In his prime time speech on health care reform President Obama acknowledged public skepticism about his plan:
"I realize that with all the charges and criticisms that are being thrown around in Washington, a lot of Americans may be wondering, "What's in this for me? How does my family stand to benefit from health insurance reform?’ "
Here is how he answered that question:
"If you have health insurance, the reform we're proposing will provide you with more security and more stability. It will keep government out of health care decisions, giving you the option to keep your insurance if you're happy with it. It will prevent insurance companies from dropping your coverage if you get too sick. It will give you the security of knowing that if you lose your job, if you move, or if you change your job, you'll still be able to have coverage. It will limit the amount your insurance company can force you to pay for your medical costs out of your own pocket. And it will cover preventive care like check-ups and mammograms that save lives and money."
All of that sounds pretty good, as does Obama's persistent pledge to pay for the program by taxing the rich--in his speech he defined them as people making more than $1 million a year. But then there is Obama's nods to "a marketplace that provides choice and competition"--buzzwords for the private health insurance system that now leaves 47 million people uninsured.
With Blue Dog Democrats breathing down Obama's neck, and Republicans determined to oppose any plan the White House endorses, it's hard to see how he is getting to comprehensive reform by August.
Obama has been careful not to make the same political mistakes the Clintons made when they attempted to climb the health care hill. Instead of setting up a commission to solve the problem at the White House, he is kicking the whole thing to Congress. It may or may not prove to be a winning strategy for getting something passed.
But there is an eerie similarity between Clinton's health care battle and Obama's.
Here is Bill Clinton on health care reform in 1993:
"Millions of Americans are just a pink slip away from losing their health insurance, and one serious illness away from losing all their savings. Millions more are locked into the jobs they have now just because they or someone in their family has once been sick and they have what is called the preexisting condition. And on any given day, over 37 million Americans -- most of them working people and their little children -- have no health insurance at all. And in spite of all this, our medical bills are growing at over twice the rate of inflation, and the United States spends over a third more of its income on health care than any other nation on Earth."
Now here is Obama:
"We spend much more on health care than any other nation but aren't any healthier for it. . . . This is not just about the 47 million Americans who don't have any health insurance at all. Reform is about every American who has ever feared that they may lose their coverage if they become too sick, or lose their job, or change their job. It's about every small business that has been forced to lay off employees or cut back on their coverage because it became too expensive. And it's about the fact that the biggest driving force behind our federal deficit is the skyrocketing cost of Medicare and Medicaid. . . . If we do not reform health care, your premiums and out-of-pocket costs will continue to skyrocket. If we don't act, 14,000 Americans will continue to lose their health insurance every single day. These are the consequences of inaction. These are the stakes of the debate that we're having right now."
As we know, the Clinton health care initiative collapsed. And much of Clinton's progressive speech-making turned out to be window dressing for micro-initiatives that made little impact on the big problems he spoke about so stirringly.
Clinton himself has said that Obama ought to be able to pass health care reform. He told CNN in February that public pressure for universal health care had grown dramatically since the early 1990s. Plus, he said, "You don't have to have an employer mandate. You don't have to have a tax increase now," he said. "I think the obstacles are less than they were."
Unfortunately, that may also means that a health care plan that passes this year turns out to be less than meets the eye.