Obama Pundit

by Hector N. Fertig

It sounds as though the Public Option is no longer an indispensible piece of the Obama Administration’s health care plan.  If this is true, to many observers of the health care debate, this represents a substantial shift in policy from only a month ago.

“Any plan I sign must include an insurance exchange: a one-stop shopping marketplace where you can compare the benefits, cost and track records of a variety of plans – including a public option to increase competition and keep insurance companies honest – and choose what’s best for your family.” (from July 17)

“The public option, whether we have it or we don’t have it, is not the entirety of healthcare reform,” Obama said at the town hall event in Colorado. “This is just one sliver of it. One aspect of it. And by the way, it’s both the right and the left that have become so fixated on this that they forget everything else.” (from August 15)

Whether or not a “good plan” (however that is defined) requires a public option is not the point here so much as the political fallout from such a change.  Is this Obama’s “read my lips” moment?  Hard to say, but even harder to dismiss.  Is the Obama Administration in real trouble on health care and how did they get to this point?

I believe failure on health care reform would be a serious problem for any administration that made it a priority, though not necessarily insurmountable.  What motivated opposition to his plan may be much more serious – both in 2010 and 2012.  So why did he fail?  In a single word: TRUST.  There are two kinds of trust in American politics: (1) trust that you are trying to do the right thing, motivated by principle, in the best interests of the American people, and (2) trust that regardless of your motivations, you are competent to make the things you promise actually happen.  The American people stopped trusting the Bush Administration on both counts over involvement in Iraq, the handling of aid following Katrina and ultimately the economic collapse of 2008.  Whether or not it was deserved, the Bush Administration lost the trust of the public and this lead directly to the powerful performance of the Democratic party in the 2008 elections.  The conveyed message to the voting public was: “If you don’t trust Bush and his cronies, put someone else in charge.”  The public didn’t and so they did.

With their victories, the Democratic party held the Presidency with a popular, charismatic new leader, the House with a substantial majority, and (after Arlen Specter’s party switch and Al Franken’s seating) a “sort-of” fillibuster-proof hold on the Senate.  There was talk of a permanent Democratic majority powered by a shift in public support (if you like the Democrats) or massive pandering to their political supporters (if you don’t).  There is still a long time between now and the 2010 elections, but the invincibility of the Democratic Party is no longer a foregone conclusion.

During the campaign, Obama established himself as a uniter who would reach across party lines and lead in a bipartisan way.  With the economy as the overwhelming issue, the Obama Administration claimed that by passing its stimulus package, unemployment would be capped at 8% while failure to do so could lead to 9% unemployment.  This danger, the public was told, required fast approval of enormous funds which Congress passed in an essentially party-line vote – losing a small amount of trust in his sincerity about bipartisanship.  When unemployment climbed past 9.5% and the President was forced to admit that it could cross 10% despite the stimulus package, he lost significant trust in his team’s competence.

Distrust in both his motivation and competence were fanned during the government bailouts of Chrysler and GM.  By assuring the public that bailout funds provided the best chance of avoiding bankruptcy, the Administration built expectations from the public that would ultimately prove disappointing.  At the same time accusations were made claiming he wanted (1) government running business to support his alleged socialist view of the world and (2) he intended to use this crisis to make large payoffs to his supporters – in this case the Unions.  Among his detractors, either or both allegations “stuck” when the final deals came down, selling out those with senior claims on the car companies’ debt and granting large shares to both the government and the unions.

Other issues arose, as they always do, but in my opinion played only a confirming role in the distrust equation.  Professor Gates, Justice Sotomayor, the Iranian elections, and even Cap and Trade had comparatively little effect on the public’s view of the administration.

Then came Health Care.  As with the stimulus package, the Administration claimed that this was an emergency of such magnitude that it had to be done immediately regardles of pricetag or opportunity for debate.  Despite claims of long-term savings, those suspicious of the President’s and the Congress’ competence (recalling the now-recanted unemployment claim) had only to look at the Congressional Budget Office’s numbers which seemed to disagree with his rosy projections.  For those now inclined to be suspicious of Obama’s motivations, there was even more fuel for the distrust fire… If this plan were so good, why did Congress insist on exempting themselves?  If this plan were so important, why had so few members of Congress actually read the details before being pressured to vote?  Why does it look like the President is cutting backroom deals with Big Pharma in order to gain their support?  Here, the flubs were substantive… claiming the AARP supported their plan only to be corrected… dramatically over-stating the contribution from the AMA only to be corrected… and prior to the backroom deal above, suggesting that Big Pharma would provide an $80B contribution and allow the government to negotiate down their drug costs only to be corrected.

Unfortunately for the Administration, this distrust – along with some help from those ideologically opposed to this brand of reform – manifested itself in increasingly vocal media events.  The President, members of Congress, and independent commentators fundamentally missed (or ignored) the point of these protests – describing the participants as crazy, Nazis, racists, selfish, greedy, manipulated or simply ignorant – and couched their arguments accordingly, inflaming the opposition even more.

Ultimately, I believe, the issue for the majority of protesters was simple, if not always stated:  “We’ve seen what you’ve done so far… even if we agree that there are some problems with our Health Care System, why should we trust you to fix it?”  Answers that are limited to, “The Republicans don’t have a solution” or “We can’t keep going the way we are going” can never address this concern.  I think this is a question the Obama Administration cannot accept as honest.  When you want the support of someone who doesn’t trust you, the first thing you have to do is understand that they really don’t trust you and then  establish yourself (or at least your process) as open and honest.  To that end, in the interest of saving his health care reform and the Democratic party’s chances in the upcoming elections, I would advise the President and Democratic Congressional leadership to do the following:

1. Simplify the bill, make it public, and require every member of Congress to read it
2. Give the public and independent sources time to discuss its merits and alternatives
3. Remove any and all special interest perks or exceptions from the bill
4. Set objective standards for measuring success and provide a sunset clause should it fail

I don’t know if this would be enough to win back the trust of the opposition, but it would be a start.  The Administration can’t afford to keep going down the path its on.