If there is one domestic policy accomplishment that President Barack Obama has staked his presidency on, it’s reforming the health care system.
Sure, the economy has defined his initial months. But that challenge was forced upon him, not chosen by him.
Obama’s policy centerpiece is health care, an issue that has bedeviled his predecessors.
If done right, health care reform could ease a suffocating financial burden on families, businesses and government budgets. It could produce a healthier society, with new emphasis on preventing chronic disease. And it could reduce the ranks of the uninsured.
If done poorly, the results could be politically catastrophic — as in Bill Clinton, circa 1994.
In the coming weeks, Obama will learn whether he’s defied the odds and is on a path toward victory and a place in the history books.
“The progress so far is good, but the next couple of months are crucial,” said Peter Orszag, Obama’s budget director and a central player in the process.
Most of the public action will take place on Capitol Hill.
out legislative language expected to be introduced in June. A tentative timetable sets floor debate and votes for late July or August.
The House, with its oversized Democratic majority, would follow the Senate action, setting the stage for conference committee negotiations by the end of the year.
It’s an ambitious agenda driven by a president who vows, privately and publicly, to see health care reform passed in his first year.
But with so many major players — hospitals, doctors, drug makers, private employers, unions, insurance companies — with skin in the game, it won’t take much to bog down the process in the notoriously inefficient Senate.
The Obama team knows that, of course, and it is pushing back primarily on two fronts: laying a firmer political and intellectual foundation for the debate than in past efforts and implementing an aggressive behind-the-scenes effort to keep the issue on track.
Change the terms of the debate
From the outset, Obama has framed the health care debate differently than have many Democrats.
His primary emphasis is on the economic threats of spiraling costs rather than a moral imperative to provide every American with good health care.
When he tapped Orszag to head his Office of Management and Budget, he added gravitas and volume to those themes.
Before their White House partnership, Orszag and Obama were more acquaintances than colleagues. They met occasionally in Obama’s Senate office or at outside forums.
But they’d been sharing space in the broad health care debate for two years.
While Obama was campaigning on the issue, Orszag was preaching — from his perch as Congressional Budget Office director — the economic necessity of reining in health care costs.
Their mantra: Rising federal deficits are fueled by them; workers’ paychecks are stagnating because of them; private and public investments in education, energy and transportation projects are made smaller to make room for them.
Orszag can even show a correlation between rising health care costs for states and higher education budget cuts that have led to wage contraction for college assistant professors.
Sure, the economy has defined his initial months. But that challenge was forced upon him, not chosen by him.
Obama’s policy centerpiece is health care, an issue that has bedeviled his predecessors.
If done right, health care reform could ease a suffocating financial burden on families, businesses and government budgets. It could produce a healthier society, with new emphasis on preventing chronic disease. And it could reduce the ranks of the uninsured.
If done poorly, the results could be politically catastrophic — as in Bill Clinton, circa 1994.
In the coming weeks, Obama will learn whether he’s defied the odds and is on a path toward victory and a place in the history books.
“The progress so far is good, but the next couple of months are crucial,” said Peter Orszag, Obama’s budget director and a central player in the process.
Most of the public action will take place on Capitol Hill.
The House, with its oversized Democratic majority, would follow the Senate action, setting the stage for conference committee negotiations by the end of the year.
It’s an ambitious agenda driven by a president who vows, privately and publicly, to see health care reform passed in his first year.
But with so many major players — hospitals, doctors, drug makers, private employers, unions, insurance companies — with skin in the game, it won’t take much to bog down the process in the notoriously inefficient Senate.
The Obama team knows that, of course, and it is pushing back primarily on two fronts: laying a firmer political and intellectual foundation for the debate than in past efforts and implementing an aggressive behind-the-scenes effort to keep the issue on track.
Change the terms of the debate
From the outset, Obama has framed the health care debate differently than have many Democrats.
His primary emphasis is on the economic threats of spiraling costs rather than a moral imperative to provide every American with good health care.
When he tapped Orszag to head his Office of Management and Budget, he added gravitas and volume to those themes.
Before their White House partnership, Orszag and Obama were more acquaintances than colleagues. They met occasionally in Obama’s Senate office or at outside forums.
But they’d been sharing space in the broad health care debate for two years.
While Obama was campaigning on the issue, Orszag was preaching — from his perch as Congressional Budget Office director — the economic necessity of reining in health care costs.
Their mantra: Rising federal deficits are fueled by them; workers’ paychecks are stagnating because of them; private and public investments in education, energy and transportation projects are made smaller to make room for them.
Orszag can even show a correlation between rising health care costs for states and higher education budget cuts that have led to wage contraction for college assistant professors.