From Chuck Todd, Mark Murray, and Domenico Montanaro
*** And we're off: Over the past few weeks, Washington has been girding for a policy fight over health-care reform. And today -- with President Obama's speech to the American Medical Association in Chicago at 12:15 pm ET -- we can safely say that fight truly gets underway. In his address, per an administration official, Obama will say that reform can't wait; that fixing America's health system is the most important thing for the country's long-term fiscal health; that (as he mentioned in Green Bay) he wants to keep what works and fix what's broken; that while reforming health care will save the nation money in the long term, it will increase costs in the short run; and that he supports a public/government insurance option to keep costs low. Of course, that final point -- on the public/government option -- remains the most politically divisive part of the debate. Last week, the American Medical Association said it opposed such an approach, although it later backtracked somewhat, saying that a "government-run health care plan is certainly not the only option on the table, and there are alternatives we are actively considering." Also, with the president hinting at some support for curbing medical malpractice lawsuits, it'll be interesting to see if Obama makes any mention of this issue in the speech today.
*** Feels like October 2008, doesn't it? But the true reason why the fight over health-care reform begins today is all the other activity besides Obama's speech. Supporting the president, the liberal group Americans United for Change has a TV ad running on DC cable (read: a small buy) that cites a recent public poll showing that 62% support Obama's attempt to reform the nation's health-care system. "If the Republicans in Congress ignore what 62% of us support," the ad states, "you gotta wonder: Who are they listening to?" Yet pre-butting Obama's speech, the Republican National Committee holds a conference call at 11:15 am ET with Georgia Rep. Tom Price, who's a doctor. And the SEIU also is holding a conference call at 4:00 pm ET with physicians who support a public/government option. Be sure not to miss this piece from the AP, which looks at the buzzwords the GOP is using in this fight -- like "rationing" and "socialized medicine."
*** Lots of room to compromise: Staying with health care, Vice President Biden appears to have made two bits of news on "Meet the Press" yesterday. First, he didn't rule out the president signing a bill that included some taxing of health-care benefits. Biden did say the administration disagreed with that approach, but he wouldn't draw a line in the sand about signing a "comprehensive" bill that included that option. Second, the public/government insurance option is a truly subjective measure. One person's public option is another person's "co-op" idea, which is another person's Medicare-plus. Anyway, there's clearly room to compromise on this issue, too. And given all the Sunday press the Kent Conrad "co-op" option got, it seems his method has the most momentum. But as one commentator asked yesterday: If it is such a good idea, why not go ahead and start the co-op idea now since it doesn't cost anything?
*** Mayo vs. McAllen: One other thing Obama will address in his speech: that the U.S. is spending too much on treatments that don't necessarily translate into better care, and he'll ask doctors and other health professionals to do their part in driving down those costs. That, in fact, was the subject of recent New Yorker article, which chronicled how one place in the country (McAllen, TX, where one of your co-authors hails from) has some of the most expensive Medicare costs in the nation but doesn't truly have better quality, while another place (the Mayo Clinic in Minnesota) has some of the least expensive Medicare costs but has very high quality in care. As Atul Gawande in the New Yorker wrote, "This is a disturbing and perhaps surprising diagnosis. Americans like to believe that, with most things, more is better. But research suggests that where medicine is concerned it may actually be worse." Indeed, Gawande concludes that the debate over public vs. private insurance won't matter if places like McAllen aren't able to bring down their costs.
*** Two ways to look at the situation in Iran: While health care is today's top domestic political issue, Iran's disputed election -- which President Mahmoud Ahmadinejad won by a seemingly improbable 2-to-1 margin -- remains the top international one. In the latest news, Iran's supreme leader order a probe of the election results, which NBC's Richard Engel said on TODAY was a change in course since the ayatollah had earlier congratulated Ahmadinejad's victory. What do the Iran results mean for U.S. policy? On the one hand, it's a blow to the administration since there had been so much optimism that Ahmadinejad could lose or at least be forced into a runoff. But the way the regime is reacting to protests over the results may actually give the U.S. a stronger hand to get tougher on Iran and do so with the support of the international community. Iran's always had a better relationship with many of America's allies than we'd like to admit. But the way the protests are being dealt with could swing world opinion a tad closer to the U.S. position. So while the result could very well set things back in the region for some time, it COULD lead to a more united policy against Iran from key allies. Of course, the Obama White House is going to have to deal with the "I told you so" from Israel and others on Capitol Hill. What will the administration do this week? Will there be more hints that the administration will still hold out a hand to Iran? Will there be some public statement suggesting punishment for the way Iran has behaved so far?
Video: NBC's Richard Engel joins Lester Holt to discuss the Islamic Republic's response to the "outpouring of opposition."
*** Bibi's big speech: In other Middle East news, Israeli Prime Minister Benjamin Netanyahu -- in a response to Obama's big Cairo speech -- yesterday called for the first time for a two-state solution to the Israeli-Palestinian conflict. But, according to the New York Times, he issued some caveats the Palestinians immediately rejected: that Palestinians recognize Israel as the state of the Jewish people and that the Palestinian state be demilitarized. Netanyahu also dismissed American calls to halt Israeli settlements on the West Bank. Nevertheless, the White House called Netanyahu's speech an "important step forward." Said Press Secretary Robert Gibbs: "The President is committed to two states, a Jewish state of Israel and an independent Palestine, in the historic homeland of both peoples. He believes this solution can and must ensure both Israel's security and the fulfillment of the Palestinians' legitimate aspirations for a viable state, and he welcomes Prime Minister Netanyahu's endorsement of that goal." Netanyahu was interviewed on TODAY saying, "I share the president's view to start a new beginning in the Middle East."
*** Panetta vs. Cheney: Here's our final question of the day: Why did CIA Director Leon Panetta engage Dick Cheney? It's not everyday the head of the CIA gives an on-the-record interview to the New Yorker in which he says the former VP is rooting for a terrorist attack. "I think [Cheney] smells some blood in the water on the national-security issue," Panetta told the magazine. "It's almost, a little bit, gallows politics. When you read behind it, it's almost as if he's wishing that this country would be attacked again, in order to make his point. I think that's dangerous politics." All in all, this has the makings of a made-for-cable fight, and probably something the White House wishes the CIA director didn't ignite.
Countdown to Election Day 2009: 141 days
Countdown to Election Day 2010: 505 days
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