Tag Archives: healthcare

What’s Hidden in the Healthcare Hyperbole?

Speaking yesterday to some very enthusiastic students at the University of Maryland, President Obama called health insurance reform a “defining struggle of this generation.” I know the President frequently resorts to hyperbole when he wants to heighten the emotion around a point, but I have to wonder: if I were still that young, and belonged to that generation, wouldn’t I be sorely and sadly disappointed if I learned that this was the hand history had dealt me?

I think of myself at 19, 20, or 21, and I have a hard time imagining that a drive to reform the healthcare system, or change the way people buy health insurance, would be a cause I would have embraced or taken up. Obama himself admits that when he was young, healthcare wasn’t exactly top of mind. I know what he’s saying; we’re the same age. It wasn’t just that I was young and thought I was “invulnerable,” as the President put it. Other priorities shaped my politics and my commitments.

We thought we were up against some great and mighty forces that threatened us and the entire world and made the future look grim. We took on big causes, because the world seemed big with causes that needed taking on.

Maybe we were just raging incoherently against the machine. But in the late 70s or early 80s, would I even have dignified healthcare with the word “struggle”? And “defining”? Would I want to be defined by it? Not a great struggle against fascism or totalitarianism, not a high-stakes cold war game of nuclear chess in which the fate of the entire world hung in the balance, not a struggle for Human Rights, not even the Peace Corps, or the elimination of nuclear weaponry, or ending hunger and poverty, not a call to great works or great causes, but a piece of wonkery — a policy fix that is already looking like another bloated and ineffectual piece of legislation from a bloated, ineffectual and dysfunctional Congress. Next to this, bringing democracy to the Middle East starts to look like a piece of high-mindedness.

Is this really what hope looks like? Maybe piecemeal reforms on healthcare or student loans (another issue the President singled out in Maryland) are precisely the kind of repairs we need to make right now; the idealists of the last administration certainly didn’t make them. But that doesn’t mean fixing healthcare or student loan packages amounts to making history or the great work of a whole generation. You’d have to work pretty hard to find any real inspiration or idealism in all this, despite the President’s appeal to youthful idealism. It looks as if the President is a pragmatist who talks like an idealist when trying to make reforms.

Of course, Obama prepared the ground for this particular piece of hyperbole in his joint session speech, when he spun the debate over health insurance as a test of our country’s “character,” a battle between selfishness and altruism. As I noted in a previous post, that’s not such a bad framework for policy debate, and this latest speech may indicate that the President is willing to stick with the moral argument for now. At the very least, and to his credit, he’s trying to engage people in some real questions about who we are and who we want to be. Which makes it all sound very defining indeed.

And perhaps it is, but not exactly in the way Obama intends it to be. In their latest op ed against Obamacare, David Rivkin and Lee Casey suggest that Obama’s idealist rhetoric is really an attempt to sell a whole generation down the river. The President’s appeal to the young people gathered at the University of Maryland, and to young people across the country, is

far more cynical and political. Making healthy young adults pay billions of dollars in premiums into the national health-care market is the only way to fund universal coverage without raising substantial new taxes. In effect, this mandate would be one more giant, cross-generational subsidy—imposed on generations who are already stuck with the bill for the federal government’s prior spending sprees.

What’s more, Rivkin and Casey go on to argue, requiring those same healthy young adults to purchase insurance may turn out to be unconstitutional; and it’s clear from their article that a constitutional challenge to mandatory health insurance is in the works.

The merits of that legal argument aside, the President’s hyperbole on healthcare may not be entirely cynical or sinister. He may simply be trying to divert youthful energy and idealism into constructive channels. But consider this: diverting those energies into healthcare, and turning healthcare reform into the calling of an entire generation, is also a diversionary tactic — a way of narrowing the debate, ruling things out or deciding what causes count, what counts as history. And that’s a way of advancing an agenda and consolidating power.

Now more than ever, young Americans have every reason to be suspicious of anyone who comes to them with a plan for their generation or the struggles that will define it. Given the the planet, the world, the country they have inherited, young people today could do worse than heed the advice of their grandfathers and grandmothers: don’t let anyone define you, and don’t trust anyone over 30.

Character makes a comeback

It’s almost as if Obama was channeling Thomas Frank last night. The President’s remarks on the American “character” in last night’s speech did exactly what Frank said the Democrats had to do: counter the Republican’s appeal to American self-reliance (or just plain selfishness) with the argument that “we are a society,” and position healthcare as a public good. And best of all he couched this principled stand for liberalism in an emotional passage about Ted Kennedy.

“What we face,” [Kennedy] wrote, “is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.”

I’ve thought about that phrase quite a bit in recent days — the character of our country. One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government. And figuring out the appropriate size and role of government has always been a source of rigorous and sometimes angry debate….

[Ted Kennedy’s] large-heartedness — that concern and regard for the plight of others — is not a partisan feeling. It is not a Republican or a Democratic feeling. It, too, is part of the American character. Our ability to stand in other people’s shoes. A recognition that we are all in this together; that when fortune turns against one of us, others are there to lend a helping hand. A belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgment that sometimes government has to step in to help deliver on that promise.

No doubt about it: Obama won the night. It was no contest. Most Republicans looked dour or sulked throughout the speech; the official response by Charles Boustany was uninspired and didn’t offer a single constructive idea; and Joe Wilson acted like a Town Hall rube. If these are the Defenders of Liberty and Free Enterprise against the Socialist Alien who has taken over the White House, then may God have mercy on all free men.

Joe Wilson has apologized, but of course he’s not really sorry. He just feels like a fool, as he should. I shouted at the television a few times, and though I am not ready to take back everything I said about Obama’s leadership on this issue — or what the squabble over healthcare reform has revealed about Obama’s leadership — I feel contrite. Maybe speeches and appeals to reasonable compromise can actually prevail over finger-biting, shouting and demagoguery. Or maybe there was method in all the summer madness, and it will turn out that the President was more cunning than his opponents. He let them blow off steam, rant and rave, make him out to be a bogey man; and now he can appear reasonable, calming, reassuringly above the Town Hall fray, and inspiring.

The President made a good speech, some say a great speech. Every early indication is that the healthcare debate will continue. The progressives still cling to the public option; the GOP remains entrenched. Last night’s speech may not change much on that front, but it may re-animate the conversation (and boost the President’s ratings).

Now the big unanswered question that remains is not a policy question at all: it’s a question about the American “character.”

I wonder if we’re ready for a debate about “the moral issue” and the content of our character — and if the President is ready to lead us through one.

I wonder if we take ideas like this seriously anymore, whether we can even talk coherently about a character that is uniquely or distinctly American, an American ethos. It’s almost Victorian to talk in this way. Or the word “character” used in this sense seems to have a Harvard pedigree. “The character of our country” sounds like something JFK might say; Obama took it from Ted Kennedy’s letter.

You can’t be scientific about society when you talk about character. Or if you try to be, you will probably have to rely on the notion that there is what Edward Banfield called a “moral basis” to social arrangements, to prosperity and backwardness. Be that as it may, it is a question way beyond the ken of technocrats and wonks. And it may be one of the most important questions of the Obama era.

I wonder, too, if the President has read our character right.

This is Not Camelot

We were treated this week, courtesy of the White House, to this picture of Sasha Obama sneaking up on her father as he worked at his desk in the Oval Office. The Obama public relations machine would have us believe that this Camelot moment was snapped by a White House photographer who just happened to be in the room as the President worked and Sasha played. What serendipity! But ask yourself: what went into the making of this moment? What political purpose does it serve? And where is Obama hiding his inner JFK?

We were treated this week, courtesy of the White House, to this picture of Sasha Obama sneaking up on her father as he worked at his desk in the Oval Office. The Obama public relations machine would have us believe that this Camelot moment was snapped by a White House photographer who just happened to be in the room as the President worked and Sasha played. What serendipity! But ask yourself: what went into the making of this moment? What political purpose does it serve? And where is Obama hiding his inner JFK?

During the 2008 presidential campaign, I heard Ken Burns make a speech at an Obama fundraiser in which he made Barack Obama out to be another Lincoln. Both senators were young – too young, many thought, too inexperienced — when they first appeared on the national stage. Both, Burns continued, were lanky, rail thin, almost wispy: surely there must be something in that. Both came from Illinois, or at least both sort of came from Illinois, and both possessed the extraordinarily eloquence needed to bring together a suffering, divided nation.

As the speech unfolded, and the fact of Obama’s ordination became unavoidable, inescapable, the crowd made appreciative sounds. Burns is widely considered a genius of history, especially in liberal circles, and if Ken Burns said Obama was going to be the next Lincoln, quell our civil strife, and make us whole again, then it must be so. One could almost see a PBS special in the works, the image of one man dissolving into the other.

Burns was not the only one to serve up this particular blend of historical swill. He was good at it, because he’s used to reducing history to a mix of inoffensive platitudes and emotional mush, but in the run up to the election I heard the comparison with Lincoln made frequently (only not too loudly, not too publicly, as if saying it out loud too often or to too many people would break the spell, or at least invite some difficult questions).

Of course, this was not, and could not be the popular narrative. Opinions varied; and the thin man from Illinois had to be kept a cipher in order to have the widest appeal possible. Some conservative commentators who had become disillusioned with McCain discovered Reaganesque traits in candidate Obama. I thought I saw – or I wanted to see — in him the makings of a second Eisenhower, who would undertake big, green, ambitious 21st century infrastructure projects. Most people just hoped for anything other than more of the same.

Then, after the elation of the Obama victory, when it really did seem as if the reign of ignorance, brutality, cronyism and incompetence under which this country and the whole world had suffered was finally over, we were told ad nauseam by every major network and every news outlet that what matters is what happens in the first 100 days of a new presidency.

The big media started dutifully reporting that the Obama and his advisers – “Team Obama” — were studying FDR’s first 100 days, reading history, no less, to help them think through the challenges ahead. The narrative shifted: in the wake of the financial crisis, our troubles looked more like those FDR inherited in the 1930s. It was time for a New Deal, or a second Great Society – a Newer and Greater Society, I guess. And, by gum, with some teamwork and the right model, we would set things right.

But as Thomas Frank pointed out so brilliantly in his most recent column, the Democrats and President Obama have failed on healthcare so far because they have failed miserably at making the simple argument that “we are a society.” And that’s one key argument needed to counter the story Republicans are pushing: that we are a nation of rugged individualists and social Darwinists, and that social obligations limit individual liberties. Republicans would be wise to stick with this story as long as they can, and to build a strategy around it.

Why should I pay for someone else’s healthcare? First, because I already do: that’s the way the insurance business works. We all pay into the system every month so that the system can cover the medical expenses some subscribers incur. And along the way, some companies and some individuals – those who run the system, or game it — profit from our hedge against illness and catastrophe.

But that’s not the real argument Democrats needed to make. They need to persuade us, or at least (for starters) persuade themselves, that healthcare is a public good — not a “right.” Many Democrats so far have been unable or unwilling to give up the talk about rights (by which they really often mean entitlements), when it would be better to talk about healthcare as a public good, or even a public utility or service. And in order to make an argument that healthcare is a public good, you have to first remind people that there is such a “thing” as “the public,” a res publica or “republic”; and people have to do more than understand it. They need to feel it in their gut or their heart or wherever conviction is born. You have to persuade them that we are a society of free people with the potential to be great – which is something Lincoln and FDR and Ronald Reagan were all able to do.

Of course, it may already be too late to change course: the word “public” has now been tainted by “the public option”; and a public option may or may not serve the public good or be in the public interest. We don’t know, and we are not likely to have the nuanced discussion required to find out. Instead, opponents have been able to cast reform as just another big government takeover or entitlement program. Democrats are still trying to debate policy, but they have already lost the battle if their opponents have persuaded people that “policy” is just the politics of income redistribution.

What does all this have to do with the thin man from Illinois? The hijacking of the healthcare debate and the disintegration of the republic into fractious town halls is his failure – a failure of leadership and a lack of what George Bush the First called the vision thing. This is the last kind of failure I expected from candidate Obama, who was able to appeal to our better natures, even when we were down, and make us feel that we are all in this together (even if we disagreed on matters of policy). But it was, I fear, just a feeling. We thought he would call on us all, to ask what we can do for our country; but the call hasn’t come.

“Yes, we can!” was good and strong enough to get him through November, but President Obama seems lately to have forgotten that phrase, its energy and enthusiasm as well as the electoral mandate for real change it helped to produce. We all knew it was an advertiser’s slogan, but we hoped beyond hope that it was something more than cynical manipulation, or that this time there was really something in it for us and for what used to be termed, without embarrassment or apology, our republic.