Taking Note

Public Holding Steady on Key Elements of Health Care Reform

In the last month, the public’s view of Congress’ health care reform efforts has certainly darkened. But it’s striking how little change there has been in the public’s view of the basic elements of health care reform as articulated by President Barack Obama and progressives. These essentials of health care reform remain not just popular, but very popular. Consider these data from the just-released August edition of the Kaiser Health Care Tracking poll.

In the poll, 68 percent favor “requiring all Americans to have health insurance, either from their employer or from another source, with financial help for those who can’t afford it.” One month ago, the figure in the Kaiser tracking poll was an identical 68 percent. Similarly, 70 percent favor “offering tax credits to help people buy private health insurance,” which is actually up a point from July’s 69 percent. And 68 percent favor “requiring employers to offer health insurance to their workers or pay money into a government fund that will pay to cover those without insurance,” up 4 points from July’s 64 percent.

Finally, what about the public health insurance option that conservatives have attacked mercilessly and about which there has been so much controversy? Surely here the public has been scared away from their previous level of support. Nope. In the Kaiser poll, 59 percent favor “creating a government-administered public health insurance option similar to Medicare to compete with private health insurance plans,” exactly the same as July’s 59 percent.

Still Waiting

Recently, The New York Times published a story about the long delays in selecting and confirming appointees to the top 500 jobs in the Obama administration.  As of the end of August, only 43% of those positions had been filled.  This statistic reflects a larger reality that has been a problem for several decades as sharper partisanship and other factors have made the whole process more difficult and the results less satisfactory.

A decade ago at The Century Foundation, we undertook studies designed to reach conclusions that might help streamline the process for both parties. We commissioned papers by Professor G. Calvin Mackenzie and journalist Robert Shogan on how the process worked and what seemed to be the major problems. In addition, the following year G. Calvin Mackenzie, The Goldfarb Family Distinguished Professor of Government at Colby College, wrote The Presidential Appointment Process in 1997, on our behalf laying out the nature of the problem and offering even more far reaching solutions. 

Let Health Care Reformers Listen to Ted Kennedy’s 1980 Speech—and Rally

I still recall Ted Kennedy’s speech at the 1980 Democratic convention. It remains the finest, most inspiring political oration that I have ever heard. This is in part because Kennedy was speaking from a position of defeat. He had just lost the Democratic nomination to Jimmy Carter. And yet this was a full-hearted, rousing speech delivered by a man who realized that in the battle ahead, the issues at stake were far, far more important than his own loss. Intuitively, he knew that the country had reached a turning point.

Many people are talking about that speech today. Instead of substituting my prose for Kennedy’s, I have decided to quote high points from that speech for the many readers who either didn’t hear it-- or don’t remember it in all of its richness. This was a speech written long before slippery political strategists had learned to “frame” ideas as bumper-stickers. In its eloquence, it shows great respect for the English language, for ideas, and for its audience. And, I think, it reminds health care reformers that this is not a time to “yield.”

Secretary Duncan: Let Charter Schools Be Charter Schools

This is the third commentary on Secretary Arne Duncan’s campaign to strengthen charter schools, including an expanded role as turn-around specialists for failed district schools. 

It is a policy initiative that puts undeserved and unmanageable weight on still-fragile institutions, and deflects attention from more effective alternatives.

In his June speech to the national charter school association, Secretary Duncan challenged the evolving charter networks like KIPP, Aspire, and Uncommon Schools to turn their attention to failed district schools, particularly those that make up the bottom 5%.  Some may wonder if this modest point is worthy of such expansive commentary, but ill-conceived policies have a way of gaining momentum.

Certainly, everyone can learn from the examples that some of the schools in these networks have set.  Frequently, they have taken students from a random applicant pool in the nation’s poorest neighborhoods and demonstrated that such kids could perform at a dramatically higher level.

Don Hewitt's Secrets

The deaths of Don Hewitt, producer extraordinaire, and earlier this summer of Walter Cronkite highlight from both sides of the camera the passing of broadcasters who epitomized the best in television news: great storytelling that combined journalism with showmanship of the sort that television, from its earliest days, has always demanded. It is striking and sad that both men in their later years talked openly of their disappointment with how news on the airwaves had been degraded in favor of profit. In fact, these frustrations were nothing new. Their predecessors in the superstar pantheon of CBS, Edward R. Murrow and Fred Friendly, were already warning of the corrupting values of television news in the 1960s, when Hewitt and Cronkite's brilliant careers were on the upswing.

Who Will Watch the Children?

With the H1N1 virus, which is usually referred to as swine flu, expected to hit hard just as the new school year begins and the announcement of delays until October at best in the availability of the vaccine now in development against the disease, a great deal more attention must be paid to the child care dilemma that all too many working American parents face. The efforts going forward to contain the spread of the disease, in addition to the development of the vaccine and plans by many school districts to provide it when it becomes available, include increased attention to hand-washing, making children aware of the dangers of sharing drinks and food, and emphasizing the need to cover the mouth when coughing or sneezing—and keeping those infected with the virus away from others.

This means that one of the major questions facing the nation is when and if schools should be closed as a precautionary measure. This past spring, school closings were a common response to large flu outbreaks, but according to an article in the Washington Post, that recommendation is now being reconsidered by the administration’s health officials, with the most probable outcome being that this fall closures would be recommended “only under ‘extenuating circumstances,’ such as if a campus has many children with underlying medical conditions.” During the outbreak of this flu last year, according to the same article, “more than 700 schools nationwide dismissed nearly a half-million students within days.” The closures did not seem to do much to limit the outbreaks since they took place after most children within those schools had already been exposed to the virus.

A Solution to the DTC Advertising Dilemma

The pharmaceutical industry has been settling into its “good guy” role in recent days; first committing to $80 billion in cost savings over ten years to help defray the cost of health reform and then forking over $150 million to finance an ad campaign championing the administration’s plan. (Of course there was that slight fall from grace when it looked as if, in exchange, PhRMA had secured guarantees that Medicare would not be able to negotiate drug prices…click here for Maggie’s take on that.)

But what else can the industry do to help burnish its image with the American people? How about finally consenting to some common-sense limits on the barrage of prescription drug ads confronting consumers every time they turn on the TV or open a magazine? While a complete ban is probably not possible (in part because such a ban might violate the First Amendment) how about making prescription drug ads a lot more educational and a lot less like a hard sell for a new BMW?

A Japan earthquake felt in Washington

TOKYO.   Political seismologists are predicting an earthquake to strike Japan next Sunday, with aftershocks potentially reaching as far as Washington.

Polls conducted for each of Japan's major newspapers point to an unprecedented repudiation of the conservative Liberal Democratic Party (LDP) that has controlled Japanese governments virtually continuously since 1955.  An anticommunist bulwark in their half-century alliance with Washington, the conservatives seem almost certain to be ousted by a Democratic Party that vows to end the LDP's subcontracting of Japanese foreign policy to the United States.

The Next Labor: Tax Reform

Like Hercules, whose labors went on and on, President Obama’s work stretches out before him without respite.  Even before the fate of health care reform is settled, the next giant task is looming.  The administration will have to tackle fiscal policy or risk loss of confidence, not only in this administration but in the dollar.  One piece of that fiscal policy reform should be a full restructuring of the tax system.

The fate of President Obama’s efforts to reform health care is not yet clear.  The Democratic majority probably will get some bill passed, but whether it can guarantee health care to all Americans while reducing the rate of growth of health care costs is another matter.  With opponents eager to inflict political wounds, and the insurance industry fighting for a package that will enrich it, the light has not yet appeared at the end of this tunnel.

Squeezing between elephants

ULAANBAATAR.  Except for the eruption of Genghis Khan's Mongol hordes across much of Asia and eastern Europe in the 13th century, Mongolia has not loomed large in international diplomatic history.  But it is currently building a profile that gives clear signals of what works and what doesn't in 21st century global politics.  Leaders in developing countries and Washington geostrategists alike should study it with interest, since its recent trajectory offers lessons for both.