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Michael Maccoby

Michael Maccoby

Michael Maccoby is an anthropologist and psychoanalyst globally recognized as an expert on leadership. He is the author of The Leaders We Need, And What Makes Us Follow.

Two critical mistakes

Q: Even before we know the outcome of the health care vote in the House, how would you rate President Obama's leadership on the issue?

President Obama made two major mistakes in his leadership on health care. The first was to draw a wrong lesson from the Clintons' failure to pass health care legislation in 1993.

Back then, Hillary Clinton led a task force that presented Congress with a detailed plan, which was rejected. The erroneous lesson was that Congress should be given an outline of principles but that the president should stand back and let Congress develop the legislation. But in 1993, two exceptional senators, George Mitchell and Bob Dole, leaders of Democrats and Republicans, were ready to work together to lead the process, and Senators Edward Kennedy and Daniel Patrick Moynihan were prepared to help.

If these senators had been allowed to lead, the result might have been different. But no one in the Senate today has comparative standing and clout. By handing away the leadership to a Senate that lacked bipartisan leaders, Obama lost the momentum he had from his initial popularity. Instead of taking the lead to educate the country about the policy, he stood back and allowed the Republicans to distort it as a government takeover of health care that would bankrupt the country.

Obama's second mistake was to put too much emphasis on trying to sell the policy on moral grounds, providing insurance to 30 million Americans at risk. In the past, large entitlements like social security and Medicare have been sold largely on the grounds that everyone will benefit. Many voters were convinced that this was a Robin Hood project, giving their hard-earned money to people who might not deserve it. Maybe these people without insurance didn't work as hard and some of them didn't buy insurance even though they could afford it.

Although Obama did state that the legislation would control the unsustainable costs of Medicare, seniors interpreted this as cutting Medicare benefits and the Republicans picked this up, pointing to proposed cuts in Medicare Advantage and suggesting that "death panels" would cut costs by pulling the plug on dying seniors. Furthermore, people on the left argued that without a public insurance policy option there would be no way to control insurance companies which would reap the benefits from the legislation that required everyone to buy a policy.

I believe the legislation could be a major improvement of our health care system. Lives will be saved. There will be incentives for health-care providers to improve quality and control costs. The legislation could be better, especially in controlling costs, but rejecting it will be a step back for this country. If the bill passes, history will give Obama the credit for his leadership and his mistakes will be forgotten. If it does not, the list of his mistakes will doubtless be longer than the two offered here.

By Michael Maccoby

 |  March 18, 2010; 6:35 AM ET
Category:  Public policy Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   Del.icio.us   StumbleUpon   Technorati  
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This legislation will create innumerable problems which embroil the political class in Washington in health care costs and coverage decisions every year until it is repealed. Medicare and Medicaid will be starved to fund Obamacare and the entire healthcare structure will bankrupt our country. The budget projections are a sham, the same as the approval process.

Posted by: bruce18 | March 18, 2010 10:18 AM
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