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Reclaiming Control of the Health Care Debate

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Frequent readers of these comments know that I am an ardent devotee of Sunday morning talk shows and of the New York Times. This morning's talk shows and various Times articles of the last week have put the problem of the debate over health care reform into clear focus for me for the first time.

Note that I said "the problem of the debate" and not "the problem with health care reform." The difference is important. Frankly, I am not expert enough to solve the health care problem. But I have some pretty clear ideas on the debate.

First, as has often been noted and was repeated by Ron Brownstein on This Week with George Stephanopoulos (without George) this morning, the Obama administration learned the wrong lesson from the defeat of health care during the Clinton administration. In 1993, President Clinton and Hillary put a complete package before the Congress; they and their package became an easy target -- and they lost.

The Obama team vowed not to make that mistake, allowing the various congressional committees to work on their own bills, hoping to reconcile differences in conference. The problem with that strategy is that the Administration has not provided the public, hungry for health care reform, with a specific bill behind which to coalesce. The opposition has taken advantage of the lack of one bill to target one section of one bill and another, in another. The result has been that the majority favoring health care reform has been transformed into a majority against the Obama approach.

Second, the Obama team lost control not only of the message but also of how it has been delivered. The volume has been turned on "high" but both sides. Evan Tracey, COO of the Campaign Media Analysis Group, a non-partisan enterprise that tracks television ad buys, reports that proponents and opponents of health care reform have spent nearly $60 million already, more than at this time on any other issue. Sarah Palin has moved the debate with a blatant lie, that the bill will create "death panels," but that lie -- probably the most egregious of the debate -- does not stand alone. Democrats have inflated what the bill will do and underestimated its cost. And the President bears some of the blame for those exaggerations. Liberal Democratic groups have attacked Democratic moderates who have counseled moderation in the proposal -- and the White House was slow to clamp down on them.

Third, both sides have sought to turn this into a battle defining success or failure of the Obama administration. South Carolina's Republican Senator Jim DeMint wants this to be "Obama's Waterloo." President Clinton has rallied Democratic forces, saying his experience, referring the GOP gains in 1994, taught what can happen if the Democrats lose on a key promised initiative and embolden the opposition.

Is the opportunity for needed health care reform lost? Perhaps not. The Obama administration needs to recall why he appealed to so many people early in the presidential campaign. Skeptics were not won over just by his rhetoric and certainly not by his promises. The key factor was his desire to change the tone of the debate. The President's op-ed in the New York Times and his tone at this week's town hall meetings are steps in cooling the debate, in looking for solutions not victories.

The next steps will be to continue working with moderates, particularly those in the Senate, who are looking for proximate solutions, for win-wins, not win-losses. In a recent column, David Shribman of the Pittsburgh Post-Gazette referred to Maine's Olympia Snowe, who is right at the center of the efforts to find a bi-partisan compromise, as a combination of two of her predecessors, Margaret Chase Smith and Ed Muskie. Snowe is smart, understanding both the interplay of personalities and the power of numbers. Obama and his team need to look to congressional leaders like Snowe, on both sides of the aisle, if they are to succeed.

Finally, as David Brooks has commented in a number of different venues, major social policy cannot be accomplished on a partisan basis. The Democrats might have the votes to force through a health care reform bill. They would be making a huge mistake to do so without significant Republican support -- and most importantly, without widespread support for a specific package among the electorate. They do not have to win over the Jim DeMints of this world -- but they do need to capture the moderate center.

We are in the dog days of August. Even those areas of the country for whom summer has been an illusion are now sweltering in 90 degree heat. Washington is, of course, unbearable. Congress is out of session. The President is about to go on a vacation. Good for him -- and good for all of us. Let's take ten days off from this heated debate, let tempers cool, and see if it can be approached afresh come September.

L. Sandy Maisel is director of the Goldfarb Center for Public Affairs and Civic Engagement at Colby College.

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