By John Reichard, CQ HealthBeat Editor
January 25, 2007 -- Decrying a Washington scene he said cynically responds to bold proposals as a form of sport, presidential contender Barack Obama Thursday predicted a breakthrough in American politics that will lead to U.S. adoption no later than 2012 of a plan for universal health coverage.
Obama's address to a conference sponsored by the liberal advocacy group Families USA offered a somewhat detailed look at his thinking on health care as he jockeys for advantage against Sen. Hillary Rodham Clinton, D-N.Y., and other aspirants in the early going in the race to win the 2008 Democratic presidential nomination. But the Democratic senator from Illinois didn't commit himself to a specific plan for achieving universal coverage, saying after the speech that he would be working to develop one "over the next several months."
The speech appeared to give Obama a rhetorical jump on Clinton on the health care issue by saying the moment has arrived for a renewed effort to cover every American and by saying a plan to do so will become law no later than 2012.
Clinton recently began saying more and more about health care after the 1994 collapse of the universal coverage plan she developed for her husband Bill Clinton when he was president. But she hasn't set a timetable for universal coverage.
"There's a cynicism out there about whether this can happen, and there's reason for it," Obama said in his remarks to liberal activists. "Every four years, health care plans are offered up in campaigns with great fanfare and promise. But once those campaigns end, the plans collapse under the weight of Washington politics, leaving the rest of America to struggle with skyrocketing costs."
"For too long, this debate has been stunted by what I call the smallness of our politics—the idea that there isn't much we can agree on or do about the major challenges facing our country," he said.
"When we try to propose something bold, the interest groups and the partisans treat it like a sporting event, with each side keeping score of who's up and who's down, using fear and divisiveness and other cheap tricks to win their argument, even if we lose our solution in the process," Obama said. "It's not only tiresome, it's wrong."
He said the latest surge of interest in covering the uninsured has a different tenor because of its bipartisan nature and broad economic appeal. "From Maine to California, from business to labor, from Democrats to Republicans, the emergence of new and bold proposals from across the spectrum has effectively ended the debate over whether or not we should have universal health care in this country," he said.
"Plans that tinker and halfway measures now belong to yesterday," He said. "The president's latest proposal that does little to bring down cost or guarantee coverage falls into this category."
"In the 2008 campaign, affordable, universal health care for every single American must not be a question of whether, it must be a question of how. We have the ideas, we have the resources and we must find the will to pass a plan by the end of the next president's first term."
Obama exposed himself to some of those Washington potshots by revealing some of his thinking on the issue, but perhaps not enough to really draw heavy fire.
"At a time when businesses are facing increased competition and workers rarely stay with one company throughout their entire lives, we also have to ask if the employer-based system of health care itself is still the best for providing insurance to all Americans," he said.
Obama's call to consider moving away from that system opens him to criticism from those who attacked the Bush plan for potentially eroding employer-based health care.
Asked whether he is considering a single-payer system as an alternative to the employer-based system, Obama said, "No, I think there are a variety of ways to get there, but I think that one of the things that we're going to have to look at is portability. I don't think we immediately replace the employer-based system, but I think that setting up pools that provide a capacity for more and more people to not be dependent on an employer for their health care is important."
Obama also opened himself to criticism from the right by questioning the profits earned by health care companies. "I'm an American and I'm a capitalist," he said. "It's perfectly understandable for a corporation to make a profit." But a "controversial area we need to look at is how much of our health care spending is going toward the record-breaking profits earned by the drug and health care industry." When "those profits are soaring higher and higher each year while millions lose their coverage and premiums skyrocket, we have a responsibility to ask why."
Obama said times are different now because Republicans are proposing universal coverage plans, citing proposals advanced by Mitt Romney when he was governor of Massachusetts and current California Gov. Arnold Schwarzenegger as examples. Another difference is that corporations want action, saying "giants of industry like GM and Ford are watching foreign competitors based in countries with universal health care run circles around them."
"It is not in our character to sit idly by as victims of fate or circumstance, for we are a people of action and innovation, forever pushing the boundaries of what's possible," Obama declared.
Clinton's office didn't immediately respond to a phone call seeking comment on the speech. However, Clinton on Thursday was inviting comments on Yahoo! about health care, specifically asking "based on your own family's experience, what do you think we should do to improve health care in America?"
President Bush hit the road Thursday to pitch the health care tax deduction plan the White House unveiled earlier this week, appearing with Health and Human Services Secretary Michael O. Leavitt at a health care "roundtable" in Kansas City, Mo. Bush extolled health information technology and private insurance as the best way to make health care affordable to and accessible by all Americans.
Responding to Obama's characterization of the Bush plan as a "halfway measure," White House spokesman Tony Fratto said "the president's health care reforms are bold, serious proposals that will make health coverage more affordable, more accessible and fair for millions of Americans."
Fratto added that "we want all Americans to have health insurance coverage. The key is to provide coverage without sacrificing quality and putting the government between you and your doctor. Americans shouldn't be forced to make that trade-off. There are better ways and the president's plans get us closer to that goal while avoiding the pitfalls of government intrusion or lower quality."