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The constant in Obama's presidency has been his determination to chart a new course.

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babylonsister Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-20-10 07:45 AM
Original message
The constant in Obama's presidency has been his determination to chart a new course.
Edited on Sat Mar-20-10 07:47 AM by babylonsister
http://www.nationaljournal.com/njmagazine/nj_20100320_4698.php

Obama And The Supertanker
The constant in Obama's presidency has been his determination to chart a new course.

by Ronald Brownstein

Saturday, March 20, 2010

snip//

Win or lose, Obama has pursued health care reform as tenaciously as any president has pursued any domestic initiative in decades. Health care has now been his presidency's central domestic focus for a full year. That's about as long as it took to pass the Civil Rights Act of 1964, originally introduced by John F. Kennedy and driven home by Lyndon Johnson. Rarely since World War II has a president devoted so much time, at so much political cost, to shouldering a single priority through Congress. It's reasonable to debate whether Obama should have invested so heavily in health care. But it's difficult to quibble with Emanuel's assessment that once the president placed that bet, "He has shown fortitude, stamina, and strength."

The fight has opened a second window into Obama. The key here is his 2008 campaign assertion that "Ronald Reagan changed the trajectory of America" more than Richard Nixon or Bill Clinton did. The health care struggle suggests that Obama views changing that trajectory as the ultimate measure of a presidency's success. His aim is to establish a long-term political direction -- one centered on a more activist government that shapes and polices the market to strengthen the foundation for sustainable, broadly shared growth. Everything else -- the legislative tactics, even most individual policies -- is negotiable. He wants to chart the course for the supertanker, not to steer it around each wave or decide which crates are loaded into its hull.

Obama's core health care goals have been to establish the principle that Americans are entitled to insurance and to build a framework for controlling costs by incentivizing providers to work more efficiently. He has been unwavering about that destination but flexible and eclectic in his route. He has cut deals with traditional adversaries, such as the drug industry, and confronted allies to demand an independent Medicare reform commission. But Obama has also waged unconditional war on the insurance industry. He has negotiated and jousted with Senate Republicans. He has deferred (excessively at times) to congressional Democratic leaders but has also muscled them at key moments. He has pursued the liberal priority of expanded coverage through a centrist plan that largely tracks the Republican alternative to Clinton's 1993 proposal.

Yale University political scientist Stephen Skowronek, a shrewd student of the presidency, sees in this complex record evidence that Obama and his team are torn between consensual and confrontational leadership styles. The first, he says, stresses "the progressive reform idea of bringing everybody to the table {for} rational, pragmatic decision-making." The second argues "that you transform politics only through wrenching confrontation." Skowronek believes that the most-consequential presidents, such as Abraham Lincoln and Franklin Roosevelt, usually start with the first approach and evolve toward the second as they encounter entrenched resistance.

Liberals who consider Obama too conciliatory have speculated that his willingness to use the Senate reconciliation process to force a final vote on health care signals a turn toward consistent confrontation. But it seems more likely that he will continue to seek broad coalitions on some issues (education, energy, immigration) while accepting, even welcoming, greater partisan conflict on others (financial reform). The approaches that Skowronek views as alternatives Obama may consider tools he can wield in different combinations for each challenge. The constant is Obama's determination to turn the supertanker -- and his Reagan-like willingness to bet his party's future on his ability to sell the country on the ambitious course he has set.
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bread_and_roses Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-20-10 07:51 AM
Response to Original message
1. "Americans are entitled to [for profit] insurance " - "change we can believe in- ROFL (n/t)
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babylonsister Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-20-10 07:53 AM
Response to Reply #1
3. You're right. It would have been much better if no one addressed
HCR. :eyes:

http://www.democraticunderground.com/discuss/duboard.php?az=show_topic&forum=433&topic_id=229911

KEY PROVISIONS THAT TAKE EFFECT IMMEDIATELY
UNDER SENATE BILL AS AMENDED BY RECONCILIATION BILL

Below are some of the key provisions that will take effect immediately, under the legislative package the House will consider later this week (the Senate health bill as amended by the reconciliation bill). The reconciliation bill is based largely on the improvements put forward by the President’s proposal – moving towards the House bill in certain critical areas.

1. SMALL BUSINESS TAX CREDITS—Offers tax credits to small businesses to make employee coverage more affordable. Tax credits of up to 35 percent of premiums will be immediately available to firms that choose to offer coverage. Effective beginning for calendar year 2010. (Beginning in 2014, the small business tax credits will cover 50 percent of premiums.)
2. BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE—Provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. Effective for calendar year 2010. (Beginning in 2011, institutes a 50% discount on brand‐name drugs in the donut hole; also completely closes the donut hole by 2020.)
3. FREE PREVENTIVE CARE UNDER MEDICARE—Eliminates co‐payments for preventive services and exempts preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011.
4. HELP FOR EARLY RETIREES—Creates a temporary re‐insurance program (until the Exchanges are available) to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55‐64. Effective 90 days after enactment
5. ENDS RESCISSIONS—Bans insurance companies from dropping people from coverage when they get sick. Effective 6 months after enactment.
6. NO DISCRIMINATON AGAINST CHILDREN WITH PRE‐EXISTING CONDITIONS—Prohibits health insurers from denying coverage to children with pre‐existing conditions. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to all persons.)
7. BANS LIFETIME LIMITS ON COVERAGE—Prohibits health insurance companies from placing lifetime caps on coverage. Effective 6 months after enactment.
8. BANS RESTRICTIVE ANNUAL LIMITS ON COVERAGE—Tightly restricts new plans’ use of annual limits to ensure access to needed care. These tight restrictions will be defined by HHS. Effective 6 months after enactment. (Beginning in 2014, the use of any annual limits would be prohibited for all plans.)
9. FREE PREVENTIVE CARE UNDER NEW PRIVATE PLANS—Requires new private plans to cover preventive services with no co‐payments and with preventive services being exempt from deductibles. Effective 6 months after enactment. (Beginning in 2018, this requirement applies to all plans.)
10. NEW, INDEPENDENT APPEALS PROCESS—Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions by their health insurance plan. Effective 6 months after enactment.
11. ENSURING VALUE FOR PREMIUM PAYMENTS—Requires plans in the individual and small group market to spend 80 percent of premium dollars on medical services, and plans in the large group market to spend 85 percent. Insurers that do not meet these thresholds must provide rebates to policyholders. Effective on January 1, 2011.
12. IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH‐RISK POOL)—Provides immediate access to insurance for Americans who are uninsured because of a pre‐existing condition ‐ through a temporary high‐risk pool. Effective 90 days after enactment.
13. EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH PARENTS’ INSURANCE – Requires health plans to allow young people up to their 26th birthday to remain on their parents’ insurance policy, at the parents’ choice. Effective 6 months after enactment.
14. COMMUNITY HEALTH CENTERS—Increases funding for Community Health Centers to allow for nearly a doubling of the number of patients seen by the centers over the next 5 years. Effective beginning in fiscal year 2010.
15. INCREASING NUMBER OF PRIMARY CARE DOCTORS—Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals. Effective beginning in fiscal year 2010.
16. PROHIBITING DISCRIMINATION BASED ON SALARY—Prohibits new group health plans from establishing any eligibility rules for health care coverage that have the effect of discriminating in favor of higher wage employees. Effective 6 months after enactment.
17. HEALTH INSURANCE CONSUMER INFORMATION—Provides aid to states in establishing offices of health insurance consumer assistance in order to help individuals with the filing of complaints and appeals. Effective beginning in FY 2010.
18. CREATES NEW, VOLUNTARY, PUBLIC LONG‐TERM CARE INSURANCE PROGRAM—Creates a long‐term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled. Effective on January 1, 2011.
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Clio the Leo Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-20-10 07:56 AM
Response to Reply #3
5. Dont even bother wasting your time.
Those who get it, get it. Those who dont, never will.
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cornermouse Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-20-10 07:57 AM
Response to Reply #3
6. Why don't we just call that the List of Lies and be done with it?
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babylonsister Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-20-10 08:01 AM
Response to Reply #6
7. Aww, poor lil mouse. That list came from the House. Can you provide
an alternate list? A link?? Anything???

Yea, I didn't think so.
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cornermouse Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-20-10 08:12 AM
Response to Reply #7
8. Why bother?
Edited on Sat Mar-20-10 08:16 AM by cornermouse
You didn't believe the link to the GAO pdf, who has no horse in this race, which countered much of the list the House generated. I'm not going to waste my time providing facts any more.

If I hadn't already known who was behind this bill, I would have sworn it was the republican party, not the democratic party.
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babylonsister Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-20-10 08:16 AM
Response to Reply #8
9. Why bother bitching if you have nothing to support you?
And I have no idea what link you're talking about. Are you saying a GAO link disputes these findings? Do tell because that's the first I heard of it.
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cornermouse Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-20-10 08:20 AM
Response to Reply #9
11. List of Lies it is.
And yes, there was a GAO link. And no, I'm not bothering any more. I'm just sitting back and waiting for the implosion at this point.
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bread_and_roses Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-20-10 08:17 AM
Response to Reply #3
10. false choice - which has been the hallmark tactic of this debate
The outcome is much bigger than even health care - big as that is, not just enshrining a for-profit model but transferring vast sums of the peoples' common wealth to private profit - but absolutely confirming Rahm's "fuck you, you'll fall into line when we crack the whip" to any progressive attempt to curb the power of private $$ and the for-profit vampires

you can kiss any chance of real change good-bye

goodbye real financial reform

goodbye real labor law reform

goodbye real energy reform

goodbye real agriculture reform

goodbye real educational reform

goodbye real efforts at peace

well done! let's all cheer the three-dimensional chess player!!

too bad we're the pawns
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babylonsister Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-20-10 08:54 AM
Response to Reply #10
12. Yawn. You must be so miserable if you actually believe this. nt
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bread_and_roses Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-20-10 09:52 AM
Response to Reply #12
13. Being part of the reality-based community does tend to make one miserable these days
it is - literally - painful. How I envy rose-colored glasses!
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babylonsister Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-20-10 10:17 AM
Response to Reply #13
14. Can't you come up with a more original line, at least?
And look around and see who is more reality-based; you, or all the economists, doctors, nuns, Krugman, Reich, etc., etc., etc., who are in favor of passage of HCR?

You're in the minority, just like the rethugs who happen to agree with you.
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cleveramerican Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-20-10 07:52 AM
Response to Original message
2. "damn the torpedoes, full speed ahead"
I voted for him
I trust him
I will continue to be baffled by him at times.
I will adjust.
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Clio the Leo Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-20-10 07:55 AM
Response to Original message
4. We are lucky to have a President with more foresight and patience than the average bear. NT
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bvar22 Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-20-10 10:22 AM
Response to Original message
15. After Obama's historic Change of Course....
...Americans will be able to buy Health Insurance from Health Insurance Companies !!!
(Thanks, Bill Maher)

A Once in a Generation Opportunity for REAL "Change", and we get some re-adjustments to Health Insurance Regulations, a Republican Individual Mandate, a (Republican) torpedo of the Public Option, a Republican Anti-LABOR Tax Increase of Working Americans, and a $500Billion de-funding of Medicare.

"Rarely since World War II has a president devoted so much time, at so much political cost, to shouldering a single priority through Congress."

Was the author here in the US last Summer when Obama was MIA on Health Care Reform?
OR
During the Fall & Winter when the White House surrendered to Joe Lieberman and The Republicans on Issue after Issue until there was practically nothing "Democratic" left in this bill?

This bill is a far,FAR cry from the "Comprehensive Health Care Reform" promised during Campaign 2008.
Obama easily surrendered on every major issue included in his campaign.
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