> wearing my pessimistic hat, I see that.......!
I see the calculation but I don't see the votes. The basic problem is
> that
> the "moderate" Senate or "Blue Dog" House Democrats for whom budget
> responsibility is a key issue have preferences that don't add up. They
> sort
> of think health insurance for everyone would be nice, but they don't like
> big-government regulation, or government displacing the private sector;
> object to most new taxes; and definitely don't want to increase the
> deficit.
> Since the process in the U.S. requires that the Congressional Budget
> Office
> estimate the effects on the deficit of any new legislation, and
> Republicans
> will be screaming about those effects, the Blue Dogs can't just ignore the
> costs. So "we'll fix the costs later" isn't really an option because the
> Blue Dogs and their equivalent Senators won't vote for it. Unless and
> until
> the Blue Dogs figure out that they have to endorse serious cost controls,
> there is no solution. And the Blue Dogs came out against the public plan
> a
> couple of weeks ago.
>
> Not-especially-cheers,
> Joe White
>
> -----Original Message-----
> From: Anglo-American Health Policy Network [mailto:[log in to unmask]]
> On
> Behalf Of Calum Paton
> Sent: Tuesday, June 23, 2009 7:37 AM
> To: [log in to unmask]
> Subject: Re: UK view of US health care (Times)
>
>> Thanks, Mark.
>
> I am recently back from visiting the US with a study group and discussing
> health reform with some first-rate people.
>
> My understanding is that (while any 'major' progressive reform will
> always be difficult) Obama's team has overtly sought to learn from the
> Clintons' failure in 1993. Then, cost-control - as well as 'managed
> competition' - was built in to a greater extent than is (initially) the
> case now, in the hope that fiscal conservatives as well as
> 'pro-competition' reformers would support. Thus the Clinton Plan became
> 1,00 pages of ingenious analytics which dies politically. Alain Enthoven
> and others didn't return the complement of the genuflection to their
> ideas; and fiscal conservatives on the Democrat side ( as well as being
> 'got at' by the insurance industry) were soon less significant than a
> rising Republican tide at the Congressional level. The 'interests' were
> offended.
>
> Now, Obama seems to be saying (not explicitly!) something like.....at this
> special moment (ie as Anatole Kaltesky rehearses), we will seek a big
> tent, and try not to alienate (too much) the special, powerful interests
> (providers and insurers)....get something passed a.s.a.p. and then
> cost-control will be a necessity in any case, so it'll have to happen.
>
> One hopes that, at this moment, the crass response of some Republicans
> (like Karl Rove) is too much.....
>
>
>
> Good luck to Obama, and Ted Kennedy et al (genuinely)
>
> Calum
>
>
>
> ttp://www.timesonline.co.uk/tol/comment/columnists/anatole_kaletsky/article6
> 523512.ece
>>
>> This article from The Times offers a UK view of recent events in the US
>>
>>
>> Dr M. Exworthy
>> Reader in Public Management and Policy
>> & Director, Centre for Public Services Organisations (CPSO)
>> & Deputy Director, Institute of Leadership & Management in Health (ILMH)
>> School of Management
>> Royal Holloway-University of London
>> Tel: +44-1784-414186
>> Email: [log in to unmask]
>> CPSO webpage: http://www.rhul.ac.uk/Management/cpso/
>> ILMH webpage: http://www.swlacademicnetwork.ac.uk/ilmh/
>> Personal webpage:
>> http://www.rhul.ac.uk/Management/About-Us/academics/exworthy.html
>>
>>
>
>
>
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