Confluence on Health Care Reform

It's a couple days old, but this Boston Globe story about the Obama Administration's plans for health care gives me some confidence that they have learned from the pitfalls of the Clinton plan in 1993-94.

President-elect Barack Obama and his team have signaled that they plan to work jointly with Congress to overhaul the healthcare system, rather than produce a separate White House bill that would be sent to Capitol Hill, according to people involved in healthcare strategy discussions.

The Obama team is determined to avoid the mistakes of the early 1990s, when the Clinton White House created a healthcare policy team that had more than 500 members and spent months secretly developing a 1,342-page proposal with minimal input from Congress. A lack of investment among congressional leaders helped doom the bill, which never even went to a vote.

Obama and his team - headed by former Senate majority leader Tom Daschle, who will serve as a bridge to Congress - have already begun privately engaging with congressional leaders and have emphasized that they intend to work more collaboratively on healthcare than the Clintons did, said the two leading Democratic senators on healthcare reform.

"Congress did not want to be told what to do," said Max Baucus, the Senate Finance Committee chairman, whose committee will determine whether a healthcare overhaul is fiscally feasible. "They're very cognizant of that and they don't want to make the same mistake."

Dealing in politics necessarily means dealing with a lot of egos. If you have to massage them, make them feel like they are a part of the process, as long as the effects on an overall health care plan aren't completely sullied it's the best practice toward getting something done.

Meanwhile the transition continues to hold public events to hear the health care stories of ordinary Americans. While I don't ultimately believe that Jane Doe from Pittsburgh is going to have a central role in a plank of the policy, the more that the transition hears about the urgency of the matter, the more pressured they are to act, and in addition they can leverage the stories of these thousands of people to force the Congress, particularly Republican moderates up for re-election, into action as well. I would expect lots of health care town halls in Pennsylvania and Ohio, to that end (Voinovich and Specter are two of the most inviting targets).