10.16.10

Dems' New Misfire on Health Care

It’s probably too late to save the party from electoral disaster next month. But Obama and the Democrats can turn health care from an albatross into a positive for 2012 by flipping their script on the issue, says Douglas E. Schoen.

Earlier this year, top Democrats forecast boldly that once the president’s health-care bill passed, seemingly reluctant Americans would support the legislation.

They were wrong.

Back then, I wrote with Pat Caddell that ignoring the growing public opinion against the bill meant that the Democrats risked “unmitigated disaster” this fall.

Just a month before the midterm elections, the polls have demonstrated that my prediction was closer to the mark than that of the White House, and the administration and the Democrats are suffering as a result.

At least half, if not more, of the American people favor repealing the bill, according to a recent Rasmussen poll of likely voters, and other polling has echoed that finding.

Right now, almost all the Democrats who voted against the bill are campaigning against it. And most Democrats who voted for the legislation are distancing themselves as much as they can.

Both groups are avoiding talking about what the electorate wants and requires: a smart, reasonable, and rational discussion about health care in the next two years.

But by changing their dialogue fundamentally on health care, the Democrats can turn what almost certainly will prove to be an electoral disaster this year into a positive going forward—both for congressional Democrats and President Obama, as he approaches 2012.

Health-care reform has been an unmitigated disaster to date, that’s for sure. But it does not have to be that way going forward.

The health-care reform bill actually contains a number of components that are popular on a bipartisan basis, and can be emphasized—both in the waning days of the campaign, and in the future—as long as the Democrats fundamentally change their approach to the issue. 
Only with a different type of dialogue, message, and policies can they regain the high ground on health care and do what the American people want: contain costs, provide high-quality care, and take steps to rein in excesses in the system.

The American people do want insurance reform that prevents insurance companies from dropping coverage for people who become very ill. And they don’t want insurance companies to deny coverage to patients with preexisting conditions, which will be prohibited as of 2014.

The majority of Americans support a number of long-overdue reforms included in the bill that allow families to get free preventive check-ups with their doctor and young adults to stay on their parents’ insurance plans, and eliminating the “doughnut hole” in Medicare prescription drug coverage.

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There’s no need for the Democrats to run away from these popular elements of the bill, if they are put in the appropriate issue frame.

But if they are to have a meaningful dialogue on health care, the Democrats must talk not only about these popular initiatives, but also about what they have done and will do to curtail costs, as well as to develop new drugs.

Put simply, the Democrats must talk about health care within the context of fiscal discipline and budgetary restraint, specifically referencing the work of the National Commission on Fiscal Responsibility and Reform, a bipartisan commission chaired by former Sen. Alan Simpson (R-WY) and former Clinton chief of staff Erskine Bowles that has been charged with addressing the nation’s overall budget problems.

The party must exhibit a willingness to take on all aspects of spending and make clear that the administration is committed to entitlement reform while addressing the large-scale fiscal problems facing the nation.

But beyond that the Democrats must put forth a national strategy that facilitates and encourages private sector innovation as one of the critical ways to resolve our economic crisis and create a path that ensures long-term economic opportunities are facilitated, as well as developing the cutting-edge technologies and new drugs we need to help cure chronic, debilitating, and frequently fatal diseases.

If the Democrats can succeed in doing this in a way that makes it clear that they have a positive and optimistic agenda, they will be able to achieve two goals the American people regard as fundamental:

Address costs in a serious and sustained manner.

Facilitate private sector job creation and the development of new drugs

They can talk about cost containment in several ways.

The Democrats should talk about reducing insurance costs—not simply by bashing insurance companies but by working with them constructively, as part of a public-private sector initiative.

To that end, IBM CEO Samuel Palmisano recently met with Obama and offered to work, free of charge, to reduce health-care waste, fraud, and costs by $900 billion. The Obama administration turned down this offer flat, for reasons best known to itself.

To be fair, the new health-care law did attempt to contain Medicare costs through a new body called the Independent Payment Advisory Board, which has gotten little attention to date.

Medicare cost containment is critical, and the IPAB has the opportunity to become a model of bipartisanship, efficacy, and accountability to average voters by functioning as the body to rein in Medicare’s cost growth.

Finally, there needs to be a commitment to and a mechanism that takes the recommendations of the bipartisan budget commission and the IPAB and make them operational.

The bottom line remains that unless the Democrats are able to become credible advocates for cost containment, they will not succeed politically, and they certainly will not begin to have any success in doing what the American people regard as fundamental: reining in costs.

Health-care reform has been an unmitigated disaster to date, that’s for sure. But it does not have to be that way going forward.

With an emphasis on those aspects of the bill that work, an acknowledgement that the health-care reform needs to be fundamentally recast to encourage innovation and the development of new drugs, and by putting cost containment at the center of all efforts going forward, the Democrats have the chance to recast an initiative that could well play a major role in costing them control of the House and the Senate next month.

Douglas Schoen is a political strategist and author of the upcoming book Mad as Hell: How the Tea Party Movement is Fundamentally Remaking Our Two-Party System to be published by Harper, an imprint of HarperCollins on September 14. Schoen has worked on numerous campaigns, including those of Bill Clinton, Hillary Clinton, Michael Bloomberg, Evan Bayh, Tony Blair, and Ed Koch.