Pelosi's Switch on the Dem's Pitch for Health Care

| Tue Mar. 3, 2009 8:52 AM PST

On Tuesday morning, House Speaker Nancy Pelosi met with a bunch of journalists and bloggers from assorted progressive media outlets. As they asked her about the stimulus package, health care, and her relationship with the White House, she mainly stuck to talking points and hailed President Barack Obama, his budget, the stimulus legislation, and the policy agenda she enthusiastically shares with the White House. She declined to bash Rush Limbaugh (or even talk about him), and said she had no plans to apply pressure on Republican legislators from districts that Obama had won in November.

But what was intriguing was how she foreshadowed the health care reform fight to come. With the White House holding a health care summit this week, the Democrats in Congress are gearing up for the titanic legislative challenge of passing a major health care reform package. In years past, the champions of health care reform have relied on a simple slogan: There are 40 million Americans without health care coverage, and they deserve it. (Now, it's 48 million.) Yet Pelosi noted that delivering insurance to this group of Americans will not be the political or rhetorical centerpiece of the latest health care reform effort.

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The "appeal" of this push, she said, will not be that 48 million people don't have health care insurance. "What is important to the bigger population," she explained, "is their own health care." She noted that with health care costs rising faster than any other costs, the key issues these days are the impact of these increasing costs on the economy, on the quality of the care delivered, and on federal entitlements (meaning the costs of Medicare and Medicaid).

Pelosi was signaling how congressional Democrats will be selling their drive for health care reform. She said that the package will focus on science and technology and include major investments in biomedical research, preventative health care, and electronic medical records. She noted that when technological improvements in maintaining medical records render it easy for health care providers to compare the medical treatment of a low-income person with a certain disease with a wealthy person with the same illness, both patients will benefit. That is, the more patients in the information pool, the better for all, including those who already have coverage.

So health care reform will be pitched not primarily as a benefit (or handout) for the uninsured, but as a way to deliver higher quality health care at a lower cost with fewer errors to those who posses some degree of coverage, especially those in the anxious middle class.

Pelosi did say that universality--meaning coverage for all, or close to all--will be a key component of the package. But she and other House Democrats have obviously calculated that concentrating on providing coverage to the uninsured will not win over sufficient majorities in the House and Senate. Given that there are indeed more covered than uncovered Americans, her political calculus makes sense.

The bottom line: the battle cry will not be, "Health care for all!" Instead, it will be "Better health care for you--and also the rest of us." Given how the Hillary Clinton-led crusade for health care reform flamed out terribly in the 1990s, this sort of tactical shift may be warranted. It may even be wise.

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BTW, Pelosi also said that legislation to end the don't ask/don't tell policy regarding gays and lesbians in the US military is a lower priority than both legislation related to hate crimes against homosexuals and a bill to prohibit workplace discrimination against gays and lesbians. Before bringing to a vote a measure to kill don't ask/don't tell, she said, "We will have to create an environment in which we will win." And she said she hoped that a cap-and-trade climate change measure will be passed by the House by the end of the year, as part of a larger bill covering alternative energy funding and the development of a smart grid.

David Corn is Mother Jones' Washington bureau chief. For more of his stories, click here. He's also on Twitter.

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Comments

No comments?

I find it interesting that there are no comments yet about this piece. Between Obama and Pelosi, many progressives don't know what to think.

Nancy's Lies

Maybe Pelosi/Reid figured out that, while "48 million Americans have no healthcare!" makes for a great speech, the reality is every American (and illegal immigrant, for that matter) has the right to healthcare (ER's, Medicaid, etc.). The simple goal of putting everyone on the government teat won't win enough support for the socialization to be passed, since many wouldn't change their means of consuming healthcare in any case. She's simply trotting out the oldest brand of higwash known to advertising by claiming the healthcare "reform" will result in "New & Improved!" medicine for America.

What will it actually look like?

It's hard to comment on this article because details are still so very sketchy. It's equally difficult to know how much of what we will hear from politicians is sell and how much will be the actual meat. What is being left unsaid that we aren't sufficiently aware of ? Will the 48 million be covered or not? Will the necessary changes regarding waste and fraud from both ends and quality of care be made or not? And how? Need more info...!

I wonder if they'll be

I wonder if they'll be tackling the problems of the cost of medical school and improving incentives for medical students to become primary care physicians (such as if you decide to become a primary care physician, the government will forgive your student loans). The costs of medical school are outrageous and get passed on to the consumer. Primary care physicians are spending too much time dealing with adminstrative problems instead of dealing with sick people. And when a doctor gets reimbursed from an insurance company, he or she has to wait several months to receive payment. Funny, this is capitalism's version of beauracratic delays. I think their guiding philosophy should be "How do we disconnet HMO's from primary care physicians?" But ultimately, there is something that the American people can do that Congress can't. That is to say that Americans need to take better care of themselves. And we all know it. Its a total lie if you think its cheaper to live on fast food, its just more convenient.

The US will continue its

tagged as: 
The US will continue its decline into third world status with a first world facade unless and until it joins the civilized world and provides for its citizens. All civilized countries on Earth, including the French, Canadians, Japanese and British, to name a few, even that tiny little island of Cuba, utilize taxpayer dollars for the benefit of their citizens and provide better health care than Americans have for a FRACTION of what we pay private insurers. The USA is the only nation in the civilized world where citizens can go bankrupt and end up homeless because they had the poor fortune to get ill. And why? Because the private insurance lobby has more influence on the certifiable whores in congress than the American taxpayer. OUR TAX DOLLARS ARE NOT USED FOR THE BENEFIT OF MOST AMERICANS: Instead, American tax dollars are used to bail out bloated, greedy investors and banksters when their shitty investments are exposed for the Ponzi schemes they always were, without penalty or recourse to those who caused this problem to begin with. Why should American taxpayers take out a LOAN from the Fed at INTEREST in order to bail out these frauds? The obscene amounts of money for which American taxpayers have taken an at interest (5%) LOAN from the Fed in order to finance these bailouts have actually been used in part, by their recipients, to LOBBY CONGRESS AGAINST THE INTERESTS OF THE AMERICAN TAXPAYER!!!! Instead of trillions to these frauds, why not pay off EVERYONE's mortgage? This would accomplish precisely what the alleged purpose of the bailouts is -- to recapitalize the banks; make these "toxic" assets good and at the same time save communities from becoming ghost towns as their inhabitants continue to get kicked out of their homes. Why can we reward the incessant and unending greed of these bankers and financial fraudsters with regulation/accountability -free tax dollars while refusing to "bail out" average people who are on the other side of these toxic transactions? The claim that helping the average taxpayer is socialism is a MYTH. Socialism is the state-controlled means of PRODUCTION and DISTRBUTION. Look it up sometime. Using tax dollars to assist taxpayers is at the nexus of our system. Read the Constitution, particularly the Preamble. But in a nation addicted to "Survivor" it is not difficult to understand that the people are ignorant enough to believe that giving trillions to fraudulent financiers to save them from having to be responsible for their own follys is somehow different from giving substantially less amounts to ordinary people. If one is "socialism" then surely the other is as well -- it's just a matter of the degree of giveaway. Instead, American tax dollars are used to finance foreign wars, which result in causing death and destructions to MILLIONS of innocent people abroad. Instead, American tax dollars are used to subsidize Frankenfarming by Monstanto and ADM, whose GM crops are destroying the indigenous food supply, bankrupting farmers and ultimately depleting the supply of good, nutritious food around the world. Instead, American tax dollars are used to subsidize big pharamceutical companies who continue to experiment on impoverished human beings in Africa and elsewhere; who charge grossly inflated prices for drugs in the USA, which drugs are easily available elsewhere in the world for a fraction of the cost; and who spend MILLIONS of those ill-gotten dollars lobbying our "lawmakers" (i.e., the rubber stamps in congress who push the legislation authored by these corporations) to make laws in their favor and who have managed to stack the FDA with compliant cronies and sycophants. On the subject of health care: Insurance is not health care. It's insurance. And the private insurance industry has been allowed to run amuk and cherry pick insureds to the point where the only people who can get insurance are those who don't need it. The private insurance industry spends more fighting claims than paying them (I include not only litigation but the personnel whose job it is to reject claims all the way up the line). Regan's legacy of "hooray for me and screw you" has infected the American population who now have no problems throwing billions and trillions of tax dollars at millionaire fraudsters and financial incompetents who have managed to destroy the economic well being of this country, but who in the same breath, strongly disapprove using any of their tax dollars to assist ordinary people in need.. The US will continue its decline into third world status and 99% of the American population will slide into near poverty, unless its citizens learn that for our country to be strong and healty again, ALL Americans must have basic services, including health care. Yes, sometimes that means paying someone else's way. However why is it more appealing to pay a millionaire's way out of his/her bad debt, than to help a struggling poor person? The image of the "lazy" poor person is another unfortunate Reagan legacy that must be jettisoned if this country is to survive. Just because someone is wealthy doesn't mean they work any harder than someone else who is poor. THAT IS A MYTH. In fact, Bankers don't work for a living -- they are scum sucking parasites who got fat off of EVERYONE's back with their "emperor's new money" (debt based monetary system) (see http://video.google.com/videoplay?docid=-9050474362583451279) while many poor people often work 2-3 jobs just to put a meager meal on the table, often having to choose between having utilities or rent from month to month -- those who are fortunate enough to be able to afford a home. Single payer universal health care would be a small start for a nation filled with self absorbed "individualists" who continue to assert their independence until, of course, they find themselves needing a handout. Then all of a sudden, they singi a different toon. Until people realize that we must provide for each other, according to need, not caprice; that we are all brothers and sisters in this and, that our greatest duty is to each other, the US will continue its backslide into flagrant barbarism. Another down side to an unhealthy population is that it simply isn't SANITARY or good for everyone else. Plague, disease and pestilence often become pandemic when millions go without appropriate health care. And to the obscenely wealthy of this country who already have theirs, it is useful to remember that germs and bacteria don't give a shit what's in your portfolio. If the US is ever to reclaim her status as a genuine first world nation; a beacon for the rest of the world; it must start by providing for the basic needs of its citizens. After all, that's why we agree to pay taxes, isn't it? For the common good and the general welfare. Well, it's time to start attending to that business and a great place to start is with a universal health care system, JUST LIKE every other civilized nation on Earth has. I favor the single payer plan since it excises the private insurance industry altogether -- let it continue to insure "stuff" and not people's health -- but other countries have succeeded with other models (i.e., Japan) Otherwise, we should just get comfortable in our decline and accept the fact that the US's run as a world leader is over.

I feel your frustration!

I feel your frustration!

re: The US will continue its

Well put. Thanks for the intelligent, thoughtful comment. I say 'ditto'!

"every American (and illegal

"every American (and illegal immigrant, for that matter) has the right to healthcare (ER's, Medicaid, etc.). " I haven't had health insurance since my husband's position at Indiana University was eliminated three years ago. I work full time but my employer does not offer health insurance. My husband, who is in his 50s, works as an independent contractor now. We make far too much money to qualify for Medicaid or even the free clinic which cuts off at $20,000.00 a year. You cannot get preventative care at an emergency room and if you do use an emergency room with no insurance you are left with thousands, if not tens of thousands, of dollars in debt. Heck, even when we did have health insurance our co-pay for a broken arm was almost a thousand dollars. Health care costs are a drain on everybody, including those companies that still offer health care benefits to employees. The United States desperately needs to get in line with the rest of the industrialized world and guarantee universal health care.

More people have cell phones in the US than Health Care.

It is an odd thing where something people consider a necessity (health care) is of less financial concern than something we lived without for decades (cell phones). In your case, not having health care truly is your choice. I am also self employed as an independent contractor working for a small consulting company and provide for my own health care. I take personal responsibility for providing that.

The current plan in the house would have me paying an additional $12,000 - 16,000/year and still not provide any health care for me (The penalty the company I contract through would cut my pay to cover their "penalty"). That is a huge drain personally, and represents a major transfer of wealth. In short, for the added tax imposed on me for working in the small business sector, I could purchase the best health care in the world. This is much more than I need and there are much better plans (in High Dollar Deductible plans) that meet my needs better. So while I agree there are serious and deep routed issues in the US health care system, none of the current plans in congress do nothing to address them.

So my advise is, if you want health care, take your own future into your own hands and go buy some. You can get it affordably if you use plans like the Archer MSAs and pay substantially less than the propose house plans will cost you in lost income going to taxes Note: your husband would qualify to cover you with an Archer MSA. They are a great option for the self employed and those that work for small businesses.

People of United States is

People of United States is presently facing unique challenges for health cares access, which is one of the biggest issues of the nation. President Barack Obama, under his administration promised that healthcare is going to be one of the issues that they will tackle. There hasn't been any legislature introduced yet, but there should be a bill on the Congressional floor by the end of summer. The amount spent per family on health services has gone up dramatically in the last decade, and a lot of people are sick of getting personal loans just to cover the most basic of medical care. The aim is to reduce cost to providers, insurers, the government, and ultimately the public, so that no one needs debt consolidation for the most basic of health care needs.

Hmmm... Health Care for All

tagged as: 
Hmmm... Health Care for All Americans is Simple! 1) Merge Medicare with Medicaide into one single "Income Based" system for elderly and poor citizens. 2) Require insurance companies to provide the same basic coverage for all Non-Medicare/Medicaide citizens, regardless of health status, at government established rates. 3) Allow insurance companies to profit by offering additional benefits and options to those who qualify and are willing to pay the difference. As for Funding... 1) Changing from an "Emergency Treatment" to a "Preventive Care" system will save local communities billions, maybe even trillions of taxpayer dollars! 2) Small business will be able to compete globally and hire additional taxpaying employees! 3) Wealthy seniors will pay their fair share! 4) The tremendous burden on future generations will be greatly reduced! Hmmm... www.jpinsatx.newsvine.com/

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