Can Obama Deliver on Health?

By Rosenblatt, Robert A. | Aging Today, November/December 2008 | Go to article overview

Can Obama Deliver on Health?

Rosenblatt, Robert A., Aging Today

Potomac Sources

Can President-elect Barack Obama deliver on his expensive promises? That's the big question for the liberal wing of the Democratic Party, riding high after a series of election wins boosted the party's majority in both houses of Congress.

President-elect Obama promised a huge effort to expand healthcare coverage to millions of uninsured Americans. The price tag is about $100 billion a year, and Obama provided no specific recommendations about how to pay the bill other than vague claims of increased efficiencies through better use of technology and encouragement of prevention and self-care.


In facing a huge and growing deficit, a recession underway and a fragile financial system, Obama may decide he can't keep his promises on healthcare, at least not in one term. That would enrage some of the old lions in the Democratic Party, who watched Bill Clinton fail in his efforts to expand coverage in 1993 and 1994. Clinton had the same-size majorities as Obama does now in both houses of Congress, but he couldn't even get a vote in the full House or Senate for his complex proposal.

The Democrats held 253 seats in the House in 1993. As of November 7, they had an advantage of 251 to 173, with 11 seats still undecided. The Democrats held 57 Senate seats in 1993 and will control at least 57 in the new Congress, with three races undecided as Aging Today went to press. Their winning a filibuster-proof supermajority of 60 is possible but not likely at this writing.

The significance of all these numbers is to remind readers that control of the White House, the Senate and the House provides no guarantee of action on the costly and contentious issue of healthcare.

One thing seems certain: Congress will pass and Obama will sign a bill President Bush vetoed that will increase federal funding to expand coverage for children from lowincome families, in a package that would cost $50 billion over five years. That's a drop in the budget bucket compared with the 1 o-year price tag of $ 1 . 1 7 trillion if the Obama health plan were enacted in 2010, according to an analysis by the nonpartisan Lewin Group.

A "comprehensive healthcare reform plan like the Obama health plan is not realistic in these times of financial crisis," stated die healthcare blog of Robert Laszewski, a veteran of the insurance industry and an independent consultant on healthcare issues.

He forecasts mat the new administration will take only incremental steps and added, "There is already bipartisan support for a children's health insurance program (schip) extension and the means to pay for it, reform of Medicare provider payments and the means to pay for that, a list of commonly agreed to cost-containment initiatives that would cost the government little or nothing, and bipartisan support for help to the small employer to offer health insurance."

Obama told AARP, "I want to stop talking about the outrage of 47 million uninsured Americans and start actually doing something about it. To do so, we need a president who can bring Democrats and Republicans together, stand up to the drug and insurance industry lobbyists, and create a transparent process so that the American people can participate in the debate. That's how I expanded healthcare in Illinois, and that's how FU do it as president."

The president-elect said he is committed to signing a universal healthcare plan into law by the end of his first term that will lower costs by $2,500 per year for the average family - a figure questioned by many experts-»^Md enable people in the United States to buy "affordable, quality and portable health insurance coverage."

Obama has yet to explain in detail how he hopes to lower insurance premiums. The cost of healthcare has been steadily rising, faster than the growth in wages or the productivity of the American workforce. Health spending now consumes 16% of the total output of goods and services - the gross domestic product of the United States. …

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