By Brad Alexander
President Obama appears to believe a new national health care system can be created by winning the support of every Democrat in Congress and enough Republicans to get one vote past a majority in both chambers. Democratic leaders in both chambers appear even more fervent in their belief that a partisan outcome on health reform is desirable.
The President and Congress would be well advised to review recent political history before trying to ram through a plan in this fashion.
In 1999, Republicans held a majority in both chambers of Congress and wanted to impeach and remove President Clinton. In the House, they ran a starkly partisan process that ground to a virtual halt in the Senate. The outcome: Clinton strengthened his position and congressional Republicans spent a huge amount of political capital.
Skip ahead to the 21st century: President Bush believed he had a mandate for reform and decided to use it to completely remake the Social Security system. Despite running a skillful national campaign with strong support from his party’s leadership in Congress, the president was unable to get movement on a solution that was universally opposed by the minority party.
On the other hand, take a look at major national policy efforts that have succeeded over the past century. New Deal reforms, winning the Cold War, the No Child Left Behind legislation, and the early stages of the War on Terror were all highly successful from a political standpoint because they were rooted in broad bipartisan agreement about the need for action, and the kind of action that would succeed.
Time and again, American leaders have attempted to leverage a strong political position to enact major changes with lopsided support from a single side of the ideological spectrum. It almost never succeeds. It’s when leaders govern to the middle and build consensus across party lines that major achievements result.
In health care, there is general agreement that the current system is broken. Too many working Americans are uninsured because they cannot afford private insurance or have pre-existing conditions that make them ineligible for coverage. Climbing costs create a medical inflation rate that dramatically outpaces the Consumer Price Index every year. Cost shifting spreads the burden of paying for care unequally and creates insurmountable financial challenges for many providers. Meanwhile, the system has largely failed to use technology to reduce cost and improve quality.
That said, the American public has not given the president a popular mandate to remake the system. There’s a difference between corporate executives, elected officials and think tank experts realizing the scope and impact of our healthcare dilemma, and the American public seeing the same reality. In poll after poll, economic and job issues far outpace health care – and any other issue – as a public priority. This creates ripe ground for opponents to leverage a public environment of uncertainty to block a plan that does not enjoy broad support.
At the same time, neither party enjoys a decisive advantage in party identification at the electoral level. Democrats may be doing well in Washington today, but they do not hold anything that could be described as a decisive electoral majority. Any plan will require cooperation at the state level for effective implementation, and with Republicans holding strong majorities in many states, the odds of forcibly extracting support at the state level are low.
Furthermore, effective reform requires some level of buy-in from the health care providers. Unless the federal government intends to nationalize every hospital, clinic, doctor’s office, drug store, pharmaceutical company and insurance agent, cooperation – not coercion – will be required for Obama to succeed. To get that kind of broad cooperation, the president and Congress need a centrist solution that enjoys the vocal support of strong majorities in both parties.
President Obama deserves praise for his willingness to spend political capital on an enormous challenge for our nation’s future. Too many elected officials are more concerned with high ratings, not meaningful change. However, there’s a difference between investing political capital and squandering it. Simply put, no amount of TV ads, press conferences and legislative maneuvering will replace bipartisan consensus on an issue of this magnitude.
It would be shame to see an opportunity for reform missed by a strategic miscalculation. Americans can only hope that this nation’s leaders will recognize this reality and adjust accordingly, or be left with a package that simply exacerbates the problems of our current system.
Brad Alexander, the former chief of staff to Lt. Gov. Casey Cagle who now leads communications and government relations at Georgia360 public affairs company, wrote this commentary for the Georgia Public Policy Foundation. The Georgia Public Policy Foundation is an independent think tank that proposes practical, market-oriented approaches to public policy to improve the lives of Georgians. Nothing written here is to be construed as necessarily reflecting the views of the Foundation or as an attempt to aid or hinder the passage of any bill before the U.S. Congress or the Georgia Legislature.
© Georgia Public Policy Foundation (August 7, 2009). Permission to reprint in whole or in part is hereby granted, provided the author and his affiliations are cited.
By Brad Alexander
President Obama appears to believe a new national health care system can be created by winning the support of every Democrat in Congress and enough Republicans to get one vote past a majority in both chambers. Democratic leaders in both chambers appear even more fervent in their belief that a partisan outcome on health reform is desirable.
The President and Congress would be well advised to review recent political history before trying to ram through a plan in this fashion.
In 1999, Republicans held a majority in both chambers of Congress and wanted to impeach and remove President Clinton. In the House, they ran a starkly partisan process that ground to a virtual halt in the Senate. The outcome: Clinton strengthened his position and congressional Republicans spent a huge amount of political capital.
Skip ahead to the 21st century: President Bush believed he had a mandate for reform and decided to use it to completely remake the Social Security system. Despite running a skillful national campaign with strong support from his party’s leadership in Congress, the president was unable to get movement on a solution that was universally opposed by the minority party.
On the other hand, take a look at major national policy efforts that have succeeded over the past century. New Deal reforms, winning the Cold War, the No Child Left Behind legislation, and the early stages of the War on Terror were all highly successful from a political standpoint because they were rooted in broad bipartisan agreement about the need for action, and the kind of action that would succeed.
Time and again, American leaders have attempted to leverage a strong political position to enact major changes with lopsided support from a single side of the ideological spectrum. It almost never succeeds. It’s when leaders govern to the middle and build consensus across party lines that major achievements result.
In health care, there is general agreement that the current system is broken. Too many working Americans are uninsured because they cannot afford private insurance or have pre-existing conditions that make them ineligible for coverage. Climbing costs create a medical inflation rate that dramatically outpaces the Consumer Price Index every year. Cost shifting spreads the burden of paying for care unequally and creates insurmountable financial challenges for many providers. Meanwhile, the system has largely failed to use technology to reduce cost and improve quality.
That said, the American public has not given the president a popular mandate to remake the system. There’s a difference between corporate executives, elected officials and think tank experts realizing the scope and impact of our healthcare dilemma, and the American public seeing the same reality. In poll after poll, economic and job issues far outpace health care – and any other issue – as a public priority. This creates ripe ground for opponents to leverage a public environment of uncertainty to block a plan that does not enjoy broad support.
At the same time, neither party enjoys a decisive advantage in party identification at the electoral level. Democrats may be doing well in Washington today, but they do not hold anything that could be described as a decisive electoral majority. Any plan will require cooperation at the state level for effective implementation, and with Republicans holding strong majorities in many states, the odds of forcibly extracting support at the state level are low.
Furthermore, effective reform requires some level of buy-in from the health care providers. Unless the federal government intends to nationalize every hospital, clinic, doctor’s office, drug store, pharmaceutical company and insurance agent, cooperation – not coercion – will be required for Obama to succeed. To get that kind of broad cooperation, the president and Congress need a centrist solution that enjoys the vocal support of strong majorities in both parties.
President Obama deserves praise for his willingness to spend political capital on an enormous challenge for our nation’s future. Too many elected officials are more concerned with high ratings, not meaningful change. However, there’s a difference between investing political capital and squandering it. Simply put, no amount of TV ads, press conferences and legislative maneuvering will replace bipartisan consensus on an issue of this magnitude.
It would be shame to see an opportunity for reform missed by a strategic miscalculation. Americans can only hope that this nation’s leaders will recognize this reality and adjust accordingly, or be left with a package that simply exacerbates the problems of our current system.
Brad Alexander, the former chief of staff to Lt. Gov. Casey Cagle who now leads communications and government relations at Georgia360 public affairs company, wrote this commentary for the Georgia Public Policy Foundation. The Georgia Public Policy Foundation is an independent think tank that proposes practical, market-oriented approaches to public policy to improve the lives of Georgians. Nothing written here is to be construed as necessarily reflecting the views of the Foundation or as an attempt to aid or hinder the passage of any bill before the U.S. Congress or the Georgia Legislature.
© Georgia Public Policy Foundation (August 7, 2009). Permission to reprint in whole or in part is hereby granted, provided the author and his affiliations are cited.
