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Checking In With Linda Douglass

Linda Douglass spent three decades as a television news reporter in California and Washington before joining the Obama administration. In May, she was named communications director of the White House Office of Health Reform, which was established by the administration to coordinate and develop reform policy and outreach efforts among different government departments and agencies. Among the efforts is a Web site, Reality Check, to explain the issues from the adminstration’s perspective and counter complaints about the proposed plan.

When she was with CBS News in Washington in the early 1990s, Douglass covered failed efforts to overhaul the country’s health care system. Now, she’s leading the public relations effort at the White House to make sure the same thing doesn’t happen to President Barack Obama’s plan.

Douglass, who also worked on Obama’s presidential campaign, talked by phone on Tuesday with KFF Health News’s Phil Galewitz. Here are the edited excerpts:

Q: Polls show about two-thirds of Americans don’t understand the health overhaul plan. How is the administration doing explaining its proposed changes?

A: I covered President Clinton’s health reform plan and have certainly seen this genre movie play out before where you have an array of interest groups do everything they can to cloud the picture and spread misinformation and that’s certainly what happened with the bizarre death panels and concentrated misinformation campaign. Health care is complex and is one-sixth of the economy and is deeply personal. 

It was inevitable that when we got to the point of moving to a discussion of mechanism versus fundamentals that the opponents of health reform would do what they are doing.

But what the president did (Sept. 9) with skill and effectiveness in his address to Congress was bring the discussion back to its basic components, which is the status quo cannot continue along with unfair insurance practices and the rate of growth of health spending. It is crushing families and government and it is incumbent on us to finally act on this problem. It’s always a challenge to break through the noise, but I think the president is succeeding.

Q: Are the many speeches around the country by President Obama, Vice President Joe Biden and other members of the administration having an effect on changing Americans’ views toward health overhaul or do you think most Americans already have their minds made up?

A: I don’t think everyone’s mind is made up. I don’t think that at all. I think people are curious because it affects them so much and people have vivid experiences with rising costs or being denied insurance with preexisting conditions that I don’t believe that all minds are made up. The magnitude of the problem facing the country and individual families rings true to people and they are very curious and want to know the answers.

Q: The president has talked about shared responsibility but in the health overhaul package released by Senate Finance Committee Chairman Max Baucus, employers with more than 50 workers who don’t provide coverage would only pay a $400 a year per employee penalty – one tenth the cost of an average individual health insurance policy?

A: This is evolving, and I think as part of shared responsibility it is important for employers to do their part and provide coverage for employees and build on the employer-based system. The employer’s role in providing coverage is crucial.

Q: The White House made deals with the hospital and pharmaceutical industries this summer to build momentum for the overhaul, but why haven’t you reached an agreement with the insurance industry?

A: I can’t say whether overtures were made. The health insurers joined with other groups at the White House in May who said they believed there were substantial savings that could be achieved and they would do their part and rein in costs to the tune of $2 trillion.

It has been very important to the whole health reform effort that some folks in the industry come to the table to do their part. The $80 billion from the pharmaceutical industry and $155 billion from the hospitals are substantial contributions to lower costs for all Americans.

Q: Does the president’s plan do enough to slow rising costs?

A: One of the crucial centerpieces of the plan is that it brings more choice and competition to the marketplace through the exchanges where those who don’t have health insurance and those who buy on their own can have access to affordable options. Competition will help to lower costs. There are steps taken in the Medicare program to begin to lower costs by providing better care and more efficient care such as reducing hospital readmissions. There are programs to coordinate care such as (pilots programs for) accountable care organizations or medical homes that can produce better care. The president believes providing incentives for preventive care will produce healthier people and savings in Medicare.

Q: Why do you think the outcome for national health reform will be different this time than in 1994?

A: It’s a different time. The costs of health care premiums has more than doubled in the past decade, rising three times faster than wages and people know an increasing percentage of their salary is going to pay health costs. So the landscape has changed in the past 16 years. The option of doing nothing is much more politically risky for everyone involved.