Thursday, December 17, 2009

Health-care reform in prose, not poetry -- Dec. 17, 2009 column


Leave it to the sausage-makers in Washington to labor for months and produce a hot dog nobody wants.

Once hungry for meaty health-care reform, many Americans have lost their appetite for the junk food the Senate is concocting. A Wall Street Journal-NBC News poll released Thursday found that 44 percent of those surveyed now favor keeping the current health-care system, and 41 percent favor passing an overhaul.

In March, as President Barack Obama launched reform with a forum at the White House, nearly three-fourths of Americans supported government efforts to remake the health-care system, polls reported. What happened?

The heart of the problem is that Obama lost the war of words. Remember what former New York Gov. Mario Cuomo said, “We campaign in poetry. We govern in prose.”

Candidate Obama made many people eager for health-care reform with populist poetry about universal coverage, more choices, lower costs and an open process of drafting reform.

Here’s Obama at a town hall in Chester, Va., in August 2008, "I'm going to have all the negotiations around a big table. We'll have doctors and nurses and hospital administrators. Insurance companies, drug companies -- they'll get a seat at the table, they just won't be able to buy every chair.

“But what we will do is, we'll have the negotiations televised on C-SPAN, so that people can see who is making arguments on behalf of their constituents, and who are making arguments on behalf of the drug companies or the insurance companies. And so, that approach, I think is what is going to allow people to stay involved in this process," he said.

The reality was far different. After the televised kick-off event, reform negotiations moved to back rooms. That gave Obama’s foes plenty of time to warn about a government takeover of health care, socialism and death panels. Summer brought vociferous critics to congressional town hall meetings. And just this month, a few cranky senators dictated substantial changes that turned off progressives.

Gone from the Senate bill are universal coverage, cost-containment measures and lower drug prices through importation. A public option or another plan to compete with the insurance companies? Nope. Allowing those 55 and over to buy into Medicare? That’s gone too.

Obama was determined not to be Bill Clinton, who presented a fully formed health-care plan that critics picked apart, that he failed to stake out essentials for Congress to include in a final bill. Obama wanted bipartisan support, but Republicans rebuffed him.

The thorniest issue was always cost. Obama said he could pay for the overhaul without raising taxes for anyone making less than $250,000. This led to a vague plan to cut $500 billion from Medicare – without, he said, harming seniors’ medical care.

Many seniors didn’t believe it possible, and congressional Republicans ratcheted up fear with talk of rationing and pulling the plug on grandma.

Progressives and liberals were enraged when Sen. Joseph Lieberman, I-Conn., demanded an end to the public option and the Medicare buy-in provision.

Howard Dean wrote in an op-ed in the Washington Post Thursday, “I know health reform when I see it, and there isn’t much left in the Senate bill.”

Dean, a former governor of Vermont, presidential candidate and Democratic national chairman, wants Congress to start over.

But if Obama could not make the case this year that the country would be better off after reform, it’s hard to see how a delay would help the argument.

“We are on the precipice” of health-care change, he said after a meeting with Senate Democrats at the White House the other day. His critics gleefully agreed that the country is on a cliff, about to leap into the abyss.

Obama signaled he’s also ready to use fear, warning in an interview with ABC’s Charlie Gibson that if Congress fails to act, individual premiums will rise, employers will drop coverage and “the federal government will go bankrupt.”

The Senate may yet pass something. A Senate-House conference committee could restore some of the meaty provisions in a compromise bill and send it to the White House. Obama will declare an historic victory. He’ll tout the triumph in his State of the Union address.

But he’ll be speaking in prose, not poetry.

© 2009 Marsha Mercer. All rights reserved.

1 comment:

  1. Your column is on the mark. Obama care is a mess. I can't believe the Senate will be asked to vote on a bill that is murky at best. We can do better, be it prose or poetry -health care reform must be clear as to who gains and who pays.