Thursday, July 30, 2009

Reform School

It is the 'devil you know' philosophy that seems to be driving the public perception on health care these days. Despite repeated efforts by the administration to allay fears and calm the waters, those in opposition have managed to drive the message of the President into the ground. He can talk forever about being able to stay with your own plan and continue to go to your present doctor, if that is your desire. He can repeat the mantra that inaction is not an answer. Few are hearing his words.

Health care reform appears to be the change that is too big to succeed. The administration has been unable to convince the masses that the need for reform is similar to addressing, with urgency, the possible failure of AIG or one those infamous investment banks.

In the 1980's, then President Reagan championed an overhaul of the coverage relating to catastrophic illness and seniors. The Medicare Catastrophic Coverage Act of 1988 was short lived. By 1989 it had been repealed under a tidal wave of dissent. In analyzing where we went wrong, a recent article surmised that "the lawmakers of the late 80's forgot to engage the American people in a thoughtful , deliberate discussion, ignored the need to educate them on the specific elements of the reform proposals, and inappropriately relied only on experts and advocates to draft a bill" (Are we learning from the "Correct" failed attempt at Health Reform, by Greg Pierce, June 17,2009 in Centered Politics. com).

One cannot reasonably conclude that this error has been repeated by President Obama. He is attempting to include the American people in the dialogue, addressing them, meeting with them, listening to them through every means available. From website, to White House, to town halls, he has tried to explain the ABC's of what is happening. This then can't be the predicate for the inertia.

More recently, in the 1990's, Hillary Clinton spearheaded an attempt to overhaul the health care system.Her efforts as Chairperson of the Task Force on National Health Care Reform were seen as producing a massive document, too complex and bogged down to be understood or effective. To Clinton, that experience taught her "the importance of bipartisan cooperation and the wisdom of taking small steps to get a big job done" (NY Times, February 13, 2001).

Speaking on Meet the Press last Sunday, now Secretary of State Clinton distinguishes her failures from the present situation. "I think everyone's convinced there's a problem. Back in 93' we had to keep making the case over and over again... We know that our system, left unchecked, is going to bankrupt not just families and businesses, but our country."

As the unfolding problems in Washington suggest, and as history has taught us, it is not that simple. I believe that all attempts to create good from not so good have shown us the multiple layers that weigh down these efforts.

Move too slowly and nothing gets done. Move too quickly and nothing gets done. Seek bi-partisan support and nothing gets done. Don't seek bi-partisan support and nothing gets done. Don't explain in enough detail and nothing gets done. Explain with too much detail and nothing gets done. Assist some but not all and nothing gets done. Assist all at the expense of the few and nothing gets done.

As President Obama staggers along and the Congressional recess looms with no clear cut answer on the horizon, we are once again left struggling to find the right words to move forward with a workable answer. It is one that continues to elude us. Ultimately, sadly the 'too big to succeed' dilemma may prove even too much for this popular President to overcome.

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