Obama's health-care plan: New New Deal, or his 'Waterloo'?

IS HEALTH-CARE reform going to be President Obama's 21st Century reincarnation of the New Deal, or will it be - in the words of a GOP opponent - the new president's "Waterloo"?

Last night, Obama focused on his health-care plan during an hour-long news conference. In measured, almost somber tones, the president chose not to break any major news on the sweeping overhaul, but seemed eager to simply better explain the plan to a suddenly wavering public.

"If you already have health insurance, the reform we're proposing will provide you with more security and more stability," Obama said last night, addressing skepticism about the plan from Americans who already have coverage. He added: "It will prevent insurance companies from dropping your coverage if you get too sick."

His broader message was that doing nothing will cost more to the economy and individuals than the price tag for a reform package. "We will pass reform that lowers cost, promotes choice and provides coverage that every American can count on," he said. "And we will do it this year."

So, what is really going on with health-care reform? Here are some questions and answers:

Q. So, why is Obama pushing health-care reform this year, anyway? Didn't he say that his No. 1 priority in his initial months would be fixing the economy?

A. Yes, but the Obama administration has a ready answer for that, which is that health care is a component of the American economy, and a very significant one at that. The $2 trillion that Americans will spend on health care this year is about 16 percent of our gross national product. It's also an extremely inefficient sector - studies have shown that Americans spend double or triple on health care than what those in other industrialized countries pay.

That said, Obama and other proponents have reasons to push a reform program in 2009 that have less to do with the economy and more to do with politics. The closer we remain to last fall's huge Democratic victory - and Obama's high personal-approval ratings - and the farther away from the 2010 mid-term election, the more likely the Dems can get a bill passed.

Q. Isn't health-care reform unpopular with the public?

A. Not as a general principle - before you get into the partisan politics of it all. For example, polls thoughout this year have shown that more than 70 percent of voters support the so-called "public option" - that is, a government health plan that would compete with private insurers to provide coverage to the millions of uncovered Americans.

On the other hand, recent polls have shown that - in a more general sense - public support for Obama on health care had dipped below 50 percent.

Q. Haven't other presidents tried to get a national health system and failed?

A. You bet. In the 1930s, President Franklin Roosevelt believed that such a program, to be administered by the states, would be the capper to his New Deal reforms, but the American Medical Association and other interest groups succeeded in crushing that. Harry Truman's late 1940s plan met the same fate.

In 1993, President Bill Clinton thought his plan, devised with the involvement of his wife, Hillary, was a sure thing. But the complexity of that proposal and aggressive lobbying by insurance companies killed that plan and any serious talk of reform for 15 years.

Q. So what's different now?

A. For one thing, Obama has had better success than those predecessors in getting some of the major interest groups - including hospitals and drug companies - behind the program.

He's also trying to get Congress much more involved than Clinton did in drafting the specifics of a program, but that has proved to be a double-edged sword, as a flow of news stories about what the legislation will or will not include has been confusing to many voters.

Q. But if polls show that most Americans want reform, why is it so hard to get done?

A. For one thing, it's just a complicated issue - in part because most experts say that the only kind of overhaul that makes sense is one that both seeks to lower health costs for all and also provides coverage to the vast majority of the 46 million Americans who don't have it now. And the details of doing those two things are highly involved - it's just not an easy "yes" or "no" issue like, say, smoking cigarettes in public places.

Q. But the most confusing thing is cost: I read that this plan will add to the deficit, and Obama said last night that it will not. Who is right?

A. The nonpartisan Congressional Budget Office reported recently that reform will add $239 billion to the deficit over the next 10 years, even if Congress raises taxes on the wealthy and reduces costs elsewhere. The Obama administration disagrees with that assessment; it acknowledges that the cost of expanding medical coverage will increase in the short run - but claims that over time health-care costs will decline because of efficiencies.

Q. What do we know about the Republicans' ideas on health care?

A. Not enough, beyond the obvious fact that they oppose Obama's plan and that some GOPers clearly relish the political gain that might come out of a defeat for the president. Last month, House Republicans offered a four-page plan that would expand coverage through tax credits, allowing small businesses to pool coverage and letting those under 25 stay on their parents' coverage. There was no cost or other specifics attached. *