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Optimism and Pessimism on Health Care Reform in Today’s Washington Post

August 12th, 2009 . by economistmom

Steven Pearlstein sounds quite optimistic today about President Obama’s ability to turn the current health care reform debate into something real and good:

Republican strategists and their media rabble-rousers cleverly thought they could dispatch their shock troops this month and kill health reform once and for all.

Instead, they’re on the verge of generating what they’ve been desperate to avoid — an urgent, national, rational conversation on how to make the health-care system fairer and more affordable.

To be sure, many details of health reform are still to be ironed out. But in the end, what is likely to emerge from this conversation is a health system that looks more like what President Obama has in mind than what Republicans have been peddling these past 15 years without any visible signs of success.

At his town hall meeting Tuesday in Portsmouth, N.H., Obama reminded us of the deft political touch and mastery of policy details that won him the presidency. He and the good citizens of southern New Hampshire have set the standard against which other politicians and citizens will be judged…

But Steven’s colleague Ruth Marcus? …Not so much:

Candidate Barack Obama offered a lofty vision of how his White House would operate. When the details of health reform were being hammered out, he vowed, “We’ll have the negotiations televised on C-SPAN so that people can see who is making arguments on behalf of their constituents, and who are making arguments on behalf of the drug companies or the insurance companies.”

The campaign even aired an ad singling out Billy Tauzin, the drug industry’s chief lobbyist. “The pharmaceutical industry wrote into the prescription drug plan that Medicare could not negotiate with drug companies,” Obama said in the ad. “And you know what? The chairman of the committee, who pushed the law through, went to work for the pharmaceutical industry making $2 million a year. Imagine that.”

Now, it turns out, the Obama White House has cut a backroom — actually, Roosevelt Room — deal with Tauzin: Drugmakers would ante up $80 billion in savings in return for a promise that Medicare wouldn’t be allowed to negotiate drug prices.

“We were assured: ‘We need somebody to come in first. If you come in first, you will have a rock-solid deal,’ ” Tauzin told the New York Times.

Imagine that…

[T]he episode underscores the dangerously wide gap between Obama’s idealistic campaign-trail promises and the gritty realities of governing…

Seemingly simple campaign pledges turn out to be intractable problems… campaigns worry about election first, implementation later.

Clear positions yield to political realities. Having Medicare negotiate prescription drug prices gives way to the need to get drug companies on board. The campaign climate-change plan to auction off all emissions permits morphs, without a presidential peep, into a House-passed measure that would hand out 85 percent of the permits as political candy to mollify lawmakers in districts that would be hit hard by strict emissions limits…

[T]he greatest peril for Obama, I think, lies in the question of whether he can produce the new, post-partisan, surmounting-special-interests politics that he envisioned during the campaign. In a month of raucous town hall meetings and stalled legislation, that hardly seems likely. The secret deal with Tauzin can only deepen the skepticism.

Ruth, haven’t you read the study?  Don’t worry.  Be happy.

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