Ezra Klein reports on Jeanne Lambrew’s health speech from this morning:
She aggressively framed health reform as a response to the fiscal crisis. Every one percent drop in employment means 1.1 million more uninsured, larger Medicaid rolls, more people relying on COBRA as transitional insurance. She divided the stimulus spending into multiple parts. The first part she called “protection policies” to deal with that displacement: More money for COBRA and Medicaid. Allow unemployed adults to buy into Medicaid for one year (why only one year?).
The next set of policies are being framed as job creation. This includes workforce training programs, money for health IT adoption, money for prevention, and money for comparative effectiveness research. She noted that a Kaiser Family Foundation poll showed a solid majority of Americans saying the recession makes health reform more, not less, urgent. She also mentioned a study showing that half of families in foreclosure pointed to medical debt as a partial cause.
Reading the tea-leaves about the probability of comprehensive health care reform has been rather difficult. Reps. James Clyburn (D-SC), Henry Waxman (D-CA), and Pete Stark (D-CA) have voiced conflicting opinions on the probability of imminent reform and on Friday, Matt Yglesias noted that Ron Pollack, the President and CEO of Families USA, and a man with his ear close to the ground, has his own doubts about whether reform will actually happen. Pollack told a group of bloggers at his Health Action Conference, “it’s unclear if the president and key leadership in Congress are prepared to move on health care reform. There are real temptations to do something else earlier. Things like balancing the budget…”
Such temptations may spell doom to health reform efforts. As David Blumenthal and Paul Begala both noted at the very same event, health care reform must be done early, if it is to be done at all. The President needs to override the innate caution and concern of economists — or the other nay-sayers who may be asking Obama, ‘do you really want to hang your entire first term on risky health reform?’ — and use the presidential bully pulpit to mobilize public support for reform.
This is what Obama’s health team seems to be doing. By adopting the econ-health framework, Obama seems to be suggesting that the two issues need to be dealt with simultaneously. Moreover, Obama’s support for Tom Daschle, despite his tax problems, suggests that Obama may be on the reform-now bandwagon for the long haul.