Professor Walter Zellman
(CSULA—UT) President Barack Obama pushed back hard against Republican critics of his health care overhaul plan this week, vowing to fight "the politics of the moment" but also giving ground on his tight timetable for passage of legislation. "We can't afford the politics of delay and defeat when it comes to health care," Obama said after meeting with doctors, nurses and other health care workers at Children's National Medical Center. "Not this time. Not now. There are too many lives and livelihoods at stake."
Obama spoke after the chairman of the Republican Party called the president's push for health care overhaul "socialism," and accused him of conducting a risky experiment that will hurt the economy and force millions to drop their current coverage.
Obama has repeatedly said he does not favor a government-run health care system.
Legislation taking shape in the House envisions private insurance companies selling coverage in competition with the government. A Washington Post-ABC News survey released Monday shows approval of Obama's handling of health care reform slipping below 50 percent for the first time.
Below we print comments from professor Walter Zelman, on the current debates. Professor Zelman is
CSULA Professor and Director of Health Science. He is an expert on health policy and markets, specifically on the uninsured, insurance and managed care, and health care costs. He has published two books on health policy, many articles on government and California politics, and multiple op-eds on government and politics, health policy and health insurance.
Q: Do you think a health care overhaul plan is needed now or should it be delayed? Why?
Zelman: It is needed now. Costs continue to rise, as do the numbers of the uninsured, especially in the current recession. These problems will only get worse and will nag at the economy and government budgets. But covering the uninsured will cost money (meaning new revenues for government) and reducing cost growth will mean some forms of cost containment, most of which many people reject, at least when exposed to distortions of reform opponents. That is why this is so difficult.
Q: What would you like to see in a health care reform plan? Do current proposals provide them?
Zelman: I think Congress and Obama are in the right ball park: We need to cover the uninsured, create exchanges or purchasing pools for small employers and individuals, expand Medicaid to cover more low income adults, and begin to put things in place that will reduce cost growth over time.
Q: What are your major concerns about reform plans as they shape up?
Zelman: That the inability to raise any tax will make getting revenues difficult. That proponents may fight so hard for all they want that compromise and getting something done becomes more difficult and we end up with nothing when clearly we could have gotten something; that various interests may scare the public into thinking this will be government run health care and then the public will weigh in negatively on key legislators.
Q: Who will benefit most from reform? Who will benefit least? How should conflicting interests be addressed?
Zelman: In most of the current reform proposals the biggest beneficiaries will be low-income people who get health coverage. How others benefit will depend on the outcome. One problem is that the easiest way to get some of the interests on board is to give them something or not do something to them. Both alternatives usually mean spending more money, when what we need to do is spend less. But short-term costs may be the price of long term reform.
Q:
Any additional comments?
Zelman: This is a major test for the President and Congressional Democrats. Obama is now going all out, putting prestige and popularity on the line. That is what leaders have to do to achieve major change. But it will not be just a public sell –he will need to get in a room one on one with key members of congress and convince them not so much that they should the “right” thing, but that there will be political rewards for doing the “right” thing and political price for doing the “wrong thing.” He has got to look people in the eye and let them know they need to do what he wants them to do.
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