Even before President Barack Obama’s address last week, it was easy to diagnose the current state of the union: undeniably anxious.
Time to restore trust
Lawmakers, administration need to reform their 'closed door' policy
Given political events over the past several months—most recently the Democrats’ loss of the Senate seat long held by Ted Kennedy to an upstart Republican—it’s also easy to see that the anxiety runs deep.
And it’s understandable. While the economy seems to be slowly yawning back from its slumber, one out of every 10 Americans still can’t find employment. Annual deficits are now routinely trailed by 12 zeroes. We’re waging two protracted wars. Our national security once again seems vulnerable, this time to the clumsiest would-be terrorists. Even Toyota cars have suddenly become unreliable.
Then there’s healthcare. Just last week on this page we published the obituary for comprehensive healthcare reform, documenting multiple reasons for its likely demise. Fear of its overarching effects, whether real or contrived, has steadily eroded public support. According to a recent Washington Post–ABC News Poll, approval of the president’s handling of healthcare dropped from a solid 57% last April to just 44% in January. Meanwhile, a Pew Research Center survey shows the percentage of those saying healthcare costs are a top priority is now lower than it was in both 2008 and 2007.
All of this is only a year after the overwhelming consensus in this country was that something needed to be done to revamp healthcare—to bend the cost curve, to cover more of the uninsured and to rein in abusive practices of the insurance industry. What happened? Did Congress and the White House overreach?
One line from the president’s speech last week might best explain what ails healthcare reform right now. “We face more than a deficit of dollars,” he said, referring to the massive challenges facing the nation. “We face a deficit of trust.”
Nowhere does that apply more than to the process Democrats in Congress employed to entice members of their own party—and a few others—to support the blockbuster bills that emerged in both houses. Who hasn’t heard repeated citations of “sweetheart deals” and bowing to special interests? A special Medicaid deal in Nebraska. More favored treatment in Louisiana. A lucrative exemption for labor unions to protect their “Cadillac” insurance plans. Whether such political horse-trading is just business as usual, to the American public it comes off as sleazy and destroys trust.
And we can’t ignore the secrecy issue. Too many negotiations during this long process have occurred in sessions closed to the media and the public. A search of the archives of Modern Healthcare returned dozens of reports since early 2009 citing “closed door” meetings during congressional health reform discussions. That’s sending the wrong message, especially with an administration that campaigned on transparency.
It’s also a lesson that should have been learned from the last serious attempt to revamp healthcare, during the Clinton administration, when such secrecy helped doom that bill.
The Clinton era is also remembered for the mantra, “It’s the economy, stupid.” It served as a constant reminder during Bill Clinton’s first presidential campaign of the one issue that superseded everything else. Democrats would do well to keep that in mind if and when they attempt to resurrect healthcare reform. The No. 1 issue is once again the economy, but healthcare represents one-sixth of that economy. Real healthcare reform could mean real economic gains. There’s opportunity here for lawmakers if they play it smart and work to regain the public’s trust.
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