05/22/2010 05:12 am ET Updated May 25, 2011

Health Reform Post-Mortem

A post-mortem, in the medical sense, is when you carve up a body to figure out why it died. But the term has migrated into the patois of American business, where (in corporate terms) a post-mortem is a meeting held after the completion of a project, where you review the course of the project from beginning to end. You look at what went right, and what went wrong, and then you try to improve the procedure for future projects, in an effort to avoid making the same mistakes over again. Now that fight for health reform legislation (in one form or another) is just about over, I feel it's time to take a look back, and identify some areas for improvement for the future Democratic legislation.

So, in no particular order (I jotted most of these down while waiting for the vote to be announced last night), here are a few problem areas Democrats need to work on so that (in future) we won't have to go through the same tortuous process health reform just did. I offer these up as constructive criticism, to strengthen the Democratic Party, President Obama, and the chances for enacting more of the "change" we were promised.

Before I begin, I need to define one bit of terminology, or one metaphor I'll be using. Like a pregnancy, I'm dividing the legislative process into trimesters here. The "early game" of passing legislation is defining it and writing it in the congressional committees. The "middle game" is getting it through the committees, and all the various votes necessary to pass both houses. And the "end game" is when the real bill is hammered out between the two houses of Congress, and the White House. Now, I'm not suggesting every piece of legislation should take nine months, since bills can move faster than that at times (although, with health reform, nine months would have actually been quicker). But enough of this defining of terms. Let's get on with the post-mortem-ing instead.


End the endless bipartisanship

President Obama actually believes in bipartisanship. He campaigned on it, and he bends over backwards to try to get Republicans on board. But, as we saw, this can lead to Republicans "playing" the president for time -- dragging negotiations out endlessly in an effort to kill them altogether. It's not just Obama who is susceptible to this tactic, either (remember the months of Max Baucus?).

Bipartisanship needs to be tried early, and very publicly. Bring in the television cameras and meet with Republicans in the early parts of the process. But let everyone know that there's a deadline for negotiations. Clearly state: "We've got to get something done, we'll do it with your help, but beyond our deadline, we will do it on our own."

There was entirely too much "middle game" -- which almost killed the health reform effort off entirely. This was due to nobody putting their foot down. Ideally, President Obama should be the one attempting to do so. Obama, and Harry Reid (for that matter), need to show some spine in the middle of the legislative game, so things don't get completely out of control (as they almost did last summer and fall, and then again in January).


Don't squelch Obama in the middle game

This White House apparently over-learned the lesson of Bill Clinton's health reform defeat. Clinton had big meetings on his own, wrote his own plan (with Hillary's help), and presented it to Congress as a fait accompli for them to rubber-stamp. They declined to do so, and Clinton's bill never even made it out of committee.

Obama figured he'd go the complete opposite route -- suggest to Congress a list of goals, and then sit back and let them do the actual drafting of the bill. Which included the early game, the middle game, and part of the late game. Obama's White House largely kept above the fray in the raging debates over different provisions and ideas. Maybe they figured that politically it was safer not to push any one proposal, because then at the end of it, Obama would never have to see anything he wanted "defeated" in the final bill. No political defeats, and at the end Obama could claim credit for the bill without the tarnish of unmet goals.

This is political cowardice, and it needs to be fixed. President Obama can keep out of the early game (it is, after all, Congress' responsibility to write laws), but when things bog down in the middle game, he's got to act as a referee and draw some lines in the sand. If things must be thrown overboard, it is a lot better to do it early and decisively than it is to let false hopes grow among your own supporters, only to be quashed at the last minute.

This also would have allowed Obama an opportunity to answer back all the town hall fervor (and lies), and not let them seep in to the public unchallenged. Since Obama remained aloof at this key juncture, with no particular plan of his own to champion, his opponents won the public "framing" debate, which led to a gradual slide in popularity for what Democrats were attempting to do.


Pay more attention to the polls

Of course, politicians always say "I don't look at the polls," but they all do. Unfortunately, Obama and his team didn't read the correct message from the polls. His slipping approval numbers during the health reform debate, and the slipping approval for the plan being hammered out was due to two major factors. The first was that the Republicans were winning the "messaging" war on the issue. Obama simply wasn't getting his message out, and neither were congressional Democrats, for the most part. Framing your message correctly helps you gain public support for your plan. Obama is reportedly going to do a public relations blitz in the next few weeks to "sell" what just passed to the public. But if he had done so in about September or October, it could have made a bigger difference.

The second major factor in the slipping support was not readily identified in most polls, because they simply weren't asking the right questions. Because a lot of people "against" the proposals in Congress were against them because they didn't go far enough. Supporters of single-payer and the public option just threw up their hands in disgust at some point along the way, and washed their hands of the entire mess. But the pollsters didn't have a box to check for "against it because it goes too far" versus "against it because it doesn't go far enough." This is easily rectified -- commission your own polls, and get them to ask the right questions.

Politicians shouldn't allow opinion polls to totally dictate what they should or shouldn't do with a piece of legislation, but they do need to understand the mood of the public in order to gain support for what they're doing, and to understand the consequences in that public opinion for compromising or not compromising on any individual idea. The poll numbers now show how the Democrats failed in this regard -- when pollsters ask whether people now support the bill or not, support is around 40 percent. But when pollsters ask about each individual item in the bill, support spikes upwards. This shows a failure of communication by the Democrats.


Stop picking fights with the base

It's not so much that the Democratic base or the Left didn't get exactly what they wanted, it was more the way it was handled. The White House -- Rahm Emanuel in particular -- and some congressional leaders showed open, naked contempt for the wishes of a huge amount of their own supporters. Even now, after legislation has been passed, many of Obama's initial supporters feel pretty downright ambivalent (or worse) about the entire process. These feelings wouldn't be as bad if occasionally Obama would have fought for specific goals against the Republicans, instead of dragging out the "let's be bipartisan" process long past when it had the chance to accomplish anything. And instead of always fighting so hard against his own party's base.


Toot your own horn

Instead of forever being defined by their opponents, Democrats have simply got to learn to play offense in the marketplace of ideas, instead of always joining the verbal battle in a defensive crouch. At the beginning of the process, define your goals and then repeat as a soundbite until everyone "knows" it is true: "We Democrats are for X, Y, and Z. Republicans are against these fine ideas."

Also, while Obama did do this at the end of the process, from the very beginning, personalize the storyline. Pick a poster child, and say you're fighting to make his or her life better. Republicans are fighting to keep her in misery. Paint this one with broad strokes, and make the Republicans play defense, for once. Define the Republicans as being "on the wrong side of history, and on the wrong side of public opinion."


Inspire some fear

I've seen a number of articles over the past four of five months which make the point: nobody's afraid of Obama. This political calculus may have changed a bit, now that the House has voted, but the perception on Capitol Hill for the most part is that the White House will fold rather than fight for what they want in a legislative scuffle. Democrats aren't afraid of Obama vetoing anything, or afraid of Obama's ability to sway public support. Republicans aren't afraid of any negative consequences for opposing him.

Like I said, this perception may be changing. President Obama can claim a truly important victory now, and with all the arm-twisting of late, the White House may be gaining new respect among Congressmen. And if Obama's poll numbers go back up, it could also change the equation.


More Debbie Wasserman-Schultz, please

House Chief Deputy Majority Whip Debbie Wasserman-Schultz needs to be on television during any important legislative debate. A lot more than she is now. She is one of the best and most natural debaters the Democrats have right now. She is sharp, she is feisty, she is always prepared, and she knows what to say and how to say it. On a bad day, she is better than most Democrats in countering nonsense from Republicans, and on a good day she leaves behind her nothing but the tiny shreds of credibility of any Republicans who face her. When she's on top of her game, she can absolutely eviscerate opponents in interviews, on each and every point.

So. please, let's put her on the Sunday morning shows every chance we get.


No special deals

This one will be the toughest one to keep, because it truly is "business as usual" in Washington. Congress -- no matter which party is in control -- is notorious for such back-scratching deals as the "Cornhusker Kickback" (and all the rest of the cutesy names Republicans came up with). They happen all the time. It's how bills get passed. It's a fact of life on Capitol Hill -- from Democrats and Republicans.

But Republicans have shown how effective they can be in shining the spotlight of shame on the practice. In this case, they're blatant hypocrites, but they're also right. They've never done business any other way, but they still have a point about what a messy business it is.

Democrats, if they were smart, would loudly and publicly forswear such deal-making, and challenge the Republicans to live up to the same high standard. It takes away a powerful argument against your legislation, which is nothing more than a distraction from what you are trying to do.

I realize this one is likely asking too much of politicians, but it certainly would help in the court of public opinion to just voluntarily ban the practice. Or, at the very least, don't be so blatant about it when it happens.



President Obama, and Democrats in Congress, have achieved a very historic legislative victory. But I don't think anyone would say that it couldn't have been a better bill, or that the process it took couldn't have been improved upon.

Democrats have the rest of this year to get more of their agenda passed. But that is less than ten months now, and the election is even closer than that. In order to get anything done this year, things are going to have to move a lot faster than health reform moved. The pace has to be stepped up from "glacial."

To achieve this, define the goals earlier in the game. Forcefully defend these goals to the public -- make your own case, not your opponent's. Let Republicans know that there will be a time for bipartisan hand-reaching across the aisle, but that there's a window of time for such discussions. After that window closes, move forward anyway. Shorten the middle game. In the middle game, Obama needs to put his markers on the table instead of sitting it out. Get Obama out on the bully pulpit trail to get to the end game a lot faster. Fight for a few things which please the party's base (and don't insult them, even if you have to compromise). Swear off the deal-making. Communicate to the public better, and pay attention to the public's reaction. Make your case as best you can, and often. Tell the public why you're doing what you're doing, passionately. If you win the battle for public opinion, the battle within Congress will be a lot easier to win as well.

And, of course, more Debbie Wasserman-Schultz, please.


Chris Weigant blogs at:

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