What Obama Must Demand from Congress on Health Care

Picture 11 Congress returns this week to one of the fiercest and most important debates in recent memory — whether and to what extent the nation will provide health care to all Americans, and how we will reign in the soaring costs of health care overall. But do not expect unusual courage from this Congress in standing up to demagogic lies and money-toting lobbyists. An unusually large portion is facing close races in 2010, both in primaries and in the general election. Republicans have many primary challenges from the right. A record number of Democrats, who took over Congress in 2006, hail from traditionally Republican or swing states and districts.

In order to get anything meaningful through this session of Congress, then, the President will have to give congressional Democrats far more leadership and more cover. Doing so is harder now than before the recess, when he was still basking in the afterglow of a honeymoon and 60 percent favorabilities.Yet it’s not too late. Addressing a joint session of Congress next Wednesday is a good idea but Obama can’t rely solely on his exceptional rhetorical skills. He’ll need to twist arms, cajole, force recalcitrant members to join him, threaten retribution if they don’t come along.

Most importantly, he’ll need to be specific about what he wants — especially about three things. I hope says the following next Wednesday, and makes clear to individual members that he means business.

1. I will not stand for a bill that leaves millions of Americans without health care. It’s vitally important to cover all Americans, not only for their and their childrens’ sakes and not only because it’s a moral imperitive, but because doing so will be good for all of us. One out of three Americans will experience job loss and potential loss of health insurance for themselves and their families at some point. One out of four of us who have health insurance is underinsured –unable to afford the preventive care we and our kids need on an ongoing basis. And those of us who don’t get preventive care can get walloped with diabetes, heart disease, and other major illnesses that wipe us out financially, or force us into emergency rooms that all of us end up paying for.

2. The only way to cover all Americans without causing deficits to rise is to require that the wealthiest Americans pay a bit extra. The wealthy can afford to make sure all Americans are healthy. The top 1 percent of earners now take home 23 percent of total national income, the highest percentage since 1928. Their tax burden is not excessive. Even as income and wealth have become more concentrated than at any time in the past 80 years, those at the top are now taxed at lower rates than rich Americans have been taxed since before the start of World War II. Indeed, many managers of hedge funds, private-equity partners, and investment bankers — including those who have been bailed out by taxpayers over the last year — are paying 15 percent of their income in taxes because their earnings are, absurdly, treated as capital gains. We should eliminate this loophole as well, and use it to guarantee the health of all.

3. Finally, I want a true public insurance option — not a “cooperative,” and not something that’s triggered if certain goals aren’t met. A public option is critical for lowering health-care costs. Today, private insurers don’t face enough competition to guarantee low prices and high service. In 36 states, three or fewer insurers account for 65 percent of the insurance market. A public insurance option would also have the scale and authority needed to negotiate low drug prices and low prices from medical providers. Commercial insurers now pay about 30 higher rates to providers than the government pays through Medicare, because Medicare has the scale to get those lower rates. A nationwide public option could get similar savings. And those savings would mean lower premiums, deductibles and co-payments for Americans who can barely afford health insurance right now.We’ll see.

Robert Reich served as the 22nd United States Secretary of Labor under President William Jefferson Clinton from 1992 to 1997.  He blogs regularly at robertreich.blogspot.com, where this post first appeared.

Livongo’s Post Ad Banner 728*90

Categories: Uncategorized

Tagged as: , , ,

23
Leave a Reply

23 Comment threads
0 Thread replies
0 Followers
 
Most reacted comment
Hottest comment thread
11 Comment authors
Scott DaveAlexander SaipBirel86xinchoate but earnestPeter Recent comment authors
newest oldest most voted
Scott Dave
Guest

Thank you, I can only care for one person at a time…who will decide who is first, and then second, and then…? Healthcare On Demand

MD as HELL
Guest
MD as HELL

Yes.
It is not the job of the federal government.
Sounds cruel, but it is not. There are other ways to care for these deserving people, but not by the federal government.
That is the slippery slope of never saying “no” to a worthy cause. The federal gov’t must say “no” to all special causes.
It is not their job.

Alexander Saip
Guest

One has to be really skilled in drawing the line between general welfare of the nation and benefits for individuals. Most of us are blessed to be able-bodied. Should we withhold the portion of our taxes that finance the Rehabilitation Services Administration, on the premises that the activities of the agency benefit certain individuals?
As I said before, our society keeps evolving, together with our views on the role of the government in our lives.

MD as HELL
Guest
MD as HELL

Mr. Saip,
If you are taxed by the federal government for a service provided to individuals rather than for the general welfare of the country, then, yes, it is tyranny to be forced to pay such a tax.
The feds have overreached their authority and no one is standing in their wasy

Alexander Saip
Guest

Taxation = tyranny if I personally don’t use services my taxes pay for?

MD as HELL
Guest
MD as HELL

Lots of fools are educated. Indoctrination is much more insideous.

MD as HELL
Guest
MD as HELL

No one will force care on you, but you will be forced to pay for it whether or not you use it. That is the tyranny.
I can only care for one person at a time…who will decide who is first, and then second, and then…?
When the line stretches all the way to Washington, maybe the last person in line can turn around and ask the government for a fast pass. I am sure there will be a loophole for the priveleged elite and their lapdogs to get VIP treatment.

Nate
Guest
Nate

A state politician isn’t hiding 2000 miles away for starters. Second they answer to the states population not the nations.
There is and has been far more coruption by Democrats then republicans ever have committed.
States rights was closer to ideal then the centralized power/planing system road we are headed down. ANy such experiments should be undertaken by individual states.

Alexander Saip
Guest

Nate: “…I want my taxes paid to a government that is accountable to me, not DC 2000 miles away to a handful of crooks that don’t know I am alive.” What makes you think that your Senator or House Representative in DC are less accountable to you than their State counterparts? After all, they all receive political contributions… “…Democracy doesn’t win when you have political machines like Daly in Chicago, Tamney Hall in NY and the corruption of NJ, CT, and MA.” Do you mean there is no corruption in TX, SC or AK? The color of the state doesn’t… Read more »

Birel86x
Guest
Birel86x

Mr. Reich, Given a 2.5X variance in healthcare costs from region-to-region (www.dartmouthatlas.org), why wouldn’t we find ways to change the system delivery first before we add tax burdens? This is not to defend wealth accumulation, but instead to drive change…as soon as we have a way to finance access for the uninsured, i.e., by an additional tax, we relieve the pressure that is so important in a change process. The numbers associated with the over-supply of care (too many tests, too many specialist visits, etc) are really big. Estimated by a number of analyses to be about 30% of the… Read more »

inchoate but earnest
Guest
inchoate but earnest

MD as Hell wrote: “This eliminates freedom from government, which was the dream and vision of our Founders.” It’s not even possible for anything to be further from the truth. It’s barely possible to carry on a substantive conversation with anyone whose thinking actually proceeds from such obvious nonsense. “Freedom from government”? Really? There was not one Founder who imagined, let alone proposed, that anything they were up to would “free” people from “government”. Please, your ability to compose entire legible words and post them on the internet indicates you have sufficient intelligence to sit down and actually learn something… Read more »

Margalit Gur-Arie
Guest
Margalit Gur-Arie

MD as HELL: I do agree with almost every word you wrote. The problem is that if you have no means, you cannot exercise that freedom. If you cannot afford health care when you are seriously ill, you cannot freely decide that you want to live. And yes, it is the government’s role to make sure that you have the freedom to decide if you want to live in sickness or receive treatment. I am not suggesting that government forces you to undergo heart surgery, only that it allows poor folks the same freedom to choose as the more fortunate… Read more »

Peter
Guest
Peter

“What we fought off them is no different then the left coast we are trying to fight off now. It was about 1 set of people living off the work and labor of another against their will.”
Yup, it’s about Red State welfare bums living off the hard working people of the left coast.
http://online.wsj.com/article/SB110290129211398078-search.html
http://www.huffingtonpost.com/2009/07/15/blue-states-pick-up-healt_n_234217.html

MD as HELL
Guest
MD as HELL

Margalit, Theirin lies the problem with “”helping” people: Freedom to live and die as one chooses or as someone who loves you chooses for you IS the cenral concept in The United States of America. Having the government choose for you is anathema to the continuation of the country under the Constitution. It is better to be free and sick than QALY’d and sick. It is better to be free and illiterate rather than indoctrinated and educated. This is the basic difference between liberal and conservative: Who chooses your life? The United States was founded to protect the individual from… Read more »

Nate
Guest
Nate

are we foreign to Hawaii? We are surly foreign to guam then? you need to seperate the word taxes into its legal taxing entities. I am willing to pay federal taxes for the defence of our nation and its borders. I am willing to pay state taxes for for the regulation of commerace and some consumer saftey I am willing to pay county & Local taxes for my police, fire, and some utilities. I want my taxes paid to a government that is accountable to me, not DC 2000 miles away to a handful of crooks that don’t know I… Read more »