A year ago this week, Capitol Hill was full of noise as the House of Representatives debated, and then voted, on the Affordable Care Act. But one of the most vivid memories of that experience for me was an extended moment of silence. It came very late on Sunday evening--after the floor speeches, the votes, and the press conferences had ended.
On the train this morning I thought back to a grad school lunch I attended long ago with Randy Shilts. He noted that he would be out for coffee with someone, notice a blotch on the man's forehead, and then quietly register that yet another friend would probably be dead in six months. Shilts died not long after that, one of almost 600,000 Americans who have died of AIDS. You won't hear this from me every day—virtually any day, ever. I hope President Obama, Harry Reid, and John Boehner read George W. Bush's op-ed this morning in Washington Post.
Although health care has been a major preoccupation of this blog, global health has come up only very occasionally. But that’s something we’ve wanted to change for a while. So, when Ezekiel Emanuel approached us, offering to write a diary while traveling through Africa, we accepted. Emanuel is a bioethicist and oncologist. He serves in the Office of Management and Budget, where he has helped shape President Obama’s policies on global health. He also happens to be an accomplished writer, having contributed articles to a wide range of publications over the years.
A few days later, my impressions of the president's bipartisan fiscal commission proposal haven't changed that much: The parts still seem better than the whole. Plenty of the chairmen's recommendations make sense to me: Curbing or eliminating the mortgage interest deduction, as my colleague Alex Hart explains today, is a particularly good idea. I'm less wild about the emphasis on spending cuts over revenue increases. And I think the commission loses credibility points for failing to specify the cuts that would yield expected much of its expected savings.
Conservatives have been on the warpath against the Affordable Care Act’s individual mandate. But recently one of the left’s best known advocates of health care reform, former Vermont Governor Howard Dean, chimed in to suggest that the mandate was not as essential as its proponents (like me) have suggested. Writing for the Huffington Post, Dean pointed out that his state enacted health care reform while he was governor. Those reforms did not include a mandate, yet the state significantly reduced the number of people without insurance.
Health care reform has been in the news a lot lately: Judges are ruling on whether the individual mandate is constitutional, companies are announcing changes to their health plans, and congressional candidates are arguing over repeal. But there’s another big story happening, down in central Florida, where some state-level officials, a handful of consumer advocates, and a whole bunch of insurance industry lobbyists are fighting over how to implement a key part of reform. (Update, 11:30 a.m.: The key votes took place this morning and the consumer advocates won on all counts.
I've never put huge faith in the polling on health care reform. The public's grasp of the law is too fuzzy, the questions too easy to manipulate. But since nary a day goes by when somebody doesn't point out how incredibly unpopular reform is, the latest Kaiser Family Foundation tracking poll deserves a look. Via Politico's daily Pulse: A new Kaiser Family Foundation poll due out today has support for the overhaul at 48 percent – up seven percentage points over the past month.
[Guest post by Jonathan Cohn] Advocates for health care reform (including yours truly) have frequently argued that it is possible to reduce the amount of care without reducing the quality--or, to put it more simply, that less care doesn't have to equal worse care. A story in today's New York Times may leave readers thinking that argument is bunk. It isn't.
[This is a guest post by Jonathan Cohn; photo from White House Flickr stream] During the debate over health care, there were a handful of moments when President Obama presided over a serious discussion of whether to pull back--that is, to give up on comprehensive reform, at least for the moment, and hunt for quick agreement on a much smaller bill. One of these moments came in early August, as polls showed the public was turning against reform and the prospects of getting legislation out of the Senate Finance Committee seemed bleak.
When Franklin Roosevelt decided at the end of his third term to dump Henry Wallace as vice president, he of course had to choose someone else to run with him in 1944. He had more or less decided on Harry Truman but felt he needed his choice to be okayed by someone else. He told his aides, “Clear it with Sidney.” And clear it they did. That Sidney was Sidney Hillman, president of the Amalgamated Clothing Workers of America, who was a confidante of FDR.