Guest Post: Obama Needs to Accept His Role as Goatherd in the Health Care Debate

This guest post was submitted by a reader who wishes to be known as “Marlowe.” We thank him for his contribution.

I don’t have my own blog. I am no policy wonk. I am just a working stiff with a family, and I happen to read this blog during lunch. But I am worried: worried about the direction of the debate regarding health care reform. As congress debates, and the details of more proposals come out, we are getting further and further away from the complete overhaul the system needs. I am sure you all are bored of hearing the numbers over and over, for instance, how the amount we spend on health care is much larger than other developed nations for no better results

and that costs are rising faster than inflation, etc., etc.

Sure, Obama has given us broad — and admirable — goals for what he wants from health care reform.

In his press conference last week we learned he wants a plan that

  • allows any American currently insured to “keep what you have”
  • provides an insurance exchange
  • won’t add to the deficit
  • must control cost growth in the future
  • will eliminate waste and inefficiency in Medicare

I hope that the press conference, and subsequent town hall meetings, signal additional involvement from the president on the issue, but the president’s own website doesn’t make me optimistic by simply echoing the main (nonspecific) points from the press conference. gives us some reports on what is wrong with the current system and a couple of “success stor(ies) in American health care”:  one about heart disease and stroke screening in Nebraska and one about preventing medical errors from Michigan. Excellent programs to be sure. But surely these bright spots are not a road map for an overhaul of the whole system. And while publicly praising places that have developed new models for health care like the Cleveland and Mayo Clinics, we continue to be without proposals from the Obama administration for how to adopt their systems to the entire nation.

I am not the only one feeling frustrated with Obama’s silence:

It would help, lawmakers are saying more frequently in private, if the President would be clearer about how he wants to fix the problem. His strategy of keeping his distance from the legislative machinery while only saying that any final product must meet certain broad principles means that Representatives and Senators have no clue as to what kind of bill he would accept in the end – and what they should be trying to sell to their constituents.

And on Tuesday morning I read in the New York Times that “the fate of the health care overhaul largely rests on the shoulders of six senators” and that ” the group of six has tossed aside the idea of a government-run insurance plan.” While the CBO hasn’t weighed in on the Baucus group’s proposals, the verdict on the other congressional proposals is not good as “bills crafted by House leaders and the Senate health committee do not propose ,the sort of fundamental changes, necessary to rein in the skyrocketing cost of government health programs.”

If Obama has some specifics in order to accomplish his many goals — including that of universal coverage — we need to see them before these various Congressional proposals become entrenched and we end up with a bill that does little to fix the problem, or — worse — fixes nothing at all. This is a once-in-a-generation opportunity. Maybe once in a lifetime.

Obama needs to seize control of the debate. Congress has had plenty of time to group think on its own. Now is the time for Obama to send a nearly complete bill to Congress. Presidents writing legislation and sending it directly to congress is not uncommon for significant and/or controversial legislation. Now, even more than in the past, it is one of the only ways to ensure that the White House’s priorities are reflected in the bill.

Kennedy wrote the Civil Rights Act.

Bush wrote the PATRIOT ACT.

Hell, Lincoln freed the slaves by executive order.

And while he is being more aggressive, how about getting out in front of the torture issue? We need a full accounting of what happened in the Bush Administration (and earlier) so that it doesn’t happen again. Sunlight is the best disinfectant.

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