THE BLOG
07/26/2009 02:56 pm ET | Updated May 25, 2011

Debate on Health Care Is More About Politics Than Policy

Health care for all raises a series of fascinating questions.

Why does health care tend to poll better in theory and declines as it becomes closer to fruition? Why does America struggle with an issue that is fait accompli in other industrialized nations?

Why have presidential administrations dating back to 1935 offered the Utopian dream of affordable health care for every man, woman, and child only to have those efforts thwarted by the opposition?

Representing an estimated 15 percent of the economy, the health care industry is a fragmented behemoth consisting of, but not limited to, hospitals, HMOs, physicians, and pharmaceutical companies. Though they possess a variety of interests, many are galvanized in opposition to any new health care legislation and dedicated to maintaining the status quo that they are the ultimate benefactors.

The other problem that has plagued health care as an issue is cost. There are the upfront cost, currently estimated at $1.3 trillion; and if those costs cannot be controlled then there is the problem of health care inflation. Therefore, the possibility of a $1.3 trillion government program spiraling out of control is unfathomable.

Another aspect making health care legislation so challenging is what I define as an "intangible-tangible." It is an intangible until one becomes ill or hurt. At that point, health care becomes a tangible item -- assuming one has it.

The services that we receive are tangible, but the way health care is usually paid for tends to be intangible in the sense that it does not come directly out of pocket. Most of the debate is conducted while health care is in the intangible stage.

It is tough for President Barack Obama to make the "what's in it for me" argument needed to sway a majority of Americans to his side, especially since there has yet to be a clearly defined piece of legislation put forth.

It is difficult to expect a majority of Americans to support legislation that has yet to arrive, already expected to cost a daunting $1.3 trillion. But the $1.3 trillion cost is based on a 10-year period, making the projected health care cost on an annual basis on par with the cost America is currently spending on war. The differences being the cost associated with war are borrowed dollars. Any proposed health care legislation, as the president has already stated, must responsibly control cost, expand coverage, and provide choice.

Though cost is often discussed, it is not ultimately what the health care debate is about -- at least in the public conversation. To be sure, there are myriad public policy aspects to this legislation, some are quite complicated, but that's not driving the debate on Capitol Hill.

When Republican Sen. Jim DeMint of South Carolina stated in an e-mail: "If we're able to stop Obama on this, it will be his Waterloo. It will break him," it became the most accurate barometer for the political health care debate.

At last week's press conference the president suggested the health care debate was not about him. I disagree; it is definitely about him.

DeMint's comments were not about the 47 million people who don't have health care; it was about stopping the president's agenda.

If stopping Obama on health care would be his Waterloo, would it also be fair to conclude the passage of health care would be the Republicans' Waterloo?

If President Obama were successful on health care, he would have accomplished something that was beyond the reach of Presidents Roosevelt, Truman, Johnson, Carter, and Clinton. He would have ushered in the most significant domestic legislation since Roosevelt signed the Social Security Act in 1935.

Social Security helped Democrats become the dominate political party for more than a generation, are not the same stakes at play if the president signs health care legislation that meets his criteria of cost, coverage, and choice?

As a result, the GOP is forced to advocate for a status quo that has its own spiraling cost that leaves out 47 million individuals, by using the primordial tactics of fear.

Seldom, in American history, has the use of fear to sway public opinion in the short-term proven to serve the public interest in the long-term. Unfortunately for the Republican Party, as the old Texas saying goes: "You dance with who brung ya!"

Byron Williams is an Oakland pastor and syndicated columnist and blog-talk radio host. He is the author of Strip Mall Patriotism: Moral Reflections of the Iraq War. E-mail him at byron@byronspeaks.com or visit his website: byronspeaks.com