Decoding Obama’s Health Care Plan

by Jonathan Chait
The New Republic, February 5, 2010

At a fundraiser last night, President Obama laid out his vision for health care reform. This is interesting:

Mr. Obama said that once Congressional Democrats had worked out their differences and settled on a final bill, he would push for a vibrant, public debate over the health care legislation. He said he planned “to call on our Republican friends to present their ideas.”

“What I’d like to do is have a meeting whereby I am sitting with the Republicans, sitting with the Democrats, sitting with health care experts and let’s just go through these bills,” Mr. Obama said. “Their ideas, our ideas. Let’s walk through them in a methodical way, so that the American people can see and compare what makes the most sense. And then I think that we have got to move forward on a vote. We have got to move forward on a vote.”

Mr. Obama said that Americans were apprehensive about the health care legislation because there was too much misinformation that he would now work to clear up.

“They are certain that they would have to go onto a government plan, which isn’t true,” the president said. “But that’s still a perception a lot of people have. They are still pretty sure that they would have to give up their doctor. They are still pretty sure that if they are happy with their health care plan, that it’s bad for them. They are still positive that this is going to add to the deficit. So there is a lot of information out there that people understandably are concerned about.”

He continued, “That’s why I think it’s very important for us to have a methodical, open process over the next several weeks and then let’s go ahead and make a decision. And it may be that if Congress decides, if Congress decides we’re not going to do it, even after all the facts are laid out, all the options are clear, then the American people can make a judgment as to whether this Congress has done the right thing for them or not. And that’s how democracy works, and there will be elections coming up and they will be able to make a determination and register their concerns one way or another during election time.”

Is this wishy-washy capitulation? Greg Sargent is worried:

Maybe I’m misreading this. But if you look at the transcript of Obama’s remarks at a fundraiser last night, it seems like the President was at least raising the possibility that health reform may not happen.

To be clear, Obama didn’t say this was a desirable outcome — quite the opposite, in fact — but he did seem to suggest that it’s possible.

I don’t think that’s what’s going on. I actually had to read Obama’s remark twice to fully understand what he’s getting at, but now that I have, it seems pretty clear. I think Obama sees the perception that the process is broken — that it’s backroom deals and “ignoring the will of the people” — to be the biggest impediment to passage of the bill. So he’s proposing a remedy to that perception.

The most important part is what Obama says should happen first: Democrats should settle their differences and work out a final bill. That’s crucial. Then he wants to sit down with both parties, and health care experts, and walk through the details in a methodical way. I’d guess he’s imagining a process that might look a little like his back-and-forth with House Republicans — they present him with wild claims about a government takeover, and he calmly responds. They insist that their ideas are better, and he gets to show that they’re not. Then you vote. In other words, a debate in which he gets to take center stage, on top of the kabuki theater of a House debate. That way Obama gets to demonstrate that the plan he has is the product of having considered all the alternatives and arriving at the best way to solve the problem, not just cooking up a backroom deal. The idea seems to be to use his wonky, technocratic style to counteract the process-based objections and sell the bill.

Another key element of Obama’s remarks is his insistence that Congress actually have a vote. Let me repeat that section:

That’s why I think it’s very important for us to have a methodical, open process over the next several weeks and then let’s go ahead and make a decision. And it may be that if Congress decides, if Congress decides we’re not going to do it, even after all the facts are laid out, all the options are clear, then the American people can make a judgment as to whether this Congress has done the right thing for them or not.

He’s saying that Congress can’t just ignore the issue and let it die in quiet. It needs to have a vote, relatively soon, and make a decision, rather than decide by default to keep the status quo. This strikes me as enormously positive news.