Skip to content

Wall Street Journal – Obama, Health-Care Players Agree to Seek Overhaul

Wall Street Journal – Obama, Health-Care Players Agree to Seek Overhaul

By Laura Meckler

WASHINGTON — President Barack Obama said Thursday that he would fight for an overhaul of the U.S. health-care system this year, and legislators and lobbyists gathered at the White House promised to help.

Mr. Obama hosted the White House Forum on Health Reform to help build momentum for legislation that has evaded several of his predecessors. The president promised to compromise to get a bill, and the afternoon was filled with vows to fix problems that have long plagued the U.S. system, to work with people in the other party, and to learn from past mistakes, particularly those made by Bill and Hillary Clinton when they tried for an overhaul in 1993-94 at the start of his presidency.

Mr. Obama made clear that he wants to help people with insurance today, and emphasized his interest in controlling spiraling health-care costs. He spoke about the need to cover the uninsured, but warned that it would break the bank to expand coverage to millions more Americans if costs are not brought under control.

“We’re here today to discuss one of the greatest threats…and that’s the exploding costs of health care in America today,” he told some 150 attendees.

On Capitol Hill, leaders of the Senate Finance Committee set out an aggressive schedule under which they hope to bring bipartisan legislation to the floor by June. House leaders said they want a floor vote by August, leaving time to reconcile the two chambers’ bills before year end.

The president made clear that he will take on those who try to block his efforts, and blamed “special interests” for killing past attempts. “Those who seek to block any reform at any cost will not prevail this time around,” he warned.

The very groups — and in some cases, the very people — who were instrumental in blocking the Clinton plan were at the White House on Thursday, vowing to make it happen this time around.

“You have our commitment to play, to contribute and to help pass health-care reform this year,” Karen Ignagni, president of America’s Health Insurance Plans, an industry lobby group, told the president.

The afternoon included five smaller group discussions, followed by a large meeting with Mr. Obama. At one of the smaller sessions, a White House official addressed Chip Kahn, currently president of the Federation of American Hospital Systems. In 1993, Mr. Kahn worked for the insurance lobby that sponsored the “Harry and Louise” TV ads that helped defeat the Clinton plan.

“Are you going to run an ad? That’s what we really want to know,” Zeke Emanuel, a health-care expert at the Office of Management and Budget, asked Mr. Kahn.

Mr. Kahn, who has spoken in favor of an overhaul this year, replied that he realizes that hospitals will see some reduced payments. “We’re ready to do that as long as it’s fair and reasonable,” he said.

Despite the warm words, it was clear that difficult work remains. In one session, Democratic and Republican House leaders spoke of producing a bipartisan bill. Yet they were unable to come to agreement on legislation renewing the Children’s Health Insurance Program, a considerably more modest effort.

“From our breakout session, you’d probably get the idea that it’s pretty easy to get done,” said Sen. Charles Grassley of Iowa, the top Republican on the Finance Committee, who will work to write a bill with the committee’s Democratic chairman. “We know it’s very difficult to get done. But without that sort of feeling starting out, nothing would get done.”

Overall, the White House sessions were designed to show a variety of lessons learned in the 16 years since the Clinton effort. The sessions were held in public view, unlike the Clinton planning, which was criticized for being too secretive. The White House is sending Congress guidelines rather than fully developed legislation, hoping for more congressional commitment. And Mr. Obama is promising to be flexible.

“I just want to figure out what works,” the president said, saying he is open to various combinations of government and private-sector involvement.

Mr. Obama appears to have learned another lesson from the Clinton administration’s failed attempt. He is overtly working to appeal to those who already have insurance by emphasizing the cost-cutting goals.

Experts on the federal budget and many U.S. businesses agree that the country’s long-term fiscal health depends on controlling health-care costs. But the focus on costs is also being driven by politics. Especially during a recession, it is easier to make the case for a program that would reduce the cost of care than for one that would increase costs by providing new subsidies to help the uninsured buy coverage.

The health plan that Mr. Obama had proposed as a presidential candidate, which is similar to ideas under consideration in Congress, is expected to cost more than $1 trillion over 10 years. That money would cover tax credits to help families and small businesses afford premiums.

Results of a Wall Street Journal/NBC News poll released this week bear out his approach: More people are more interested in reducing costs than expanding coverage. And while 49% said they would be willing to pay higher taxes so everyone could have health insurance, that is down from the 66% who said the same in March 1993, when Mr. Clinton was embarking on his ultimately unsuccessful effort.

The day’s emotional high came near the end, when Sen. Ted Kennedy (D., Mass.), who has been fighting brain cancer, appeared at the closing session to an ovation from the group. He has long been working for universal health-care coverage.

“I look forward to being a foot soldier in this undertaking,” he said. “And this time, we will not fail.”

Write to Laura Meckler at