Right-sizing health care
One year ago, we were a nation ripe with possibilities. Change appeared to be more than a campaign catchphrase, but a reckoning force. Though the economy stalled and we faced financial insecurity, there remained a glimmer of renewal. Then came the tedious realities of policy making. Mistakes were made. The message was hijacked. Politics got ahead of policy and the nation's appetite for a health-care turnaround soured. Discontent grew into unexpected backlash.
All of a sudden, the fate of health-care reform hangs in the balance. A new change agent has arrived and his name is Senator Brown.
What now? Well Mr. President, grab the reins and show active leadership. The nation needs to move forward. This does not mean to plow through and incur more public angst. Rather, the country needs level headed, decisive action. Perception is reality. And the prevailing thought is that average Americans are losing out to last-minute backdoor deals. Hence public distrust is rising and "process" has become as important as "outcome." What we need is a credible start, if nothing else. History has shown us two things: change is neither a flawless journey nor is piecemeal victory our enemy. We need to go basic. Emphasize where we agree and then dare adversaries to take an incremental step forward out from their respective corners.
In other words, we need: 1) an eclectic mix of commonsense solutions (wellness and prevention measures); 2) middle ground politics (find a 60th vote); 3) a dash of policy innovation (health insurance reforms); and 4) goodwill programs (i.e., expand Medicaid eligibility and phase out the Medicare drug coverage gap). Don't abandon all ambition or moxie. Instead flirt with the return of a public option with a trigger mechanism in the near future if we are unable to tame the beast, but also don't hold the entire bill hostage to one idea. Lay the framework for serious cost-containment measures on a roll out basis. Realize that we either expand access or we cut costs; one has to be a priority with the other a soon to come goal. Otherwise, bipolar ideologies threaten passage of any legislation.
Finally, what cannot happen is that we walk away empty handed. The rest of the Obama agenda cannot afford this nor can the majority of Democratic incumbents who will risk being labeled inept. On the other hand, Republicans cannot afford to be on the wrong side of right. Likewise, everyday citizens cannot wait for another opening, which may not come in the foreseeable future. All who are vulnerable will pay a disproportionate price if we choose to linger. Rather, honest relief is necessary.
Americans have been wearied by trench warfare, which has pit one group against the other. Instead we must find a workable coalition to advance the ball, even if by a less than desirable amount. We must act in a timely fashion but not recklessly. The greatest leaders are those who can repair the breech, see forward and navigate land mines and yes, that means building consensus among fractured sometimes cantankerous parts. The game has changed and what's in play is "right-sizing" the health-care agenda.
Chris T. Pernell
January 21, 2010; 1:13 AM ET
Health Care Reform
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