Whose Healthcare Reform Plan Is It?

President Obama is making a push to have healthcare reform passed in 2009. But has he done enough this fall to overcome earlier mistakes?

By Thomas J. Slattery

It's been a rocky road again on the path to healthcare reform this past month. The highlight was President Obama's address to a joint session of Congress on the subject. To date, many would argue, he has not presented a "plan" per se. To date, many would argue, he has laid back from the debate and left the details to the liberal Democrat from San Francisco, House Speaker Nancy Pelosi, and to the chairman of the Senate Finance Committee, Max Baucus, D-Mt., to write the bill and frame the debate, perhaps a fatal political mistake.

All of which made it a "Pelosi Plan" and a "Baucus Plan", but still not a "Obama Plan". His speech was good but was it winning?

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The reputation of his presidency, we are told, rests on its success, and I don't doubt that. Most presidents since the progressive Republican Theodore Roosevelt to the Democratic liberals Franklin Delano Roosevelt and Lyndon Baines Johnson, and most recently Bill Clinton have tried and failed to enact universal healthcare. The debate is now over a century old, and we are the only democracy in the western world to have failed to come to grasp with the issue.

What's clear and what's not? What's clear is that, to my mind, President Obama is not going to achieve the "sweeping" healthcare reform that is his heart's desire. What's not clear yet is how much he's going to get, for surely he will get something, and perhaps something that we've not witnessed over the past 100 years. He still may get relief for the uninsured and for the underinsured and for the children who have no coverage.

Health insurers, meanwhile, are breathing a sigh of relief because, in his recent speech, President Obama drew back somewhat from his attacks on the health insurance companies. He said he had no interest in putting private carriers out of business, but he did want to hold their heels to the fire.

For example, he said that a public option was not necessarily a deal breaker. The public option would have a government-run health insurer that would compete with private insurance companies. He will consider, he suggested, options like the nonprofit cooperatives championed by Senator Baucus. Still, he said, he favored the public option.

Industry executives, in the wake of the president's speech, seemed encouraged by what they saw as his positive tone. They are particularly encouraged by his espousal that every citizen have health insurance coverage.

"Under my plan," President Obama said, individuals will be required to carry basic health insurance--just as most states require you to carry auto insurance."

"Of course," said a report in the New York Times, "there is still a possibility that Congress will back the creation of some sort of government-run plan, which is what insurers fear most. Because they say they cannot compete."

This story is far from over. Stand by.

THOMAS J. SLATTERY, a writer on industry affairs, is managing director of Slattery-Esterkamp Communications, Baldwin, N.Y.

October 8, 2009

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