President-Elect Barack Obama, Congressional Democrats Frame Health Care, Other Proposals As Job-Creation Plans

Main Category: Health Insurance / Medical Insurance
Also Included In: Public Health
Article Date: 18 Nov 2008 - 10:00 PDT

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President-elect Barack Obama and congressional Democrats have begun to frame their proposals for health care and other issues as "job-creation measures" in response to the current economic downturn, the Washington Post reports. According to the Post, the "thinking is that universal coverage will lower health care costs and make companies more willing to hire, as well as create new health care jobs." House Labor and Education Committee Chair George Miller (D-Calif.) said, "People are starting to see that the loss of jobs is starting to cascade," adding, "Health care becomes about jobs as much as it is about the economy" (MacGillis, Washington Post, 11/16).

Meanwhile, Obama and Democrats are "wrestling with how aggressively to use their governing majority to move toward cherished goals such as universal health care," the Chicago Tribune reports (Dorning, Chicago Tribune, 11/16). According to the Arizona Republic, "Obama's to-do list of domestic fixes will be long and pricey," but "perhaps no reform will be as controversial as his vow to overhaul the nation's health care system" (Alltucker, Arizona Republic, 11/16).

"One view is that Democrats should seize the opportunity to rapidly press the party's agenda on health care, middle-class tax cuts and major spending programs," according to the Tribune. Bill Galston, a domestic policy adviser to former President Clinton, said, "There's a lot of pent-up demand, a lot of impatience," with "a number of Democrats in Congress who will say, 'If we can't pass universal health care this time, when can we?'"

However, the "risk of backlash is real," and the "party's rank and file says it prefers a centrist course," the Tribune reports. House Majority Whip James Clyburn (D-S.C.) said, "We need to have a measured approach. I don't think we need to be lurching left or right" (Chicago Tribune, 11/16).

HHS Transition
The Obama transition team on Friday named William Corr, executive director of the Campaign for Tobacco-Free Kids, and Nicole Lurie, a public health and health care disparities expert with RAND, as "agency review team" leaders to manage transition activities for HHS, CQ HealthBeat reports. In addition, the team named Jonathan Moreno, a professor of medical ethics at the University of Pennsylvania, to manage transition activities related to bioethics issues (Reichard, CQ HealthBeat, 11/14).

In related news, outgoing HHS Secretary Mike Leavitt in a report released on Friday said that the Obama administration should seek to promote personalized medicine and expand use of electronic health records to address problems with the health care system, Bloomberg reports. The report, which Leavitt called a "note on the desk" to his successor, also cited the need to eliminate waste and overuse of treatments and medical tests to reduce health care costs and promote access (Lauerman, Bloomberg, 11/14).

Meanwhile, according to unnamed sources, Democratic National Committee Chair Howard Dean, a physician and former governor of Vermont, is not under serious consideration for HHS secretary, The Politico reports. According to The Politico, the "chief attributes ... Obama is seeking in his HHS secretary will be an ability to work with members of Congress and shepherd reform legislation through the House and Senate," a job description that is "particularly ill-suited" for Dean because of his partisan background and lack of congressional experience, sources said (Cummings, The Politico, 11/13).

Opinion Pieces
Summaries of several recent opinion pieces related to health care issues in the new Obama administration appear below.

• Ezekiel Emanuel, New York Times: "In health care, big plans are necessary not only to motivate people but as a matter of sound policy," Emanuel, an oncologist and chair of the Department of Bioethics at the NIH Clinical Center, writes in a Times opinion piece. According to Emanuel, the "health care system needs major surgery, not more Band-aids," but, if "we have to settle for incremental Band-aids, it should be only as a last resort." The costs of health care "are the long-term driving force in federal and state budgets," so to "control the deficit and keep the country solvent, health care must be solved," he writes, adding that when Obama "considers senior economic advisers, one test should be whether they really get health care policy." Emanuel continues, "One of the secrets of health care reform ... is that bigger changes to the system actually cost less." However, as the efforts for reform will be "incredibly complex" and "improvements are made, problems will arise and unintended consequences will occur" that will require "numerous mid-course corrections," he writes. "Good reform will make addressing these issues easy by not requiring major legislation for each adjustment," he adds. Emanuel concludes, "Health care reform cannot be considered in isolation," adding, "Everything is affected by health policy, and every decision should be examined for its impact on health care reform" (Emanuel, New York Times, 11/16).
  
  
• Stuart Butler, New York Times: Reforming the U.S. health care system and "[g]etting it done right will require Mr. Obama to keep four things strongly in mind or his honeymoon on health care will end soon," Butler, vice president for domestic policy at the Heritage Foundation, writes in a Times opinion piece. "First, he has to make a strong commitment to bipartisanship" and "tell the more triumphalist liberal supporters on Capitol Hill to chill" as "he's looking for common ground," Butler writes. He continues, "Second, these very difficult economic and budget times underscore the need to find better ways to use the money we are currently spending on health rather than throwing tens of billions in new money at the health industry in an effort to expand coverage." Butler adds that "Mr. Obama should put meat on the bones of his campaign proposal to allow states flexibility to redesign existing health programs and use money more efficiently to reach the goal of maximizing affordable coverage." Butler writes, "And finally, he needs to remember that Americans are very conservative about their health care" because people "with coverage are extremely nervous about changing what they already have." He concludes, "All the more reason, then, for President-elect Obama to tread carefully, to set up models at the state level so Americans can kick the tires of major reforms first, and to reach across the aisle to build trust and broad support for a workable way of reaching the goal we all share" (Butler, New York Times, 11/16).
  
  
• Jim McTague/Dimitra DeFotis, Wall Street Journal: Obama "faces daunting challenges trying to right problems in the U.S.," but his "approaches to these issues and the policies he promotes are likely to produce winners and losers among an array of industries," including health care, McTague and DeFotis, of Barron's, write in an opinion piece in the Journal. According to the writers, "Drug company stocks could be hurt as Democrats struggle to hammer out a universal health care plan that would reduce the cost of drugs and services." They add that "[t]here could also be some winners in health care," especially businesses that "drive for efficiencies in health care record-keeping," such as Humana, Medco Health Solutions and Express Scripts. McTague and DeFotis conclude, "Perhaps the best hope for the health care sector -- and investors generally -- is a hefty dose of painkillers, good until the U.S. economy finds a way out of its current mess" (McTague/DeFotis, Wall Street Journal, 11/15).
  
  
• Michael Gerson, Washington Post: Obama must "be aware of certain issues -- certain tripwires -- that could trigger explosive controversy, turning suspicion into anger and undermining his broader legislative objectives," including abortion and bioethics, Gerson, a senior fellow at the Council on Foreign Relations, writes in a Post opinion piece. According to Gerson, there are "at least 16 provisions passed routinely by Congress that limit governmental involvement," including "measures that prevent the domestic funding of abortion, forbid the use of international family planning funds for abortion, protect the rights of medical professionals to refuse involvement in the procedure and prohibit the patenting of human life." He continues, "Removing this firewall between government and abortion would seem -- and be -- a massive assault on the pro-life movement," adding, "By abandoning government neutrality on abortion, Obama would permanently embitter most with pro-life views" (Gerson, Washington Post, 11/15).

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