On Healthcare, Obama Needs More Drama

Given all the vocal fear that has spread throughout the national healthcare debate, I was surprised by the virtual absence of emotion in President Obama's press conference performance yesterday.  As a candidate, his speeches about "change" were so powerful that they spawned a pop culture industry.  And yet, now that he is president and talking healthcare "change" -- a national policy that will end the daily suffering and humiliation of tens of millions of Americans -- Obama's rhetorical passion has been displaced by the soporific drone of a mid-grade federal accountant.  Where is the passion, Mr. President?

I bring up the question of "passion" because the facts that Obama presented to the nation in his press conference were ghastly and shameful:  47,000,000 Americans without healthcare coverage, 14,000 people losing their health insurance every day, dozens of letters each day from parents with children who are dying from cancer and cannot get treatment. The combined level of human pain and anguish hidden in those statistics should be enough to make anyone tear out their own eyes, let alone raise their voice.  Instead, the president gave us this:

This is not just about the 47 million Americans who don't have any health insurance at all. Reform is about every American who has ever feared that they may lose their coverage if they become too sick, or lose their job, or change their job. It's about every small business that has been forced to lay off employees or cut back on their coverage because it became too expensive. And it's about the fact that the biggest driving force behind our federal deficit is the skyrocketing cost of Medicare and Medicaid. (link)

It was dull stuff.  Ho, hum at best.

OK, sure.  Health care reform is about all those things the president described.  The cost of inaction is greater than the cost of action, true.  I agree.  But healthcare reform is also about:  the infuriating inhumanity of the current system all! 

People are living lives in fear -- children are dying, for goodness sakes.  This is about injustice and the anger that tens of millions of people have been trapped in lives of fear as a result of  health insurance business model that Congress has been too cowardly to confront for decades. And this is about the very real, very legitimate fears that people have as a result of thinking about the social and cultural shift that will result from having a public healthcare system that did not exist before.

These are legitimate fears, and people are talking passionately about them all over the country. 

What worries me about Obama's "no drama" approach to the healthcare debate is not that he simply refuses to raise his voice when necessary.  The problem is that most Americans are engaged in a deeply passionate argument about this issue, but when we tuned in to the President's press conference, it was as if the President was completely outside those emotions. 

Obama's words seemed to be governed by the logic of balance sheets rather than the emotion of lives in the balance.

What are the emotions in the healthcare debate? They seem to fall into three main topics: denial, access, and money.

Tens of millions of Americans are outraged by the current culture of health insurance coverage and claim denial to the point that they can no longer speak in a reasonable tone about the issue.  While there are 47,000,000 people without insurance in this country, I would hazard a conservative guess that there are at least that many people each year who have legitimate health insurance claims denied each year.  These people are sick and tired of being fleeced by a system that makes them pay up front only to be denied coverage when they need it. They are shouting at the top of their lungs about healthcare reform.

But they are not the only people raising their voices.

There are also millions of people who are truly afraid that a new healthcare system dominated by a big public competitor will suddenly make it very difficult to see the doctors and get the procedures they need.  These people are very concerned about having to wait months just to see, for example, a kidney doctor should they need one.  They are scared to death about rumors they hear about other national healthcare systems where people die waiting for procedures that people with insurance in the U.S. get without waiting.  These people are sick and tired of being told that everything will work out fine for them in the new system without being told how it will work.  They are shouting at the top of their lungs about healthcare reform.

But they are not the only people raising their voices.

There are also millions of people who are truly worried that a new public option will bankrupt the United States government, leading to public deficits that will undercut any chance we have at a better life from better health insurance. These people are very concerned that the new public approach to healthcare will be a failed program like some of the over budget, overly bureaucratic failed public programs in the past.  They believe that a public option will just lead to the healthcare equivalent of million dollar wrenches and thousand dollar washers -- the sort of government spending horror stories we used to hear so often.  These people are sick and tired of being told that the new system will not cost any more money than we are already spending.  They are shouting at the top of their lungs about healthcare reform.

Now, given all this shouting, the White House seems to believe that the best way for the President to chart a path through the noise is to focus on the relative cost effectiveness of reform versus the continued high cost of inaction. 

The White House has chosen, in other words, to turn the Commander in Chief into the Accountant in Chief.

Bad decision.  Very bad decision.

Listening to the President roll out massive, tangled descriptions of one set of expenditures "incentivizing" the cost differential of a second set of expenditures was the political equivalent of clipping off a birds wings and then pushing it out of plane and telling it to fly.

Obama's single greatest strength as a politician has been his ability to speak in such a way that it makes Americans feel that we are soaring to new heights together.

Franklin Roosevelt had that gift.  John Kennedy had that gift.  And Barack Obama has that gift, too.  and needs to use it.

To find his passion again, this is where I suggest President Obama start: with his own words.

About midway through his press conference, the president was asked why he was in such a hurry to pass healthcare reform, to which he said the following:

I'm rushed because I get letters every day from families that are being clobbered by health care costs. And they ask me, "Can you help?"

So I've got a middle-aged couple that will write me and they say, "Our daughter just found out she's got leukemia and, if I don't do something soon, we just either are going to go bankrupt or we're not going to be able to provide our daughter with the care that she needs."

And in a country like ours, that's not right.

That is the scenario on which a passionate appeals to a caring nation can be built.  Helping parents provide care for their children and protect them from the injustices of the healthcare system -- that is the essence of a passionate approach to the kind of reform we need.

And then, having set the stage with real voices expressing real concern, the president should drop the accounting rhetoric and state simply how much each of us can expect to have deducted from our paychecks to pay for healthcare coverage: 2 percent of our take home pay?  3 percent? 5 percent? 

Just tell us.

And then tell us what kind of social and cultural change we can expect in our experience of healthcare. If we take the new public option, will we be able to go to our current doctor or will there be new clinics and new doctors we need to see?

Just tell us.

Even if all  the details are not in place, yet:  just tell us the basics. 

The president needs to lay out the principled, passionate reason why we need healthcare reform, and then he needs to answer the few big questions that everybody wants to hear.

When it comes to healthcare reform, we need more drama, not less drama, from Obama.

Follow Jeffrey Feldman on Twitter: www.twitter.com/JeffreyFeldman

Comments

[squirrealistpainting]

The problem with Democrats is that they think that if they give people the facts in just the right, educational way, that, somehow, the people they need to convince most (i.e. the mighty swaths of ignorant throughout the land), will suddenly have the introspection or intelligence to have a breakthrough moment of enlightenment. Sadly, not so. These people can only be convinced with fear, and the Republicans know this. In addition to their relentless campaign of misinformation, they're not afraid to stoop to such sleaze as telling old people that Obama's plan means that "the government will send someone to your house and make you sign something telling them how you want to DIE before you can get coverage,"

So, if the Dems want to turn the tide of this debate in their favor, they should stay on message about how catastrophic the continuation of our current private health insurance system will be. I know it's icky, but saying something like "If Grandma has had breast cancer, private health insurers can easily deny her any coverage at all for her preexisting condition, and she could die. Or, if she can get coverage, it could be so expensive that she'd go bankrupt." They need to push the message that the private insurance industry doesn't care about helping people with their health; they care only about making a profit.

Repugs have the dissemination of BS down pat, but Dems are too unwilling to learn from their techniques.

[johnashman]

Please back up this comment -

"While there are 47,000,000 people without insurance in this country, I would hazard a conservative guess that there are at least that many people each year who have legitimate health insurance claims denied each year. "

Over 47,000,000 people are denied health insurance claims? Come on. We clearly need LESS drama, thank you.

[hsr0601]

The House leaders reached a deal on Medicare payments: A "Pay for Value" reimbursement system that rewards doctors and hospitals that achieve the best outcomes at the lowest cost.

As a result, The House gained a lot of votes, a lot of people who were withholding support.

The federal Medicare program insures some 44 million elderly and disabled Americans at an annual cost of $450 billion, almost one-fifth of total U.S. health care spending.

Supporters of the agreement say it could save the Medicare System more than $100 billion a year and improve care, that means $1trillian over a decade.

No one can disagree with this best outcome / evidence-based system, and private insurance, too, will be greatly influenced by this change with the focus on value over volume.

THANK YOU !

[Lemastre]

Mr Obama can't sell me on any plan unless he details what it is. He won't detail a health plan, probably because he fears that if it loses, he'll be identified with a loser. Well, that will be the case regardless of who concocts the plan that passes during his administration. I've been hoping that before the lobbyists' plan for enlarging the private sector's hold on our health is presented by Congress, he will get a single-payer, federal plan on the table.

[PigLipstick]

Those $400 toilet seats and $1000 wrench's did'nt come from social spending programs, they came from a DOD purchasing system that has never had to justify a dime of what they requested from Congress. Another multi-billion dollar funding bill last week for Obama's Afghanistan war and no emotion was seen as Congress rubber stamped it.

The bailout of corrupt Wall Street Banks that played fast and loose with average people's money and the Congress rubber stamps billions and billions of bailout dollars to save the crooks while home owners were thrown into the streets without any support from a government who simply looked the other way while the gangsters plundered the economy. There wasn't much emotion for those average Americans.

Now most American's want a healthcare system where they can get a reasonable level of medical care without going into bankruptcy, and most of our elected government representatives become a deer in headlights. Let me remind everyone that they are not the government in a Democracy, we are !

[Arthur Crichlow]

I find most of the blogs on this topic outright hilarious. Obama should do this, Obama should do that. He needs more passion, he's doing to much, he's doing to little. yada, yada yada. It is easy to give your opinions, thats what we do best. everybody needs to ask this one question, How are you helping to push the discussion forward. This is not a dictatorship nor should it be, change management takes time, and this requires educating those you serve. Once you educate your target percentage, then you execute the change. Note this change will be 12 to 18 month and will note the first draft will not be perfect. Get informed, get involved and get working.

[Awake-and-Sing]

Since you describe this as "hilarious", the political naivety you espouse would be funny if it weren't so misguided.

We don't have 12-18 months to "move the discussion" forward. We have 2-3 months at the most.

2010 is an election year. Then the 2012 Presidential campaign starts. New Presidents have political capital in their first year.

It's either now or never for a significant overhaul.

Lots of delusional naive "new politics" types were advocating the President taking a few years to build "consensus" on this issue -- as if people really want to set aside their ideology and come together in a group hug, and as any elected politician would retain his political capital that long..

That's not the way politics works in the real world. Sorry to break the news to you.

[BobN1952]

What is missing here is the confidence when a patient walks into their doctors office that what he/she orders for this patient will take place. That no bureaucrat whether by an insurance company or government agency will countermand the orders and thinking of the physician is the primary objective of all patients. Unfortunately this occurs way too often and this patient-doctor relationship is no longer sacrosanct. This should be the primary goal of any health care reform bill out of Congress. Right now in Texas, Humana insurance is purging many of its doctors supposedly because they order too many tests for their patients. What kind of value does the patient have after paying for their premiums? No one seems to be interested in this. Are we missing the forrest for the trees?

[PaxEterna]

I think this editorial is spot on.

Obama has become part of the problem because he abandoned the people who elected him into office in favor of the power elite and the special interests.

If he had had the courage to come out for SINGLE PAYER instead of refusing to even consider it, he would have the majority of Americans and business behind him.

So, he started with a huge compromise which has gotten bigger and bigger. Maybe he is not passionate about the issue because he knows the outcome will be lackluster and he will be blamed, rightly, for lack of leadership.

Neither bill in Congress addresses the two-fold problem this nation faces: 1) equal coverage for all 2)controls on costs.

Starts in 2013, 97% not 100% covered, Congress exempt from public option if there is one.

What's to brag about?

[Awake-and-Sing]

I don't even need for Obama to have endorsed single-payer.

For me, the inexcusable act was excluding them from the table to even make their case.

Excluding single-payer advocates as a pre-condition to get the pharmaceutical and insurance industries and other conservatives at the table (AS IF that is even a meritorious goal in itself) was the nadir of the total failure that "new politics" has exposed itself to be as a governing strategy.

Single-payer advocates are not at all scared or nervous about arguing the merits of what they believe. Obstructing their ability to make their arguments has been part of this failed "new politics" strategy all along. To have been denied the chance to make their case was not just wrong, but a colossal error in judgment.

If single-payer advocates had been allowed to make their case, then the Presidents public, not-for-profit "option" would have been the natural compromise. And since the President continues to poke his base with a stick to prove how "centrist" he is, he is without the masses of volunteers who would provide the counterbalancing energy to overcome $1.4 million a day in corporate lobbying.

Even if we get a watered down public option, designed not to reduce corporate profits, which is probably the best case scenario left, historians will write books about a President who threw away his political capital on a naive, wimpy and ineffective governing strategy.

[blueken]

The Democrats better grow a spine and give us universal single payer health care, or I know one vote they will lose.

[Gewyne]

Only Democrats could take an issue that 70-80% of the public are in favour for and drag it out into what is being played in papers and media as a slowly losing issue becoming more and more stuck in the mud thats being slung so freely.

P.Obama should have spoken like he did at the NAAPC - lets the 1000's of people stood behind you deal witht he numbers - the Democrats are becoimg an embarassment on the health issue and their handling of it.

There is a Public option - it will be on the floor on "this date" - if you congressman or senator votes against this option, go talk to them.... they are acting against your interest.

[epiphany1234]

Careful Jeffrey -- Ed Schultz had the audacity to say Obama's press conference was lackluster and took a whollop in the blogs for it. Some even stated that a press conference was no place for drama......wha??? The people need a FORCEFUL defense of health care reform in this climate where Republicans are plotting the slow demise of "Obama-man­ia".....wh­ere they are chipping away at his "teflon" popularity with the goal of bringing on his Waterloo. This is ACTUALLY happening, and they see health care and his falling poll numbers and birthers and the recent "stupid" comment as the conduit to this end.

But oh, no, Mr President.­.....don't raise your voice on behalf of the people, on behalf of saving 22,000 unnecessary deaths annually. That would diminish his professor's armor after all...and of course we can't have that!

[toggan]

Part 2---Is he ill, maybe...I know I have a very bad cold...I hope it is not the swine flu...He has ignored all requests for him to do the leaning toward microphone speech with passion...Hasn't he? I know he is not expected to do this at a press conference, but can't he show a little energy? Put some faces of human suffering on this picture Obama!!! Stop reading your 10 letters daily someone else selected for you...Get out of your bubble...10 Letters...The average American? Do you really know about average Americans!!! I've got news for you, most people assume themselves average Americans. I ended my stream of consciousness questioning, muted my teevee, and waited for the Rachel Maddow Show. A breath of fresh air.

[toggan]

Part 1--- I have referred to Obama's lack of passion on Health Care Reform in the past. I was very disappointed with his press conference Wednesday. I started my stream of consciousness questioning: Hasn't he heard the collective voices of the people favoring strong Health Care Reform? Why is he addressing the affect on the middle class only? What about the working class? What about the former middle class? What about a day late and a dollar short class? What about EVERYBODY who can benefit from Health Care Reform? Where's John Edwards when you need him for the rhetoric of All Americans? What is wrong with Obama? Where is his fire and brimstone passion of yesteryear? I am becoming annoyed. So I continue my stream of consciousness questioning: Why did I vote for this guy? I am tempted to scream at my teevee. Doesn't he know people are dying daily because of denials on health care costs? Where is the Ted Kennedy passion that would put this drivel to shame. Where's the details on what this current system is doing? Adverse effects...please!!! Human suffering anyone?

[Wake-up]

Passion has nothing to do with this issue... it's about data... numbers... and when it comes to numbers and facts, this is dangerous and stupid.

Big Gov. running healthcare is robbing the people of their rights to healthcare and there is no model he can point to that shows this is a good thing...

Fact is, Canadians come to America for healthcare and no-one from America goes to Canada for healthcare.

This is reckless and stupid...

[Awake-and-Sing]

LOL. Another delusional conservative. What color is the sky in your world? You must watch Fox "news" for your information.

Many Americans go to Canada for treatments. Having lived in London, I can state from my own experience how far superior their system is to our system. Canadians are generally happy with their system. There is no surer path to defeat than for a Canadian politician to want to make the health care system more like the U.S. non-system.

As for "reckless and stupid", perhaps we should mention George W. Bush misleading the nation into war under false pretenses against the wrong country, resulting in hundreds of thousands of needless deaths and millions of refugees.

Or how about giving wealthy tax cuts they didn't need during wartime, bankrupting the treasury.

We'll take no lectures from conservatives about "reckless and stupid" since George W. Bush proved that conservatism doesn't work and proved that everything they believe in their minds and hearts is a LIE.

Note: I hate to break the news to you, but "Atlas Shrugged" is not a documentary, it is non-fiction.

[Wake-up]

Really... Americans are going to Canada for healthcare services??? HAHAHA... dude, is there a sky in your world??

Yes, reckless... this administration is spending BIG money we don't have - fact!

Oh and Ernestine, tax cuts have over the years proved that they stimulate our economy that benefit all Americans... more taxes do not.

Wake-up!!

[Artemis34]

Obama Renews Vow of No Middle-Class Tax Increase
http://www.nytimes.com/2009/08/04/us/politics/04obama.html

[WmC]

I'd like to buy into the Canadian health care system if I could. I have a hunch what I pay now for a lousy hospitalization plan would be more than enough to pay for full care in Canada with enough left over to cover my air fare.

[Wake-up]

Sure... go ahead and move to Canada... look at the numbers, the US has better results and 10 times the number of people... look it up!

[Artemis34]

Immigrate.

I could easily afford to maintain a second residence in Canada for what health care was costing our family in the US.

I felt like I got a HUGE RAISE when I moved to Canada b/c I had so much money left over.

[Maezeppa]

Drama? You can't be serious. We need RESULTS.

[Wake-up]

Since when does the let care about results? Sorry, don't mean to be rude but honestly that's the way I see it...

That is, results means you can't care about polls and opinion... and the left is more focused on that than the right...

[Pablo Manriquez - Huffpost Blogger]

Word.