Obama And Health Care: Big Hurdles Yet To Come The Obama administration has pushed through several health measures, expanding the State Children's Health Insurance Program and dedicating more than $100 billion in stimulus money to health care. But the big test will come when Obama tries to get Congress to act on a bill overhauling the U.S. health care system.
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Obama And Health Care: Big Hurdles Yet To Come

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Obama And Health Care: Big Hurdles Yet To Come

Obama And Health Care: Big Hurdles Yet To Come

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And President Obama's nominee to lead the Department of Health and Human Services was confirmed yesterday. Kathleen Sebelius quickly resigned her job as governor of Kansas, took the oath of office, and went to work.

When it comes to health care, President Obama has made good on several campaign promises in his first 100 days. Congress is pushing ahead on efforts to overhaul the nation's health-care system.

But as NPR's Julie Rovner reports, health care is so daunting that even doing things right is no guarantee of success.

JULIE ROVNER: President Obama wasted no time checking off his first health-care box. He signed an expansion of the children's health-insurance program just two weeks after his swearing in.

President BARACK OBAMA: This is good.

(Soundbite of laughter)

Pres. OBAMA: This is good.

(Soundbite of applause)

ROVNER: It added 4 million children to the roles of the program that already covered 7 million children in low- and moderate-income families. Just weeks later, Congress passed an economic stimulus bill that included several more of the president's health care priorities. Billions of dollars went to state Medicaid programs for the poor, and to help people who'd been laid off keep their health insurance. It also provided funding to computerize medical records, and boost research that compares how well various drugs and medical procedures work when compared to each other. The combination of accomplishments prompted this boast for Mr. Obama in his speech to Congress later in February.

(Soundbite of clapping)

Pres. OBAMA: Already, we've done more to advance the cause of health- care reform in the last 30 days than we've done in the last decade.

ROVNER: But in that same speech, he also made it clear he wasn't satisfied with those wins, and he wasn't willing to wait for the economy to improve to press on with the health fight.

Pres. OBAMA: So let there be no doubt: Health-care reform cannot wait. It must not wait, and it will not wait another year.

(Soundbite of applause)

ROVNER: So far, President Obama's backers, like Ron Pollack of the consumer group Families USA, are giving him high marks. Pollack says he is most pleased with the administration's quick start.

Mr. RON POLLACK (Consumer Advocacy Group, Families USA): In 1993, President Clinton did not give a speech on health-care reform 'til September of '93, and didn't introduce his proposal until November of '93. So here, we have a real contrast with that.

ROVNER: Even those who have philosophical differences with the administration say the Obama administration has well-learned the lessons from that failed Clinton effort. Grace-Marie Turner heads the Galen Institute, which favors less government involvement in health care. She particularly praises the president's ability to reach out even to those who disagree with him.

Ms. GRACE-MARIE TURNER (President, Galen Institute): There's still -is a lot of positive feedback from the forum that he did bringing so many different players to the table.

ROVNER: But for all the things President Obama has done right, getting a health-care overhaul done, and getting it done this year, is still a formidable task. Health economist Stuart Altman is a veteran of several past overhaul efforts. He says what's been done so far is the easy part.

Dr. STUART ALTMAN (Health Economist): But I think the tough part is just hitting us, which is if we're going to have comprehensive reform, which would most importantly include the probably 50 million Americans with no health insurance today, it's going to require new money. In the short run, it's just not possible to save the kind of dollars that would be needed to sort of cover these people.

ROVNER: Most analysts think those dollars will total somewhere around 1.5 trillion over the next 10 years, which even in Washington is real money. Grace Marie Turner agrees that money is likely to be a big problem, but she says there's another major hurdle. She calls it the 80-20 rule.

Ms. TURNER: Most people, and most of the interest groups around those tables, are willing and ready to go along with 80 percent of the agenda.

ROVNER: On things ranging from a new government-run option, to a requirement that employers provide workers coverage, to changes in the way doctors and hospitals get paid.

Ms. TURNER: But there's 20 percent of it that they just can't do because it destroys their business model; it's opposed to their whole reason for being.

ROVNER: The problem is that for each interest group, the 20 percent they can't accept is different. Years ago, Stuart Altman coined what's known as Altman's Law, which says that for every interest group in favor of changing the health system, its second choice is always the status quo - no change.

Mr. ALTMAN: And Altman's Law, unfortunately, this is the law I want repealed.

ROVNER: But he and a lot of other experts aren't ready quite yet to predict that it will be.

Julie Rovner, NPR News, Washington.

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