulties that inevitably confront any plan to overhaul one-seventh of the U.S. economy and bring high-quality medicine to millions of the uninsured.
But developments at both ends of Pennsylvania Avenue last week — and across the country — pointed to the urgency of the problem and the prospects for seeing significant action.
When Barack Obama’s transition team let out word former Senate majority leader Tom Daschle would be his choice to run the Department of Health and Human Services and to quarterback his work on health reform, it signaled Obama is serious about his campaign promise to make that issue a first-term priority. Daschle can be of great help to Obama in achieving the goal. He has made his own in-depth study of health-care issues and brings a genuine passion to the subject. And he knows the Senate, where past efforts have foundered.
There are positive signs within the Senate as well. Max Baucus of Montana, the chairman of the Finance Committee, one of the two main centers of Senate action, moved first by releasing a detailed outline of his preferred piece of legislation. Edward M. Kennedy of Massachusetts, the chairman of the other committee of jurisdiction — Health, Education, Labor and Pensions — quickly asserted his right to be at the center of action. He organized three task forces within his committee and reached out to Baucus to suggest their staffs start exchanging ideas as well.
A fast start is important because it takes untold hours to work through all the complex issues involved in comprehensive health care. When Bill Clinton delayed in getting Hillary Clinton’s legislative proposal up to Capitol Hill until the end of 1993, his first year in office, he made it much easier for opponents to throw up roadblocks.
The architects of the Clintons’ defeat were Newt Gingrich and Bob Dole, then the leaders of GOP forces in the House and Senate. Gingrich has now become an advocate for systemic change in the way health care is financed and delivered. And Dole, who in 1994 moved belatedly to opposing the Clinton effort as his own presidential ambitions rose, told me last week today’s circumstances make a repetition of those tactics inappropriate. Instead, he is reminding Republicans of his own contributions to bipartisan successes.
It would not surprise me if Dole finds ways to be helpful to Daschle and Obama in the coming fight.
Some have argued Obama will be forced to delay his promised effort at health-care reform, either because of the urgency of the economic problems facing the country or because there will be no money in the budget to pay for such an enterprise.
But every indication is he will not wait. Indeed, he could well argue the current plight of the Big Three automakers stems in part from the burden that Ford, General Motors and Chrysler are carrying for the failures of our employer-based health-care system. One of their basic competitive disadvantages stems from the fact Japanese and other foreign carmakers are operating in countries where government and society as a whole — not individual companies — pay the costs of health care.
No question, it will be a tough fight. But you can see the possibility of success.
— © The Washington Post Co.
