Barack Obama

HEALTH REFORM: We've Come a Long Way, Baby

Micah Weinberg — Wed, 11 Mar 2009 20:46:00 -0400

President Obama’s Health Care Summit last week was seen as the opening salvo in the coming battle for health care reform in the United States. But before we gear ourselves up for that conflict, it’s worth pausing for a moment to note that the president - in less than two months in office - already has a substantial legacy of major health reform to his credit.

Take for example efforts to get doctors and hospitals to use the latest information technology. The “HITECH” bill is one relatively minor component of the mind-bendingly massive $787 billion stimulus package passed last month. This single piece of legislation, though, increases federal investment in health information technology by 12,000 percent, according to the California HealthCare Foundation. This is no mean feat and it comes not a moment too soon.

As consumers of health care, we regularly use online tools such as WebMD to check out whether we should treat the symptoms that we and our families are having at home or whether we should go to the doctor’s office. We may be shocked, therefore, in the age of Google and Blackberry, at how relatively primitive our doctors’ offices often are in terms of their use of IT. Handling drug prescriptions over the internet is one of the simplest uses of technology in this area. Yet as of 2007, only 1.2% of prescriptions in California were done electronically, outside of the highly networked systems of Kaiser and the Veterans Administration. This major new federal investment may help revolutionize the use of IT in health care delivery.

The stimulus package also devoted $1.1 billion to “comparative effectiveness” research. Again, this is a drop in the bucket of the total cost of the package. But it is an investment that may transform how health care is delivered in the United States. It will help give doctors and hospitals better information to evaluate how new medicines, therapies, and procedures stack up against those that are already in the market. New is often, but not always, better.

And investments in technology and comparative effectiveness research are only two transformative pieces of health care legislation. We also witnessed the expansion of children’s health insurance and the extension of COBRA coverage as well as the provision of billions of additional dollars for the National Institute of Health, community health centers, and health workforce investments. The list of projects funded with stimulus dollars goes on and on and on and certainly isn’t confined just to health care.

Together these projects and programs – already funded and now being implemented – could easily represent a presidential term’s worth of accomplishments. Not that Obama and Congressional health care policy leaders such as Senators Kennedy and Baucus, and House chairmen Waxman, Miller and Rangel intend to rest on these laurels. Working together with HHS Secretary-designate Sebelius, they are pushing forward on comprehensive reform to the nation’s health care system. But, it is impossible to deny that quite a bit has been accomplished before the drive to enact comprehensive health reform has even begun.

A Shout-out for Savings in a Primetime Press Conference

Mark Huelsman — Tue, 10 Feb 2009 14:43:00 -0500

In a primetime news conference designed mainly to promote and defend the pending economic recovery bill, I expected to hear a few curveballs from the media. What was fairly unexpected, however, was a chunk of time devoted to the delicate balance between consumer spending and savings in the context of economic recovery. But sure enough, near the halfway point of the broadcast, there was Chuck Todd of NBC News playing the role of inquisitive asset-builder. Here's the exchange (my emphasis added):

Chuck Todd, NBC News: Thank you, Mr. President. In your opening remarks, you talked about that, if your plan works the way you want it to work, it's going to increase consumer spending. But isn't consumer spending, or overspending, how we got into this mess? And if people get money back into their pockets, do you not want them saving it or paying down debt first before they start spending money into the economy?

President Obama: Well, first of all, I don't think it's accurate to say that consumer spending got us into this mess. What got us into this mess initially were banks taking exorbitant, wild risks with other people's monies based on shaky assets and because of the enormous leverage, where they had $1 worth of assets and they were betting $30 on that $1, what we had was a crisis in the financial system.

That led to a contraction of credit, which, in turn, meant businesses couldn't make payroll or make inventories, which meant that everybody became uncertain about the future of the economy, so people started making decisions accordingly, reducing investment, initiating layoffs, which, in turn, made things worse.

Now, you are making a legitimate point, Chuck, about the fact that our savings rate has declined and this economy has been driven by consumer spending for a very long time. And that's not going to be sustainable.

You know, if -- if all we're doing is spending and we're not making things, then over time other countries are going to get tired of lending us money and eventually the party's going to be over. Well, in fact, the party now is over.

And so the -- the sequence of how we're approaching this is as follows. Our immediate job is to stop the downward spiral, and that means putting money into consumers' pockets. It means loosening up credit.

It means putting forward investments that not only employ people immediately, but also lay the groundwork for long-term economic growth.

...

Now, what we are going to also have to do is to make sure that, as soon as the economy stabilizes, investment begins again, we're no longer contracting but we're growing, that our mid-term and long-term budget is dealt with, and I think the same is true for individual consumers.

Right now, they're -- they're just trying to figure out, how do I make sure that, if I lose my job, you know, I'm still going to be able to make my mortgage payments? Or they're worried about, how am I going to pay next month's bills? So they're not engaging in a lot of long-term financial planning.

Once the economy stabilizes and people are less fearful, then I do think that we're going to have to start thinking about, how do we operate more prudently? Because there's no such thing as a free lunch.

So if -- if you want to get -- if you want to buy a house, then putting zero down and buying a house that is probably not affordable for you in case something goes wrong, that's something that has to be reconsidered. So we're going to have to change our -- our bad habits.

But right now, the key is making sure that we pull ourselves out of the economic slump that we're in.

The tone and the sequencing of the answer seems right, and hints that in the midst of trying to jumpstart the economy, the President takes seriously the importance of individual savings as a long-term strategy for economic stability. While it is true that declining consumer spending on its own could have a negative effect on an already shaky economy, it is also certainly the case that a reemphasis on savings will facilitate long-term growth.

The balance and timing are tricky, but the argument can easily be made that, in a time of de-facto belt-tightening by the average American consumer, the federal government should fill the void being left by consumers. This makes it possible for people to save without shouldering the burden of economic recovery now, and it lays the groundwork for policy that incentivizes responsible behavior by consumers and businesses down the road.

A California Inaugural

Joe Mathews — Tue, 20 Jan 2009 15:55:00 -0500

I had planned to spend today making phone calls on various stories. Bad idea.

No one's here. The governor, the lieutenant governor, the leaders of the state assembly and the state senate, the attorney general, the secretary of state, the mayors of San Francisco and Los Angeles -- they're all in Washington for the inaugural. In fact, the ceremony was dominated by Californians. U.S. Sen. Dianne Feinstein presided. Feinstein and House Speaker Nancy Pelosi escorted Obama in. Orange County's Rev. Rick Warren said the opening prayer.

With everyone out of town, one wonders who is in charge. Fortunately, it's not a bad time for our leaders to be gone, since the state is in such great shape, big budget surplus, no calamity staring us in the face... Oh, yes?... Never mind.

At Clinton Confirmation Hearing, a Glimmering of Possibility for Asset Building in Foreign Assistance

Leila Seradj — Wed, 14 Jan 2009 18:04:00 -0500

As all of Washington-- and indeed, the United States, if not the world-- awaits with anticipation President-elect Barack Obama's inauguration next week, a glimmering of possibility regarding a more prominent role for asset-building strategies was evident in Secretary of State Hillary Clinton's confirmation hearing yesterday. Giving a nod to toward social development, microfinance, and bottom-up empowerment as key elements of a foreign policy strategy, we can't help but suggest how an asset-building framework would enhance the impact of such strategies.

When discussing her foreign policy goals, Clinton noted that world leaders, enmeshed in "the cross currents of the most severe global economic contraction since the Great Depression," have much to learn from that crisis regarding "the consequences of diplomatic failures and uncoordinated reactions." But she continued:

"Yet history alone is an insufficient guide; the world has changed too much. We have already seen that this crisis extends beyond the housing and banking sectors, and our solutions will have to be as wide in scope as the causes themselves, taking into account the complexities of the global economy, the geopolitics involved, and the likelihood of continued political and economic repercussions from the damage already done."

Where to begin? Clinton's call to the importance of a "bottom-up" approach to development, "to ensure that America remains a positive force in the world" resonates with the Global Assets Project's work on providing opportunities for savings and wealth accumulation for the poor from the grassroots. (See, for example, my colleague Jamie Zimmerman's Reform Foreign Assistance proposal, which made the final cut for the Better World Campaign's One Day One "9 for ‘09" contest.) She continued

"The President-elect and I believe in this strongly. Investing in our common humanity through social development is not marginal to our foreign policy but integral to accomplishing our goals."

In what ways could this bottom-up approach manifest itself, as a part of the U.S. top foreign policy priorities? As Clinton highlighted in her remarks, microfinance and social development are proving to play an increasingly key-and notably promising- role in poverty alleviation efforts. Linking this with President-elect Obama's upbringing, and his foreign policy priorities, Clinton poignantly remarked:

"...I want to mention that President-elect Obama's mother, Ann Dunham, was a pioneer in microfinance in Indonesia. In my own work on microfinance around the world... I've seen firsthand how small loans given to poor women to start small businesses can raise standards of living and transform local economies."

Noting that Dunham's illness had prevented her from attending a microfinance forum at the Beijing women's conference in 1995, in which Clinton had participated, passing away shortly thereafter, she observed:

"...I think it's fair to say that her work in international development, the care and concern she showed for women and for poor people around the world, mattered greatly to her son, and certainly has informed his views and his vision. We will be honored to carry on Ann Dunham's work in the months and years ahead."

What might this look like? If we had any say, it would include a foreign assistance framework that exemplifies a commitment toward incorporating asset-building policies and initiatives. Be this in the form of child development accounts for education and health purposes, conditional cash transfer programs, or opportunities for microenterprise development, the time is ripe for a U.S. foreign assistance strategy that takes into consideration the crucial nature of accumulating assets in enhancing the well-being of the poor. Should President-elect Obama, through the work of his Secretary of State, embrace asset-building strategies as a part of his foreign assistance framework, his already historic election could prove to be path-breaking in more ways than one.

Camp 'No on 8'

Joe Mathews — Thu, 08 Jan 2009 23:27:00 -0500

The Courage Campaign, a progressive web site and organization in California, is inviting supporters of same-sex marriage to attend the first "Camp Courage" in Los Angeles later this month. What kind of camp is this? It's a camp for training people to organize to repeal Prop 8 and secure marriage equality for gay couples. It may sound a bit strange, but it's exactly the sort of planning and organizing that same-sex marriage supporters need to be doing. The camp concept appears to be modeled on the so-called "Camp Obamas," the weekend training sessions that the Obama conducted to turn volunteers into organizers.

Panetta's Departure Could Be Blow to California Reform

Joe Mathews — Mon, 05 Jan 2009 20:27:00 -0500

Unintentionally, Barack Obama may have delivered a blow to political reform in California. Various news reports say former Congressman and Clinton chief of staff Leon Panetta is Obama's pick for CIA director. In California, Panetta has been a leading voice for budget and political reform, most recently as the leader of the reform coalition California Forward. 2009 has been shaping up as a year for reform, as various groups try to capitalize on the state's budget crisis and political stalemates to push big ideas (including the possibility of a constitutional convention). For those folks, losing Panetta is not good news. He can't be easily replaced.

How Should Obama Invest $10 Billion in Early Education?

Sara Mead — Sun, 28 Dec 2008 21:09:00 -0500

I tackle the question in today's Washington Times:

Advocates for early childhood education are understandably excited about their prospects under President-elect Barack Obama's administration. During the campaign, Mr. Obama pledged to increase federal early education spending by $10 billion annually.

Currently, the two largest federal early childhood programs, Head Start and the Child Care and Development Block Grant, spend about $12 billion annually combined. A $10 billion increase would almost double that investment.

Just as remarkably, Mr. Obama deliberately singled out early education as an important investment he would prioritize even in tight economic times. Add in a potentially $1 trillion economic stimulus package that's raising the prospects for even previously inconceivable public investments, and advocates are downright giddy.

It seems terribly Grinch-like to throw cold water on these hopes. But in fact this is a dangerous moment for both Mr. Obama and the early education movement.

If new early education investments are made too quickly - if funding gets ahead of capacity to deliver high-quality programs - the results will not live up to the high expectations advocates have created. Policymakers and the public could ultimately lose faith in early education, backtracking on investments. That would be tragic.

To prevent this outcome, the Obama administration must ensure that any new early education investments focus on quality, invest in capacity, and are integrated into a broader education reform agenda.

A substantial and compelling body of research demonstrates that high-quality early education programs have positive long-term effects on children's school performance, educational attainment and adult earnings. In other words, high-quality early education is an investment in our future economic growth. That new investment should come from the federal government.

Since 2002, states have more than doubled their spending on pre-kindergarten programs, fueling dramatic enrollment growth - even as federal investment has stagnated. Now, as the economic crisis puts increasing pressure on state budgets, it's time for Washington to step up.

But money alone isn't enough. The major lesson we should take from the past eight years of state pre-K experiences is that how policymakers design and implement early education investments is just as important as the money they spend.

States like New Jersey, which thoughtfully implemented high-quality pre-K in its highest-poverty school districts as part of a larger school reform agenda, have seen student achievement gains. Other states, which implemented large pre-K programs on the cheap with low standards, have not.

How can Mr. Obama ensure that new early education investments produce results?

First, he must ensure that all new early education investments focus on quality above all else. Research shows that early education has positive impacts on children's learning and lives - but only if early education programs are of high quality. Expanding access to poor quality pre-K or child care programs doesn't cut it.

Any new federal investment must be accompanied by strong quality standards that ensure states and providers use funds to deliver high-quality services that reflect what research tells us works to improve young children's learning. These standards must include small class sizes, qualified teachers, well-designed comprehensive curriculum, and ongoing monitoring of classroom quality and child outcomes.

Federal funds must also help build the state and local infrastructure needed to support quality early education - monitoring capacity, technical assistance, parent resources, and high-quality training and professional development for early childhood educators.

Equally important, Mr. Obama and his incoming secretary of education, Arne Duncan, must integrate new early education investments into their broader education reform agenda. Too often, federal policymakers address early childhood and K-12 education in separate policy silos. This artificial division undermines the effectiveness of both early education and school reform efforts.

Consider: The No Child Left Behind Act seeks to narrow achievement gaps for low-income and minority children. Yet research shows that as much as half of the achievement gap between disadvantaged children and their peers already exists before first grade. If we are serious about narrowing achievement gaps, expanding access to high-quality early education - particularly for disadvantaged youngsters - must be part of the education reform agenda.

At the same time, evidence shows that the benefits of even high-quality pre-K programs can fade out over time if children go on to poorly performing public schools. Therefore, public schooling reforms are critical to maximize the long-term impact of early childhood investments. Simply put, we must also focus on improving the quality of the elementary grades so precious pre-K gains aren't lost.

The Obama administration must treat new early education investments not as ends in themselves, but as the starting place for a high-quality, aligned system of pre-K to third grade education that ensures all children develop a solid foundation of math, reading and social skills by the end of third grade.

Fortunately, Mr. Duncan has a strong record of supporting early education and pre-K to third grade reforms in Chicago, which should prepare him to integrate new early education investments with the administration's larger education reform agenda.

To ensure the effectiveness of new early education investments, the Obama administration must resist the temptation to cram early education spending into the stimulus bill. That doesn't mean early education has no place in the stimulus: School construction funding - including money to improve and expand early education facilities - is a good idea.

Congress should also increase child care funding to ensure that financially strained families can continue to access the affordable care they need to work.

But beyond these emergency measures, Mr. Obama must take a long view on early education. Focus on quality. Build state and local capacity before expanding services. Integrate early education into a broader education reform agenda.

This is a more challenging approach - both as policy and as politics - than simply pouring money into the system. But, in the long-run, it's the only way to ensure early childhood investments really achieve our ultimate goal: better outcomes for our nation's children and the adults they will become.

So there.

Obama's Early Education Opportunity

Sara Mead — Wed, 17 Dec 2008 15:38:00 -0500

Big front pages NYT article today looks at the palpable excitement within the early education community about President-elect Barack Obama's support for early education, and the ambitious agenda he put forward for early childhood investments during the campaign. The article's a big win for early childhood advocates, but it's also a bit diappointing from an analytical perspective. Although the NYT's Sam Dillon offers some interesting glimpses into the forces that influenced Mr. Obama's support for early education, there's nothing here that will be news to EarlyEdWatch readers, and the article touches only tangentially on some of the tougher policy questions that any effort to enact or implement these proposals will have to deal with: How will new investments interact with existing early childhood programs and funding streams, such as Head Start? What kinds of quality controls and state-level accountability can be incorporated into new federal investments to ensure that states are using them in ways that actually improve outcomes for kids? How can states ensure quality in early education services across a network of diverse providers? If we're talking about a federal role in fostering the development of systems of early care and education at the state and local level, what should those systems look like? How will new investments be integrated into broader school reform goals to ensure that benefits of quality early education are maintained and leveraged as children progress through their schooling? These are important questions that shouldn't be glossed over in the excitement about the potential of new resources for early education.

After eight years of stagnant or declining federal funding for early childhood, and a tremendous vacuum of federal leadership on this issue, the early childhood community is understandably excited about the higher profile the Obama administration seems poised to give early education issues. And this really does seem to be an opportune time for advancing a much stronger federal role in supporting access to high-quality early education. But the fact that there is a tremendous opportunity to do good for early education now also means there's a substantial risk that opportunity could be squandered. If we are not careful in the policy choices we make about new early education investments, if we pour money into the existing non-system without first building the infrastructure and capacity needed to ensure that money goes to quality, these new investments could easily be wasted. That's one reason that Early Ed Watch has argued against rushing to include early education funding in the stimulus package--tempting as that possibility may be.

It's important to ensure that new federal early education investments are well thought out, that they fund quality and build the state level capacity and infrastructure needed to ensure high-quality programs. It's equally important that any new federal early education investments be integrated into a broader vision and agenda for education reform--from early childhood through higher education--that addresses our dual national needs to narrow achievement gaps and raise overall student performance and attainment. Until we break down the false divide that now exists between early education and K-12, we're likely to see energy and resources wasted in both sectors, as they proceed on separate tracks without heeding the lessons to be learned from one another. And we're unlikely to see the outcomes that both education reformers and early childhood advocates promise their favored policies will deliver.

President-elect Obama and Secretary designee Duncan have an important opportunity to improve early education quality, access, and alignment, and in doing so to improve outcomes for a generation of American children. Let's hope that the understandable excitement that exists about this opportunity doesn't end up becoming an obstacle to their ability to do so in a well-designed, thoughtful, and effective fashion.

Obama Used To Make Case for Tax Hikes In California

Joe Mathews — Mon, 01 Dec 2008 17:41:00 -0500

In this new ad, from the California state council of SEIU, the country's largest union, clips from President-elect Obama's speeches are juxtaposed with arguments that Sacramento must change and provide revenues to support state spending on education and health. It's an indirect way of using Obama to argue for state tax hikes. One wonders if the president elect, who ran on a pledge to cut taxes for most Americans, appreciates being used to make the case for tax increases here.

Call It America

Terry Tamminen — Wed, 12 Nov 2008 17:09:00 -0500

The day after Barack Obama was elected as our next President, Ethan Bronner wrote in the New York Times...

"There is a country out there where tens of millions of white Christians, voting freely, select as their leader a black man of modest origin, the son of a Muslim. There is a place on Earth - - call it America - - where such a thing happens."

No matter who we supported in the election, I suspect that now each of us feels pride that our nation overcame its past and dared to reinvent its future. But in sending Mr. Obama to the White House, we did more than send "a black man of modest origin" - - we sent ourselves. Like Jimmy Stewart in "Mr. Smith Goes to Washington" we sent a man that has some part in him that resembles something good and constructive in each one of us.

So why not go beyond metaphor and actually send ourselves to Washington? Given the economic crisis and the imposing challenges ahead - - from climate change to a widening gulf between haves and have-nots - - now is the time to answer the question posed to a nation more than four decades ago. Knowing that he will find his own soaring and inspirational rhetoric, I doubt Mr. Obama will repeat John Kennedy's challenge, but it's hard not to hear those words like a song we can't get out of our heads - - "Ask not what your country can do for you. Ask what you can do for your country."

So let's "go to Washington" with our new President by offering a literal answer to that question this time. If every American and every business volunteered to do one thing to make our communities safer, more prosperous, and more equitable, that would equate to over 300 million contributions to a better America. We could commit to spend a few hours a week helping out at a local school or senior center; we could pound nails for groups like Habitat for Humanity; we could adopt a classroom and help teachers get supplies and extra books; we could pledge a small % of our profits to charities that do many of these things for us.

If each of us does one small thing, to quote another great President "the world will little note nor long remember what we say here." But the impact of those contributions will amount to more than any bailout plan Congress or our new President could devise. We will work our way out of the current challenges, economic and otherwise, much faster and with much more hope and joy in our hearts than by waiting timidly for Washington to do it all for us.

In the end, we will remind the world that is indeed America..."where such a thing happens."