Current health reform efforts echo past struggles as chances are weighed

The chances for President Barack Obama and the Democratic Congress to enact health reform is being weighed by a number of analysts, who are handicapping the outcome based on past and present experiences.

The Washington Post columnist Abigail Trafford writes that Obama's struggles mirror that of the Clinton administration's experience in the mid-1990s. "The Obama and Clinton initiatives had very different strategies. Hillary Clinton and her team of wonks labored in secrecy to design a perfect bill; early on, they dissed members of Congress. … This time, the Obama administration did the reverse. The White House turned to Congress to design the bill. Meanwhile, the president courted the health-care industry and won over organizations that had opposed the Clinton plan." The Clinton plan touched on all parts of health care while the Obama plan focused almost completely on insurance reforms "but it seems like a really big and overly complicated plan." She notes that health reform appears to play well on the campaign trail, "but the details of a plan can be fatal. Cumbersome, controversial, confusing bills seem to get dashed by the cumbersome, controversial, confusing political process" (Trafford, 2/2).

The Philadelphia Inquirer has a Q&A with Robert Field, a law and public health professor at Drexel University on health reform's chances. To be more successful, Field said, Obama "needed to be more like a tactician and get his party in line. Some people say Democrats can never be put in line. But LBJ figured out how to do it. You need to be an arm-twister." Obama has "gotten a tremendous amount of money to develop electronic medical records, which could transform the way medicine is practiced. He also got comparative effectiveness analysis funded through the stimulus bill. If it succeeds, it could cut costs and raise quality. There could be a lot less unnecessary and harmful care and less waste" (2/1).

Obama, in a YouTube sponsored Q&A session took questions from American on many issues, including health reform, The Wall Street Journal reports. He also offered his take on how the overhaul might move forward. "The president (said) that they are 'extremely close' (to enacting reform) and then said he was hoping for Republicans to finish the job. 'We had this enormous opportunity, but the way the rules work in the United States Senate, you've got to have 60 votes for everything. After the special election in Massachusetts, we now only have 59. We are calling on our Republican colleagues to get behind a serious health reform bill, one that actually provides not only the insurance reforms for people who do have health insurance but also the coverage for folks who don't. My hope is, is that they accept that invitation and that they work with us together over the next several weeks to get it done'" (Meckler, 2/1).

The New York Times Prescriptions blog examines what course Democrats might have going forward. What Democrats "have not suggested, perhaps because of the exceedingly bellicose comments by Republican Congressional leaders, is that they would try to rewrite the bill in such a way that lawmakers in both parties would find it virtually irresistible. … If they did, they just might start with a phone call to Representative John Shadegg, Republican of Arizona, who recently said he would retire after this year. … Mr. Shadegg has long had a keen interest in health care issues. Unlike his party's leaders, he has no personal stake in the outcome of this year's hotly contested mid-term elections and therefore no personal interest in seeing the Democrats fail. He has studied the nation's health care system and has some serious ideas. And he believes that Republicans and Democrats share common goals" (Herszenhorn, 2/1).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.