Health care reform: The natural enemy of simplicity

Health care reform is not particularly suited to the simplicity doctrine.

As Barack Obama prepares for Wednesday’s speech on health-care reform to a joint session of Congress, he’s faced with a situation not unlike the fairgrounds game of Whack a Mole.  In that game, the mole keeps popping out of holes as you try to pound it back down with a rubber hammer. 

He’s got Republicans talking in bumper stickers (Death Squads!).  He has a system that doesn’t reward a focus on high-quality, low-cost health care.  Individual pieces of his proposal are under siege from special-interest groups.  And he’s offered up a watered-down proposal that seems to recognize political expediency over what’s right and audacious.

What we’re likely to hear on Wednesday night are a lot of stories about people who have been let down by the health-care system.  Don’t bother.  We’ve heard enough of those stories already.

What would I like to see on Wednesday night? A speech that lays out the key issues in a clear enough way that the media can’t screw it up in their summaries — which is how most people will learn what he says.  I’d like to see an empassioned speech that recognizes the fact that most of us find this issue incredibly confusing.  I’d like him to take back the details of this initiative from people like Nancy Pelosi and Harry Reid.

I want to be moved by his passion and determination and faith.  I want to be forced to think about right and wrong.  I want him to make partisanship a dangerous decision.   I don’t want a long speech that hammers me with facts and flowery language.

I want him to outline what Alan Webber calls an “iconic project” in his book Rules of Thumb.  I want the President to explain how change can happen, focus on what’s doable with economics that actually work (“Change happens when the cost of the status quo is greater than the risk of change,” Webber says elsewhere in the book.), identify key partners, and identify projects and actions that will establish his credibility.  I’d like him to “eat a frog” and outline exactly how we’re going to eliminate the ugliest part of this whole mess — however he defines that — over the next 90-120 days.

And I’d like a promise that says — in crystal clear terms — “I will veto any bill that doesn’t contain the following…” 

It is most important that President Obama draw a line in the sand that’s clear and doesn’t pander.  That would be leadership…and that would be Bulldog Simplicity.


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