Obama Must Face Reality
Politicians think speechwriters are miracle workers: “I was just arrested on charges of soliciting underage prostitutes and charging the cost to my government department … can you write a speech that will turn things around for me?”
Barack Obama is not in that kind of trouble, not yet anyway. But his health reform plans are sinking, and so Wednesday evening he will try to rescue them with a big speech, a televised address to a joint session of Congress.
Bill Clinton tried exactly the same thing, on exactly the same subject, almost exactly 16 years ago. The speech briefly boosted the poll numbers for Clinton’s health plans. But it could not overcome the political realities that doomed the Clinton plan. Will Obama succeed better?
Only if he understands exactly why he is in trouble. The President’s supporters may believe that he is being battered by a fear-mongering right wing. In reality, the President’s ambitions are bumping up against hard realities of American politics — and unless he accommodates those realities, he will fail.
Reality 1: The people who care most about health care are senior citizens — but senior citizens are the biggest losers under the Democratic plans.
Americans over age 65 are covered by the U.S. Medicare program. Medicare is hugely popular but financially unstable: If the program followed private-sector accounting rules, it would be underfunded by US$34-trillion.
The version of health reform enacted by the Democratic majority in the House of Representatives proposed to cut US$500-billion out of Medicare over the next 10 years. Most of that savings would come from curtailing Medicare Advantage, a sub-program within Medicare run by private insurers that offers a more attractive package of benefits. About one-fifth of American seniors are enrolled in Medicare Advantage.
Predictably, seniors dislike the idea. They know that Medicare is in trouble as is. Now its problems are to be made worse in order to finance an expansion of benefits for people under 65. No surprise that of all age groups, the over 65s are most hostile to the President’s plans. Over 65s also are more likely to turn out to vote than any other age group — especially in off-year congressional elections like those in 2010. It will take more than a speech to reassure seniors.
Reality 2: The President’s liberal supporters are in no mood to compromise — but lack the votes to win without compromising.
The House bill includes a so-called “public option,” meaning a government-run insurance program. This public option has become a fetish for liberals, who claim that as many as 60 House Democrats will oppose any plan that fails to include such a thing. On the other hand, not only Republicans but important moderate Democrats like Senator Kent Conrad will oppose any bill that includes a public option.
Democratic liberals often look back wistfully at previous reform proposals they rejected — like the plan for universal coverage offered by Richard Nixon in 1969. They promise themselves that if they ever get the chance again, they will learn from past mistakes. Now they have that chance — and they are repeating their past mistakes. It will take more than a speech to discipline rambunctious House liberals.
Reality 3: The U.S. public debt is bulging to the point that it has become a voting issue — and all independent analysis shows that the President’s plans will make the debt burden even higher.
The recession plus the Obama stimulus plus the spending increases in the ordinary budget plus the cost of fighting in Afghanistan and Iraq together imply that the debt will rise by the middle of this decade to nearly 100% of GDP, a level last seen at the end of the Second World War.
This immense debt is seriously frightening voters. More than 80% tell Gallup they are worried about the accumulation of debt, and Obama scores worse on handling of debt than any other issue. The Congressional Budget Office estimates that the House plan will add US$200-billion to the U.S. budget deficit, lethally contradicting the President’s promises that his plans will actually save money.
It will take more than a speech to convince wary taxpayers that the country can afford the President’s ambitions.
Can those three realities be confronted and overcome? Yes theoretically. But can they be overcome by Barack Obama? Does he have the wisdom, restraint and flexibility to jettison the bad approach foisted on him by liberal House Democrats and build a broad national consensus? More than soaring rhetoric, it is the presence or lack of those qualities that will determine the success of Wednesday’s speech, of health reform — and indeed of the Obama presidency.
Originally published in the National Post.