Washington Campaigning for president, Barack Obama said repeatedly that any overhaul of the health care system should be negotiated publicly and televised for all to see. Throughout this year’s negotiations, however, the big deals have been struck in secret.
With tax increases and limits on what’s covered among the possible ways of offsetting perhaps $1 trillion over a decade in expenses, neither the administration nor Congress is willing to give up its right to do the most sensitive talking in private, as it’s always been done.
“It’s unrealistic to think every aspect of the negotiations is going to be public,” said Senate Assistant Majority Leader Richard Durbin, D-Ill.
White House press secretary Robert Gibbs, traveling with Obama in L’Aquila, Italy, said Thursday that “this president has demonstrated more transparency than any president.” He said Obama had participated in multiple town hall meetings with doctors, nurses and providers to discuss revamping health care.
“I don’t think the president intimated that every decision putting together a health care bill would be on public TV,” Gibbs said.
But the notion of televising negotiations behind a health care revamp was so central to Obama’s campaign promises of change and openness, it became part of his stump speech as he traveled the country in 2007 and 2008.
He’d describe how televised deliberations would take place around a big table, with seats filled by doctors, nurses, insurers and other interested parties. As president, he’d joke, he’d get the biggest chair.
“Not negotiating behind closed doors, but bringing all parties together and broadcasting those negotiations on C-SPAN,” Obama explained in a Democratic debate in Los Angeles in January 2008, in language similar to many of his campaign stops.
However, the two biggest deals so far — industry agreements to cut drug and hospital costs — were reached in secret.
“They were private, yes,” said Senate Finance Committee Chairman Max Baucus, D-Mont., a key participant in the process.
C-SPAN, the cable public policy network, did carry a White House Forum on Health Reform in early March in which the president spoke and participants fanned into working groups.
That was a kickoff event, however, not a negotiation. C-SPAN spokesman John Cardarelli said that beyond that, “there hasn’t been a collaborative effort of coordination of coverage of ‘special events.’” The decisions about what to air are made independently on a case-by-case basis, he said.
The Senate Health, Education, Labor and Pensions Committee’s bill-writing sessions, which began about three weeks ago, have been open, and various committees and subcommittees have had dozens of public hearings.
But the private sessions continue.
Four Senate Republicans met for an hour and a half Wednesday to discuss health care with Senate Majority Leader Harry Reid, D-Nev. Separately, Sens. Olympia Snowe, R-Maine, and John Kerry, D-Mass., have been in intense discussions. White House chief of staff Rahm Emanuel and Office of Health Reform director Nancy-Ann DeParle are in constant, private contact with key players.
The House of Representatives could vote on a plan before the August recess. The Senate is poised for a longer debate. Assuming they pass differing plans, any final product would emerge from a conference committee, whose negotiations typically offer even less public scrutiny.
Lawmakers, health care interests and public policy experts acknowledge that Obama’s campaign vision hasn’t exactly come to pass.
“Sometimes for people to say what’s really on their mind, it helps to do it outside the public eye,” said Senate Finance Committee member Thomas Carper, D-Del. “Could the process be more transparent? I suppose it could be.”
The health care negotiations are “no different from any other negotiation over the years when deals are struck quietly,” said Sen. Judd Gregg of New Hampshire, the top Republican on the Senate Budget Committee and a member of the health committee.