Gov. Jindal Op-Ed: What Hillary Knew–In 1993

Former White House press secretary Robert Gibbs’ recent comments doubting that Obamacare’s employer mandate will ever be implemented—he called it “one of the first things to go”—likely caused heartburn among his onetime West Wing colleagues. But there’s one former Obama administration official whom Gibbs must have terrified more than most.

Years ago, that famous figure testified publicly that if Congress were to pass legislation with an individual mandate to purchase insurance, “we worry that the numbers of people who currently are insured through their employment will decrease because there will no longer be any reason for many employers” to offer coverage, when individuals can receive government subsidies instead.

That figure’s name is Hillary Clinton.

It is a well-known fact that Clinton came to strenuously support an individual health insurance mandate in her 2008 primary campaign against Barack Obama. Less well-remembered, however, is that Clinton considered an employer mandate—not an individual mandate—the best way to achieve “universal coverage” in her health care task force’s ill-fated 1993 proposal, put forth while she was first lady.

Back then, both Hillary and President Bill Clinton believed that placing responsibility primarily on individuals, as opposed to employers, to obtain coverage could cause employers to drop their existing plans. Little wonder that after millions of Americans had their health plans canceled last fall, Bill Clinton criticized President Obama’s “if you like your health care plan” promise; in fact, the Clinton White House knew that pledge was dubious two decades before Politifact finally named it the “lie of the year.”

The Clintons were onto something at the time, but the health policies they and their party have since advocated have not only failed to solve our nation’s health care problems—in some cases, they’ve made them worse. Read two decades later, Clinton’s 1993 congressional testimony reinforces both what has changed and what has not.

Consider another truth the Hillary Clinton of 1993 could tell Obama today. “If we subsidize individuals below a certain income level,” she noted in her testimony before Congress, “there would be pressure on employers to keep wages below the subsidy level so that they [health insurance premiums] would continue to be paid for by the government.” That sounds a lot like what the Congressional Budget Office concluded in February: that Obamacare will reduce the labor force by the equivalent of 2.3 million workers, because employers will not raise wages and individuals will choose not to work in order to retain access to government insurance subsidies.

Clinton’s statements demonstrate the colossal failures not just of the Obama administration but of two decades of government planning in health policy. For instance, before the House Ways and Means Committee in September 1993, Clinton testified, “We have 70 percent specialists, 30 percent primary care physicians. We need to move toward 50-50.” Today, more than two-thirds of practicing physicians remain specialists, and a June 2013 study found that only one-quarter of new doctors go into primary care. The Department of Health and Human Services predicts a shortage of 20,400 primary care physicians by 2020, while outside estimates are more than double that figure. All this despite dozens of government education and training programs for health care professionals; just in fiscal year 2012, four federal departments administered 91 separate programs, to the tune of $14.2 billion, many of which had been expanded under Obamacare.

Clinton’s testimony is also replete with data regarding geographic variations in health costs. Like Obama in 2009, both Clintons argued in 1993 that reducing these variations would lower health care costs on balance, while improving quality of care. But the Clinton administration utterly failed to address this concern: The CBO has found that variations in Medicare spending actually increased during the Clinton years. And in fact, an Institute of Medicine report released in June found that high-spending regions in 1992 remained high-spending regions in 2010. What does it say about the Clinton administration—and, so far, the Obama administration too—that for two decades liberal policymakers have utterly failed to “fix” one of the supposed rationales for proposing Hillarycare in the first place?

The left continues to argue that the next new program, the next new bureaucracy or the next new tweak to Medicare’s more than 7,000 reimbursement codes will finally provide the magic elixir needed to fix all that’s wrong with the U.S. health care system. But none has worked. In health care, as in many things, the Clintons were the future—once. But after 20 years of false hope and undelivered promises, their vision, as eventually implemented in Obamacare, looks more dystopian than utopian. With apologies to Lincoln Steffens, we have seen the past, and it didn’t work—then or now.

There is a better way—and it involves promoting freedom and choice to control rising health costs. The America Next health plan I unveiled last month empowers both states and individuals, not federal bureaucrats, giving states new incentives to reform their insurance markets and health systems and providing more insurance options for individuals. And it focuses on reducing health costs—the CBO concluded that a proposal similar to the America Next plan would reduce individual health insurance premiums by thousands of dollars per family.

The question neither Hillary Clinton nor Barack Obama will want to answer is why the problems outlined by Clinton in her testimony two decades ago remain unsolved. The reason is that the left keeps coming up with the same wrong answers; it brings to mind that insanity is sometimes defined as doing the same thing over and over again, hoping for a better result. It’s time for conservatives to propose better solutions—and the America Next health plan is a big step in that direction.

This post was originally published at Politico.

Robert Gibbs and IPAB Members

Speaking on Fox News Sunday yesterday, Robert Gibbs was challenged about the composition of Obamacare’s Independent Payment Advisory Board, or IPAB.  He said that the IPAB would be composed of “medical professionals. They are people that we trust to make medical decisions.”

Actually, that statement is FALSE.  Obamacare specifically states that practicing medical professionals may NOT comprise the majority of the IPAB’s membership – meaning economists and other potential bean-counters will by definition maintain a majority voting share on the board.  Here’s the specific language from page 423 of the statute (emphasis mine):

(iii) MAJORITY NONPROVIDERS.—Individuals who are directly involved in the provision or management of the delivery of items and services covered under this title shall not constitute a majority of the appointed membership of the Board.

Of course, if Gibbs – and by extension the Obama campaign – want to argue that the IPAB’s members will be thoroughly respected, then President Obama could actually follow the law and appoint IPAB nominees.  According to page 426 of the statute, the law appropriates funds for IPAB (originally $15 million, but lowered to $5 million last December) “for fiscal year 2012” – that’s the fiscal year ending this September 30.  So Obamacare contemplates IPAB being up and running NOW – yet President Obama has failed to nominate any appointees to the board.  If the President wants to save Medicare so badly – and IPAB is so critical to saving Medicare – what’s he waiting for?  And if IPAB is so innocuous and won’t harm seniors, why is he waiting until AFTER his re-election campaign to announce who he wants to put on the board?

Given the massive powers of the IPAB officials – the rulings of these bureaucrats will be exempt from both administrative AND judicial review – there’s a good government argument to be made that the American people should have full knowledge of who these powerful people will be BEFORE they make their choice in November.  Of course, given this Administration’s history of radical appointees – i.e., Donald “Rationing with Our Eyes Open” Berwick – it’s entirely likely that the Administration does NOT want to tell the American people exactly who will be supervising the Medicare program under IPAB’s new world order.

One Year Later: Where’s Obama?

Today the President will observe the one-year anniversary of the signing of Obamacare in…El Salvador.  As he wraps up his overseas trip to Latin America, the President isn’t scheduled to arrive back in Washington until early this evening, and no health care events are listed on his calendar.

There are of course many competing demands on any President’s schedule, not least in the wake of recent events in the Middle East and Japan.  But the fact that the President decamped on an overseas trip during the one-year anniversary of Obamacare may seem particularly striking to some, because of the way he postponed a scheduled trip to Asia as the bill neared passage in March 2010.  Press Secretary Robert Gibbs said then that “passage of health insurance reform is of paramount importance, and the President is determined to see this battle through.”  Speaker Pelosi complimented the President for his decision last year, sayingthis is historical.  I’m sure he wants to be here for the history.”  From this perspective, the contrast from events 12 short months ago is stark.

Also last March, Speaker Pelosi famously said we had to pass the bill to find out what’s in it.  Given that he is spending the one-year anniversary of Obamacare completing an overseas trip, some may wonder whether the President finally took Speaker Pelosi’s advice.

Backroom Deals — In Law and Rules

In his Wall Street Journal column this morning, Karl Rove writes about how Democrats have used the health care law to reward friends and punish enemies.  Two examples mentioned in the column: The Administration’s frequent waivers granted to union plans from the new health insurance regulations, and all the exemptions provided in statute to the AARP’s lucrative Medigap business.

Politico also examines this issue from a slightly different angle, writing about the Administration’s decision to withdraw a portion of its Medicare physician payment regulation relating to end-of-life counseling.  Its article quotes both White House press secretary Robert Gibbs (the full exchange from yesterday’s press briefing on the issue can be found here) and Rep. Earl Blumenauer as saying that only “process” concerns resulted in the withdrawal of the end-of-life provision.

There are several potential problems associated with this stance:

  • If the problem with a proposed regulation is solely one of “process,” doesn’t that imply that the substance of the regulation has already been decided, and that allowing the public an opportunity to comment is merely a “tick-the-box” exercise?
  • Why did the Administration go from attempting to defend the end-of-life provision in a Wall Street Journal article last week to withdrawing the provision entirely this week?  What information about the regulatory process did White House officials learn in that time to prompt the U-turn – and when will that information be disclosed to the public?
  • What about all the other backroom deals included in the health care law – or waiver actions alluded to in Mr. Rove’s column below?  Will the American people be granted “an adequate space in a public comment period to debate these kinds of things” that Mr. Gibbs said would be provided on the end-of-life provision?

Finally, it’s worth pointing out that this morning’s Politico piece also quotes the president of Compassion and Choices – an organization formerly known as the Hemlock Society – as offering her support for end-of-life counseling.  Prior to his controversial recess appointment as head of CMS, Dr. Donald Berwick was asked by a member of the Finance Committee whether he “had ever received funding from, been a member of, consulted with or for, or been associated in any way” with that organization.  Has Dr. Berwick ever answered this question about any prior relationships with the former Hemlock Society – and does his silence explain why CMS acted the way it did regarding the end-of-life provisions?

More Questions for the White House on Berwick Appointment

I wanted to highlight comments from Monday’s White House press briefing, where Robert Gibbs was again asked about the President’s recess appointment of Don Berwick to head the Centers for Medicare and Medicaid Services (CMS).  Mr. Gibbs admitted that the President likely never asked for a hearing on his nominee (and for that matter, he didn’t publicly demand a vote either).  Gibbs also sidestepped a question suggesting that the Finance Committee could have held a hearing in July, with a recess appointment in August “if there’s a blockage” later in the process.  And he noted the Administration did not want to be “waiting around” to allow the Senate to complete its constitutional duty to provide “advice and consent” – even though that process had barely begun, because the majority refused to schedule a hearing.

Amidst all the talk of “waiting around,” It’s also worth noting that the Senate spent 454 days “waiting around” for the White House to nominate Dr. Berwick in the first place – and Republicans spent an additional 79 days “waiting around” for the Finance Committee to schedule a hearing.  Given that Mr. Gibbs once again stated that “this wasn’t a hearing problem,” it’s worth asking how long Republicans will be “waiting around” for the Finance Committee to schedule a hearing on Dr. Berwick’s still-pending nomination for a permanent appointment at CMS.

Video of the exchange can be found here, and a transcript follows below.


Q Thank you, Robert. You point out frequently the differences between this administration and the previous administration. With the latest recess appointment, the obvious question is, why do you simply not wait for the confirmation process to go through and submit it to a Senate when they schedule a hearing before the appropriate committee and —
MR. GIBBS: This wasn’t a hearing problem, right? This is — we’ve had plenty of nominees that have had hearings that wait months and months and months and months before the Senate will be allowed to take it up. And what I mean, be allowed to take it up, meaning simply getting unanimous consent to have a debate and a vote. Sometimes after 10 months of waiting, that unanimous consent is gotten and the approval of the nominees is unanimous.
And then one simply wonders why we’ve waited 10 months. The health care law —
Q So you’re saying the Senate was too slow on Berwick, is what it is?
MR. GIBBS: I will tell you, there are those in the Senate that had no intention of dealing with this nomination other than to play the political game —
Q But how do know — are you that cynical of the process already that you don’t even want to see it play its way through?
MR. GIBBS: I’m not a cynical person. I just have ample evidence — 21 times — 21 times. Let me compare the Bush administration and the previous administration and find a break. On 21 occasions, unanimous consent was blocked in order to — and cloture had to be invoked to get somebody a vote — 21 occasions. In the first year of the Bush administration, how many times did that happen? How many times did that happen?
Q Did the President ever take —
MR. GIBBS: How many times did that happen? How many times did that happen?
Q How many?
MR. GIBBS: How many? Zero. Zero. And guess what, both of you knew the answer to that.
Q Did the President ever ask — Chairman Baucus for a hearing?
MR. GIBBS: Did who?
Q Did the President ever ask the Chairman for —
MR. GIBBS: Not to my knowledge.
Yes, sir.
Q Robert, on Israel and Iran —
Q Excuse me, Robert. How can you complain then about the process when the President —
MR. GIBBS: Because as I said, this wasn’t a hearing. This wasn’t an issue about a hearing. This is your latest attempt to decide that the process was being upheld because there hadn’t been a hearing scheduled. The hearing wasn’t a problem, right? If there would have been a hearing, he would have gotten out. And guess what. Months and months and months would have passed before anybody would have consented to simply taking up the nomination.
Now, we passed a law — Health Care Affordable Care Act that has to be implemented. There are things that have to be implemented by the first of the year per the law. We are not going to wait for those in the Senate that want to see this delayed and delayed and delayed before —
Q Well, Robert —
MR. GIBBS: Let me finish my answer — before this is taken up.
Now, I know there’s these grand conspiracy theories, right, that somehow the American Medical Association, the American Hospital Association, the American Association of Retired Persons, Mark McClellan, and Tom Scully seem clearly not to be complicit in, in supporting somebody amply qualified to run CMS and to implement the law. And that’s what the President sought to do.
Q Well, why not have a hearing where all of that can be decided in July and if there’s a blockage, a recess appointment in August?
MR. GIBBS: Because — because, Major, we’re not going to —
Q What you just described would not be affected by that. He’d still be in place.
MR. GIBBS: Absolutely. What’s today? July 12th — we got three weeks until August. We’re going to implement the law, Major. We’re not going to wait around —
Q If you had a hearing in July and a recess appointment in August —
MR. GIBBS: No, no, no. We’re not going to wait around for the same old people to play the same old political games time after time after time. We’re just not waiting around for that.

The Berwick Evasion

The Wall Street Journal’s editorial titled thusly does an excellent job explaining both why Dr. Berwick’s recess appointment shows “lack of respect for the public’s health care views,” and the problems with Dr. Berwick’s way of thinking about health care that prompted the nomination controversy in the first place.  The problem with Dr. Berwick lies not just in his quotes about rationing and in praise of Britain’s National Health Service, but in the “command and control vision…widespread among America’s technocratic left” that underpins his positions.  Of course, this technocratic vision – that a team of centralized planners can devise a system to reduce health costs nationwide – “is also increasingly anachronistic amid today’s breakneck medical progress.  There isn’t a single ‘ideal model’ in a world of treatments tailored to the genetic patterns of specific cancers, or for the artificial pancreas for individual diabetics, or other innovations that are increasingly common.”  Thus technocrats are forced to ration “with our eyes open,” resulting in the widely distributed quotes Dr. Berwick made last year.

From the other end of the political spectrum, the New York Times’ editorial claims that “Republican senators made it clear that they would use [Berwick’s] confirmation hearing to distort his record…mostly to score political points for the November elections.”  That statement is ironic on several levels.  First,  Speaker Pelosi sent out a memo last week advertising the Administration’s new health care website – paid for at taxpayer’s expense – as “the best marketing tool yet available for how reform affects American [sic].”  Second, the Hill quotes one expert as saying the White House’s recess appointment “protects vulnerable Democrats…from having to weigh in on the controversial figure of Berwick. ‘This way…nobody gets forced to vote on it.’”

Finally, during yesterday’s White House press briefing, Jake Tapper pointed out that Sen. Grassley requested a hearing on Dr. Berwick weeks ago, which was not scheduled prior to the President’s appointment.  Robert Gibbs didn’t directly answer a question as to why Democrats decided not to arrange a hearing sooner, but denied that the Administration wanted to avoid a hearing “because of some of Dr. Berwick’s statements.”

It’s worth pointing out that Dr. Berwick’s nomination for a permanent posting at CMS remains pending before the Finance Committee, and a hearing can be called on that nomination at any time.  Republicans have asked for a hearing, the Administration has said it is not trying to avoid one, and Chairman Baucus said he wants to ensure that “critical questions are asked of the nominee – and answered.”  There’s one easy way to address everyone’s concerns – to schedule a hearing for the upcoming work period.  Will Democrats do so?  The ball’s in their court…

More Taxpayer-Funded Propaganda…

CongressDaily reports this morning that the Administration is mailing out millions of postcards to small businesses to tout the small business tax credit included in Democrats’ health care takeover.  This of course raises intriguing questions about what other elements of the health care law the Administration will be reaching out to inform Americans about:

  • Has the White House pointed out in its postcards about the tax credit that businesses who do not offer “acceptable” coverage will be taxed by $2,000 per employee beginning in 2014?
  • Will the White House send postcards to the 11 million seniors in Medicare Advantage plans highlighting the fact that their extra benefits will be reduced to fund the health care takeover – and the coverage they have and like could go away entirely?
  • Will the White House send postcards informing consumers insurance premiums on the individual market will go up by $2,100 per family?
  • Will the White House send postcards to all Americans pointing out that they will be taxed if they do not purchase government-approved health insurance, and that the IRS will have the power to garnish their tax refunds and take other punitive actions against them?

Of course, the White House had its own response to these questions: “The outreach is going to vary depending on what the provision is.”  In other words, benefits of the law will be trumpeted through mass mailings to millions of Americans sent at taxpayers’ expense – while the costs will be ignored and minimized whenever possible.

Wikipedia notes that propaganda as defined “often presents facts selectively to encourage a particular synthesis, or uses loaded messages to produce an emotional rather than rational response to the information presented” – which sounds a lot like the scenario being described by the White House.  So the ultimate question is: With the federal government running up trillion-dollar record deficits, why are millions of dollars in taxpayer funds being used for these transparent attempts to promote Democrats’ unpopular government takeover of health care?


For Small Businesses, Healthcare Pitch Is In The Mail

Tuesday, April 20, 2010
by George E. Condon Jr.

More than 4 million postcards were mailed Monday to small-business owners, touting a tax credit in the new healthcare law that many of them are eligible to receive.

The mass mailing is the first step in an aggressive sales and information campaign planned by the White House in an effort to blunt criticism of the law.

“We want to make sure small employers across the nation realize that effective this tax year you may be eligible for a valuable new tax credit,” said White House Press Secretary Robert Gibbs. “We urge every small employer to take advantage of this credit if they qualify.”

Behind the mailing shows concern that pummeling from critics has taken a toll and branded the law as a big-spending, tax-raising measure to many Americans who are already skeptical of government solutions.

“There has been a lot of misinformation,” said a White House official, speaking on background. “But the facts are facts. And we are dead-set on doing everything we can to communicate what is in the bill.”

Opponents of the law predicted the mass mailing will have little impact on reluctance to embrace healthcare reform as it passed Congress. “Good luck with that,” joked conservative strategist Keith Appell, laughing at the notion that 4.4 million postcards could make people embrace the changes.

“The tax credit is going to be transcended by the higher costs,” said Appell. “Costs inevitably go up and up and up. So what good does a tax credit do for you?”

Ryan Ellis, tax policy director for the right-leaning Americans for Tax Reform, acknowledged the tax credits, but said the postcards leave out the context.

“They are $32 billion in costs, which is pretty small when you compare it to the fact that the whole healthcare bill had a tax increase total of $550 [billion] to $560 billion. … “It is tax relief that goes to small-business owners. But it kind of misses the larger point,” Ellis said.

The White House aide said the IRS mailing is “an example of the kind of thing we are going to be doing now. The outreach is going to vary depending on what the provision is. But in this case, the IRS wants to make sure that small-business owners know that the tax credit is retroactive to Jan. 1st of this year.”

The White House hopes that when millions of postcards start arriving, it will be a powerful sign “to show that this is happening right now, and they can take advantage of it.”

Politically, the White House expects Democratic candidates to become more aggressive in touting specific benefits in the law and President Obama also getting specific in his remarks. “He surely is not done talking about it,” said the aide. “He is proud of the bill and the good things it does, particularly the immediate benefits that start this year. And he will talk about them.”

The White House credited Sen. Debbie Stabenow, D-Mich., with pushing them toward this kind of campaign. “This is the kind of things they wanted us to do, something tangible that they can put in the hands of constituents who come to the office,” the aide said, adding the White House plans to keep adjusting based on what Congress reports.

“We are basically trying to make sure that every question that comes up we are getting answers to, that if there is a prevalent question that it is a question we answer online,” he said. “If a member comes to us and says we know we are getting a great reaction or people are confused by this, we will take that into account and respond quickly.”

Much of the response will be online on the White House Web site, which will be updated as criticisms or vulnerabilities surface. The aide acknowledged “it can be frustrating” keeping up with misperceptions of what is actually in the law.

But Ellis said the opposition is not based on a misreading of the law or on a lack of education about the contents. “It is not a matter of perception. It is a matter of arithmetic,” he said. “This is a matter of facts.

“It is not that conservatives are being irrational. What would be irrational is to only look at what they’re telling us to look at. We are looking at the total picture.”

White House Admits: President Obama to Offer “Rewards” for Health Care Votes

A story in today’s Washington Post about the President’s trip to St. Louis to stump for his health care proposal includes several paragraphs of interest.  Specifically, the piece reports that White House officials are saying the President is “ready to offer…rewards” to House Democrats who vote for his government takeover of health care, including “election-year visits to competitive congressional districts, where a presidential appearance can bring in hundreds of thousands of dollars in campaign funds.”

Even as the Administration attempts to persuade Senate Democrats to give up some of their backroom deals, it appears to be engaging in another attempt to trade special favors – this time, fundraisers for struggling House Democrats – in exchange for votes.  Is this what Press Secretary Robert Gibbs meant when he said the White House would do “whatever it takes” to pass a health care takeover bill?  And how many White House “rewards” will it take for House Democrats to abandon their principles – and their constituents – and vote for the health care bill?   With nearly three in four Americans calling for Democrats to scale back their government takeover or abandon their bill entirely, how high will the “going rate” in this latest escapade soar?


In St. Louis area, Obama pounds drum for health-care initiative

By Scott Wilson
Thursday, March 11, 2010; A03

ST. CHARLES, MO. — President Obama made an impassioned case Wednesday for his health-care proposal, delivering a folksy, partisan argument for reform as industry groups prepare a multimillion-dollar advertising campaign to defeat it.

Stripping off his suit jacket and pushing up his sleeves within minutes of entering a stuffy high school gym in this St. Louis suburb, Obama criticized his Republican opposition, Washington’s wasteful spending and rising insurance premiums. He spoke with evident anger about “political gamesmanship” in Washington leading to “terrible consequences,” as he evoked the outsider’s message that he delivered successfully in his 2008 campaign.

“Congress owes America an up-or-down vote,” he said over raucous applause, which greeted his remarks at several points. “The time for talk is over. It’s time to vote.”

Obama’s appearance at St. Charles High School was the most visible element of his endgame strategy to push through health-care legislation. Unfolding inside and outside the Capital Beltway, the effort is designed to revive the sense that passage is inevitable, a feeling that evaporated when Democrats lost their filibuster-proof Senate majority in January. One senior administration official described the final phase as “working both sides of the street.”

A populist message

Obama is visiting media markets that touch multiple congressional districts, particularly in swing states such as Missouri and Pennsylvania, which he visited earlier this week. He might head to Cleveland early next week for a town hall-style appearance to discuss health care, White House aides said Wednesday.

The president is delivering to his audiences a sharply populist warning that doing nothing about the health-care system would reward the insurance industry and Wall Street investors, easy targets in communities anxious about the economy. He is also calling on the public to make its opinion known to members of Congress as he works to secure enough House votes to pass the measure before he leaves the country late next week.

Wavering Democrats

At the same time, Obama intends to lobby wavering House Democrats to vote for a Senate version of the legislation and to support the subsequent reconciliation process, which Republicans have characterized as an unjustified use of majority power. Among the rewards Obama is ready to offer, White House officials said, are election-year visits to competitive congressional districts, where a presidential appearance can bring in hundreds of thousands of dollars in campaign funds.

“The president has breathed some new life into this effort,” said Dan Pfeiffer, the White House communications director. “The opportunity to get this done exists, but it won’t last forever.”

For much of the past year, the White House health-care strategy revolved around maintaining momentum behind the politically vulnerable initiative. The effort faltered, though, as Republican critics convinced more and more Americans that it was an unwieldy and expensive government intrusion. When Democrats lost a special election in Massachusetts, and with it the Senate supermajority, the health-care bill appeared moribund.

But late last month Obama introduced his own 11-page health-care proposal. He then followed it up with a seven-hour televised work session with Democratic and Republican congressional leaders, indicating at its conclusion that he would do whatever it takes to pass a bill.

“We will continue this momentum, as you’ve seen in the last few weeks,” said Rahm Emanuel, the White House chief of staff. “And we must keep people focused on the price of failure.”

In recent days, Obama has reduced his argument to a simple campaign-style choice with a clear set of campaign-style opponents, namely insurance companies, a recalcitrant Republican opposition and a Washington political culture he campaigned against in 2008.

As he did in suburban Philadelphia earlier this week, Obama framed the debate in his 35-minute speech in St. Charles as a choice between doing something about the health-care system or leaving it unchanged, even as insurance companies announce double-digit rate increases.

“I don’t believe we should give either the government or the insurance companies more control over health care in America,” Obama said. “I want to give you more control over health care in America.”

His visit to Missouri, a state he lost in 2008 by less than one percentage point, came against a backdrop of mounting industry opposition to his proposal.

The U.S. Chamber of Commerce has announced a $10 million advertising campaign opposing Obama’s proposal. Demonstrators in St. Charles displayed signs reading “Health Care Strictly a Power Grab.”

A senior administration official said the advertising effort “validates our argument that the bill is good for American families and not necessarily good for the insurance industry.”

‘This gets harder’

But the official, who spoke about internal White House strategy on the condition of anonymity, said the gathering opposition from the chamber and other groups “should be a warning sign to members of Congress.”

“This gets harder and not easier as time goes by,” the official said.

White House press secretary Robert Gibbs told reporters Tuesday that Obama had not made any phone calls to undecided lawmakers so far this week. Obama planned to meet at the White House on Thursday with the Congressional Black Caucus and the Congressional Hispanic Caucus in separate sessions on health-care legislation.

“We are not backing down, we are not quitting St. Charles, and we are going to get this done,” Obama concluded. Then he waded into the cheering crowd to shake scores of hands.

Obama’s Tax Increase Bombshell

“If You Like Obama’s No-Tax Promise…He May Not Keep It”


“White House Budget Director Peter R. Orszag acknowledged, ‘there are additional steps that will be necessary’ [to reduce deficit spending]….Treasury Secretary Timothy F. Geithner and White House economic advisor Lawrence H. Summers have both delicately sidestepped the tax question…Orszag has also refused to discuss what steps Obama might take to reduce the deficit in the budget blueprint he will present to Congress in February.”

The Washington Post, “Tax Pledge Is A Target As Deficits, Debt Grow: Obama Advisers Will Not Rule Out Broad-Based Hike,” August 29, 2009


In announcing the release of updated deficit projections totaling more than $9 trillion over the next decade, Office of Management and Budget Director Peter Orszag vowed that next year’s White House budget submission would make deficit reduction a “top priority.” An examination of comments made by senior Administration officials over the past several months demonstrates a clear indication of the main ingredient in any Obama deficit reduction package—job-killing tax increases:

BOB SCHIEFFER: No—no tax increases for middle-income Americans?

LARRY SUMMERS: …There’s a lot—oh, there’s a lot that can happen over time. But the priority right now, and so it’s never a good idea to absolutely rule things—rule things out no matter what.

Face the Nation, August 2, 2009

TIM GEITHNER: When we have the recovery established…then we have to bring these deficits down very dramatically….And that’s going to require some very hard choices….

GEORGE STEPHANOPOULOS: So revenues are on the table, as well?

GEITHNER: Again, we’re not at the point yet where we’re going to make a judgment about what it’s going to take….

STEPHANOPOULOS: But you’re not ruling it out, you can’t rule it out.

GEITHNER: I think what the country needs to do is understand we’re going to have to do what it takes, we’re going to do what’s necessary.

This Week, August 2, 2009

QUESTION: The President on the campaign said that—he made a flat pledge that he would not raise taxes on anybody making under $250,000.  So is that pledge still operable?

ROBERT GIBBS:  Well, again, I think in some ways your question is hypothetical because there are any number of different bills, different proposals.  I think the President has outlined what he believes is the very best way to pay for health care.

QUESTION: He said, I am not going to raise taxes on anyone making under $250,000.  Is that pledge still active?

GIBBS:  We are going to let the process work its way through.

— White House press briefing, June 29, 2009

GEORGE STEPHANOPOULOS: That would get—would be a tax increase for many families earning under $250,000. But the president said he was open to it. So that means that the tax pledge he made back in September is no longer operative?

AXELROD: Well, George, first of all, there are a lot of different formulations of that plan….But there are a number of formulations, and we’ll wait and see. The important thing at this point is to keep the process moving, to keep people at the table, to the keep the discussions going. We’ve gotten a long way down the road and we want to finish that journey.

STEPHANOPOULOS: But if you’re open to tax increases for people under $250,000, that means that the pledge he made last September in Dover is no longer operative.

AXELROD: George, I think the president has made clear the way he feels this should be funded.

This Week, June 28, 2009

OMB Director Orszag’s comments about an impending deficit reduction package, coupled with comments from senior officials indicating a growing White House consensus about yet more job-killing tax increases, raises additional questions about the Administration’s fiscal priorities—and its candor with the American people about its true intent:

  • What exactly is the Administration’s secret plan to reduce the deficit? What kind of tax increases does it include?
  • If deficit reduction is such a “top priority,” as OMB Director Orszag claimed, why will the Administration wait months longer before bringing its proposals forward? Is the White House concealing its deficit reduction plans until February to prevent the erosion of yet more support for a $1.6 trillion government takeover of health care that Democrats intend to ram through this year?
  • Does the Administration believe that the more than $800 billion in tax increases in House Democrats’ health “reform” legislation (H.R. 3200) are insufficient to finance the full measure of Democrats’ appetite for government spending?
  • As the White House’s own budget estimates project an average unemployment rate of 8.6 percent in 2011, why does the Administration seem insistent on proposing new job-killing taxes? How many jobs does the Administration believe its apparent new tax increases will demolish or destroy?
  • Given Administration officials’ repeated refusal to re-state President Obama’s campaign pledge that “Under my plan, no family making less than $250,000 a year will see any form of tax increase. Not your income tax, not your payroll tax, not your capital gains taxes, not any of your taxes,” what faith can the American people place in the President’s health care pledge that “If you like your current plan, you can keep it?”

Given the White House’s apparent legislative strategy—enact a government takeover of health care this year, with additional tax increases to finance new spending next year—many Americans may question how serious the Administration is regarding deficit reduction if it fails to take on exploding government spending—and how badly the struggling economy will be damaged by the new tax increases to pay for it.

Weekly Newsletter: August 17, 2009

Not an “Option”

Yesterday’s Sunday talk shows saw several White House officials—including Health and Human Services Secretary Kathleen Sebelius and press secretary Robert Gibbs—indicating the Administration’s willingness to strike the so-called “public option” from health “reform” legislation in lieu of a system of health insurance cooperatives. The apparent reversal comes amid growing criticism of Democrats’ attempted government takeover of health care, and surveys from outside experts indicating that as many as 114 million Americans could lose their current coverage if a government-run health plan were created.

Despite the apparent change in tone by the Administration, recent press reports indicate that the House Democrat majority—at the insistence of its liberal Members—will continue to include a government-run plan in any legislation considered on the House floor. Indeed, just before Congress embarked on its August recess, Speaker Pelosi reportedly acquiesced to a floor vote on a single-payer health care system.

While supporting the White House’s newfound conciliatory tone, Members may still have many other concerns surrounding the legislation—including nearly $1.6 trillion in spending, an increase in the federal deficit in the short-term and the long-term, abolition of the private market for individual health insurance, and onerous tax increases on the middle class and large and small businesses alike. Many of these concerns surround issues tangential to the Administration’s stated goal of reducing health costs—and many of the new mandates, regulations, and bureaucracies will raise costs for both the private sector and the federal government.

Similarly, while Members may support the concept of increasing private insurance market competition, Members may also be concerned by the import of some of the cooperative proposals being discussed. Many leading Democrats have made statements equating co-op proposals to a government-run “public option,” and most of the proposals being discussed would involve billions of dollars of federal cash infusions to fund the co-ops—which could lead to additional federal dollars being spent to bail such institutions out if they prove unsuccessful. Therefore, Members may be concerned that the co-op proposals being advanced by Democrats will do for health care what Fannie Mae and Freddie Mac have done for the housing sector.

“Just the Facts, Ma’am”

Amidst all the White House claims of “misinformation” surrounding access to treatments and government rationing, it bears worth repeating that the United Kingdom and other countries with government-run health plans deny costly therapies to patients, particularly older patients. For instance, a report regarding Britain’s National Health Service released in June prompted complaints from patient advocates that senior citizens receive sub-standard care; one activist found it “appalling that people over 75 are not getting the care they need…it is scandalous that not everyone is getting” access to treatment. In its coverage of the report, the BBC relayed the story of one 74-year old ovarian cancer patient, who according to her daughter had to travel to Iran in order to receive a proper diagnosis:

Mum started to have bleeding early in 2007. She went to the [general practitioner], but they just took her off her [hormone replacement therapy] and sent her to a gynecologist. He said it was probably just stress. It was only when she went back to visit family in Iran and saw a doctor there that she was diagnosed. They did a scan and found a large lump in her fallopian tube. When she came back to the UK, doctors found the cancer had spread to one of her lymph glands. It was the size of a tennis ball. She then had a six-week wait before having a hysterectomy and then chemo. Her treatment was very good, but the diagnosis was abysmal. If it had been found 18 months earlier, it could have been removed easily and she wouldn’t have needed a hysterectomy or chemo.”

Given that President Obama’s key advisors have admitted that government-run health plans will always be under-funded—and that waiting times are an acceptable “trade off between patient costs and capital costs”—many Members may be highly skeptical of any claims that a government takeover of health care will not lead to denial of life-saving treatments for patients.

Other key facts surrounding Democrats’ health care “reform” include these:

  • Individuals who like their current plan may not be able to keep it—millions of seniors will lose access to Medicare Advantage plans under Democrats’ proposed cuts, employers may drop coverage due to costly federal mandates imposed in the bills, and the House legislation would abolish the private market for individual health insurance entirely;
  • The non-partisan Congressional Budget Office has confirmed that all the bills being considered would raise, not lower, the growth of health costs—CBO has estimated that the House bill would increase the federal deficit by $239 billion in its first ten years, and “would probably generate substantial increases in federal budget deficits” in the years following;
  • The bills include tax increases on families with incomes under $250,000 who cannot afford to purchase “bureaucrat-approved” health coverage—a violation of then-Senator Obama’s campaign promise not to raise taxes on the middle class;
  • Job losses will result from the more than $800 billion in tax increases included in the House bill—according to a model developed by President Obama’s chief economic advisors, as many as 5.5 million jobs could be lost.

All these reasons should give the American people pause before embracing Democrats’ proposed government takeover of the health care industry.