The President’s Letter to Congress

Posted on 03/02/2010 at 2:30 pm by Bob Cesca

President Obama wrote a letter to congressional leadership outlining (in a general sense) what he wants to see in terms of the sidecar legislation for the healthcare bill.

Strangely, he included several Republican ideas.

1. Engaging “medical professionals to conduct random undercover investigations of health care providers that receive reimbursements from Medicare, Medicaid, and other Federal programs.”

2. An additional $50 million in funding to states “for demonstrations of alternatives to resolving medical malpractice disputes, including health courts.”

3. Additional funds for Medicaid reimbursements to doctors to correct the problem that those reimbursements are currently “inadequate in many states.”

4. An expansion of Health Savings Accounts (HSAs).

In the grand scheme, these are rather innocuous, but the idea of it is weird. Basically: why? No Republicans will vote for this bill — that’s for sure and the president knows it. I suppose these are minor inclusions for the sake of saying “we tried.” Nevertheless, it makes him appear a little naive on the surface — hasn’t he learned that these guys are attempting to sabotage the legislation?

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  • camel54

    My hope is that there is some secret possibility Collins or Snowe are waffling, and the Prez is trying to tip the balance. Either that or it’s the old political move where you get your opponent to vote for something they allegedly support so you can use it against them in the next election–it’s a pretty weak move, though. Or if nothing else he’s hedging his bet on the “I tried to be bipartisan about this…” after HCR is done.If he’s still actually trying based on the hope he might get Repubs to see the light, that would make him more than just naive. And the worse part is his base and those to the left are dropping off because they think he looks weak and ridiculous for continuing to take this moronic route. For what? For people who call him Hitler. Yeah, expanded HSAs will change that. Never mind that the middle and lower class don’t benefit at all from HSAs and they’re loudest mouths in the Anti-Obama camp.

  • West of the Cascades

    Maybe the reason they’re in is because — at least on the surface — some of them are good ideas? It seems that (in the absence of single payer, which is my preferred health insurance reform), the basic thrust of the health insurance/health care reform that may get passed is a big melange of different tools to (a) get more people covered by some health insurance and (b) bring down the overall costs of insurance and health care. So why not include a few extra tools, even if Republicans suggested them?None of these are stupid on their face. As a lawyer, I actually like the idea of experimenting with Alternative Dispute Resolution for ANYTHING, so why not some federal funding for testing it on medical malpractice suits? Given the highly technical nature of many of such suits, perhaps it makes sense to have a “health court” where the adjudicator is an expert — I could conceive of that actually helping malpractice plaintiffs in some instances (for example by specifying certain mandatory, standardized disclosures and expediting getting the case to a judgment, where a defendant hospital might otherwise overwhelm the plaintiff’s experts and/or financial resources). Likewise, it’s indisputable that some people like HSAs (I don’t), and that some doctors in some states probably don’t get adequate reimbursement from Medicare (especially when Jim Bunning is talking).I get the sense that the President sees this bill as just the first step in a several-year process to reform health insurance and health care. Toss in a lot of different experimental mechanisms and see what works, then boost the good ones and drop the unsuccessful ones in a few years.

  • Nicole473

    I think that we can assume that Obama is not a stupid man. ;) I think it’s likely that he included the GOP’s ideas in order to make the point that he has given their ideas consideration, and is willing to accept what he believes will work regardless of which party it comes from.A smart move politically, IMO.

  • jane

    Ooh! Maybe this guy can help in number one.

  • http://politicalpartypooper.wordpress.com/ Political Party Pooper

    “Nevertheless, it makes him appear a little naive on the surface — hasn’t he learned that these guys are attempting to sabotage the legislation?”No, I think it makes him look honest. For the last year, he has stated for everyone to hear that he wanted to hear their ideas, and if they were good, he would use them. This is a little lesson from FDR and Reagan’s playbook…”if you say it…do it.”In the end, it’s about making the Republicans look small and petty, because people don’t get that they are…yet. But every little time he does something like this, he is building the case against them.You guys forget, the honeymoon is over. The only way he can win America’s trust and love now is by doing exactly what he says he will do.

  • Dr. Squid

    No matter what, the GOP will shriek about being completely shut out. With this, the president can claim, “Liar liar pants on fire,” and be 100% correct.

  • Timothy Barron

    These are actually legitimate ideas. When Repubs are being honest and sincere, they can actually make some good points. The undercover patients and medicaid reimbursements are legit.Bob also left out that he is eliminating some giveaways in the congressional bills, particularly the exception for Florida’s seniors that d-bag McCain complained about at the summit.

  • camel54

    These are all excellent points. I feel like we are far past the point of having evidence the president is doing what he said, trying to be bipartisan and being rebuked. We’ve been past having that proof for a long while now. The president should have changed to a more aggressive messaging of that proof. How long did Max Baucus work with Repubs only to get no votes? Honestly, do we need to continue with this exercise?And again, maybe internally there are things happening that put all of this into a context I can’t access. Maybe I’m just frustrated from going from one year-long, bipartisan clusterfuck right into the financial reform quagmire and doing the same damn thing.Either way, none of this political mastery will amount to anything if Dems don’t get out there and spread the message.

  • jhw22

    I think each of those points is reasonable. In fact, Bernie Sanders made a great argument for an increase in fraud prevention during the committee meetings. He was extremely insightful and passionate about it so I see that more as Sanders’ issue than Coburn’s. I don’t see how HSA expansion is bad (although it irks me a tad that he gave ANYTHING to Barasso the asshole in the letter) and I do think payments to doctors in Medicaid and Medicare are essential.So, if anything, I think it makes him look like he’s obliging them on things that are really as much our issues as theirs. The question is how naive will Republicans be and think he moved their way? Well, OK, I know the answer to that one…Jennifer

  • Irish Girl

    Wait, it’s not clear to me from Bob’s post as to whether these Repub ideas are in the main bill or will be put in the sidecar legislation. If in the main bill, it sweetens the pot for anyone on the fence (as many of you have already said). If it’s in the sidecar that will be decided through reconciliation AND the Repubs vote against it, then it will be one more obvious point where the President included the oppositions ideas and they said NO. Either way, it plays well to Independents and will help in the upcoming Fall campaign.IMHO, it’s very smart.

  • staci

    Agreed, PPP with one exception: I don’t think Obama ever had a honeymoon period. I always thought that the left would be Obama’s biggest crybabies, the folks that would hurt him most, and sadly, I think I was right. As a matter of fact, the only group that I think has given Obama room to work has been the AA and Hispanic people. The gays have been very vocal with their unhappiness with Obama from about his second month in office. Add in the FDL folks, the Daily Kos folks, the HuffPo folks, the anti-torture folks, the Republicans and the bullshit media — nope, no honeymoon for this president. Hell, if I were him, I would have said screw it all and left this country to figure it all out the best way they could. Even for including ideas that on the surface seem to be good ideas, Obama is getting shit just because the ideas originated with a Republican? Really? Have we been reduced to complaining just for the sake of complaining?