President Obama's New Aggressiveness Welcomed

Eugene Robinson expressed disappointment in President Obama's wish to take the middle road and seek bipartisan support for health care reform, acknowledging that attempting to work with Republicans would be expedient, "But we didn't elect Obama to be an expedient president. We elected him to be a great one."

The president's waffling on the issue of a "public option" as a counterbalance and as competition to and with the private for-profit insurance industry is endemic to the overall approach by the White House in proposing a comprehensive reform of the American health care delivery system. During the past several days, there have been some suggestions by Democrats that they should push for legislation on their own; after all, the Democrats won the past two elections based upon the promise that government had a role in promoting, in the words of the Constitution's Preamble, "the general welfare" of the people. (Lest anyone become distracted, the word "welfare" in the 18^th century document meant health, well-being and happiness and not organized programs to aid the poor or otherwise disadvantaged.)

I have urged, in this space and elsewhere, that President Obama had to become more aggressive and clear in his statements as to exactly what he is proposing and the minimum reforms he will accept. The president's failure to do so may be understandable in the light of past efforts to address the inadequacies in health care, but it is time that he fills in the blanks.

The last attempt at a total overhaul of the health care system was during the Clinton administration. The conventional wisdom is that it failed because it was drafted behind closed doors with minimal input by lobbyists or others not specifically invited to the discussions and then presented to the Congress and the public as a fait accompli. Thus, President Obama took the other extreme; without setting forth details of that which he would demand, he looked to members of Congress to negotiate and hash out those details in a cooperative and bi-partisan manner.

He has failed because for the past 30 years since Ronald Reagan there has been a strange and unhealthy concept being sold to the public: Government is incapable of addressing, much less solving, society's problems. The Obama administration is expressing their beliefs to the contrary. If Government is so impotent, then why have a government at all? There are, after all, examples aplenty where the federal government is quite successful in its duties. If one were to, for example, consider federal efforts at health services, the Veterans' Administration appears to be providing health care more efficiently and at lower cost than the private system. With some exceptions, the Medicare program is successful enough that few seniors would want it eliminated or replaced.

There seems to be a general agreement that the present system is broken. Unless something is done, increasing projected costs to Medicare and Medicaid will be not be sustainable within a few years. Moreover, escalating non-government health costs will be exerting an overpowering drag on the nation's economy. All the while, the United States drags behind other industrial countries in providing for universal health care for its citizens and is also behind in the quality and results of health care generally. We simply do not get our money's worth; we can argue that it's the greedy lawyers, the greedy doctors, the redundant testing of patients, the greed of the pharmaceutical industry, the imbalance of physicians and equipment throughout the country - and some or all of that may be true - but the fact remains we spend more and benefit less. There are non-governmental operations that appear to serve as examples of how the system could and should run; the Mayo and Cleveland Clinics and the Kaiser Permanente organization headquartered in California are often suggested as exemplars.

The failure by President Obama to take the lead in pushing for specific programs has created a vacuum, one in which those fringe interest groups opposed to any reform have tried to fill. There has been a long history in this country wherein the threat of "socialism" has been used to condemn change and progress. As I have noted, Medicare is now accepted and favored by virtually all senior citizens who benefit from the program, yet, in 1981, Ronald Reagan raised the specter of socialism. [http://www.youtube.com/watch?v=6FzNTB1qtFA]

Some of the vociferous voices raised in opposition to President Obama come from political opportunists. Some Republicans, in Congress and elsewhere, wish to have the president and his party fail and be perceived as failures. While a failure by President Obama will cause drastic failure for the nation as a whole, they look only to the 2010, 2012 and future elections; if the Democrats are repudiated by the voters (just as were the Republicans last year), then the GOP power will be restored.

There are, however, many sincere and well intentioned people who are uneasy and frightened, frightened by the unknown. These fears have led to absurdities and falsehoods regarding the health care proposals supported by the administration and being considered in Congress.

In the absence of facts, some woefully ignorant, or cynically manipulative, Republican spokespersons have warned of death panels, of government officials deciding on whether your grandmother should be euthanized, of children being taken from loving parents so that they may be raised communally, of adoption of Nazi-like horrors and the list goes on. Up to now, the Democrats and the White House have been spending time and effort in repudiating these tales but these same officials, including the president, have not explained the details of what they want, how it will be paid and why it is necessary.

Cent Uyger, writing in The Huffington Post, reflects on what Democrats should do and should have been doing all along:

"Announce that you must do the will of the people by voting as a Democratic bloc. The American people voted for 60 Democratic senators, and 60 Democratic senators they should have. Anything else would be a slap in the face of democracy.

"If they wanted the Republicans to be in charge, they could have easily voted that way. If they wanted the Republicans to be able to block legislation with filibusters, they could have given them 41 senators. But the American people in their infinite wisdom chose not to. They chose to give the Democrats an unstoppable coalition so that they could bring the real change they were promised.

"Treat the Republicans as the irrelevancy they are. Let them cry in the corner, but under no circumstances should you allow the press to consider them a pertinent part of this debate. Remind the press at every turn what they said and what they wrote when the Democrats were in the minority -- that the Republicans represented mainstream America and that the Democrats should not be covered because media coverage is about what will actually get done. Now that the Democrats have much larger majorities than the Republicans ever had, the opposite must also be true -- Republicans are an irrelevant minority party and the Democrats are the mainstream."

Perhaps we are moving to that point, at long last. Jim Manley, spokesman for Senate majority leader Harry Reid, warned Republicans that the White House and Senate Democratic leaders still prefer a bipartisan bill, but "patience is not unlimited, and we are determined to get something done this year by any legislative means necessary,''

It's about time. We've been waiting far too long.