Obama administration faces increasing challenges to health reform

The Obama administration is facing increasing opposition to various aspects of health reform proposals - especially the idea of a "public plan." 

In an interview with The New York Times and CNBC, President Obama said that the public plan approach is "sensible," he is willing to be flexible. "Let's just make sure that, you know, we're open-minded. And if, for example, the cooperative idea that Kent Conrad has put forward, if that is a better way to reduce costs and help families and business with their health care, I'm more than happy to accept those good ideas," Obama said. He added that spending could be reduced significantly by trimming costs within the health care system. "Medicare and Medicaid, the biggest cost drivers are ones that we can reform if we look at how we're reimbursing doctors and hospitals, if we look at prevention and health IT, if we look at the concept of comparative effectiveness. Those communities that are doing a better job providing high-quality care at low cost, let's duplicate that across the system" (Harwood, 6/16).

Meanwhile, when USA Today interviewed CBO Director Douglas Elmendorf on Monday, he said that the cost to cover the 46 million uninsured Americans "will continue to rise, and savings from efforts to curb health care spending may be elusive." Elmendorf said the savings Obama mentions "cutting costs in high-spending regions, expanding best practices and bundling services - won't be easy to achieve," USA Today reports. "There's tremendous potential to reap savings in the health sector without harming health, but turning that potential into reality is challenging… It's going to be a long, hard slog," Elmendorf said. As for eliminating regional variations in medical spending, "the director said that's due to ingrained ways of treating patients," which is not easily altered" (Wolf, 6/17).

In a news analysis, The Philadelphia Inquirer calls health care "the sternest political test so far in [Obama's] young presidency]. Voters "worry that government might assume too much control of health care, and most pronounce themselves satisfied with the insurance they have." The paper quotes Democratic pollster Stanley Greenberg, who "wrote in a memo summarizing the results of his recent Democracy Corps survey on the issue: 'People really need to know how they will pay less, how the plan will be paid for, and how they will have choice... Their presumption is that reform costs more, not less - and so, we have to be doubly diligent, respecting how personal a choice this is for people in very tough times.'"

"And a recent Rasmussen Reports poll "found that only 32 percent of Americans believed a government-run insurance plan would, in fact, lower costs."

The public plan is a "key element" of Obama's health care initiative, but it has spurred "intense opposition" from Republicans as well as special interest groups, including doctors, hospitals and insurers. The Administration has recently back-stepped on the issue. "White House senior adviser David Axelrod said yesterday that Obama was not wedded to a public plan's being entirely funded or run by the government" (Fitzgerald, 6/17).