The Note, 3/5/09: Healthy Start — Battle lines remain, but Obama begins with agreement on need for change

By Caitlin Taylor

Mar 5, 2009 8:11am

By RICK KLEIN Put all that partisan stuff on hold — Rush Limbaugh and taxes and spending, you can wait right here. Here comes everybody’s feel-good bipartisan issue of the year . . . health care? OK, maybe President Obama’s latest policy push won’t sprinkle magical consensus dust on the capital. In the 15 years since this was seriously attempted, to famously disastrous political consequences for Democrats, the partisan battle lines and the terms of the debate haven’t changed substantially. (Think we’ll hear about socialized medicine? Is it possible that we will avoid another take on Harry and Louise?) But the larger point is that so much has changed since Hillarycare — not least the prices of health care services, the evident costs of inaction, and the corporate environment surrounding all of it. Will the politics follow? (Can it afford not to?) On Thursday, the symbolism is substance again — all the major interests in the room for a televised summit on health care, and all agreeing the current system is unsustainable and more than a little ridiculous. Where once the president might have wanted health reform to benefit from a new bipartisan attitude, we’re not quite there yet. So bipartisanship will have be forged in the fires that melted down the first two years of Bill Clinton’s presidency. The president is avoiding the contentious stuff for now — that will be hashed out in rooms where C-SPAN cameras are barred — but he is starting by bringing it all back to the economy. “The cost of health care now causes a bankruptcy in America every 30 seconds,” President Obama will say in his 1 pm ET remarks, at the White House forum on health care reform. “By the end of the year, it could cause 1.5 million Americans to lose their homes.”  “If we want to create jobs and rebuild our economy, then we must address the crushing cost of health care this year, in this Administration,” the president will say, according to excerpts provided by the White House. “Making investments in reform now, investments that will dramatically lower costs, won’t add to our budget deficits in the long-term — rather, it is one of the best ways to reduce them.”  ABC’s Jake Tapper reports that Obama will enumerate his eight health care reform principles: “Guarantee choice of health plans and physicians; Making health coverage affordable; Protecting families’ financial health; Investing in prevention and wellness; Providing portability of coverage; Aiming for universality; Improving patient safety and quality care; and Maintaining long-term fiscal sustainability.” (Read and re-read those verbs.)  With everyone in an open session, and broad representation among interest groups and players: “Call it the ‘un-Hillary’ approach to doing things,” Tapper reported on “Good Morning America” Thursday. “Among the invitees are some who helped kill the Clinton administration’s health care overhaul in the 1990s. Everyone is supposed to be on his best behavior, but will that last?” the AP’s Ricardo Alonso-Zaldivar writes.  “This is a different day,” said Chip Kahn, a hospital lobbyist who opposed President Bill Clinton’s plan and was to attend Thursday’s gathering (and whose name will be heard quite a bit this time around). “I think among most of the stakeholders, everyone wants to see this work. There is a tremendous feeling that it’s time.” “The assemblage of disparate interest groups is an important part of the summit. In 1994, the opposition of some groups, led by the health insurance lobby, doomed President Clinton’s dream of remaking the health care system,” USA Today’s Richard Wolf writes.  Just maybe a different attitude going in: "Obama’s opening gambit to dramatically expand the health care system has attracted surprising notes of support from insurers, hospitals and other players in the powerful medical lobby who are set to participate in an unusual White House summit on the issue this afternoon," Dan Eggen and Ceci Connolly write in The Washington Post. "The lure for the industry is the prospect of tens of millions of new customers: If Obama succeeds in fulfilling his pledge to cover many more Americans, those newly insured people will get checkups, purchase medicine, undergo physical therapy and get surgeries they cannot afford today."  Key insight: "The unstated intention of Obama’s approach is to dole out the pain in small, easier-to-swallow bites to minimize opposition, White House aides say. Under the president’s plan, hospitals, doctors, drugmakers, insurance companies and wealthy seniors — all of whom will be represented at today’s summit — would sacrifice. But if the system was calibrated properly, no one would lose too much." Leading with some consensus, or at least one take on it: "After the November election, Obama called on Americans to hold community forums on health care and send ideas on how to fix the country’s ailing health system. The administration will present a summary of the feedback at today’s summit," Lisa Wangsness reports in The Boston Globe.  "The report, made available to the Globe yesterday, compiles the responses of 3,272 hosts of the nearly 9,000 community discussions held nationwide, as well as surveys from some 30,000 participants. Using sophisticated data analysis and teams of volunteers sorting through the data, the administration compiled a 120-page report that shows strong consensus on the problems facing the health care system." The strategy is laid bare by who’s not coming, too: This is very much not the realm of the Secretary of State, and surely not this particular Secretary of State. "[Hillary Rodham] Clinton’s distance from the health care initiative, figuratively and literally — she will be in Brussels on Thursday when Mr. Obama begins his effort to overhaul the system with a high-profile gathering of experts — underscores how the Obama White House is grappling with the cloud that still lingers over the Clinton plan 15 years after it imploded," The New York Times’ Sheryl Gay Stolberg writes.  "I think we’ve got her pretty well occupied," said David Axelrod. (This time, read and re-read the pronouns.) Learning from mistakes: Rahm Emanuel modeled Thursday’s summit "after a forum he helped Mr. Clinton convene during his second term. The topic then was welfare legislation, an initiative that, unlike the doomed health plan, passed Congress and was signed into law," Stolberg writes. (Obama’s nominee for HHS secretary, Kathleen Sebelius, won’t be there either; she hasn’t been confirmed yet, and she’s still got a day job as governor of Kansas.)  Ready for the long sale: "President Barack Obama and senior members of his administration are to be in Dearborn next week for a health care reform discussion, one of several such meetings that will be held across the nation as the president begins wrestling with how to cut insurance costs while improving access to coverage," Todd Spangler reports in the Detroit Free Press. "On March 12, the president will attend a forum on health care reform to begin the discussion. Gov. Jennifer Granholm is expected to lead it and Sen. Debbie Stabenow, D-Mich., is expected to attend."  UPDATE: The White House said Thursday that the president will not be making this trip. And yet — Watching for battle lines (how familiar does this feel?): "We shouldn’t nationalize one more percent," Sen. Chuck Grassley, R-Iowa, tells Bloomberg’s Aliza Marcus. "There will be some broken pottery," said Sen. Orrin Hatch, R-Utah.  "Forcing free market plans to compete with these government-run programs would create an unlevel playing field and inevitably doom true competition," reads a letter sent by Senate Minority Leader Mitch McConnell, R-Ky., and other key GOP senators. "Ultimately, we would be left with a single government-run program controlling all of the market." Release coming from the RNC Thursday: "TAX AND SPEND FEVER: Will Democrats Announce More Details On How They Will Finance New Health Care Proposals At Today’s Summit?" General Rove, rallying the troops by framing the president’s new push as a broken campaign promise: "Mr. Obama’s plan will lead us to the extreme of government-run health care. And in an effort to reach that goal, Mr. Obama’s budget proposes, as a starting point, a $630 billion fund to expand government-run health care. And that $630 billion comes not from reduced spending, but higher taxes," Karl Rove writes in his Wall Street Journal column. "Eloquent words and ‘spin’ work better in a campaign than they do while governing. And as Mr. Obama is discovering, the laws of economics won’t change, even for him."  Yes, already: "As President Obama prepares to convene a health care summit on Thursday, a conservative group has launched an ad campaign with the goal of defeating a government insurance option," ABC’s Teddy Davis reports. Look who will be in the room: "Rep. John Conyers, Chairman of the Judiciary Committee and a known single payer advocate, and at least one group advocating single payer, will be there as well," a source tells Huffington Post’s Sam Stein. Stein: "The inclusion of Conyers and at least one other group or individual should quiet, for the moment, the growing chorus of voices who have been openly pressing the White House to be more open-minded to a single-payer system." None of this can be considered in a political vacuum — and fear not, it won’t be. Obama continues to take real heat on the spending front. His top aides spent another day they wanted to be discussing fiscal discipline instead explaining why a bill with more than 8,000 earmarks deserves a presidential signature. "President Obama’s ambitious budget reforms are running into stiff resistance from members of his own party on Capitol Hill, testing his relationship with key centrists and members of the congressional leadership whose support will be critical to the advancement of the Obama agenda," per ABC News.  "Despite his campaign promise to root out wasteful spending, the president is accepting, for the time being, lawmakers’ ‘earmarked’ special projects. But by trying to skirt that political battle, Obama is creating another one: His commitment to signing into law an earmark-filled, $410 billion spending plan for the current fiscal year is raising questions among Democrats about his commitment to fiscal discipline." Per ABC’s Matt Jaffe: "At a Capitol Hill hearing, Sen. John Ensign, R-Nev., today pressed Treasury Secretary Tim Geithner on why the administration isn’t taking a tougher stand. ‘What I don’t understand is why you wouldn’t have stood up and said to the Congress, "OK, yeah, this may be last year’s work but times have changed. The economy has changed. We need to start making tough choices." ‘ "  "Obama can either walk in lockstep with legislative leaders of his own party, people he needs to push his agenda. Or he can keep the good-government credentials that are part of his public image," Politico’s Jonathan Martin writes. "But it will be tough to do both."  Does the president want to own this? "Senate Democrats on Wednesday preserved pet projects sought by a lobbying firm under federal investigation and tried to nail down support for big domestic spending increases in hopes of passing a wrap-up budget bill by week’s end," the AP’s Andrew Taylor writes. "Democrats defeated, by a 52-43 vote, an amendment to strip 13 projects that the PMA Group has pressed for. The firm, now disbanded, is accused of illegally using straw donors to funnel campaign cash to lawmakers." Another tidbit-turned-talking-point: "Congress wants to boost spending on itself by nearly 11 percent this year, an increase that’s part of a massive spending bill that has smaller increases for most agencies that deal with public health, education, energy, and other domestic needs," McClatchy’s David Lightman reports. "The congressional budget, which the Senate is considering this week as part of a $410 billion fiscal 2009 spending bill, is higher than the 8 percent overall boost for most domestic programs."  If there’s flexibility here . . . "President Barack Obama is meeting strong Democratic Party resistance to his proposal to reduce tax deductions enjoyed by upper-income Americans and could be forced to drop or modify the idea," The Wall Street Journal’s John D. McKinnon and Martin Vaughan report. "Mr. Obama in his budget blueprint last week proposed a cap on itemized deductions for mortgage interest and charitable donations to help pay for his health-care overhaul. The plan would cost wealthier taxpayers about $318 billion in new taxes over 10 years, according to government estimates. But after objections from Democratic lawmakers, Treasury Secretary Timothy Geithner appeared to suggest at one point Wednesday that the administration was willing to consider dropping or modifying the proposal." Who wants to keep talking about Rush Limbaugh? (Rush, put your hand down.) House Minority Leader John Boehner, R-Ohio, in a Washington Post op-ed: "In a carefully calculated campaign, operatives and allies of the Obama administration are seeking to divert attention toward radio host Rush Limbaugh, and away from a debate about our alternative solutions on the economy and the irresponsible spending binge they are presiding over. This diversionary tactic will not create a single job or help a single family struggling in today’s economic crisis. And that is where our focus should be." Have we turned this corner? "After carefully avoiding direct criticism of President Obama, House Republican leaders are now more aggressively trying to link him with new federal spending that they believe is excessive and ultimately won’t be popular with voters," CQ’s Edward Epstein writes.  Imagine if President Bush was layering political people on top of the agencies . . . "As President Obama names more policy czars to his White House team — high-level staff members who will help oversee the administration’s top initiatives — some lawmakers and Washington interest groups are raising concerns that he may be subverting the authority of Congress and concentrating too much power in the presidency," Tom Hamburger and Christi Parsons write in the Los Angeles Times. "Some lawmakers and outside experts fear that Obama is setting up a system that is not subject to congressional oversight and creates the potential for conflict among his many advisors." You can feel this one bubbling up: "An independent inspector general will look into the foreign financial ties of Chas W. Freeman Jr., the Obama administration’s pick to serve as chairman of the group that prepares the U.S. intelligence community’s most sensitive assessments, according to three congressional aides," Eli Lake reports in the Washington Times. "Among the areas likely to be scrutinized in the vetting process are Mr. Freeman’s position on the international advisory board of the China National Offshore Oil Corp. (CNOOC). The Chinese government and other state-owned companies own a majority stake in the concern, which has invested in Sudan and other countries sometimes at odds with the United States, including Iran."  (Isn’t vetting supposed to happen pre-nomination?) Adding to the reading list: "The Obama administration has negotiated a deal between Karl Rove and the House Judiciary Committee that will lead to Rove’s written testimony next week on the firings of several U.S. attorneys," The Hill’s Susan Crabtree and Sam Youngman report. John McCain would not have had this problem: "Just 44 days into the job, and President Obama is going gray," Helene Cooper writes in The New York Times. "Mr. Obama’s graying is still of the flecked variety, and appears to wax and wane depending on when he gets his hair cut, which he does about every two weeks." A new swing set for the Obama girls, per ABC’s Sunlen Miller. (Couldn’t they have gotten a toy that can’t be used as a ready metaphor for the markets?) Best wishes: "Former first lady Barbara Bush is recovering at The Methodist Hospital after successful open-heart surgery Wednesday to replace her aortic valve, a family spokesman said Wednesday night," Todd Ackerman reports in the Houston Chronicle. "The operation was scheduled last week, after Bush, 83, reported shortness of breath. Doctors diagnosed a hardening of the aortic valve, during which the valve narrows and obstructs blood flow."  Just announced, for your calendars: "President Bill Clinton, Founder, William J. Clinton Foundation, 42nd President of the United States, will present the keynote address at FORTUNE magazine’s annual Brainstorm: GREEN Conference on Earth Day, Wednesday, April 22, 2009. The President’s remarks will cap off a three-day gathering of America’s top CEOs, policy leaders and environmentalists at the nation’s premier green business event." The Kicker: "We do not tease about the gray at all." — President Obama’s haircutter, Zariff.  "I haven’t tested the rule yet. But what I’ve been telling people is I think the president has the right to call any citizen that he feels like calling any time he wants. I haven’t had to use him yet, but I think I ought to petition the NCAA to see what the ruling will be on that before I do it." — Oregon State basketball coach Craig Robinson, on the possibility of a recruiting phone call from a certain influential brother-in-law. 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