Berkshire Brigades’ Op-Ed’s

Spend Some of that Political Capital on Health Care, Mr. President

By Lee Harrison, Chairman, Berkshire Brigades, the Countywide Democratic Organization

I suffer no illusions that this will be an easy process. It will be hard. But I also know that nearly

a century after Teddy Roosevelt first called for reform, the cost of our health care has weighed

down our economy and the conscience of our nation long enough. So let there be no doubt:

health care reform cannot wait, it must not wait, and it will not wait another year. – President

Barack Obama, February 24, 2009

We agree, Mr. President. It is time America joined the rest of the civilized world by making

health care both universal and affordable. But clearly, you are going to have to spend some of

your political capital to bring it about.

While Berkshire Brigades favors a single-payer approach – call it Medicare for All – as the best

approach to universal health care, we also realize the level of political difficulty in making that

happen. The Medical-Industrial Complex – private insurers, health care providers, the

pharmaceutical industry, and others – would dig in their heels and spend whatever it deems

necessary to keep America spending more and getting less health care than any other

industrialized nation. And yes, they are already preparing to bring back “Harry and Louise,” the

infamous pair who helped to kill the Clinton health care plan in the 1990s.

So, we suggest a different approach, in fact the one you voiced as a candidate: a new

government health insurance option that people could choose if they are unhappy with plans

offered by their employer or private insurers. In other words an approach that true conservatives

should embrace real: world competition.

This would not only maximize choice for families and individuals, which conservatives say they

want, but also by setting up government-private competition, the “invisible hand” of the

marketplace should give consumers the best possible health care at the lowest possible cost.

As economist Robert Reich notes, “Without this option, there will be no pressure on private

insurers to adopt all the other reforms to control costs or give all Americans access to affordable

care.”

Of course, executives at health insurance companies see this threatening their mega-million

salaries and marble-lined corridors, so six of them recently made a preemptive strike, sending a

letter to President Obama outlining a plan to save $2 trillion in health care costs over the next

decade.

On its face, the plan is reason for optimism, but The Times’ Paul Krugman wonders if it’s just

blue smoke and mirrors. “The point is that there’s every reason to be cynical about these

players’ motives,” he said. “Remember that what the rest of us call health care costs, they call

income.”

Predictably, the Republicans – and certain of their friends in the Medical-Industrial Complex –

are attempting to frame competition as a government “takeover” of health care. Of course, when

you don’t have any ideas, you need to scare people, and “takeover” is the scariest thing the Party

of NO has come up with so far. By the way, they’re using the same PR firm that worked on the

Swift Boat Veterans for Truth campaign against Sen. John F. Kerry in the 2004 presidential

campaign to “swift boat” the government insurance plan.

So where does that leave us? Much better than in the 1990s, actually. First, major industrial

companies now realize they cannot compete in the world economy if they have to continue to

shoulder the bulk of health insurance costs for their workers. Second, key interest groups, as

evidenced by six that pledged to cut costs, realize change is coming. And third, we have a

President who says he wants it to happen.

But as the President said in February, this will be hard. While he’s largely leaving the details to

Congress, nothing will happen without his direct involvement. And Berkshire Brigades believes

Americans will not get the kind of universal, affordable health care insurance we need if the

public insurance option falls victim to Harry and Louise and backroom bargaining in Congress.

Yes, we need to pressure the Congress, but President Obama needs to spend some of his political

capital on this. If we want to transform health care in this country, we here in the Berkshires

need to make it clear to the President – and to the Congress – that we want this to happen, we

need this to happen, and we expect this to happen this year. For if we let the demagogues win

once again, we will have made a mockery of the last election.

###

I would strongly urge the Obama administration to hang tough in the bargaining ahead. In

particular, AHIP will surely try to use the good will created by its stance on cost control to kill an

important part of health reform: giving Americans the choice of buying into a public insurance

plan as an alternative to private insurers. The administration should not give in on this point.

covering the approximately 46 million people in the United States who have no insurance

Ahem

Politico:

Health care could soon go the way of the automobile, with users having no choice but to buy

insurance coverage.

Within four years, every American could be required to own health insurance or pay their way

through tax penalties. The odds of such a sea change rose last week when chief Democratic and

Republican Senate negotiators on a health care bill acknowledged that many on the Finance

Committee considered the so-called individual mandate essential to lower insurance costs for

those who already have coverage.

…

President Barack Obama didn’t embrace the individual mandate during the campaign, which

means he would essentially start from scratch in terms of selling the idea to voters.

The mandate was a central policy difference with Hillary Clinton, who argued that a mandate

was the only way to achieve universal coverage. Obama disagreed, saying enough people would

purchase insurance voluntarily if the costs could be brought down.

Progressive policy experts widely agreed that Obama’s plan would have left out about 15 million

people. Clinton, with an assist from New York Times columnist Paul Krugman, regularly

assailed Obama for his no-mandate position.

Actually, I don’t care who gets credit, as long as we actually get universal health care.

Public option primer

The concept: A new health insurance program provided by the federal government that people

could choose if they are unhappy with plans offered by private insurers.

Key backers: President Obama, senior congressional Democrats, consumer groups.

Key opponents: Congressional Republicans, insurance companies.

Main selling point: Advocates say it would force private insurers to provide better service and

help control soaring medical costs.

Main criticism: Opponents say it would drive insurers out of business, leaving Americans with

one choice for their health insurance — the government.

Baucus, Obama and others see a new government program as crucial to covering the

approximately 46 million people in the United States who have no insurance. They also argue

that a public alternative would pressure private insurers to control costs and improve quality.

The federal government already provides health insurance to about 83 million Americans

through Medicare, Medicaid and other public programs, including those offered by the military.

Private insurers, meanwhile, face growing criticism for refusing to cover people with preexisting

conditions and dropping coverage for sick customers. “This is a benchmark that will set a high

standard that private plans have to meet,” said Jacob Hacker, a political scientist at UC Berkeley

who advocates a public option.

But insurers say more federal regulation could ensure affordable, high-quality insurance for all.

In recent months, the industry has offered to guarantee coverage and stop charging more to

people with preexisting medical conditions.

A government-run insurance program, industry leaders and many conservatives maintain, would

have an unfair advantage and ultimately drive insurers out of business.

That would inevitably mean a single-payer system, said Stuart Butler, vice president for

domestic policy at the conservative Heritage Foundation. “The probability that a monopoly

would serve customers well is close to nil,” he said.

GOP lawmakers are intensifying warnings that a public insurance plan will lead to

nationalization of healthcare and new limits on patient choice.

That’s a message that will resonate, said veteran GOP pollster Tony Fabrizio. “People don’t want

government agencies, boards or regulators standing between them and their doctors. . . . They

understand that government control inevitably leads to rationing.”

Pushing that message is the Conservatives for Patients’ Rights Action Fund, a new group

founded by former hospital executive Richard L. Scott and assisted by CRC Public Relations, the

conservative public affairs firm that worked on the Swift Boat Veterans for Truth campaign

against Sen. John F. Kerry (D-Mass.) in the 2004 presidential election.

The fund is in the midst of what the group said would be a monthlong, $1-million television

advertising campaign featuring doctors from Canada and Britain — both of which have singlepayer

systems — discussing waiting lists and limited patient choices. A new ad featuring

dissatisfied patients from those countries began airing this weekend.

At the same time, MoveOn.org, the liberal grass-roots powerhouse, has been mobilizing its 5

million members to pressure Congress not to compromise on the creation of a new public plan

option.

Last week, the group aired its second healthcare ad of the year, featuring a pair of undertakers

bemoaning a public plan that could make people live longer. MoveOn’s first ad went after the

insurance industry for opposing Obama’s public option.

“We’re not taking anything for granted,” said Nita Chaudhary, MoveOn’s national campaigns

director. “This is likely to be our biggest fight for the year.”

MoveOn has been joined by other liberal advocacy groups such as Health Care for America

Now, which aired its own ad last month promoting a public plan. Last week, it aired a second ad

highlighting Scott’s former work for healthcare giant Columbia/HCA, which a decade ago paid

$1.7 billion to settle fraud charges against the company.

So let’s do it.d

Eric Cantor Embraces The Luntz Talking Points On Health Care Reform

by BarbinMD

Thu May 14, 2009 at 10:20:06 AM PDT

What would the Republicans do if they didn’t have Frank Luntz to tell them what to say? Here’s

House Minority Whip Eric Cantor (R-VA), parroting the talking points laid out by Luntz last

week on how to talk about health care reform:

LUNTZ: “Acknowledge the ‘crisis’ or suffer the consequences. … A better approach is to define

the crisis in your terms. ‘If you’re one of the millions who can’t afford healthcare, it is a crisis.’”

CANTOR: “Listen Bill, there’s a health crisis. You know when you have, don’t have coverage,

that’s a crisis for you and your family. We need to address it.”

LUNTZ: “The arguments against the Democrats’ healthcare plan must center around

‘politicians,’ ‘bureaucrats,’ and ‘Washington.’”

CANTOR: “But the answer is not to lay it on Washington, to pump up what Washington’s role

in this.”

LUNTZ: “You’ll notice we recommend the phrase ‘government takeover’ rather than

‘government run’ or ‘government controlled.’”

CANTOR: “We all need to be standing up and saying no to a government takeover of our

system.”

Bear in mind, Luntz’s memo is a road map on how to talk about health care reform, not to offer

actual solutions to the problem. The only goal is to derail actual reform:

The status quo is no longer acceptable. The overwhelming majority of Americans believe

significant reform is needed – and they see Republicans (and the insurance companies) as the

roadblock. [...]

The best approach is to empathize with the fear, anxiety and financial pain people are clearly

feeling right now. So instead of dismissing their concerns, acknowledge them – up front – and

then pivot to your solution. Some conservatives will undoubtedly find this distasteful. But

failure to connect on a personal level at the beginning will lead to communication failure at the

end.

But of course, when Luntz says to “pivot to your solution,” in true Republican-fashion, there is

no solution, only the goal of maintaining the very status quo that Luntz acknowledges is not

acceptable to the American people.

We knew healthcare reform would face fierce opposition — and it’s begun. As we speak, the same people behind

the notorious “swiftboat” ads of 2004 are already pumping millions of dollars into deceptive television ads.

Their plan is simple: torpedo healthcare reform before it sees the light of day by scaring the public and distorting the

President’s approach.

We need the resources to take them head on with an urgent, grassroots campaign to pass real healthcare reform in

2009.

When the swiftboaters flood the airwaves with distortions, we’ll flood the streets with volunteers armed with facts.

When they send lobbyists to tell Congress to back down, we’ll send millions of calls, letters, and stories from real

Americans asking them to stand up.

Progress

 The President signed the Children’s Health Insurance Reauthorization Act on February 4,

2009, which provides quality health care to 11 million kids – 4 million who were

previously uninsured.

 The President’s American Recovery and Reinvestment Act protects health coverage for 7

million Americans who lose their jobs through a 65 percent COBRA subsidy to make

coverage affordable.

 The Recovery Act also invests $19 billion in computerized medical records that will help

to reduce costs and improve quality while ensuring patients’ privacy.

 The Recovery Act also provides:

o $1 billion for prevention and wellness to improve America’s health and help to

reduce health care costs;

o $1.1 billion for comparative effectiveness research that will give doctors objective

information about which treatments work and which do not;

o $500 million for health workforce to help train the next generation of doctors and

nurses.

President Obama is committed to working with Congress to pass comprehensive health reform in

his first year in order to control rising health care costs, guarantee choice of doctor, and assure

high-quality, affordable health care for all Americans.

Comprehensive health care reform can no longer wait. Rapidly escalating health care costs are

crushing family, business, and government budgets. Employer-sponsored health insurance

premiums have doubled in the last 9 years, a rate 6 times faster than cumulative wage increases.

This forces families to sit around the kitchen table to make impossible choices between paying

rent or paying health premiums. Given all that we spend on health care, American families

should not be presented with that choice. The United States spent approximately $2.2 trillion on

health care in 2007, or $7,421 per person – nearly twice the average of other developed nations.

Americans spend more on health care than on housing or food. If rapid health cost growth

persists, the Congressional Budget Office estimates that by 2025, one out of every four dollars in

our national economy will be tied up in the health system. This growing burden will limit other

investments and priorities that are needed to grow our economy. Rising health care costs also

affect our economic competitiveness in the global economy, as American companies compete

against companies in other countries that have dramatically lower health care costs.

The President has vowed that the health reform process will be different in his Administration –

an open, inclusive, and transparent process where all ideas are encouraged and all parties work

together to find a solution to the health care crisis. Working together with members of Congress,

doctors and hospitals, businesses and unions, and other key health care stakeholders, the

President is committed to making sure we finally enact comprehensive health care reform.

The Administration believes that comprehensive health reform should:

 Reduce long-term growth of health care costs for businesses and government

 Protect families from bankruptcy or debt because of health care costs

 Guarantee choice of doctors and health plans

 Invest in prevention and wellness

 Improve patient safety and quality of care

 Assure affordable, quality health coverage for all Americans

 Maintain coverage when you change or lose your job

 End barriers to coverage for people with pre-existing medical conditions

Please visit www.HealthReform.gov to learn more about the President’s commitment to enacting

comprehensive health reform this year.

Lee –

Monday morning, an unlikely gathering of health care industry and union leaders emerged from the White House,

announcing a historic agreement to lower medical costs and save the average family up to $2,500. This kind of broad

coalition would have been unthinkable in the past, when the old politics of division and short-term self interest held

sway. But this is a new day.

Yesterday afternoon, President Obama announced the three bedrock principles that any comprehensive health care

reform must achieve: (1) reduce costs, (2) guarantee choice, and (3) ensure all Americans have quality,

affordable health care. And he set a hard goal for getting it done by the end of this year.

For those determined to oppose reform, the President’s announcement means lobbyists are already scrambling

across D.C. For the rest of us, it means there’s no time to lose. As we speak, Congress is negotiating the details for

health care reform, so the first step is showing where the American people stand.

Please click below to sign a declaration of support urging Congress to follow President Obama’s three core

principles for health care reform — and to enact them before the end of this year:

(The more signatures we have, the more powerful our message will be, so please add your name and then forward

this note on to family and friends.)

The health care crisis is not new, but it’s getting worse. For decades, real health care reform has been blocked by

special interest lobbying and political point-scoring. We simply cannot go any further down this dangerous road of

delay and denial. But we don’t have to.

Yesterday’s agreement marks only the beginning of the broad coalition we need. The most important reason this

round of health care reform will be different is you. Last fall millions of regular people came together and did the

impossible. Now, we’ve got to roll up our sleeves, join hands with those new to our movement, and do it again.

Congress is already hammering out the details of the health care package, and it could still go any number of ways.

Our representatives need to understand that when the President lays out these three bedrock principles, Americans

of every stripe are standing with him. Yesterday’s diverse gathering was a powerful start — and now it’s up to us.

It’s time to stand up. Please sign the declaration of support today:

http://my.barackobama.com/OrganizingforHealthcare

Reducing costs, guaranteeing choice, and ensuring care for all are ambitious goals, but they are nothing less than

what the American people deserve. And passing real health care reform this year is nothing less than what the

American people need.

Thank you,

Mitch

Mitch Stewart

Director

Organizing for America

P.S. — Here are some excerpts from the President’s announcement yesterday that lay out the three principles for

health care reform and why we need it this year. Please forward this note to people who want to know where the

President stands.

###

In the coming weeks and months, Congress will be engaged in the difficult issue of how best to reform health care in

America. I’m committed to building a transparent process where all views are welcome. But I’m also committed to

ensuring that whatever plan we design upholds three basic principles: First, the rising cost of health care must be

brought down; second, Americans must have the freedom to keep whatever doctor and health care plan they have, or

to choose a new doctor or health care plan if they want it; and third, all Americans must have quality, affordable

health care.

These are principles that I expect to see upheld in any comprehensive health care reform bill that’s sent to my desk –

I mentioned it to the groups that were here today. It’s reform that is an imperative for America’s economic future, and

reform that is a pillar of the new foundation we seek to build for our economy; reform that we can, must, and will

achieve by the end of this year.

Ultimately, the debate about reducing costs — and the larger debate about health care reform itself — is not just about

numbers; it’s not just about forms or systems; it’s about our own lives and the lives of our loved ones. And I

understand that. As I’ve mentioned before during the course of the campaign, my mother passed away from ovarian

cancer a little over a decade ago. And in the last weeks of her life, when she was coming to grips with her own

mortality and showing extraordinary courage just to get through each day, she was spending too much time worrying

about whether her health insurance would cover her bills. So I know what it’s like to see a loved one who is suffering,

but also having to deal with a broken health care system. I know that pain is shared by millions of Americans all

across this country.

And that’s why I was committed to health care reform as a presidential candidate; that’s why health care reform is a

key priority to this presidency; that’s why I will not rest until the dream of health care reform is finally achieved in the

United States of America.

February 4, 2008

Op-Ed Columnist

CLINTON, OBAMA, INSURANCE

By PAUL KRUGMAN

The principal policy division between Hillary Clinton and Barack Obama involves health care.

It’s a division that can seem technical and obscure — and I’ve read many assertions that only the

most wonkish care about the fine print of their proposals.

But as I’ve tried to explain in previous columns, there really is a big difference between the

candidates’ approaches. And new research, just released, confirms what I’ve been saying: the

difference between the plans could well be the difference between achieving universal health

coverage — a key progressive goal — and falling far short.

Specifically, new estimates say that a plan resembling Mrs. Clinton’s would cover almost twice

as many of those now uninsured as a plan resembling Mr. Obama’s — at only slightly higher

cost.

Let’s talk about how the plans compare.

Both plans require that private insurers offer policies to everyone, regardless of medical history.

Both also allow people to buy into government-offered insurance instead.

And both plans seek to make insurance affordable to lower-income Americans. The Clinton plan

is, however, more explicit about affordability, promising to limit insurance costs as a percentage

of family income. And it also seems to include more funds for subsidies.

But the big difference is mandates: the Clinton plan requires that everyone have insurance; the

Obama plan doesn’t.

Mr. Obama claims that people will buy insurance if it becomes affordable. Unfortunately, the

evidence says otherwise.

After all, we already have programs that make health insurance free or very cheap to many lowincome

Americans, without requiring that they sign up. And many of those eligible fail, for

whatever reason, to enroll.

An Obama-type plan would also face the problem of healthy people who decide to take their

chances or don’t sign up until they develop medical problems, thereby raising premiums for

everyone else. Mr. Obama, contradicting his earlier assertions that affordability is the only bar to

coverage, is now talking about penalizing those who delay signing up — but it’s not clear how

this would work.

So the Obama plan would leave more people uninsured than the Clinton plan. How big is the

difference?

To answer this question you need to make a detailed analysis of health care decisions. That’s

what Jonathan Gruber of M.I.T., one of America’s leading health care economists, does in a new

paper.

Mr. Gruber finds that a plan without mandates, broadly resembling the Obama plan, would cover

23 million of those currently uninsured, at a taxpayer cost of $102 billion per year. An otherwise

identical plan with mandates would cover 45 million of the uninsured — essentially everyone —

at a taxpayer cost of $124 billion. Over all, the Obama-type plan would cost $4,400 per newly

insured person, the Clinton-type plan only $2,700.

That doesn’t look like a trivial difference to me. One plan achieves more or less universal

coverage; the other, although it costs more than 80 percent as much, covers only about half of

those currently uninsured.

As with any economic analysis, Mr. Gruber’s results are only as good as his model. But they’re

consistent with the results of other analyses, such as a 2003 study, commissioned by the Robert

Wood Johnson Foundation, that compared health reform plans and found that mandates made a

big difference both to success in covering the uninsured and to cost-effectiveness.

And that’s why many health care experts like Mr. Gruber strongly support mandates.

Now, some might argue that none of this matters, because the legislation presidents actually

manage to get enacted often bears little resemblance to their campaign proposals. And there is,

indeed, no guarantee that Mrs. Clinton would, if elected, be able to pass anything like her current

health care plan.

But while it’s easy to see how the Clinton plan could end up being eviscerated, it’s hard to see

how the hole in the Obama plan can be repaired. Why? Because Mr. Obama’s campaigning on

the health care issue has sabotaged his own prospects.

You see, the Obama campaign has demonized the idea of mandates — most recently in a scaretactics

mailer sent to voters that bears a striking resemblance to the “Harry and Louise” ads run

by the insurance lobby in 1993, ads that helped undermine our last chance at getting universal

health care.

If Mr. Obama gets to the White House and tries to achieve universal coverage, he’ll find that it

can’t be done without mandates — but if he tries to institute mandates, the enemies of reform

will use his own words against him.

If you combine the economic analysis with these political realities, here’s what I think it says: If

Mrs. Clinton gets the Democratic nomination, there is some chance — nobody knows how big

— that we’ll get universal health care in the next administration. If Mr. Obama gets the

nomination, it just won’t happen.

Obama on Health Reform: The Dog That Didn’t Bark

May 11, 2009, 2:55PM

The only troubling thing about the President’s statements today concerning health care reform

was what he did not say: that he wanted a any health plan that emerges from Congress to include

a public insurance option for Americans who do not want to buy private insurance. But without

this option, there will be no pressure on private insurers to adopt all the other reforms to control

costs or give all Americans access to affordable care.

Every other reform proposal announced to date — electronic medical records, comparative

effectiveness research, prevention of chronic disease, payments for services rather than for

outcomes, and so on — has been talked about for years. The reason none have been adopted is

health providers and insurers can make more money without them. Only with a government plan

that competes with private insurers, and offers Americans lower costs if the providers and

insurers fail to reform themselves, will the system be genuinely reformed.

Hopefully, the President’s failure to mention a public insurance option today was not intended to

signal to Congress that the White House is no longer especially interested in it. The

Administration should quickly inform policymakers how important this option is as a spur to real

change.

Harry, Louise and Barack

By PAUL KRUGMAN

Is this the end for Harry and Louise?

Harry and Louise were the fictional couple who appeared in advertisements run by the insurance

industry in 1993, fretting about what would happen if “government bureaucrats” started making

health care decisions. The ads helped kill the Clinton health care plan, and have stood, ever

since, as a symbol of the ability of powerful special interests to block health care reform.

But on Saturday, excited administration officials called me to say that this time the medicalindustrial

complex (their term, not mine) is offering to be helpful.

Six major industry players — including America’s Health Insurance Plans (AHIP), a descendant

of the lobbying group that spawned Harry and Louise — have sent a letter to President Obama

sketching out a plan to control health care costs. What’s more, the letter implicitly endorses

much of what administration officials have been saying about health economics.

Are there reasons to be suspicious about this gift? You bet — and I’ll get to that in a bit. But first

things first: on the face of it, this is tremendously good news.

The signatories of the letter say that they’re developing proposals to help the administration

achieve its goal of shaving 1.5 percentage points off the growth rate of health care spending.

That may not sound like much, but it’s actually huge: achieving that goal would save $2 trillion

over the next decade.

How are costs to be contained? There are few details, but the industry has clearly been reading

Peter Orszag, the budget director.

In his previous job, as the director of the Congressional Budget Office, Mr. Orszag argued that

America spends far too much on some types of health care with little or no medical benefit, even

as it spends too little on other types of care, like prevention and treatment of chronic conditions.

Putting these together, he concluded that “substantial opportunities exist to reduce costs without

harming health over all.”

Sure enough, the health industry letter talks of “reducing over-use and under-use of health care

by aligning quality and efficiency incentives.” It also picks up a related favorite Orszag theme,

calling for “adherence to evidence-based best practices and therapies.” All in all, it’s just what

the doctor, er, budget director ordered.

Before we start celebrating, however, we have to ask the obvious question. Is this gift a Trojan

horse? After all, several of the organizations that sent that letter have in the past been major

villains when it comes to health care policy.

I’ve already mentioned AHIP. There’s also the Pharmaceutical Research and Manufacturers of

America (PhRMA), the lobbying group that helped push through the Medicare Modernization

Act of 2003 — a bill that both prevented Medicare from bargaining over drug prices and locked

in huge overpayments to private insurers. Indeed, one of the new letter’s signatories is former

Representative Billy Tauzin, who shepherded that bill through Congress then immediately left

public office to become PhRMA’s lavishly paid president.

The point is that there’s every reason to be cynical about these players’ motives. Remember that

what the rest of us call health care costs, they call income.

What’s presumably going on here is that key interest groups have realized that health care reform

is going to happen no matter what they do, and that aligning themselves with the Party of No will

just deny them a seat at the table. (Republicans, after all, still denounce research into which

medical procedures are effective and which are not as a dastardly plot to deprive Americans of

their freedom to choose.)

I would strongly urge the Obama administration to hang tough in the bargaining ahead. In

particular, AHIP will surely try to use the good will created by its stance on cost control to kill an

important part of health reform: giving Americans the choice of buying into a public insurance

plan as an alternative to private insurers. The administration should not give in on this point.

But let me not be too negative. The fact that the medical-industrial complex is trying to shape

health care reform rather than block it is a tremendously good omen. It looks as if America may

finally get what every other advanced country already has: a system that guarantees essential

health care to all its citizens.

And serious cost control would change everything, not just for health care, but for America’s

fiscal future. As Mr. Orszag has emphasized, rising health care costs are the main reason longrun

budget projections look so grim. Slow the rate at which those costs rise, and the future will

look far brighter.

I still won’t count my health care chickens until they’re hatched. But this is some of the best

policy news I’ve heard in a long time.

As to how costs will be contained, Krugman points to Orszag. The budget director wrote this

weekend on the White House website:

How do we do it?

First, we improve tax compliance and eliminate unjustified tax breaks for narrow interest groups.

[...]

Second, as in the February overview, the Budget would also limit the tax rate at which families

making more than $250,000 can take itemized deductions to a maximum of 28 percent. This is a

matter of fairness. If you’re a teacher making $50,000 a year and decide to donate $1,000 to the

Red Cross or United Way, you enjoy a tax break of $150. If you are Warren Buffet or Bill Gates

and make that same donation, you currently get a $350 deduction–more than twice the break as

the teacher. Limiting itemized deductions for high-income Americans would help restore balance

to the tax code, and any effect on charitable giving is likely to be swamped by other

Administration policies. The best way to boost charitable giving is to jumpstart the economy and

raise incomes–and the purpose of the Recovery Act enacted in the Administration’s first month

in office was to do precisely that. The limitation on itemized deductions is now expected to raise

about $267 billion over the next 10 years, which we will devote entirely to health care reform.

All together, these policies would raise a total of $635 billion to be devoted to health care

reform–almost exactly the same total amount as in the February overview.

It is true–more savings than this will be needed to pay for comprehensive health care reform in

its entirety. But I believe that the reserve fund, in itself, represents a historic commitment, and I

look forward to working with Congress to bring about–and pay for–fundamental health care

reform this year.

American Prospect writer Ezra Klein is more skeptical than Krugman; he wrote in response to

the news that the real test is when the health care reform bill comes out.

Maybe I’m just churlish. Maybe I’m getting cranky as I age. But I can’t shake my skepticism

about today’s big health care announcement. [...]

The big test is not today. It’s a month from now. In June, the Finance Committee will release the

first version of its health reform bill. If the bill is what we expect — something along the lines of

Baucus’s white paper, or Hillary Clinton’s campaign proposal — and these industry groups not

only endorse it but explain how they will save money within its confines, that will be something

to celebrate. If they use the credibility they’ve attained today to unleash a more vicious assault

tomorrow — if they grimly say that they proved their willingness to work with the administration

but this legislation and its public plan and its insistence on evidence and its payment reforms

sadly proves the administration’s unwillingness to work with them — then that will be a rather

less cheery outcome.

The New Republic’s Jonathan Cohn wrote that it makes sense to be dubious, “but make no

mistake: This is a big deal, if only for the clear political signal it sends.”

Health Care Now

By PAUL KRUGMAN

The whole world is in recession. But the United States is the only wealthy country in which the

economic catastrophe will also be a health care catastrophe — in which millions of people will

lose their health insurance along with their jobs, and therefore lose access to essential care.

Which raises a question: Why has the Obama administration been silent, at least so far, about one

of President Obama’s key promises during last year’s campaign — the promise of guaranteed

health care for all Americans?

Let’s talk about the magnitude of the looming health care disaster.

Just about all economic forecasts, including those of the Obama administration’s own

economists, say that we’re in for a prolonged period of very high unemployment. And high

unemployment means a sharp rise in the number of Americans without health insurance.

After the economy slumped at the beginning of this decade, five million people joined the ranks

of the uninsured — and that was with the unemployment rate peaking at only 6.3 percent. This

time the Obama administration says that even with its stimulus plan, unemployment will reach 8

percent, and that it will stay above 6 percent until 2012. Many independent forecasts are even

more pessimistic.

Why, then, aren’t we hearing more about ensuring health care access?

Now, it’s possible that those of us who care about this issue are reading too much into the

administration’s silence. But let me address three arguments that I suspect Mr. Obama is hearing

against moving on health care, and explain why they’re wrong.

First, some people are arguing that a major expansion of health care access would just be too

expensive right now, given the vast sums we’re about to spend trying to rescue the economy.

But research sponsored by the Commonwealth Fund shows that achieving universal coverage

with a plan similar to Mr. Obama’s campaign proposals would add “only” about $104 billion to

federal spending in 2010 — not a small sum, of course, but not large compared with, say, the tax

cuts in the Obama stimulus plan.

It’s true that the cost of universal health care will be a continuing expense, reaching far into the

future. But that has always been true, and Mr. Obama has always claimed that his health care

plan was affordable. The temporary expenses of his stimulus plan shouldn’t change that

calculation.

Second, some people in Mr. Obama’s circle may be arguing that health care reform isn’t a

priority right now, in the face of economic crisis.

But helping families purchase health insurance as part of a universal coverage plan would be at

least as effective a way of boosting the economy as the tax breaks that make up roughly a third

of the stimulus plan — and it would have the added benefit of directly helping families get

through the crisis, ending one of the major sources of Americans’ current anxiety.

Finally — and this is, I suspect, the real reason for the administration’s health care silence —

there’s the political argument that this is a bad time to be pushing fundamental health care

reform, because the nation’s attention is focused on the economic crisis. But if history is any

guide, this argument is precisely wrong.

Don’t take my word for it. Rahm Emanuel, the White House chief of staff, has declared that “you

never want a serious crisis to go to waste.” Indeed. F.D.R. was able to enact Social Security in

part because the Great Depression highlighted the need for a stronger social safety net. And the

current crisis presents a real opportunity to fix the gaping holes that remain in that safety net,

especially with regard to health care.

And Mr. Obama really, really doesn’t want to repeat the mistakes of Bill Clinton, whose health

care push failed politically partly because he moved too slowly: by the time his administration

was ready to submit legislation, the economy was recovering from recession and the sense of

urgency was fading.

One more thing. There’s a populist rage building in this country, as Americans see bankers

getting huge bailouts while ordinary citizens suffer.

I agree with administration officials who argue that these financial bailouts are necessary (though

I have problems with the specifics). But I also agree with Barney Frank, the chairman of the

House Financial Services Committee, who argues that — as a matter of political necessity as

well as social justice — aid to bankers has to be linked to a strengthening of the social safety net,

so that Americans can see that the government is ready to help everyone, not just the rich and

powerful.

The bottom line, then, is that this is no time to let campaign promises of guaranteed health care

be quietly forgotten. It is, instead, a time to put the push for universal care front and center.

Health care now!

Next email:

With the Convention just a few weeks away, all delegates and alternates should have

received their Call to Convention newsletter in the mail. In the newsletter, you will find a

listing of all events that will take place on Friday and Saturday as well as the workshops

after the convention on Saturday. If you are a delegate who is handicapped and need

special accommodations please call the State Party Office at 617-776-2676.

Just a reminder that if you have not already paid and would like to receive your credentials

in the mail and skip the registration line please send in your payment prior to May 28th. For

delegates in the First Essex and Middlesex area the 1EM Dems are having a Delegate

Breakfast on May 18th and for delegates in the Middlesex Worcester Area, the MW Dems

are having a Delegate Training session on May 19th. See the calendar below for more

details on both delegate events.

Convention Volunteers Needed!

The Massachusetts Democratic Party is looking for people interested in volunteering at the

2009 State Convention on June 6th at the MassMutual Center in Springfield. Anyone

interested can contact Gloribell Mota at 617-776-2676 or gmota@massdems.org, you can

also sign up through the MassDems website by clicking here.

We will be hositng two volunteer training sessions prior to convention day and one the

morning of. The times are:

 Monday June 1st at 6:00 PM at the MDP Headquarters, 56 Roland St. Suite

203, Boston, MA, 02129.

 Friday June 5th at 1:00 PM at the MassMutual Center in Springfield.

 Saturday June 6th 7:00 AM at the MassMutual Center in Springfield.

To RSVP for a training session, please contact Gloribell Mota.

Youth Convention

The convention is only a month away but there is still plenty of time to register as a Youth

Convention Delegate. The Youth Convention this year will be bigger and better than last

year!

 There will be a special breakfast prior to the start of the convention for the

students.

 The students will have a first hand view of the ratification of the

Massachusetts Democratic Party Platform.

 David Plouffe will address the students separately

 After the conclusion of the Convention the students will have a series of

workshops designed by the Youth Services Committee.

Join in a Celebration to Launch

the Mel King Institute for

Community Development

Come and be a part of the inaugural event as housing and community development

professionals, government officials, and people who have been part of the community

building movement in our state for the past 50 years join together to celebrate Mel King and

the Institute on May 20th at the Villa Victoria Center of the Arts from 5:00 -7:00 PM

To see the invitation please click here.

To purchase tickets to the event please click here.

Diversity Internship

As we celebrate the work of Mel King, it provides a great example of the benifits of diversity

in the public service sector. The Diversity Internship is trying to further this cause. Over the

following few months we will be highlighting the 2009 Diversity Interns. This year’s program

has a lot to live up to from last year’s inaugural class but the interns seem up to the

challenge. To contribute to the Program please click here.

Community Forums

Between now and the end of May, the Governor, Lieutenant Governor, and senior officials

from the administration will host forums with local residents in thirty-six cities and towns on

the choices facing the Commonwealth in the current economic climate. These conversations

will provide residents a chance to ask questions, offer suggestions and engage with their

government and their neighbors on these issues. For more information about the Governor’s

proposed reforms, please visit www.mass.gov/governor/reform.

These forums will be held all over the state throughout May, so there will be ample

opportunity for you to share your ideas and concerns. The details are at

www.mass.gov/governor/forums. On the website, you will also find tools to help you host

your own forum, and we will provide updates about each forum so that you will be able to

see and hear thoughts from other concerned citizens around the Commonwealth.

President Obama’s

Health Care Announcement

Background: On May 11th, key stakeholders in health care reform joined President Obama

at the White House to announce their commitment to achieving a sharp reduction in the

nation’s health care costs. Their plans to prioritize preventative care, manage chronic

illnesses, curtail unnecessary tests and procedures, standardize insurance claim forms and

use electronic medical records could save the nation 1.5 percent a year, or $2 trillion over

the next 10 years.

The six health care industry groups who presented President Obama with a letter

committing to these reforms include: America’s Health Insurance Plans, a trade group for

insurers and a descendant of the lobbying group that derailed reform during the Clinton

Administration; executives of the Advanced Medical Technology Association, a lobby for

medical device manufacturers; the American Hospital Association; the American Medical

Association; the Pharmaceutical Research and Manufacturers of America; and the Service

Employees International Union (SEIU).

Many of the groups who have come together around these significant commitments opposed

health reform in the past. But they are now at the table with the administration,

acknowledging that Americans can no longer tolerate the business as usual in health care.

This group of “strange bedfellows” has concluded that health care costs are rising at an

unsustainable rate and must be curtailed.

Key points:

– The President’s announcement with these “strange bedfellows” is nothing short of historic

and it shows President Obama’s ability to bring people together and provide the leadership

we need to make health care reform a reality. It will provide the momentum required to get

comprehensive health care reform passed by Congress this year.

– Skyrocketing health care costs are one of the biggest burdens on America’s families. Since

2000, health insurance premiums have almost doubled and health care premiums have

grown three times faster than wages. The changes announced today could save a family of

four $2,500 a year by 2014.

– The President is committed to making health care reform happen this year. He is

committed to building transparent process where all views are welcome. But he is also

committed to ensuring that health care reform upholds three basic principles:

 Curbing the rising costs of health care.

 Making sure Americans have the freedom to keep whatever doctor and health care

plan they have or to choose a new doctor or health care plan if they want it.

 All Americans must have quality, affordable health care.

– With the commitment of this diverse group today and Democrats and Republicans in

Congress, President Obama looks forward to completing health care reform this year,

putting the United States on a more fiscally sustainable path, and laying a new foundation

for our economy for generations to come.

May 16, 2009

Familiar Obama Phrase Being Groomed as a

Slogan

By PETER BAKER

WASHINGTON — President Obama told doctors and insurers on Monday that revamping

health care would “lay a new foundation for our economy.” He told graduating college students

on Wednesday that “we need to build a new foundation.” He told consumers on Thursday that

protecting them was vital “to the new foundation we seek to build.”

Ready for a new New Deal? How about the New Foundation? As Mr. Obama labors to pull the

country out of the deepest recession since the Great Depression and simultaneously overhaul

energy, education and health care, he has coined an expression to encapsulate his ambitious

program in the same way Franklin D. Roosevelt did in the 1930s.

New Foundation may not come tripping off the tongue quite as easily as New Deal — it has

twice as many syllables, after all — but it has become a staple of Mr. Obama’s speeches in the

last month. Whether a 21st-century public buys a 20th-century political technique is another

question.

“Every administration seeks to brand itself, and New Foundation certainly captures the recovery

and rebuilding project on the president’s hands,” said Joel P. Johnson, a White House counselor

under President Bill Clinton. “But only history decides whether or not it sticks or whether or not

an era can be defined in a phrase. If he produces results, then New Foundation could be one for

the books. If not … .”

Mr. Obama introduced the catchall phrase in his Inaugural Address in January. “The state of our

economy calls for action, bold and swift,” he said that day, “and we will act not only to create

new jobs but to lay a new foundation for growth.”

But it took months before White House officials decided to emphasize the phrase in a sustained

way. Then he gave a much-ballyhooed speech at Georgetown University on April 14 to lay out a

broader vision for his presidency and used the phrase eight times. He cited a parable from the

Sermon on the Mount about two men who build houses, one on sand and the other on rock; the

former is blown away by a storm, the latter remains standing tall against the winds. The talk was

called “the New Foundation speech,” and in the month since then, Mr. Obama has weaved the

phrase into 14 public addresses.

The signal that his advisers wanted to establish it as a formal rubric came last month on the night

of his most recent prime-time news conference, when prepared introductory remarks released by

the White House capitalized the phrase as New Foundation.

While White House officials did not respond to inquiries on the phrase, John D. Podesta, who

ran Mr. Obama’s transition and still advises him informally, said it made it “easy to understand

why three big reform projects — health, energy and education — are part of a coherent overall

economic strategy for sustainable equitable growth.”

Stanley B. Greenberg, a Democratic pollster, said it described both the status of the country Mr.

Obama inherited as well as where he wanted to take it.

“It is making a values critique and values offer: a country whose leaders were irresponsible,

greedy, hiding from big problems and thinking only of the short term without accountability,”

Mr. Greenberg said. “New Foundation captures the idea of acting with seriousness of purpose

with responsibility and for country.”

Others are not so sure.

“I think recent attempts to coin phrases suffer from over testing and over focus-grouping,” said

Russ Schriefer, a Republican political strategist.

Mr. Schriefer said he was “not sure F.D.R. contracted with the Gallup organization to test the

phrase New Deal.”

“That combined with our 24/7 news cycle, the contact sport of cable news,” he continued, “it is

harder to stay on message for a week, let alone an entire administration.”

Such slogans used to be common even before Roosevelt introduced his “New Deal for the

American people” in accepting the Democratic nomination in 1932. Theodore Roosevelt had

promised a Square Deal, and Woodrow Wilson a New Freedom; later, Harry S. Truman

promised a Fair Deal, John F. Kennedy a New Frontier and Lyndon B. Johnson a Great Society.

More recent presidents have had trouble making their labels stick. Mr. Clinton called for a New

Covenant in a series of speeches at Georgetown in 1991 as he ran for president, but pollsters

turned thumbs down and he largely dropped it. George W. Bush championed an Ownership

Society when he ran for re-election in 2004, but that also made little public impression.

Robert Dallek, a presidential historian, suspects Mr. Obama’s expression may suffer the same

fate.

“I’m not sure what it means,” Mr. Dallek said. “The successful slogans tied in a convincing way

to current events. T.R.’s Square Deal, F.D.R.’ s New Deal, J.F.K.’s New Frontier and L.B.J.’s

Great Society all resonated because they summed up what their presidents intended and what the

public was eager for at the time.”

“I guess you could say the same for the New Foundation,” he added, “but foundation doesn’t

strike me as a word people will comfortably take to.”

HARRY AND LOUISE ARE BACK: INSURERS

PLANNING ON DOUBLE-CROSSING OBAMA

One week after the nation’s health insurance lobby pledged to President Obama to do what it can

to constrain rising health costs, Blue Cross Blue Shield of North Carolina is putting the finishing

touches on a public message campaign aimed at killing a key plank in Obama’s reform platform.

As part of what it calls an “informational website,” the company has hired an outside PR

company to make a series of videos sounding the alarm about a government-sponsored health

insurance option, known as the public plan. Obama has consistently maintained that a

government-run plan, absent high-paid executives and the need for profits, could be a more

affordable option for Americans who have trouble purchasing private insurance. The industry

argues that creating a public insurance program will undermine the marketplace and eventually

lead to a single-payer style system.

Somehow, this isn’t surprising. On Friday, the health insurance industry showed how un-serious

they were about really controlling costs by backing away from the promise they made to

President Obama. And now, the same industry is planning on making videos (which can be

turned into ads) to try and kill the public health insurance option, the only real way to control

costs.

Check out the storyboards from their proposed ads [pdf]. The message is right out of the Frank

Luntz playbook – scaring the public about the dangers of “government-run health care,” and lying

by omission about the fact that Obama’s health care plan wouldn’t force anyone to choose a

public health care plan if they didn’t want one.

Up until now, the disgraced CEO Rick Scott was the only one up on the air against Obama’s

health care reform plans. Not even Republicans had a coordinated message to attack health care,

at least not until Frank Luntz came along. But now, it looks like the message carried by Harry

and Louise might be returning, once again payed for by an insurance industry desperately

looking for any way to protect their profits in the face of competition and reform.

Spend Some of that Political Capital on Health Care, Mr. President

By Lee Harrison, Chairman, Berkshire Brigades, the Countywide Democratic Organization