THE BIG QUESTION, May 12: Healthcare

The Big Question is a feature where influential lawmakers, pundits and interest group leaders give their answers to a question that’s driving discussion in news circles around the country.

Some responses are gathered via e-mail, while others are gathered in person via tape recorder.

Today’s Big Question is:

Regarding healthcare reform, how can President Obama succeed where Bill Clinton failed?

Read responses below from Dean Baker, Celinda Lake, Sam Blair, Chris Calabrese, William Redpath, James Floyd, Michael Cannon, and Jeff Blum.

Read the last Big Question here.

Dean Baker, Co-Director of the Center for Economic and Policy Research, said:

President Obama and his advisers have obviously learned a great deal from the Clinton experience. He is going about reform exactly the right way, having specified some general principles and then letting Congress take the lead. As a result, there is no detailed plan that
the opponents of reform can shoot at.

He also has been very clever in structuring reform in a way that will not scare people. At the center of his proposal is a public Medicare-type plan that people will have the option to buy into, if they want. This is 180 degrees at odds with the Clinton plan, where the industry groups could scare people about the health care plan that the government will force people into. President Obama is not proposing to take anything away; he is proposing to give people a choice (the public plan) that they do not currently have. Read the full response here.

Celinda Lake, President of Lake Research Partners, said:

We are organized in a far more effective way. We have better messages than before. Second, we have focused more on insurance company abuses, and people want help to control costs and insurance company practices. Third, business is at the table more because health care is hurting their competitiveness. Fourth, we have a better plan. The Clinton plan was simply too complex. This allows a fundamental choice between what you have and either another private plan or the public health insurance plan.

Sam Blair, National Network Director of the Main Street Alliance, said:

Here’s one group that’s in a very different place than it was in 1993-94: small business. This time around, small business owners want real health reform to go forward – and are willing to contribute to the solution.

As the Senate Finance Committee held its third roundtable Tuesday, this one about how to pay for health reform, the Committee received an unexpected message from small business, a group that walked away from the table when the chips were down last time around. Main Street Alliance small business owners from seven states with Senators on the Finance Committee submitted a statement for the record that can be summarized quite simply: “We’re willing to contribute.” Read the full response here.

Michael F. Cannon, Director of Health Policy Studies, The Cato Institute, said:

Execute a 180-degree turn and offer some health care reforms that would actually work.

Right now, the government controls half of our health care dollars, while employers control another quarter. No one disputes that letting consumers control that money will reduce health care costs. We can do so with tax reform (e.g., large health savings accounts) and Medicare reform. State regulations all too often increase the cost and reduce the quality of health insurance and medical care. Congress should let consumers and employers purchase health insurance from out of state, and should let practitioners take their licenses from state to state. Markets will make health care better, cheaper, safer, and more secure – but there will always be some people that fall through the cracks. Congress should reform Medicaid the way it reformed welfare, which would give states the flexibility to target those dollars to the truly needy.

Jeff Blum, Executive Director of USAction, said:

President Obama supports a plan to cut costs, not just feed into the private insurance industry’s ability to cover people. He is honest. He acknowledges that the option of a public health insurance plan will be expensive, but he has identified tax savings to pay for this effort. Finally, he is working with a well-organized, outside movement to make these things happen. This is a significant departure from the 1990s — or from any time in modern history.

Chris Calabrese, Attorney for the ACLU’s Technology and Liberty Project, said:

In pushing for the overhaul of the health care system President Obama has one big step up on President Clinton: he has already succeeded in putting patient privacy first. The recent stimulus legislation contains substantive new privacy protections including the first ban on the sale of medical records, allowing patient access to audit trails, limits on marketing that uses personal health information and some right to limit the sharing of medical information. By contrast it took eight years under Clinton to adopt the weak HIPAA protections (which were subsequently watered down further under President Bush).

Public buy-in to health care reform is crucial. One of Americans’ biggest fears is that the creation of electronic medical records means more access to their medical records – by insurers, by employers and even by criminals. Proper implementation of these new statutory protections can go a long way toward alleviating those fears and putting the patient in control of his or her own care. Read the full response here.

James Floyd, a healthcare researcher at Public Citizen, said:

During the Clinton health reform effort, the special interests responsible for our health care crisis were included in discussions, while the public was excluded. Although there have been dozens of forums and hearings already this year to create the appearance of transparency, once again, the White House and Congress have negotiated behind closed doors with private insurers, pharmaceutical companies, and trade groups that oppose fundamental reform. Read the full response here.

William Redpath, Chairman of the Libertarian National Committee, said:

What government should be doing is to help empower health care consumers in our society, not insurance companies, or other organized groups or government itself. Health care consumers were not represented at that confabulation yesterday, and they should be going forward.