Health Reform, Then And Now: A Lobbyist On Obama's Coalition-Building Strategy

Julius Hobson, former top congressional lobbyist for the American Medical Association (AMA), says President Obama's speech to the AMA yesterday didn't articulate anything new--but that it's significant that Obama appeared before the group at all, and that Obama's coalition-builting tactics mark a notable difference from the Clinton-era reform push.

From a phone interview this morning:

I watched it when he was giving it, and I did not hear anything new that I did not expect to hear. What I thought was different was that he went to the AMA's annual meeting. No president has spoken to the AMA's annual meeting since, I believe, Ronald Reagan...

Hobson notes that Obama is going about health care reform quite differently from the Clintons' strategy in the early 1990s. By bringing major industry players to the table, he won't get support from everyone, but he can win enough support within each group to push reform through:

What makes this different from that era is there was a conscious decision at that time to exclude a lot of different groups that weren't necessarily in agreement. So heatlh insurers were out, big business was out, a good protion of physicians were out...the secrecy under which they operated led a good deal towards the demise of the Clinton care bill...

I think it does [make a difference] because you've invited everybody in, and everybody's had the opportunity to make a case, but in the end you've gotta make some decisions and move forward, and I think that what this process has enabled him to do is maybe peel off...if he goes and sees physicians, and he made one of the things he talked about and what they're intent on is primary care...if you peel that out, then that's helpful...because of the way the process works, he's not gonna get 100 percent of anybody, but if he gets 40, 50 percent of everybody, he starts to get there.