Editore"s Note
Tilting at Windmills

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March 2, 2010

THE RESULTS OF THE HCR SUMMIT.... President Obama is scheduled to outline his vision on moving forward with health care reform tomorrow, but today the president wrote to congressional leaders from both parties, explaining several areas of agreement with Republicans.

"No matter how we move forward, there are at least four policy priorities identified by Republican Members at the meeting that I am exploring. I said throughout this process that I'd continue to draw on the best ideas from both parties, and I'm open to these proposals in that spirit," Obama's letter explained.

The GOP ideas include:

1. Although the proposal I released last week included a comprehensive set of initiatives to combat fraud, waste, and abuse, Senator Coburn had an interesting suggestion that we engage medical professionals to conduct random undercover investigations of health care providers that receive reimbursements from Medicare, Medicaid, and other Federal programs.

2. My proposal also included a provision from the Senate health reform bill that authorizes funding to states for demonstrations of alternatives to resolving medical malpractice disputes, including health courts. Last Thursday, we discussed the provision in the bills cosponsored by Senators Coburn and Burr and Representatives Ryan and Nunes (S. 1099) that provides a similar program of grants to states for demonstration projects. Senator Enzi offered a similar proposal in a health insurance reform bill he sponsored in the last Congress. As we discussed, my Administration is already moving forward in funding demonstration projects through the Department of Health and Human Services, and Secretary Sebelius will be awarding $23 million for these grants in the near future. However, in order to advance our shared interest in incentivizing states to explore what works in this arena, I am open to including an appropriation of $50 million in my proposal for additional grants. Currently there is only an authorization, which does not guarantee that the grants will be funded.

3. At the meeting, Senator Grassley raised a concern, shared by many Democrats, that Medicaid reimbursements to doctors are inadequate in many states, and that if Medicaid is expanded to cover more people, we should consider increasing doctor reimbursement. I'm open to exploring ways to address this issue in a fiscally responsible manner.

4. Senator Barrasso raised a suggestion that we expand Health Savings Accounts (HSAs). I know many Republicans believe that HSAs, when used in conjunction with high-deductible health plans, are a good vehicle to encourage more cost-consciousness in consumers' use of health care services. I believe that high-deductible health plans could be offered in the exchange under my proposal, and I'm open to including language to ensure that is clear. This could help to encourage more people to take advantage of HSAs.

The president also said his final package would do away with the special Medicare Advantage deal for Florida, and Ben Nelson's Medicaid deal for Nebraska.

It's not clear, at least not yet, how policymakers would act on this. President Obama is accepting some of the Republicans' proposals, but GOP lawmakers will still not accept the reform package that incorporates ideas from both parties. Presumably, the White House would like to see the areas highlighted in the president's letter incorporated into the reconciliation measure, but whether that would get approval from the parliamentarian remains unclear.

Nevertheless, it's that much more difficult to suggest the Obama administration is driving a partisan process with no input from the GOP when the president keeps accepting Republican proposals (though the discredited minority won't take "yes" for an answer).

Steve Benen 1:25 PM Permalink | Trackbacks | Comments (18)

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Nevertheless, it's that much more difficult to suggest the Obama administration is driving a partisan process with no input from the GOP

No it isn't, and they will do it because the media lets them get away with.

Posted by: qwerty on March 2, 2010 at 1:38 PM | PERMALINK

Fuck Obama,the GOP and this horseshit corrupt bill.

Posted by: par4 on March 2, 2010 at 1:38 PM | PERMALINK

I bet none of the republican senators will support their own ideas. Obama will forever be known as someone who is more interested in republican ideas than from his base.

Posted by: sfsmskater on March 2, 2010 at 1:42 PM | PERMALINK

"GOP Lawmakers will still not accept the reform package that incorporates ideas from both parties."

This is the most important point that should be hammered home. The GOP will not compromise. Their definition of bi-partisan is Dems aggreeing to GOP ideas. When they ran Congress no Democrats were invited to conference committees (tell me if I'm wrong). They knew the Dems wouldn't filibuster and they got alot of bad laws through.

It's hard for the Democratic agenda when the sole purpose of the highest rated Cable news network (FOX) seems to be to push the Republican agenda. And all the other news outlets are trying hard to imitate them.

Posted by: Ian on March 2, 2010 at 1:44 PM | PERMALINK

i am pleasantly surprised to see that this ploy is actually working a bit. MSNBC.com has a headline that Obama is making a bipartisan outreach. Its about freakin' time the media actually broke away from the "pox on both your houses" that they've sold the public on for the last 8 months. I figure in 10 minutes someone will have told the webmaster to change the headline.

Posted by: zeitgeist on March 2, 2010 at 1:53 PM | PERMALINK

Random undercover investigation of health care providers sounds like the stint pulled on ACORN, just disgusting. We have courts to resolve malpractice cases, #3 makes sense and #4 high deductibles are available now. Why keep watering down for nothing in return.

Posted by: Renate on March 2, 2010 at 1:54 PM | PERMALINK

He should have said that "HSAs are a are a good vehicle to encourage more cost-consciousness in consumers' use of health care services for all those people for whom going to the doctor to get something checked out for three or four or five hundred bucks or more is no big deal." Or maybe "HSAs are a are a good vehicle to encourage more cost-consciousness in consumers' use of health care services for all those low and middle and upper middle income people for whom finding out if they may have high blood pressure or cancer or diabetes or not doesn't really matter."

Posted by: emjayay on March 2, 2010 at 2:00 PM | PERMALINK

zeitgeist,

I was going to say the same thing. I'm seeing more and more about the White House's outreach in traditional new sources, and over the last couple of days a lot about Senator Bunning and GOP obstructionism.

It's enough to give one, dare I say, hope.

Close your eyes and imagine that 80% of the people in Washington were as legitimately devoted to working together and crafting policy as Obama is. Say what you will about his devotion to progressive ideals, I think no one can argue that he's not steadfast in his belief that government should and can work.

Posted by: doubtful on March 2, 2010 at 2:00 PM | PERMALINK

Is it not nice how the Republicans keep getting what they want without giving anything in return? They will never be held responsible for lousy legislation. At the end the Democrats will legislate a weak bill and they will be held responsible

Posted by: Renate on March 2, 2010 at 2:01 PM | PERMALINK

I love me some Obama. These are wonderful token ideas from the GOP that are only being put forward to make the GOP look like hack partisans. None of these proposals even touch the core differences between the parties, e.g. market mechanism with no gov. oversight v. government oversight of the health insurance markets.

What is interesting, is the triangulation between the Dem Congress and the President? Is this good cop, bad cop, or is there really some distance between the WH and the DEM Leadership.

I think not, and I think Steve is right that there is no real mechanism for incorporating these ideas. This is just window dressing.

For those of you squawking about capitulation, take a look at these proposals and tell me if these proposals even touch the core structure of the Dem bills. Not even close.

What I think many of you are complaining about is that Obama is not liberal enough for your tastes (mine too). But, come on, it was so obvious in the primary that he was more conservative on every social issue than HRC or Edwards. He's a centrist, and he likes the Evan Bayh's of the Senate, and so does Rahm. So, if you want, think about a primary challenge to Obama if you want him to pay attention to progressive ideas. That's what the Republican right is doing. What is silly IMHO, and beneath the intelligence of the contributors to this blog, is to keep imagining that BO is capitulating on his preferred policies out of some inherent weakness, or accomodationist fixation, or, hallarious, fear of Republicans. He loaths them. It was obvious from the Summit. But, politics is optics.

Posted by: Scott F. on March 2, 2010 at 2:05 PM | PERMALINK

doubtful -

my view of the MSM is perhaps a little different than some here in that I view them as evil, incompetent, crass, greedy and worthless but not necessarily partisan in any traditional sense. it merely looks that way more often than not because the right has better figured out how to play what really moves the media than the left has.

i preface with all that simply to say that my fervent hope is that Obama has the timing right: what we are seeing may (hopefully)be a case of the media loving to prove its power by first building Obama up as a Savior, then tearing him down because everyone loves a good come-uppance, and now - if we're lucky - proving they can rehabilitate him just in time for midterms because the only story that sells better than come-uppance is a good comeback.

We just have to hope the cycle doesn't peak too soon and have the media putting Obama back down by election time.

Posted by: zeitgeist on March 2, 2010 at 2:07 PM | PERMALINK

Zeit, unfortunately, it's MSNBC, that bastion of communistic socialism (bastards!). Tell me when it's on CNN or Fox (HA!). Watching CNN lately is a bit too reminiscent of Fox. Let me know when the "real" news stations carry it.

Oh, and what qwerty said!

Posted by: MsJoanne on March 2, 2010 at 2:09 PM | PERMALINK

Did we not just waste the entire time the Democrats had a super majority waiting on one or two Republicans to go along with at least one part or another of this bill? Only to find out that they voted against the very things they said they supported? As so as Lucy the Republican holds up the football you all think this time it is for real. What a bunch of gullible dumb asses, there has not been room in Washington DC for truth or fact checking since 1973 at the end of the day it only matters what you were able to force thought the halls of Congress. please quit telling me about it and show me.

Posted by: Fed up and Tired on March 2, 2010 at 2:18 PM | PERMALINK

Well, notice that every time, he says, in effect, "This is already in the bill, but we'll put it in slightly differently now." The only way to deal with these guys is to keep drawing attention to the bogusness of their outrage.

I'm not happy with O, but really, Dr. Phil and Oprah both couldn't figure out how to deal with these guys. I wish the media would pay more attention to this than to some social secretary quitting at the White House, because that apparently is what they're most enchanted with today.

Posted by: ashenden on March 2, 2010 at 2:55 PM | PERMALINK

About that Kabuki poker game...

Said he: I'll see your nihilism and raise you four nihilists more...

Posted by: koreyel on March 2, 2010 at 3:11 PM | PERMALINK

Remember when George W. would lead meetings in Congress, answering questions, listening to their ideas, and addressing letters to them on important matters of state?

Posted by: beejeez on March 2, 2010 at 4:35 PM | PERMALINK

I agree with par4, except that I would substitute 'all of congress' for the GOP and I would capitalize the whole thing.

Posted by: jeff on March 2, 2010 at 5:00 PM | PERMALINK

The results of the summit are that Obama is still kicking the centerline to the right. He's still catering to Republicans, trying to win them over by watering down any reform. It's a Republican bill as it is.

Forget the Dems. They will never do what's good for ordinary Americans.


Posted by: Brian on March 3, 2010 at 3:53 AM | PERMALINK
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