What It Will Take to Win the Healthcare Debate

In a speech to a joint session of Congress on health care Wednesday night, President Obama briefly alluded to the age-old argument between the individual's desire for freedom and the need for security. He noted there has been a healthy skepticism of the federal government since the nation's founding. On occasion, in reaction to the destructive excesses of this or that Gilded Age, progressives have been able to overcome our natural Jeffersonian inclination to prefer limited government. It is only when levees burst, markets crash, or regulators fail us that there usually comes a brief burst of progressive action. That was what happened in 1933 when Social Security was enacted.

In 1993, the Clinton health care plan was undone by a series of ads featuring "Harry and Louise" who convinced each other that the federal government shouldn't play any role in the nation's health care system. That strategy worked then and the Republicans hope it can work again. They continue to parrot consultant Frank Luntz's line that the Democrats want nothing less than to accomplish a government takeover of health care.

We should be clear that the opponents of genuine reform have no comprehensive alternative they can claim as their own. Aligned with the private insurance carriers, their real goal is to maintain the status quo. Their real fear is the realization of a decades-old Democratic dream: low-cost, universal health care. They realize that should this dream come true, they will remain out of power for many years to come.

The anti-government crowd, embodied by Ronald Reagan, rode into Washington in 1981. At his first inaugural address on the steps of the nation's capitol, he said, "Government is not the solution to our problems; it's the problem." Today, all too many Americans believe that to their very core. According to data compiled by the Pew Research Center, an astounding 62% of Americans believe that when the government runs a program, it is usually inefficient and wasteful. That's what did in "Hillary care" in 1993. The outcome of the health care debate taking place in Congress today will determine if the 28-year conservative stranglehold on Washington is finally nearing an end.

There are two things holding us back as we stand on the precipice of enacting genuine health care reform, that is, one that includes a public plan as one among others. First, from 2000-2008, the Bush Administration showed us that it had little interest and limited ability to actually govern. In fact, the monumental incompetence of Bush and his cronies will make the job more difficult, for they failed in ways that have undermined Americans' confidence in the ability of government to solve the country's most pressing problems.

Second, when we speak -- as the President did the other night -- of our willingness to come to the aid of others in need, most people think of individual or organized charity or other acts of kindness. Alternatively, one thinks of "individual" giving and selflessness in times of a national emergency, as was the case with the nation's response to the destruction of the Twin Towers in New York City in 2001. "Government action" -- other than a military response -- is not the first words that come to most people's lips at such times. Nor is it clear, as the President maintained on Wednesday, that most people think government should step in when someone is in need of a helping hand. Not yet, at least.

Here, then, are suggestions for the President's next speech if he really wants to change public attitudes on the proper role and size of government in American life.

He should remind us that it was the government of the United States that substantially reduced the number of elderly in poverty, landed a man on the moon, helped conquer fascism, built interstate highways, made loans to homebuyers and students, insured bank deposits, and led the most successful anti-smoking campaign in the history of the planet. And it continues such diverse tasks as making certain that unsafe drugs don't reach the market and providing financial assistance to victims of natural disasters.

In truth, most Americans are slightly schizophrenic about their views of government. They rightly hate red tape, bureaucracy, and waste, but they want the airlines they fly, the products they use, and the food they eat to be safe.

Henceforth, liberal Democrats in Congress and the President need to go on the offensive and ask those who want to keep the public option out of health care overhaul a few questions: Do we want the Consumer Product Safety Commission to continue to inspect for lead in imported Chinese toys? Do we want the Food and Drug Administration to check for E. coli and salmonella in the food we eat? Do we really need an Environmental Protection Agency? This is far more effective strategy than simply denying that the proposed healthcare plan amounts to a government takeover.

Finally, the President and liberal Democrats in Congress need to remind all Americans that government has a role to play in the struggle between the people and the powerful, in this case the powerful healthcare industry. In 1941, President Roosevelt described the Democrats as "a party which believes that, as new conditions and problems arise beyond the power of men and women to meet as individuals, it becomes the duty of government itself to find new remedies with which to beat them." Nothing has really changed since then.
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The writer is a researcher at Demos, a New York based think tank.

Comments

[Manx]

Instead of standing up and defending liberalism as a good thing, Obama runs from it as if it's something to be ashamed of.

[vanmungo]

What do you mean by "public option"? What do you think Obama means?

The pub-op being peddled by mainstream Democrats in HR3200, which is neither really public (self-sustaining rather than publilcy funded) nor an option for most people (because it will have to charge big premiums and deductibles to stay afloat)? That will be open ONLY to those not already covered by employer-based insurance, Medicare, and Medicaid, which is a tiny minority of the country? Which will not even take effect until 2013 (if at all)? Which does nothing to control costs nor significantly expand coverage, according to the CBO? Is THAT what you mean by a public option? You've been hypnotized by MSM propaganda.

The only real reform, with a proven track record of controlling costs and guaranteeing coverage to all for fifty years in the rest of the industrialized world, is single payer Medicare for all. The rest of the half-baked, watered-down schemes being offered by the Dems, including the public option actually contained in HR3200 (as opposed to the ones that populate the fantasies of commenters out here), are a scam, a way of fostering an illusion of reform while retaining the chokehold of the HMOs who have lined ALL their pockets (Dems more than Repubs) with millions in campaign lucre.

You should read the following :

"Bait and Switch: How the Public Option Was Sold"

http://pnhp.org/blog/2009/07/20/bait-and-switch-how-the-%E2%80%9Cpublic-option%E2%80%9D-was-sold/

[JuniperSunshine]

We need to make a few points, loudly:

1. Insurance companies are bankrupting America. The #1 cause of bankruptcy is medical bills.

2. People are afraid to start their own businesses, or work for small businesses, because of the health care problem.

3. We can spend 30% more of our money on the for-profit system. We will be paying them to deny coverage to people.

OR

4. We can extend Medicare to everyone. Or, possibly, allow people to buy into it. If you don't believe we should dismantle Medicare, you need to justify your anger towards increasing coverage to other Americans.

No more, "Yes, but..." liberalism. How about.....­. "Extend Medicare coverage to all and save our economy!"

[mamalisa38]

For profit health insurance is immoral. The only way to maximize profits, and that's what Wall Street demands, is to raise premiums and deductibles and deny claims. The top twenty health insurance and drug executives earned $285 million in 2008. JUST TWENTY PEOPLE.

PER HOUR PAY FOR INSURANCE AND DRUG EXECUTIVES:

Miles White - Abbott - $17,395
Fred Hassan - Schering-Plough - $15,677
Bill Weldon - Johnson & Johnson - $13,022
Ron Williams - Aetna - $12,656
H. Edward Hanway - CIGNA - $6,373
Angela Braly - WellPoint - $5,127

For Americans to continue paying billions of dollars a year for obscene salaries, bonuses, perks and profits to the health and drug companies is unconscionable. I never thought our elected representatives would work so hard to kill health care reform. But then again, why wouldn't they? They collect millions of dollars from these same companies. We arrest street walkers for taking far less than our legislators.

Single payer is the only answer to our health care crisis.

[seawolf77]

Healthcare debate. Is that what this is? I thought we were watching a gameshow where News networks scoured the country side for the most outrageous and heinous town hall meetings so they could portray their passionate voice over the airwaves. Kind of like how record producers used to search the high schools for kids with the most angst. No a healthcare debate would mean thoughtful people making thoughtful proposals that would be evaluated by the merits and the proven and believable statistical facts. That's not what I see. I see Jerry Springer Health Care Debate.

[WorkingClass]

The debate is not real. It is a staged distraction to divert your attention from the ONLY true obstacle to reform. Graft.

[Chazet2]

Hear, hear! I heartily agree!

[Rog49Thomas]

Most Americans want a free ride.

When they're told they have to pay for something they suddenly discover imagined fiscal responsibility and other Constitutional principles.

[meko]

What we need are progressives who provide a strong enough balance to the right to shift the center back where it used to be. What we need are people on the left who use the same kind of "rhetoric" that anti-abortion folks use to intimidate doctors on the health insurance CEOs. The robber barons of the 1890s didn't back off till their lives were in danger. Today's robber barons are using our health insurance premiums to buy off our representatives so that they can continue to deny us the benefits that we paid for.

At the very least, we need to make sure that every corporate Democrat who won't support a government-run plan that everyone can buy into from day 1 that's strong enough to go toe-to-toe with insurers and big pharma will lose their big lobbyist-funded campaign war chest in heavily contested primaries.

Progressives don't understand. Conciliation and compromise isn't what brings you to power. It's winning primaries and elections.

[MBryant]

Let's be clear on this, we already have these reforms and Republicans have voted for them, even proposed them in some states.
Public Health Care = VA hospitals
Single Payer = Medicare - we already have this for people 65 and older
Public Option -= most states have ALREADY passed children's public optional health care programs (we have one in Texas - proposed and passed by Republicans)

So - obviously these programs - and we aren't even talking about the first two - are not evil or wrong for America. In fact many would say these are the things which are most right about our health care system. These programs cover among the poorest and most health vulnerable Americans in ways which we seem to be able to afford and which have acceptable, even popular quality.

So why is it such a problem to bring these programs to everyone/anyone else. It is simple.. because the everyone else is largely made up of employed people whose employers PAY for health care. And if these programs came to those people some financial interests would be hurt because the government would displace private industry or compete against it. I'm not saying that's better - I just want to clairfy the debate. Unless Republicans are ready repeal VA Hospitals, Medicare and Children's health insurance ON PRINCIPLE. Then they must concede this is not about health care at all.

It's about money. Follow the money.

[PlaceboStudman]

To win the Health Care debate, we have to do one of two things. Either start talking about Health Care, or start to call it what it is, an aspect of the financial crisis debate.

Sorry, folks, what we are talking about is NOT health care. We are not discussing how to improve medicine and technology and get it to the patient easier and faster. We are simply debating how to make the payment system cheaper, without a word of consideration of the product.

This is like buying a car warrantee for a lemon. Or asking VISA to lower its interest rates when a CD (Health Care) arrives broken from Amazon (doctors and hospitals), without ever questioning WHY our CD (medicine and technology) is broken and researching Amazon, UPS (the AMA) or the CD production companies (BigPharma and the FDA...who, by the way might as well be one in the same)

[jsarets]

I disagree. Trying to convince people to feel all warm and fuzzy about government intervention is a losing strategy. This isn't the strategy that brought about progressive reform in the past.

Politics is about fear, it's about blame, it's about bogeymen. The New Deal wasn't sold by telling people that government would take better care of them, it was sold by telling people that the nation was under attack by ruthless and reckless Wall Street investment bankers.

If Democrats are to channel FDR's policies, they have to channel FDR's politics. That means relentlessly blaming Wall Street investment bankers for the horrific state of healthcare in America. That means suggesting that the American workforce is under attack by institutional investors.

The American people need to be told who is responsible for all that's wrong in the world. The Republicans tell us that government is the problem. The Democrats should tell us that Wall Street is the problem.

In truth, both are correct: as the saying goes, the only two forces that prevent good things from happening are money and politics. Both institutions must be reined in, and for that to happen, the Democrats of today have to play their traditional role, like FDR, Jackson, and Jefferson before them.

[tjordanmsw]

I am becoming hopeless about the future of the Democratic party. Even though the Republicans make half-hearted protests against their fellow Republican's inappropriate and immoral behaviors, they are a cohesive group (albeit mindless and profoundly troubled). In contrast, the Democratic party is so divided that it seems that they can't reach consensus on anything. They therefore appear weak, ineffectual and confused. I am not surprised that it is so difficult for the Democratic party to stay in power. If they don't come together and support our President, we can look forward to a Bush look-alike three years from now.

[middleoftheroad]

you would not have the House right now if you did not have Rahm putting in candidates who are moderate and conservative to run in district where progressive liberals would have no chance of winning in the first place. What is funny, is how progressives really think they own the Democratic party, and it is somehow the blue dogs who just refuse to play ball. Maybe Dems should run liberal everywhere next time and see what happens. The country is not center left, let alone far left. This is just push back from that. It's true.