The Obama Presidency and the Coming Health Care Battle

The health care battle began in earnest several months ago, of course politicians like Baucus have been preparing for even longer and Liberals had ideas what they wanted but lacked any true framework. The biggest factor leading to the delays and breakdown in the Democratic party has been Obama's hands off approach to what type of Legislation that Congress puts forward. His failure to get involved has been the greatest mistake of his presidency so far. From the beginning with the stimulus tragedy to cap and trade we have seen the president put his credibility on the line to sell legislation that barely has his foot print on it. Classic example would be his support for Waxmen's cap and trade only to be followed by his pronouncement that he opposes the protectionist measure within the bill. Of course his support for the stimulus bill which no one including him bothered to read blew up in the democrats collective faces over the AIG bonus disaster. There is a reason the Presidents polling has been in free fall lately, he simply is not credible and no amount of swooning from media and elites is going to change that. Its this failure to clarify what type of health reform bill he wants that has led to the near collapse of House Democratic Caucus and charges of racism against the "blue dogs" .

Two Visions
There are two types of bills floating around the Congress, they are the Baucus plan who as Chair of the Senate Finance committee has an extraordinary amount of influence on what type of bill will come forward, and then their is the Dodd-Kennedy bill in the Senate as well as the Rangel-Waxmen version in the House. Both are similar in nature, contain a Public plan and would likely break the Government's finances. The key dilemma facing the President is whether to team up with Baucus and pass a bi-partisan bill that costs less or stick with the liberal base and pass legislation the country neither wants nor can afford. The sense of frustration Democrats are having with Obama on the issue is almost palpable and his disaster of a press conference the other day did not help the matter.

The Fall
As of now it appears there will be no vote on either the house or Senate bills this Summer meaning the key battles will be fought this Autumn. Of course Pelosi may pull a fast one and try and get something, anything, passed just to point to, but this is becoming increasingly unlikely. Time is not going to change the CBO's take on these cost of these bills and its unlikely the President can pull a rabbit out of his hat to dramatically change the polling or support. Of course an economic up tick might give him some more credibility for a fall battle, but that remains to be seen. Expect pressure and favors to be exerted as a first step to get Democrats and others on Board with the Liberal plan. If that fails its possible the liberal base and the netroots may turn their full fury on Democrats who will not toe the line. This internecine conflict at the end of the first year of the Obama Presidency in the last thing the Democrats want, but the chances of it occurring have been growing by the day. Of course Obama could avoid these battles by compromising on some his issues, such as the public plan or taxes, but no matter his choice, he is going to anger someone. With middle class taxes now being floated and the Presidents vow to "not raise taxes" in a recession something of a joke we can expect even more opposition from the country. Whether this dissuades Obama and the Democrats is an open question, they have the votes and their base is yearning for the nationalization of health care. Such a course would accomplish the presidents goal, but at the cost of the Democratic party being saddled with legislation that is going to cost more then predicted, lead to doctor shortages and increased expenses, and place onerous burdens on various constituencies. A good question is what type of arguments will the left and Obama make now that their original arguments have proven utterly bogus.

The Argument
Reading the Times this morning the excuse for increased taxes is that unless "reform" is passed premiums will skyrocket, the deficit will swell, and the most questionable argument of all will be trotted out as a trump card,. That its a moral imperative to take care of the 47 million uninsured. Of course in the real world many of these people either failed to sign up programs they already qualify for or are the so called invincible who refuse to pay money for insurance they don't feel they need. I doubt these arguments will fly in the face of the greatest hurdle the left and Obama face in regards to health care, that is most people are happy with their insurance and their doctors.

The Compromise
Its easy to see mandated health insurance with a small tax penalty for those who fail to comply followed by a subsidy to aid lower income families who may not qualify for existing programs but lack the financial wherewithal to purchase insurance. Its also reasonable to expect the establishment of health care co-operatives and exchanges so people have more flexibility in purchasing insurance and a way to reduce the actual costs of coverage. Both of these ideas could be passed right now and generate a significant amount of GOP support. I suspect the President might even get more Liberals voting against such a package then Republicans, as the left goes crazed over the missed chance to create a program that will be the gateway to their prized single payer system. But such a deal will come late in the game. Expect another push for the maximalist position on health care with corresponding tax increases as well as cost cutting measures which squeeze doctors and hospitals even further. On the off chance that no deal is possible, (a slim but growing possibility) expect some type of legislation expanding s-chip or greater access to Medicaid, which is currently in the works anyway, much to the ire of the countries governors.

Final Thought
The president and the left are insisting on comprehensive reform because their window of opportunity is closing. As the nations keel evens out and the apparent free fall many people felt in September as Lehman collapsed disappears, the country is becoming increasingly intransigent to the radical plans of Obama and the left, hence the brilliance of the GOP "Experiment" line of attack. With Republicans poised to pick up Governorships in Virginia and especially New Jersey this fall and with the corresponding morale boost for them going into the midterms, the Democrats will be desperate to prevent a massive battle on health care prior to the 2010 midterms.