A month later, shortly before passage of the Affordable Health Care Act, Ryan showed his gratitude toward Obama during a health care summit by assailing the bill to the president's face as "full of gimmicks and smoke and mirrors," ticking off its quantitative errors and then characterizing it with the Frank Luntz-tested phrase "government takeover health care." Obama stared icily at the Budgeteer throughout his harangue.
Ryan sat and tried not to explode. The attack felt both gratuitous and personal to him. As he would later say, "'Autism,' 'kids with Down's syndrome,' 'maybe your grandparents' -- that's demagoguery. That's rank demagoguery, and it's beneath the office."
The great irony was that a candidate who came to office in part because of his silver tongue was unable until 2010 to explain convincingly why the country should follow him on health care. He failed to persuade his fellow Democrats to use their fleeting 61 vote supermajority in the Senate to enact more of his program.
Source: 2008 Democratic Debate in Cleveland Feb 26, 2008
“I’ll be a president who finally makes health care affordable to every single American by bringing Democrats and Republicans together. I’ll be a president who ends the tax break for companies that ship our jobs overseas and put a middle class tax cut into the pockets of working Americans. And I’ll be a president who ends this war in Iraq and finally brings our troops home. We are one nation and our time for change has come.”
A: I think that local communities are making enormous strides, and I think they’re doing the right thing on this. If it turns out that we’re not seeing enough progress at the local level, then I would favor a national law. I don’t think we’ve seen the local laws play themselves out entirely, because I think you’re seeing an enormous amount of progress in Chicago, in New York, in other major cities around the country. And because I think we have been treating this as a public health problem and educating the public on the dangers of secondhand smoke, that that pressure will continue. As I said, if we can’t provide these kinds of protections at the local level, which would be my preference, I would be supportive of a national law.
Q: Have you been successful in stopping smoking?
A: I have. You know, the best cure is my wife.
A: It was fundamentally flawed as a piece of legislation. The central premise of this prescription drug bill that was passed by Bush was that the federal government, through the Medicare program, and senior citizens could not negotiate for the best possible price with the drug companies, so that they could actually get the kinds of discounts the Canadians enjoy for the drugs that are manufactured here in the US. That was done because the drug companies didn’t let it happen. What we have is a bill that’s bad for taxpayers and bad for senior citizens. Taxpayers are hit with a half-a-trillion-dollar tab that was originally estimated at three hundred billion. And about 3 weeks later, seniors have a big donut hole in the middle of their benefits. What I would do is I would say that senior citizens, through the Medicare program they can go and negotiate the best possible price as a consequence of being bulk purchasers.
It goes further than any other proposed plan in cutting the cost of health care by investing in technology and preventive care so that children are getting regular check ups instead of having to go to the emergency room for treatable illnesses like asthma, and by breaking the stranglehold of the drug companies and the insurance industries--we are tired of them dictating our health care markets--and helping businesses and families shoulder the cost of the most expensive conditions so that an illness doesn’t lead to bankruptcy. And I promise you this: I will sign a universal health care plan that covers every American by the end of my first term as president.
Obama had made health care reform his top priority during his first year in office. The debate had begun to destroy Obama's campaign aspirations of bipartisanship. Republican lawmakers stood on the steps of the Capitol and waved signs that read KILL THE BILL! Democratic lawmakers accused Republicans of "fearmongering" and termed them "the party of no." Obama himself blamed Republicans for trying to twist his self-described "centrist" plan into "some kind of Bolshevik plot." As February turned into March, Obama vowed to do everything he could to pass the bill.
So, as temperatures cool, I want everyone to take another look at the plan we've proposed. There's a reason why many doctors, nurses, and health care experts who know our system best consider this approach a vast improvement over the status quo. But if anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know. I'm eager to see it.
Here's what I ask Congress, though: Don't walk away from reform. Not now. Not when we are so close. Let us find a way to come together and finish the job for the American people. Let's get it done.
Ron Paul vs. Barack Obama on Domestic Issues
As the debate over health reform heated up that summer, the president made another pledge: "I just want everybody to know, Congress will have time to read the bill. They will have time to debate the bill. They will have all of August to review the various legislative proposals. When we come back in September, I will be available to answer any question that members of Congress have. If they want to come over to the White House and go over line by line what's going on, I will be happy to do that."
Did the health reform debate live up to the president's standard? Hardly. The American people were promised a fair, bipartisan, transparent process. But instead the Democrats wrote trillion-dollar, 2,000-plus page bills in secret with no republican input and no public oversight.
Pres. OBAMA: If you look at the health care process--overwhelmingly the majority of it actually was on C-SPAN, because it was taking place in congressional hearings in which you guys were participating. Now, I kicked it off, by the way, with a meeting with many of you, including your key leadership. I take responsibility for not having structured it in a way where it was all taking place in one place that could be filmed. How to do that logistically would not have been as easy as it sounds, because you're shuttling back and forth between the House, different offices, different legislators. But I think it's a legitimate criticism. So on that one, I take responsibility.
Pres. OBAMA: I don't think I said that. What I said was, within the context of health care, I welcome ideas that you might provide. I didn't say that you haven't provided ideas.
Rep. PRICE: Mr. President, multiple times, from your administration, there have come statements that Republicans have no ideas and no solutions. In spite of the fact that we've offered positive solutions to all of the challenges we face.
Pres. OBAMA: If you say, "We can offer coverage for all Americans, and it won't cost a penny," that's just not true. So I am absolutely committed to working with you on these issues, but it can't just be political assertions that aren't substantiated when it comes to the actual details of policy. So there's got to be some test of realism in any of these proposals, mine included.
Data show about 934,000 personal bankruptcies in FY 2008. There are about 32 million seconds in a year. So someone filed for bankruptcy roughly every 30 seconds last year. But even a very high estimate would only attribute half of those personal bankruptcies to medical expenses. So that's one health-related bankruptcy every minute at most.
OBAMA: I make sure that we have a health care system that allows for everyone to have basic coverage. McCain talked about providing a $5,000 health credit. Now, what he doesn’t tell you is that he intends to, for the first time in history, tax health benefits. So you may end up getting a $5,000 tax credit. Here’s the only problem: Your employer now has to pay taxes on the health care that you’re getting from your employer, and if you end up losing your health care from your employer, you’ve got to go out on the open market and try to buy it. It is not a good deal for the American people.
Obama said, “You may end up getting a $5,000 tax credit. Here’s the only problem: Your employer now has to pay taxes on the health care that you’re getting from your employer. McCain’s plan doesn’t call for taxing employers on health care benefits; it would instead tax employees. As the law stands now, employees don’t pay taxes on the dollar value of their health insurance benefits. Under McCain’s plan, they would.
McCain also misrepresented Obama’s plan when he said that his opponent favored “handing the health care system over to the federal government.” McCain made a similar claim in his acceptance speech, when he said that Obama’s plans would “force families into a government run health care system.” We called it false then and we stand by that. Obama’s plan mandates coverage for children, but not for adults, and it does not require anyone to be covered by a nationalized system.
Announcer: Hillary Clinton is attacking. But what’s she not telling you about her health care plan? It forces everyone to buy insurance, even if you can’t afford it. And you pay a penalty if you don’t. Barack Obama believes it’s not that people don’t want health care. It’s that they can’t afford it. That’s why the Obama plan reduces costs more than Hillary’s, saving $2,500 for the typical family. For health care we can afford, vote for change we can believe in.
The mailer focuses on the primar difference between the two candidates’ proposals: whether they would require everyone to obtain coverage. Clinton’s plan would require all Americans to get insurance, though she hasn’t said what will happen if they don’t. Obama’s plan would require insurance for all children but not for adults.
The Obama campaign is trying to shift the focus to some unspecified “punishment” that Clinton’s plan would mete out for those who didn’t obtain coverage. It’s true that a “mandate” implies penalties for noncompliance, and Clinton’s campaign has yet to outline what those would be. But Obama’s plan, which would mandate coverage for children, would presumably also have some enforcement mechanism, and he doesn’t make explicit what that would be, either
[Female announcer]: Here’s what the experts say. President Clinton’s own Labor Secretary Robert Reich says, quote, “I’ve compared the plans in detail. Obama’s plan would insure more people than the others.” The Pioneer Press confirms Obama guarantees coverage for all Americans.
[Male announcer]: But here’s the real difference on health care. Senators Edwards and Clinton favor mandates which the Daily Iowan says would, quote, “force those who cannot afford health insurance to buy it, punishing those who don’t fall in line.”
[Female announcer]: Barack Obama believes the solution isn’t making it illegal not to have health care. It’s making it affordable.
[Male announcer]: And that’s why his plan cuts costs for a typical family by twenty-five hundred dollars.
[Female Announcer]: As the Concord Monitor says, when it comes to honesty about health care, Obama has the edge.
Clinton uses a dubious statistic when she claims Obama’s plan would leave out 15 million of the uninsured. But Obama’s statement that his proposal provides “universal” health care is also suspect. Clinton based her claim on a column by The New Republic’s Jonathan Cohn, who loosely estimated Obama’s plan would leave 15 million uninsured. Cohn offered an estimate based on the best information available, not a hard and fast calculation. The best available information says that Obama’s plan would leave between 8.5 million uninsured, up to 18 million people uninsured if Obama has no individual mandates. The Obama plan does include limited mandates, including a requirement for employers to either provide health insurance or pay into a public fund.
On Thursday, January 24, two days before the primary, he called Obama to say he was ready to endorse. He told Obama that at the beginning of the campaign he was looking for somebody to inspire the nation, and how impressed he had been by Obama's emphasis after his Iowa victory on the importance of ending longtime divisions within the country. Obama's inspiration was what the country needed, he said, adding, "You're the man." But his endorsement came with conditions. Kennedy wanted a commitment from Obama that as president he would push for universal health care. He wanted it to be a first priority of an Obama administration. Obama agreed.
CLINTON: And under my plan, it is affordable because, number one, we have enough money in our plan. A comparison of the plans like the ones we’re proposing found that actually I would cover nearly everybody at a much lower cost than Sen. Obama’s plan.
In a 2007 Kaiser Family Foundation report comparing the health care spending of Organisation for Economic Co-operation and Development member countries, the United States came in first at $5,711 per capita. But Luxembourg spent $4,611, only $1,100 less per capita than the U.S. The next biggest spender, Switzerland, spent $3,874, also far more than half of U.S. spending. KFF noted, however, that the United States’ spending was “over 90% higher than in many other countries that we would consider global competitors.”