According to the Administration website:
President Obama is committed to working with Congress to pass comprehensive health reform this year in order to control rising health care costs, guarantee choice of doctor, and assure high-quality, affordable health care for all Americans. The Administration believes that comprehensive health reform should:
--Reduce long-term growth of health care costs for businesses and government
--Protect families from bankruptcy or debt because of health care costs
--Guarantee choice of doctors and health plans
--Invest in prevention and wellness
--Improve patient safety and quality of care
--Assure affordable, quality health coverage for all Americans
--Maintain coverage when you change or lose your job
--End barriers to coverage for people with pre-existing medical conditions
As you may have heard, lately, the major issue facing Washington DC today is that of health care reform. The problem is that health care costs have risen at about twice the Consumer Price Index (CPI) that is used as the primary indicator of inflation for individuals. This means that for every dollar that wages and the average cost that individual consumers pay for items have gone up, health care costs have gone up two dollars. This is an unsustainable increase, but the forces behind it are unclear.
Health Care Costs as % of GDP
Additionally, the US appears to be in a unique place, as though health care costs are rising internationally, they are rising at unusually high rates in the US.
The government believes that costs are being driven by the shrinking of the insurance pool resulting in fewer people sharing the costs of pharmaceutical development and coverage. Others feel that costs are being driven by a variety of other options, including: increases in development time and corresponding costs, fear of malpractice suits leading to an ultra-cautious corps of doctors who run unnecessary, but expensive, tests, or many other options.
Regardless of the root cause, this issue is consuming much political capital on all sides, as politicians try to hammer out an acceptable compromise to change the status quo. This will be the dominant issue in Washington until October at the earliest, based on current timelines.
With the typical Washington sausage-making progress going on over putting together a bill designed to solve all of the current problems in health care, the President's approval rating is declining fairly rapidly, as these things are measured. While the individual pieces of health care reform themselves remain popular, the proposal as a whole hovers around 50% support. If support for the entire proposal drops below that 50% mark, then the entire situation will be remarkably similar to that in which the Compromise of 1850 was struck.
The setting was the close of the Mexican-American War of 1848, in which the country grew by an extra quarter (total growth for the year was 1/3, as President Polk finalized the division of the Oregon Territory with Great Britain). The nation was increasingly divided over the slavery issue, specifically, whether or not to extend slavery to these newly conquered territories. There were three main positions: Northern Whig, anti-slavery and anti-expansion, epitomized by future Secretary of State William Seward of New York; Southern Democrat, pro-slavery and pro-expansion, epitomized by Senator and former Vice President John C. Calhoun of South Carolina; and 'none of the above,' people, including those like Sen. Sam Houston of Texas, Sen. Henry Clay of Tennessee, and Sen. Daniel Webster of Massachusetts, who spoke for compromise.
To quote the Wikipedia:
The Compromise of 1850, proposed by Henry Clay in January 1850, guided to passage by Douglas over Northern Whig and Southern Democrat opposition, and enacted September 1850:
--Admitted California as a free state including Southern California
Organized Utah Territory and New Mexico Territory with slavery to be decided by popular sovereignty
--Texas dropped its claim to land north of the 32nd parallel north and west of the 103rd meridian west in favor of New Mexico Territory, and north of the 36°30' parallel north and east of the 103rd meridian west which became unorganized territory. In return the US government assumed Texas's debts. El Paso where Texas had successfully established county government was left in Texas.
--The slave trade was abolished in Washington, DC (but not slavery itself)
--The Fugitive Slave Act was strengthened
Like health care reform, this Compromise struck at several disparate areas to try to create a broad consensus to solve a major problem facing the country. As Wikipedia notes, both extremes opposed the broad bill, and when Henry Clay attempted to bring the bill to the floor, it met defeat on a parliamentary vote. Seeing the writing on the wall, Clay withdrew the bill before it was actually brought to a vote and defeated.
As Robert Caro wrote in Master of the Senate, the third volume of his great biographical series on President Lyndon Johnson, 'a good parliamentarian can bring two sides together for a compromise, but a great parliamentarian can create the ground for compromise where none existed before."
It was Senator Stephen A. Douglas of Illinois, who sparred with future President Lincoln during their great debates, who had the brilliance (and vote counting ability) to see that each individual part was popular with enough senators to pass with a different coalition.&nbs
Does this mean that President Obama should push Congress to create a variety of different bills? For example, he could have Finance put together a bill focusing on cost controls, while the bill coming out of Health, Education, Labor, and Pensions (HELP) would focus on providing universal coverage. As long as the staffers on each committee work together, why not? It disarms the claim of "who read this X (X>1000) page bill?" as well as preventing a single set of make-or-break votes.
The key, of course, is figuring out the lines of the split. For the Compromise, there were clear lines, though the difficulty was seeing which pieces to bring to the table. For Health Care, there are clear pieces, but the order in which to play them, as well as how they fit together, is the tricky bit.
President Obama is known for playing "five dimensional chess," which is how the political-types say that he is playing several moves ahead of the 'conventional wisdom,' while tipping the hat towards the fact that Obama is a bit of a wonk on the political spectrum. It's quite likely that he uses his personal popularity to make anything pass, but perhaps another approach would allow more to be possible in this important reform period.