Health reform follies coming to you soon
Published 9:30 am Friday, August 7, 2009
One might think there was a great deal to be learned by the failed health care reform of the Clinton administration in the early 1990s. Apparently not.
President Barack Obama told America his plan to reform the health care system during the long nomination and election process of 2008.
Many Americans could agree that there are problems with cost control, equitable delivery and fairness in coverage in the mishmash of health care. But since then this President has made another mishmash from his plan to execute the changes.
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The president, veering away from the failures of the Clinton attempt, decided to open the shape of the plan and its components to definition by Congress. Admirable in theory, but chaotic in practice.
After months of debate and discussion, and distortion by opponents, the Congress has produced three House versions and one Senate version of health care reform. It remains impossible to discuss “the plan” with the public because there is no single plan. This will make for some interesting but not fun meetings with constituents back home this August as congresspeople try to explain what is not but might be, what elements could be in the plan and what proposed ingredients might be out of a final plan.
But the congressional component was hardly all the administration did that created chaos.
Early on the administration wanted to avoid industry attacks that effectively scuttled the Clinton plan with massive advertising and lobbying against reform.
So the administration worked out “arrangements” with the pharmaceutical industry to cough up $80 billion in savings over a decade by closing the current “donut hole” in the Medicare prescription program. Maybe a good idea and certainly a lot of money that will help seniors and the disabled.
However, this is the president who said he wanted a greater distance from lobbyists in his administration practicing deal-making with the very groups he criticized so strongly.
And he apparently made this arrangement without informing the decision makers in Congress that the deal meant no further contributions could be demanded from that industry.
If the president did not do enough damage to his own program by the Congressional approach to policy shaping and the side deals with lobbyists, he certainly did a good deal of damage with his public selling of health care reform.
Burying his ideas in technical language and incredibly minute details he has managed to cause even supporters to wonder why we should risk change at all.
And then of course the president was determined to seek bi-partisan support for his reforms. Apparently forgetting that the Republican Party not only opposed Social Security initially, but still does in the dark corners of the party, President Obama somehow thought he could gain Republican support for repairing health care. That won’t happen. At the end of the day, if health care reform is meaningful, it will be passed with virtually no Republican votes in Congress.
In spite of all these mistakes America needs health care reform and it can happen this year. Democrats must ignore the Republican critics and stop trying to create the best compromise and instead create the best policy for the nation.
For this will be a Democratic change, and the blame or success will be entirely theirs to shoulder. Good policy trumps chaotic creation in the end.
And the president needs to tell the American people what they get for the change and why they will benefit. Eighty-four percent of Americans like their current health care.
Why should they support these changes? So far his explanations are just not good enough.
Jim Crawford is a contributing columnist for The Tribune and a former educator at Ohio University Southern.