Transcript The Master of Public Administration Degree

Health Care Reform and its
Consequences
 Obama Claims to be Attacking the Status Quo:
Is he?
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Expand Benefits and Control Costs
Health Care Viewed by Many as a “right”
Promoting HCR seen as Moral
Cost Controls suggest Rationing
Powerful Bias Towards Expansion
History Is Clear
 Medicare Originally Covered Only Those
65+
-1972 Congress Makes Disabled Eligible
(15%)
-2003 Congress Creates a Drug Benefit
-Other Services (hospice care,
mammograms) are Subsequently Added,
Medicare Very Popular Today
Medicaid: Fed/State Program
for the Poor
 Originally Covered People on Welfare
-Now, Children Ages 6 to 18 under the
Poverty Line ($22,050 Family of 4)
-Congress Sets Higher Limit (133%) for
Pregnant Women and Children Under 6
-1997 (SCHIP) Expands Coverage
Ballooning Costs
 1965 Health Care Spending to Individuals
<1% of Federal Spending
 2008 Federal Spending to Individuals 28%
Battle For Health Care Reform
 Wasn’t Just About Health Care—For
Conservatives it is About Killing a
Progressive Agenda
 Wanted This Policy Debate to be Obama’s
“Waterloo”
 If Defeated, They Could Block Climate
Change Leg, Immigration Reform,
Marriage Equality, Bank Reform, Educ
Obama and Progressives
 Disappointed Progressives on Several
Fronts:
– Wall St. Bailouts
– Weak Foreclosure Plan
– Expansion of War in Afghanistan
– Catering to Insurance Companies
Lessons From the Last Year
 It Takes Social Movements that Exhibit,
Tenacity, Intensity, and Imagination to Get
Big Things Done
– E.g., Abolition, Women’s Suffrage, New
Deal, Great Society
– Not Won in a Single Election
Why Health Care Reform Was
So Contentious
 Tactical and Strategic Errors
 Failing to Confront Powerful Interests
 Massive Corporate Resistance to
Reform
 Tea Party Movement Successfully
Tapped into Public Populist Anger
 Massachusetts Special Election
 Rules of the Senate
Thursday, April 08, 2010
 Obama Approval Index -14
 Strongly Approve 28%
 Strongly Disapprove 42%
 Taxes Will Go Down 8%
 Gov't Spending Will Go Up 67%
 Obama on Economy - Ex/Good 41%
 Obama on Nat'l Sec - Ex/Good 43%
 Leadership - Ex/Good 44%
 Trust Obama on Economic Crisis 27%
Any Questions?