Hard Sell for Health Care Reform

It can't be good when doctors boo your health care plans. As the Associated Press reports, however, that's what happened to the president yesterday as he unveiled his reforms to the "American Medical Association.

The boos erupted when Obama told the doctors in Chicago he wouldn't try to help them win their top legislative priority—limits on jury damages in medical malpractice cases.

Other parts of the package got more favorable response. But the AP story aptly points out that big plans offer everyone something to dislike and every player in the health care debate has a wish list. Forging compromise won't be easy.

The Washington Post has the strategy in a nutshell.

The Obama strategy, articulated in the speech here and in a series of private meetings, is to present each major stakeholder with an enticement in return for a bit of sacrifice.

The WaPo shows some examples of sacrifice, inlcuding this:

Some interest groups have begun to balk as the president has staked out his position in greater detail.

Over the weekend, Obama outlined $313 billion in cuts to Medicare and Medicaid aimed primarily at the revenue of hospitals and drugmakers.

The American Hospital Association said in a statement that it was "deeply disappointed and concerned" by the announcement.

No doubt. And the report Congress received yesterday won't relieve the concerns (also from a Washington Post story). The article begins with the bottom line.

Expanding access to Medicare will not solve the nation's health-care cost problem.

Few of us thought it would. Medicare is on an unsustainable spending trajectory, but successful cost-containment efforts have proved elusive, the report says.

As Congress and the Obama administration seek to restrain potentially crushing increases in health-care spending, the report by the Medicare Payment Advisory Commission (MedPAC) is emblematic of the larger debate: long on problems and short on solutions.

There's  no reason to believe a greater government presence in health care would yield different outcomes. The Heritage Foundation reports in the Morning Bell blog that the Congressional Budget Office has looked at the numbers. The tab is stunning.

Yesterday the non-partisan Congressional Budget Office (CBO) released a preliminary analysis of the Kennedy-Dodd health care plan, and the results were truly frightening. Assessing just Title I of the draft legislation, CBO estimated the plan would add $1 trillion to the federal deficit while only extending health insurance to a net 16 million more Americans. As scary as that is, what is even more disturbing is what costs the CBO did not estimate: “The proposal does not include a ‘public plan’ that would be offered in the exchanges, nor does it contain provisions that would require employers to offer health insurance benefits or impose a fee or tax on them if they did not offer insurance coverage to their workers.”

At the Washington Policy Center, John Barnes notes that the so-called public option won't be on a level playing field with private plans. The stock market is also taking note. 

Rather than rushing to do the wrong thing, it would be wise to slow down, as Don Brunell writes in this column.

Update: The president's home town newspaper is skeptical.