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Ellen Belcher is the Dayton Daily News opinion pages editor. She writes about state government, education, the environment, higher education and all things Dayton.
Martin Gottlieb is an editorial writer and columnist for the Dayton Daily News opinion pages. He focuses on the political process itself and does such national issues as war, the economy, taxes and Social Security, as well as a hodge-podge of local and state issues.Home > Blogs > A Matter of Opinion > Archives > 2009 > July > 25 > Entry
Editorial: Obama has tough sell on health care in Ohio; needs to hear skeptics
President Barack Obama came to Ohio Thursday with a difficult case to make. He says he can reduce projected increases in the government’s health care costs at the same time he is extending health insurance to millions more people. It sounds, at first, at least, too good to be true.
To make matters worse for him, a nonpartisan government expert — from the Congressional Budget Office — recently said that a pending Democratic bill would, in fact, increase projected deficit spending.
The president used a trip to the much respected Cleveland Clinic to make the case that high-quality care need not mean high cost. The clinic prides itself on using high technology to control costs while improving quality. It pays doctors a flat salary, rather than per-procedure.
The trip made a good point. But doubts are still in order.
To ultimately sell their plan to the general public, the president and his people must
listen to skeptical nonpartisans and relatively conservative Democrats.
Substantial Republican support is simply not available. The party’s base is in an intensely conservative mood. It feels the party has not been sufficiently true to Reaganesque principles. Some party leaders have the sense that President Obama’s activism gives them a chance to reclaim a clear identity. (Sen. George Voinovich, R-Ohio, said last week that about half the motivation behind Republican opposition to health care is to score political points.)
Solid Republican opposition is an enormous problem for the president. The American political center becomes very skeptical when one party is pushing for an enormous change that is making the other party apoplectic.
In this debate, Democrats have to treasure their own skeptics. Absent real Republican participation, the Democrats must be the Democrats and the Republicans, the advocates and the skeptics. There must be real debate, not just action by Congress, as the president wanted at one point. Otherwise, the result could be a hugely unpopular, bad program.
Rep. Zack Space, a Democrat who represents Chillicothe and Zanesville, wants the party to slow down. He believes the pending legislation must change in a lot of ways, that it doesn’t now control costs enough and that it’s too tough on small business, as well as on small hospitals.
He’s in a group of 50-some moderate House Democrats called the “blue dogs.” Many represent districts that used to be held by Republicans and could be won again by Republicans.
The blue dogs appear to have won one fight already: a tentative agreement in the House to give an outside panel — rather than Congress — the power to make cuts to government-financed health care programs.
The blue dogs should have a big role. And the Democrats must be willing to bend to pick up a few Senate Republicans.
The American health care system is more expensive on a per-person basis than systems in other economically advanced countries. It is becoming hugely more expensive all the time. It’s the biggest obstacle in bringing the federal deficit under control.
And yet it has gaping holes that other modern countries don’t have. One estimate has 60,000 people just in Montgomery County being without insurance, more than 10 percent. That is appalling, unacceptable.
So what the president is trying to do is necessary.
Meanwhile, though, millions of people are largely satisfied with their coverage; and somebody will have to pay if the reforms are not to worsen the deficit.
The legislation is terribly complicated. But open-minded citizens can get a feel for things by noting what independent experts and political moderates say.
When the Democratic mayor of Dayton joins in the effort to drum up support for the Obama effort, as Rhine McLin did last week, that helps get proponents as motivated as opponents. But it’s not going to do much to move the people in between. That’s the hard part. That’s where the focus has to be.
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Comments
By Kimberly
July 26, 2009 12:11 AM | Link to this
While everyone debates the issues on the proposed health care reform, no one is bringing up the failures of the past government health care reform that has been law for thirty years. Thirty years ago, the US Congress passed into law a health care reform that gave health care benefits to a select population because many lost their health coverage and/or could not obtain health care insurance. There are many who have received the health care benefit of this law but many who qualify have been denied by the government because the government has chosen to break their own law and deny certain people. Even though various Members of Congress are aware of the failure of a health care reform passed 30 years ago, they do not disclose the failure because they know it will be the catalyst for failure of the current proposal for Health Care Reform. In 1972 Congress passed into law Sec. 1881. [42 U.S.C. 1395rr] “MEDICARE COVERAGE FOR END STAGE RENAL DISEASE”. Part of the law has been honored in the fact people with ESRD (End Stage Renal Disease)receive medical insurance through Medicare and End Stage Renal Disease Networks have been established. Dialysis, Transplant, etc are paid by the government using Medicare as the insurance provider. This is the success of the reform which overshadows the failure. The most revealing and appalling failure of this government medical insurance benefit occurs when a living donor is involved. According to Subsection (d), Living Kidney Donors are to have all medical care expenses related to the kidney donation paid by the government through Medicare. The reason for the failure of this Health Care Reform law is due to the fact the government has refused to cover many living kidney donors who qualify which is in violation of the law. Many might assume paying for living donor medical expenses related to the organ donation is an additional strain to the Medicare system but the opposite is true. It has been estimated Living Kidney Donors save the government over $200,000.00 for EACH KIDNEY donate AFTER medical expenses are paid for a kidney transplant. Multiply that by 6,000 living kidney donors per year and the government saves millions of dollars in medical expenses for ESRD patient. The government savings is due to the medical expenses ESRD patients accumulate in dialysis, hospitalizations, etc. each year. The savings of a living donor transplant is so great that Medicare actually released a guideline for transplant centers to seek a kidney from a living donor before a person is placed on the national kidney transplant wait list. While the medical expenses related to the organ donation have been paid for some living donors, there are many living donors who have accumulated thousands of dollars in medical care because the government won’t honor their own health care reform for ESRD. The benefit of the kidney donation is given to the recipient by restoration of their health, the medical community in monetary gains and to the government in monetary savings. Kidney donation is not of any monetary or health benefit for the kidney donor. To add insult to injury, according to my correspondence with CMS,Medicare requires the living kidney donor to submit their OWN private insurance information for co-ordination of medical benefits. According to CMS in Maryland, living donors must have their private insurance benefit co-ordinated with the recipient’s Medicare benefit. This co-ordination of benefits seems unethical since the transplant is not of any medical/health benefit to the donor. In other words, the recipient is allowed to receive the medical benefits of the donor’s private insurance to better their own health. It might seem as though there is a glich in the system, that no one has been made aware of the law but this is not so. In 2002 I began LODAP-Living Organ Donor Advocate Program to help living organ donors. I and others who help with LODAP have made Congressional Representatives aware of the issues. We have personally met with Senate offices and sent letters. Senator Grassely, President Obama and Vice President Biden have received information regarding the plight of living organ donors. They are aware living donors are incurring medical expenses in addition to other issues. They are aware many living donors are in financial ruins because of medical expenses related to the donation. I have presented several proposals to various Senate offices only to be told THERE ISN’T ANY MONEY IN THE GOVERNMENT to help these living donors. If the US population thinks the Government is going to provide them health care, THEY NEED TO RECONSIDER. If the government won’t pay for the medical transplant expenses for 6,000 living kidney donors in PERFECT HEALTH that are willing to give a kidney to benefit another person, HOW IN THE HECK CAN THE UNHEALTHY POPULATION EVEN THINK THE GOVERNMENT WILL PAY FOR THEIR ONGOING MEDICAL EXPENSES??? If the government doesn’t have the money or willingness to cover 6,000 HEALTHY people a year, then how can they cover millions of sick people? This health care reform is a HOAX which is proven by the government’s refusal to enforce their own law which reformed health care for a minor section of society. Even though living donors SAVE the government millions of dollars, CMS has stated “we never intended to pay for all of this”. That pretty much says it all. I am a living kidney donor who knows all to well the issues. I know of too many living donors who have lost everything they own because of medical bills that should have been paid by the health care reform that was made into law in 1972. My private insurance and I have paid for complications related to my kidney donation. I and the other kidney donors do not regret donating, we would donate again. The last thing I want is health care reform for I already know it has failed and I will be worse off than I am now.By yt27
July 26, 2009 7:51 AM | Link to this
How do you have meaningful debate and discussion about health care cost containment without tort reform? Oh, yeah, Obama and Democrats get big dollars from trial lawyers. SOS, protecting their power base instead of doing wht’s right for America.By yt27
July 26, 2009 7:52 AM | Link to this
How do you have meaningful debate and discussion about health care cost containment without tort reform? Oh, yeah, Obama and Democrats get big dollars from trial lawyers. SOS, protecting their power base instead of doing what’s right for America.By drunken orangetree
July 26, 2009 8:49 AM | Link to this
If you asked the American people about this issue, the overwhelming majority of them would call for some form of public option, as numerous polls have shown. But the American people, unlike the democrats and republicans you cite in this piece, are not working for the insurance industry. You might want to focus a little more attention, since you are journalists, on the influence peddling the industry is focussing specifically on Max Baucus.By drunken orangetree
July 26, 2009 8:58 AM | Link to this
“Democrats in the Blue Dog Coalition might have drawn the ire of party liberals for putting the brakes on the fast-moving health care overhaul, but their political action committee has been raking in contributions from business interests with an eye on reshaping President Obama’s signature initiative.” From a story in the Congressional Quarterly.By drunken orangetree
July 26, 2009 8:59 AM | Link to this
“Democrats in the Blue Dog Coalition might have drawn the ire of party liberals for putting the brakes on the fast-moving health care overhaul, but their political action committee has been raking in contributions from business interests with an eye on reshaping President Obama’s signature initiative.” From a story in the Congressional Quarterly.By fedup
July 26, 2009 4:37 PM | Link to this
This Tuesday Obama will be taking questions from AARP. I’m getting a vibe that senior citizens have gotten the impression that health reform will weaken their Medicare when it actually would strengthen Medicare.By Ron
July 27, 2009 7:02 AM | Link to this
If ObamaCare is so great why isn’t the Pres. and Members of Congress going to be in the program? I see rationed care for Medicare and tests/procedures and operations we will be denied due to our age while the old timers in Congress will still have their first class health care.