Obama Should Pull The Trigger!

With his health care reform effort on the ropes after taking a beating all summer in town halls across America, President Barack Obama is finally hitting back, making a long overdue house call to the House chamber on Sept. 9 to convince a chaotic Congress and frightened, misinformed public to jump on his bandwagon before it's too late.

President Obama tried to learn from the mistakes made by President Bill Clinton and his spouse--now his secretary of state--Hillary Clinton. Rather than unilaterally create a health care reform proposal behind closed doors and hand it to Congress to rubber stamp, as the Clintons attempted to do 16 years ago, President Obama laid out very broad goals--affordability, reduced costs, portability and insurance reform--but left it up to Congress to not only come up with the details of legislation, but to do so in a bipartisan fashion.

President Obama erred too far on the side of caution. He was much too optimistic, and perhaps even naive--not just about the ability of Congress to come to an agreement without a strong hand to guide them (organizing congressional action is like herding cats!), but in expecting the Republicans to work with him in any good-faith effort to achieve real reform.

After all, why should Republicans hand the President a signature victory on a historic piece of legislation, which might very well not only assure his reelection, but an even bigger majority in both houses of Congress in next year's midterm elections?

Better to poison the well by spreading toxic lies about President Obama's intentions--with outrageous accusations about "death panels" and "socialism"--than step up with their own comprehensive reform scheme.

By allowing President Obama and his allies in Congress to go it alone, the Democrats will absorb all the blame if reform ends up costing too much for the vast majority who are satisfied with the status quo--even though their current insurance is shaky at best, subject to holding onto their jobs and not getting sick so as to give carriers an excuse to dump them off their rolls, even if they are lucky enough to have individual coverage in the first place.

Of course, the Democrats will also reap all the credit if they can summon the courage to go it alone and reform does indeed ease the financial burden on millions of Americans, while providing affordable coverage for all. But this generation of Republicans--the most negative, cynical and partisan political party in my lifetime--appears to be incapable of seeing the big picture, or putting the country's best interests ahead of politics.

While the White House is mum about the details of his speech before a joint session of Congress and a nationally televised audience, I expect President Obama to lay out the obvious areas of agreement thus far--most likely focusing on the mistrust and hostility everyone seems to share for the insurance industry.

He will almost certainly call for an end to preexisting condition exclusions and a limit to risk-based pricing for individuals. He will also drop his call for coverage of sensible end-of-life counseling because of the way Republican provocateurs have shamelessly mischaracterized the initiative as an excuse for killing elderly patients.

However, I do not expect him to cave entirely on the one issue around which his entire reform program was built--creation of a public health insurance option. I believe he will offer a compromise--not to entice Republicans (who will never vote for any reform plan of his), but to throw a bone to his progressive supporters, while providing political cover for the so-called "Blue Dog" Democrats fearful for their reelection should they allow "socialized medicine" to prevail.

I expect President Obama to tell insurers to put up or shut up, calling on Congress to put in place a public option that would only be created if private insurers fail to cover a certain percentage of the population by a certain date--let's say, 95 percent of legal American citizens (eliminating another straw man--charges that Democrats want coverage for illegal aliens) by 2013.

This should not be objectionable to any reasonable individual. After all, most of the key reforms in the original reform plan weren't supposed to go into effect until around that date anyway. And if private insurers prove incapable or unwilling to insure the vast majority of the population in four years, then perhaps we do indeed need a public option to close the gap.

I would rather see President Obama go for my idea instead and mandate creation of state Assigned Health Insurance Risk Plans, forcing private carriers to take individuals at group rates who cannot find coverage in the private market--but there is no indication that the administration is even considering such a common sense plan.

But by setting a trigger that puts the onus on private insurers to provide coverage for all at reasonable prices, President Obama can protect his left flank by keeping a public option in play, while protecting his right flank by allowing the Blue Dogs to reassure their jumpy, more conservative constituencies that the private market will be given every chance to prevail.

What do you folks think?