Obama's Failure of Leadership

The White House healthcare proposals, the attempt to bridge the gap between the House and Senate versions, did not include a public option. On this omission, Ezra Klein writes in the Washington Post that this demonstrates "a complete and utter failure of White House leadership."

They need to give this effort their support, or they need to kill it by publicly stating their opposition. But they can't simply wait for someone else to make the decision for them, which has been their strategy until now.

If the White House decides that reviving the public option is a good idea, there's reason to believe the Senate would follow them on that. It would make some sense, after all: The public option is popular, its death was partly the product of industry pressure, and the sudden spate of high-profile rate increases offers a nice rhetorical pivot for anyone who wants to argue that individuals should be able to choose an insurer who's not a profit-hungry beast. Plus, Democrats need an excited base going into the 2010 election, and this may be the only way to get it.

While the death of the public option may have partly been a result of industry pressure, the onus lies squarely with the White House. After all, where does the buck stop? Who is willing or unwilling to fight the powers that be? Some fights are worth having but we have a President and a Chief of Staff who would rather cut a deal than fight the good (and hard) fight. It has been a complete and utter failure of White House leadership.

To be sure the White House has paid lip service to the idea of a public option now and again most recently earlier this week when they trotted out HHS Secretary Kathleen Sebelius to suggest that if the Senate wanted to push for a public option via the reconciliation process then Majority Leader Harry Reid was free to do so. Such a suggestion is a passing of the buck. Corralling 51 votes on this was always going to be arduous task but nonetheless 23 Senators had stepped forward until Senator Jay Rockefeller rained on the parade.

There's more...

David Brooks Wouldn't Mind a Single-Payer System

Maybe he has said this in the past but if so, I've missed it. His comments come around the two minute mark right after Paul Krugman notes all the flaws in the bill.

It's somewhat exasperating for me because I think I've made the argument that spending 17 percent of our GDP on healthcare is unsustainable and that most other advanced industrial nations that make up the OECD are spending on average around 10 percent of their GDP achieving universal coverage and obtaining better results in terms of socio-economic metrics such as life expectancy, infant mortality etc. So while it is refreshing to hear David Brooks admit that our current system is untenable, why didn't he write on the merits of a single payer system considering he has a national podium at the New York Times? And he's right, a single payer system would control costs and I am not convinced that this bill will accomplish that.

Paul Krugman has some thoughts on polling at the end that are also illuminating.

Update [2009-12-28 3:40:1 by Charles Lemos]: After a little research, I found this exchange between Gail Collins and David Brooks in the New York Times back on July 29, 2009 discussing the question "What's Wrong with the Single-Payer?"

I’m not crazy about the public plan. I dislike the idea of the government competing in a marketplace it regulates. I think the temptation to subsidize the public entity will be overwhelming. But I’m not vociferously against it either. That’s because:

A.) I’m not that thrilled with the insurance companies.

B.) I think it will save money, but not that much (the C.B.O. agrees).

C.) (!) I think it will produce small administrative efficiencies.

Democratic politicians throw around statistics claiming that Medicare has much, much lower administrative costs than private insurers. I’ve been told by various economists that this claim is three-quarters trickery. It’s a lot cheaper to administer a targeted population that uses a lot of care than it is to administer a large population that uses little care per capita. Plus you can save a lot of administrative costs if you don’t actually regulate treatments that much.

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