Behind the Scenes Obama Pushes the Public Option

It seems there was a method to Pelosi's latest public option madness aside from her rather obvious attempt to whip her Blue Dogs into line. A report in today's Chicago Tribune  reveals Obama's extensive behind-the-scenes machinations to ensure some version of the government health insurance plan is included in the Senate bill. Despite repeated claims the government option, or public option, was not integral to Obama's   vision of health care reform, the revelation of his private efforts could betray Obama's hidden agenda that would come as no surprise to conservative critics:


Clip via Naked Emperor News

Obama's efforts to include a public option in the final bill appear to be rather extensive according to the report in Chicago Tribune:

But now, senior administration officials are holding private meetings almost daily at the Capitol with senior Democratic staff to discuss ways to include a version of the public plan in the health care bill that Senate Majority Leader Harry Reid, D-Nev., plans to bring to the Senate floor later this month, according to senior Democratic congressional aides.

Among those regularly in the meetings are Obama's top health care adviser, Nancy-Ann DeParle, aides to Reid, and Senate finance and health committee staff, both of which developed health care bills.

At the same time, Obama has been reaching out personally to rank-and-file Senate Democrats, telephoning more than a dozen lawmakers in the last week to press the case for action.

Portions of the Tribune report read as more of an effort to bolster support for the administration among its liberal base who have been critical of Obama's seeming lack of support for a government option. The report portrays Obama as much more of a hands-on leader again countering liberal criticism his aloof approach has doomed the beloved public option:

The White House initiative, unfolding largely out of public view, follows months in which the president appeared to defer to senior lawmakers on Capitol Hill as they labored to put together gargantuan health care bills.

It also marks a critical test of Obama's command of the inside game in Washington in which deals are struck behind closed doors and wavering lawmakers are cajoled and pressured into supporting major legislation.

"The challenge is to go to the (Senate) floor, hold the deal," said Steve Elmendorf, a lobbyist who was chief of staff to former House Democratic leader Dick Gephardt. But "they are more involved than people think. They have a plan and a strategy, and they know what they want to get and they work with people to get it."

There can be no doubt the President would gladly include a government insurance program if he felt he was able to pass legislation with some version included. Deals with industry execs such as PhRMA and the American Hospital Association have been reported to be contingent upon final legislation being passed without a government program, however. It is not out of the realm of possibility the administration would weasel from those deals at the 11th hour leaving the health care industry little or no time to rally a campaign against the reform. Securing the moderate votes to pass a public option is the real hurdle that will only become increasingly difficult as gubernatorial elections loom, however. It is likely the White House strategy may include an effort to persuade liberals Obama is pulling out all stops to get them what they want. When a public option is dropped completely off the legislation at the last minute in order to gain votes to pass a bill, Pelosi and Obama will be exonerated by their base as having given it their best efforts.

The Trib report also mentions the Kaiser Foundation survey showing 58% support among the public for a government insurance program. This study largely shows how polls are influenced by arguments for and against a Medicare type program. It is unlikely such a study would be influential in the final votes of key Senate and House moderates decisions. Nevertheless, the administration that declared it would be the most transparent in the history of man or something, can have any number of tricks in store before the final vote is taken. Until such time, conservatives would be advised to keep the pressure on the moderates, Obama certainly is.

H/T: Memeorandum

Have the Stars Aligned for Health Care?

Throughout his full court press strategy to sell the American public on health care reform, President Obama has repeatedly used the phrase the "stars have aligned" implying health care reform is inevitable due to some cosmic glitch beyond our control. The last time the stars were aligned was coincidentally when the last Democratic President had a Democratic Congress, namely Clinton. We all know how that turned out. Have the stars aligned even more perfectly this time for the "One" Barack Obama or is his health care effort every bit as vulnerable as Clinton's?

Certainly things have not been going very smoothly for the President given that cosmic alignment and all. He has made several pretty disastrous mistakes while trying to maneuver legislation through the Congress. Recent polls show the public appetite for reform souring. The question remains, though, whether there was a greater appetite for reform now compared to the mood in the Clinton era.

To answer this question Robert Y. Shapiro and Sara A Arrow of Columbia University compared polling data from 1994 and 2009 and tested the hypothesis there would be greater support for Obama's reform. The results showed the public mood or climate to be roughly the same if not even slightly less favorable than during the Clinton presidency. While several questions showed a more favorable mood those that showed less favorable mood related to increased taxes required to finance the reform:

The questions that yielded less favorable responses concerning health care reform during 2008-2009 than 1993-1994 were ones that asked about paying taxes: to finance national health insurance, to enable everyone to have health insurance, or to guarantee health insurance coverage

There was also a less favorable environment with respect to the belief the country as a whole spent too much on health care and there was a 6 point increase in opposition to guaranteeing health care for all Americans.

The current mood was also compared to that of the Johnson Administration where the most sweeping reforms were passed through Congress with the creation of Medicaid and Medicare. There was one significant difference between the Johnson era and the current political environment:

But what has changed in American politics since that time is that partisan and ideological differences, both in Congress and other leadership arenas and consequently in mass public opinion itself, have widened across the full range of
economic, racial, social values, and foreign policy issues (cf. Bafumi and Shapiro, 2009; Page and Shapiro, 1992, Chapter 7)

The authors' conclude that despite a relatively stable mood over time for change in the health care system, the perils of the Clinton Administration's efforts suggest that President Obama has his work cut out for him.

Hat Tip to Andrew Gelman who provides a thorough review of this study at FiveThirtyEight.