Obama vows to launch US healthcare reform by end of year

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(Agencies)
Updated: 2009-03-06 08:27

US President Barack Obama delivers remarks at the White House forum on health reform in Washington, March 5, 2009. [Agencies]

Unlike Clinton, Obama isn't offering a specific plan, but rather is outlining general principles to guide the Democratic-controlled Congress as it writes the measure: increased coverage, improved services and better control of costs. The House and Senate will be left to do the heavy lifting.

Although he proposed a plan during the campaign, Obama said that he's open to any solution - from an entirely private system to more government involvement - as long as it meets his general priorities. "I just want to figure out what works," he said.

On Capitol Hill, Rep. Steny Hoyer, the No. 2 House Democrat, and Senate Finance Committee Chairman Max Baucus, D-Mont., said Thursday they want their respective chambers to pass bills this summer so lawmakers can spend the rest of the year working out a compromise and get a final bill to Obama's desk by year's end.

Still, the political reality of reshaping the complex medical system is certain to intervene as the broad discussion about the need for reform gives way to the details. Those may well conflict with the priorities of a host of stakeholders, including patients, doctors, labor unions, drug companies, businesses and employers, insurers and lawmakers up for re-election next year.

There is also a fault line between Democrats and Republicans over the role of government in the health care system - and that could complicate Obama's push to ensure health care for everyone.

Signaling likely areas of contention ahead, Senate Republican leader Mitch McConnell of Kentucky told Obama in a letter that his party was ready to work with the administration on health care but he also warned that the GOP would bristle at changes that lead to a government-run system and coverage expansions that don't come with curbs on costs.

In office just six weeks, Obama already has made one big move on health care. He proposed a budget that has a US$634 billion "down payment" for expanded coverage over a 10-year period. The government will spend trillions on health care over the same period.

US President Barack Obama speaks about healthcare reform in the East Room of the White House in Washington Thursday, March 5, 2009. [Agencies]

Broadly, Obama is seeking to use his popularity as a new president and the public's high level of frustration with medical costs to generate momentum for universal coverage.

In hindsight, both supporters and opponents agree that Clinton made a series of missteps and miscalculations that doomed his plan from the outset.

With first lady Hillary Rodham Clinton leading the charge, the White House wrote the measure with little input from lawmakers or interest groups. Stakeholders on all sides complained they were shut out of the process. Clinton's veto threat also limited his room to negotiate.

Now, Obama is making a point to consult openly with people.

Even before he took office, he used his campaign apparatus to encourage people to hold open meetings across the country to discuss the matter. The White House says more than 30,000 people attended more than 3,000 meetings in 50 states and Washington, D.C.

On Thursday, more than 120 people from all sectors - and with a wide range of viewpoints - were taking part in the program. They included longtime health reform heavyweights, and some people who helped kill Clinton's overhaul in the 1990s. One by one, they stood and praised Obama's willingness to cast a wide net for advice and include them in the process.

Later on, Obama is planning to hold a series of health care events around the country, including in rural areas, to solicit ideas and drum up support for his vision.

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