[Posted by Karl]
Matt Bai has a lengthy piece in The New York Times Magazine, detailing the myriad ways in which Pres. Obama, Vice Pres. Biden and WH Chief of Staff Rahm Emanuel are getting more directly involved in their proposed government takeover of the healthcare system. Biden and Emanuel have been involved below the radar for some time already, but there is also this Sorkin-esque nugget:
Of all the assets the White House has at its disposal, of course, none are more valuable than a three-dimensional president with a 60-plus-percent approval rating. Emanuel and I had been talking for just a few minutes when his office door suddenly burst open and the president strode in. I hadn’t seen Obama since interviewing him last September on the day when the stock market crashed (John McCain crashed soon after), so I congratulated him belatedly, and he chatted amiably for a few minutes, appearing entirely untroubled in the midst of the myriad crises facing his administration. Fumbling clumsily to button my suit coat as I stood in his presence, I was reminded of how different it is to talk with someone who has actually assumed the historical weight of the presidency, even if you’ve spoken with him before. Emanuel knows this phenomenon is as real for senators and congressmen as it is for reporters, which is why he choreographs the same kind of “spontaneous” drop-bys when members comes to see him. “I’ll have a lunch here, and he’ll come by to say hi to Susan Collins the way he came by to see you,” Emanuel told me after Obama departed, referring to the senator from Maine. “It’s an efficient use of his time.”
Is it? Robert Reich passes along some juicy tidbits to the contrary about Maine’s other “moderate” Senator:
Enter Olympia Snowe. Her move is important, not because she’s Republican (the Senate needs only 51 votes to pass this) [That remains to be seen –K] but because she’s well-respected and considered non-partisan, and therefore offers some cover to Democrats who may need it. Last night Snowe hosted a private meeting between members and staffers about a new proposal Pharma and Insurance are floating, and apparently she’s already gained the tentative support of several Democrats (including Ron Wyden and Thomas Carper). Under Snowe’s proposal, the public option would kick in years from now, but it would be triggered only if insurance companies fail to bring down healthcare costs and expand coverage in he meantime.
What’s the catch? First, these conditions are likely to be achieved by other pieces of the emerging legislation; for example, computerized records will bring down costs a tad, and a mandate requiring everyone to have coverage will automatically expand coverage. If it ever comes to it, Pharma and Insurance can argue that their mere participation fulfills their part of the bargain, so no public option will need to be triggered. Second, as Pharma and Insurance well know, “years from now” in legislative terms means never. There will never be a better time than now to enact a public option. If it’s not included, in a few years the public’s attention will be elsewhere.
Much the same dynamic is occurring in the House… (Emphasis added.)
Similarly, we have already seen House Majority Leader Steny Hoyer suggest there is little support for handing the Medicare Payment Advisory Commission the power to come up with recommendations to control costs with little input from Congress. This was going to be Obama’s backdoor way for voting “present” on all of those unpopular decisions to ration medical treatment that would follow from a government-dominated healthcare system. And this is before Obama’s bill has had a chance to be digested by the public, with the inevitable troublesome details that will emerge. Moreover, as Bai’s piece points out:
THE NETTLESOME THING about leaving the details of the health care plan to Congress, though, is that this Congress, like most every other Congress, doesn’t appear inclined to pay for much of anything. And it is this part of the health care debate — where to find the money — that seems most likely to derail the process.
This has been obvious for a while, but it always bears repeating, especially to readers of The New York Times. The Obama administration has studied the Clintons’ failure to take over American medicine, and is pursuing a different Congressional strategy. But Congress remains Congress.
–Karl
