Posted by
Buster Foghorn on Saturday, September 05, 2009 4:45:06 PM
What should President Obama say next week to a joint session of Congress about health care reform? Should he push ahead with more of his stump speech assurances, more guarantees of cost cutting without any impact on quality of care, or should he “reset” the playing field?
Judging by his declining approval numbers during August, a reset should certainly be considered. In fact, in a recent column, It’s Time for Obama to Change Course, blogger Jay Cost at Real Clear Politics argued that the declining poll numbers threaten the President’s “power to persuade.” And if he wants to advance new health care reforms through Congress, then he needs a course correction. His first recommendation for the President is for him to recognize that “the Cheese stands alone,” alone on the mountain top he stands, and he must act accordingly. Even if it is unpopular with those around him; the call is his alone to make. He has to take charge. He has to chart a course.
If we just focus on this idea for now that the President has to lead even if advisors or supporters are not completely happy, then how might the President change course? What might the President do if he wanted to recapture the center? What would a fundamental shakeup look like?
One suggestion, by Cost, would be for the President to adopt some of his campaign rhetoric. Following up on that suggestion, the President argued as a candidate that sacrifices—yes, sacrifices—would be asked of everyone. Why not reverse the current assumption that Congress, the unions, and trial lawyers are off limits in the health care debate?
Why not begin by asking the political class to lead by example—a time honored tradition in our military—by announcing that there will not be a two-tiered system? That any reform will apply equally to Congress and the President—and if Congress likes its current health care system and wants to keep it, then they must pass similar coverage for all Medicare recipients.
The unions were among the President’s biggest supporters. If they won’t sacrifice to help him, why should anyone else agree to inferior care or less care than they currently receive? If our private health spending is “too high because our tax rules lead to the wrong kind of insurance,” the President should urge Congress to close the current health-insurance exclusion even if the unions “are particularly vehement in their opposition to any reduction in the tax subsidy.”
Trial lawyers were big supporters of the President. But needless medical procedures ordered merely to inoculate physicians from litigation are a large part of our health care costs. Why can’t punitive damages, designed to punish a plaintiff for misconduct, be awarded to a government owned trust fund to pay for Medicaid rather than being distributed as a windfall to a plaintiff? Congress could set a 20% compensations rate for lawyers pursuing punitive damages in egregious cases, recognizing their contribution to the public interest.
A fundamental shake-up that shows real leadership might help the President gain the confidence of voters, restoring his credibility and “power to persuade,” garnering him a second chance to see health care reform succeed.