By Benjamin Cohn
Living in Northern Virginia, it’s impossible to ignore the drama unfolding in the halls of our government right next door. Inside of I-495, our local news is national news. Since it’s impossible to shut out completely, (I know, I’ve tried) most of us have the vague idea that in the past months, there’s been some sort of debate about health care going on in Washington.
That’s where the mutual understanding ends. There have been many goals set by many different parties involved, however the nature of our Congress and government ensures that the outcome of this is far from determined.
Health care reform has been on the political radar as far back as the Democratic Party primaries before the 2008 Presidential election. It was a campaign point of most of the candidates for the nomination.
In 2007, then Senator Clinton appeared on ABC’s “Good Morning America,” where she said, "We're going to have universal health care when I'm president - there's no doubt about that. We're going to get it done." She might not have been right about her future career path, but she sure knew what lay ahead on the political agenda of the next administration.
The end of that story is fairly well known. The economy tanked, the public wanted change, and Barack Obama became our first African-American president.
More recently, however, the task of reforming the health care system has made its way back to the headlines. President Obama first pushed the issue in the beginning of the summer, after the bulk of his economic stimulus and recovery legislation had been passed.
Initially, the health care debate was designed to be just that, debate. President Obama continued to be the Great Delegator, and sent the duty to make up the text of the legislation to Congress. He gave broad outlines, but wanted the details to be made up and debated by the legislature.
This method seemed reasonable given the history of attempted health care reform in the U.S. Back in the 1990’s, the Clinton administration tried the opposite approach. The White House wrote the legislation and delivered it to Congress to pass. President Obama’s tactic is betting on an open debate being more likely to withstand the opposition argument that the bill was tainted and marked up in secret.
To start the debate, President Obama gave Congress a healthcare outline. He set goals of containing the growing national costs of health care, the need for reforms in insurance practices, and a desire that affordable insurance be available to all Americans.
At first, all options of reform seemed to be on the table. This included a public insurance option, offered by the government, which would compete against private insurance companies in the open market. Other solutions include forming public cooperatives, where citizens would pool resources and bargaining power to get cheaper, more agreeable deals from insurance companies. Additional ideas for reform involved restrictions on insurance companies and consumer protections.
The summer was starting, and the ball was in Congress’s court. President Obama had given a loose request that Congress deliver legislation by the time they left for summer recess, starting August 3rd.
By early June two bills had began to develop, one in the House and one in the Senate. The House legislation was a creation largely of the House Democratic leadership. Even though the Democrats controlled a majority of the seats in both houses of Congress, question of funding remained and the possible existence of a public option continued to fuel the flames of the debate.
When July came around, progress was being made, but the debate had greatly slowed down the process. By this time, the House bill had ballooned to a cost of $1.5 trillion dollars. It had a number of the President’s desired details, including a mandate that all citizens must have insurance, provisions that would slow the growth of Medicare and Medicaid spending, and restrictions on insurance companies from discriminating against currently, or previously, sick individuals. However, it still had no public option, which was still a hot point of debate.
Concurrently, a Senate bill was being created under the lead of Sen. Max Baucus (D-Mont.), the chairman of the Senate Finance Committee. This bill had slightly different details, including provisions to cut costs through wastes in Medicare, and abilities to renegotiate doctor payments to lower costs. Still no public option.
During the midsummer months, the narrative of the debate in the public eye went off track. Interest groups were beginning to take the argument places no one had intended. Serious media campaigns we’re being waged on the public airways. Things like death panels, mythical government bueracracy which supposedly would help citizens die to cover costs, became the center fold of the narrative in the public’s eye.
Quickly, what looked like a surge of support for health care reform was turning into a whimper. The President’s approval numbers looked like they were beginning to slip, the reigns of the debate had been taken by interests, and the possibility to have health care reform by the summer recess had vanished.
Congress took its recess and lawmakers went home to their constituents all over the country. August became the month of town hall debates. Senators were being yelled at, Congress people were being scorned and the public’s anger became the newest headline in the health care story.
When Congress returned from recess, the health care debate was continuing, but without any sense of urgency delivered to the people. The House bill had stalled by this point and the Senate bill seemed to be the best shot, but the narrative was still not what it needed to be.
So, on September 9th, President Obama delivered a speech on national health care reform to a joint session of Congress. He framed the need for health care reform as a moral necessity, saying, "When fortune turns against one of us, others are there to lend a helping hand."
The President’s speech also served to invigorate the debate with new stronger language that’s been lacking from a leader.
"I will not stand by while the special interests use the same old tactics to keep things exactly the way they are…” He continued, “I will not accept the status quo as a solution. Not this time. Not now."
As of now, the ball seems to be rolling. Sen. Max Baucus and the Senate Finance Committee look ready to pass the Senate bill to a full floor vote very soon (*Needs to be updated before printing*). It looks more promising than any chance we’ve had to provide much needed health care reform to the people. With any luck, we might have some sort of national health reform by the end of the year. Still no public option.
