The Big Question, Sept. 8: How important to Obama's presidency is the fate of healthcare reform?

Dean Baker, Co-Director of the Center for Economic and Policy Research, said:

The fate of health care is hugely important to the Obama presidency because it is hugely important to the economy and the country. First, as an economic matter, if we don't fix our health care system then it will be a rapidly growing cancer on the economy. We will have many more Chryslers and GMs if health care is not fixed. Companies that pay for health care will face unmanageable costs.

The excess cost of our health care system is like a tax on the economy. Currently the size of that tax is approximately $1.2 trillion a year ($16,000 for a family of four). That is the difference between what we pay per person and what people in other countries with comparable health outcomes pay. This is a crushing tax burden that will get much larger in the years ahead. This sort of redistribution from the Joe the Plumbers of the country to the insurance industry, the pharmaceutical industry, and the highly paid specialists is unbearable.

Also, as every expert on the budget knows (this excludes most of the whiners about budget deficits), excessive health care costs are the main factor driving the deficit. If President Obama can't contain health care costs, then the country will face devastating deficit problems in the years ahead.

Of course there is the most basic issue. It is important for people to have secure health care. It is not just the 47 million who are counted as uninsured who lack real insurance. Most of us do not enjoy insurance against serious illness because if we got sick we would lose our jobs and then we would lose our insurance.

For the sake of the economy, the budget, and the country's well-being, health care reform is absolutely essential.

A.B. Stoddard, Associate Editor of The Hill, said:

The economy will determine the legacy of President Obama, and will likely determine the outcome in the next two elections of 2010 and 2012. But it is critical to that legacy that Obama and the Democrats in Congress find a way to pass some form of health care reform in the months to come.

Obama's coalition and his governing style have been profoundly tested throughout this intense debate. He has remained cool and detached while the liberal and conservative wings of his party have fought to the draw on health care reform. As of today they are as far apart as they could be, having missed deadlines to draft and pass legislation because of those disagreements and Obama is having to step in to get more "specific," on an effort he had left largely to the Congress.

Just what he will say in his televised speech to members of the U.S. House and Senate we don't know, but what he says behind closed doors to members of his party is what matters most. He must explain to them that the lesson learned from the party's last attempt to reform health care is that nothing will cost them more than something.

Since overreach isn't possible now, with the Democratic middle nervous about a public option and costs, any reforms Democrats can pass are likely easier to defend than failure. As Obama keeps stating: failure is no longer an option.


Bill Press, Pundits Blog contributor, said:

President Obama has made health care reform the first test of his presidency, and he will therefore be judged accordingly. A strong bill will empower him in all future legislative battles. Failing to get health care reform would leave him significantly weaker in any future battles.

Brent Budowsky, Pundits Blog contributor, said:

The most important issue to Obama's legacy and his presidency will be the state of the national economy. Does the economy recover and does the unemployment rate fall in the coming months? Or does the economy suffer a double-dip recession and joblessness rises above 10% into next year? This is the issue that will determine other issues. Health care is an important part of the Obama legacy and I predict a compromise will pass this year that will be better for the Obama legacy and the Democratic Congress than most pundits currently believe.

Craig Newmark, founder of Craigslist, said:

Obama's true legacy will be motivating large numbers of people to repair government, from the inside and the outside, inventing new forms of public/private partnership.

This is already happening.

Healthcare is an important part of that, part of a moral responsibility to serve one another; we need to ease the suffering of millions. That will be part of the Obama legacy.

Grace-Marie Turner, President of the Galen Institute, said:

President Obama has made health reform a legacy issue by deciding to place it at the top of his domestic policy agenda.  But for someone who was so atuned to the voters during the 2008 presidential campaign, this is a major miscalculation.

Poll after poll shows that the American people believe that getting the economy back on track should be the president’s first priority.  Only one person in five believes that health care should be his top concern.

But by calling for a joint session of Congress to call for passage of health reform legislation, Mr. Obama guarantees that tomorrow night’s speech will be the turning point in his young presidency.  If he succeeds, then he will be seen as virtually unstoppable, able to push his agenda even in the face of clear opposition from the American people.  But if he fails, he will struggle to pass any other parts of his reform agenda.

In town hall meetings across the country in August and in virtually every opinion poll taken over the summer, the American people say they are increasingly fearful about the changes and cost of the president’s sweeping reform plan.  They are very concerned about the nation’s ballooning debt and are highly reluctant to add to it with another big health spending program.  And they are frightened about what health reform would mean for them and their access to medical care.

The biggest problem that the president has right now is the growing distrust of the American people.  They don’t see, for example, how spending another $1 trillion on health care can lower health costs.  They don’t believe his assurances that if they like the coverage they have now, that they can keep it, when independent studies show that millions of people will lose their current coverage, many involuntarily.  And they are concerned that government bureaucrats will start deciding whether they should take the blue pill or the red pill or take pain killers rather than get surgery, as Dr. Obama has suggested.

It is not at all clear that stirring oratory before cheering members of Congress and a nationally televised audience will be able to put these fears to rest, especially with more and more conservative Democrats are expressing their wariness about a big reform agenda.

Mr. Obama is making a big gamble, and the stakes for the success of his presidency could not be higher.

Peter Fenn, Pundits Blog contributor, said:

There is no question that it is still "the economy, stupid!"  But, of course, one-sixth of the economy is health care and getting larger every day.  President Obama is attempting to do what Presidents have been attempting for over 50 years.  The stakes are high.  The rewards are great.  The time is now.  By passing the beginnings of real health care reform now, it will stimulate the economy further, boost public confidence, and put the U.S. further on the road to economic recovery.

Bernie Quigley, Pundits Blog contributor, said:

What will impact is the bad timing and mismanagement of this issue. In hindsight, Obama is not unlike Bill Clinton who didn’t know how to be President until he hired Dick Morris. The political culture has moved on. Afghanistan is quickly becoming the key issue and Obama is still talking about health care. It gives opposition throughout the heartland an opening, and instead of Obama being the “Change” he personifies the old, hackneyed, out-of-date political formula; the bland background against which change is occurring: Those pesky blue-haired ladies packing Glocks in the town halls are beginning to look like the Change. Ignoring Afghanistan has also forced Democrats to oppose their own President on moral grounds. As he is down to 46% approval now it is possible to see a challenge coming in 2012 on this issue if he doesn’t change direction – Hillary and Jim Webb conceivably or Mark Warner and Joe Sestak. To early to say. He’ll be alright. But he better hire Dick Morris.

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