On July 19th, 2009 Senator Jim DeMint (R-S.C.), while taking part in a conference call with conservative interest groups, reiterated his opposition to the healthcare reforms proposed by President Barrack Obama and high-ranking congressional Democrats. “If we are able to stop Obama on this, it will be his Waterloo. It will break him.” While Senator DeMint’s remarks were caulis, divisive, and mostly self-serving, they were not entirely misguided. But Waterloo is a poor reference—though it does pander to the increasingly populist Republican Party and their perennial disdain of all things French. A more accurate comparison would have been to assert that this could be Obama’s Iraq. The president has positioned himself, so far, to be defined by the success—or failure—of being able to pass a massive healthcare “reform” bill. President Obama should, however, seek to learn from his much-maligned predecessor, in that, the Bush presidency was one plagued with grandiose political plans, partisan dominance, and, what’s more, an overwhelming desire for political success. President George W. Bush built up so much momentum behind his plans to invade Iraq and oust Saddam Hussein that a he may have had no choice but to invade, not matter the potential pitfalls.[1] Concurrently, the more Obama beats the drum for healthcare “reform”, the more he may feel the need to “succeed.” While a massive healthcare bill will not result in a foreign policy disaster that has already taken the lives of thousands of Americans, nor nearly 100,000 Iraqis, the negative repercussions may be felt for decades. Moreover, while a retooling of the Bush administration’s Iraq policy may have been a foreign policy challenge, taking a step back and seeking a more pragmatic approach to healthcare reform would not harm the US image abroad, and, furthermore, may enhance Obama’s image at home.
Lead and succeed
President Obama is a gifted orator, an intellectual, and has shown an ability to adapt. He must display those qualities again, and, more importantly, a desire to actually lead. During the 2008 presidential election, President Obama managed to win over the majority of moderate voters despite being rated one of the most liberal senators in Washington. Those of us who contribute to this blog, like many Americans, hoped that Obama would live up to his promises and seek to work with conservative members of congress—in particular the moderates. This would be in the president’s interest for two main reasons. First of all, the Democrats enjoy such an advantage in both houses that they do not really need support from their Republican counterparts whose party is much maligned and in need of some degree of reinvention. Secondly, Speaker of the House Rep. Nancy Pelosi (D-CA) and Senate Majority Leader Sen. Harry Reid (D-NV) have seemingly taken control of Washington. This does not sit right with many moderate democrats, not to mention the increasingly populist GOP. Whether or not it was President Obama’s intention to delegate increased responsibilities to congressional democrats or, as some have accused, it was just his naiveté, it’s time for him to take the reins. Many high-ranking democrats seem to have diminished competencies since the departure of President Bush. Politically it would behoove the president to distance himself from these enigmatic democrats and embrace moderate republicans. He will most likely lose the democratic majority in one or both houses in 2010.
Change or victory?
President Obama should also seek to focus more on actually achieving his objective; which is different from just passing the healthcare bill. Rather than once again drawing a comparison to President George W. Bush’s initial Iraq, I would be remiss in not discussing President Bush’s ill-fated attempt at healthcare reform. I do not doubt, as with the majority of his policies, that the somewhat nefarious president did not truly seek actual and meaningful healthcare reforms during his presidency. Medicare Part D was originally intended to reduce national healthcare costs—especially for seniors, by reducing the costs of pharmaceuticals through a combination of negotiations and subsidies. But President Bush quickly ran up against the mighty pharmaceutical lobby and its massive war chest. Their lobby, which is able to gain access to party and Washington elite alike, posed a grand challenge to Bush’s original policy. The pharmaceutical lobby has no ubiquitous ideological or party affiliations, as such, the Bush administration may have seen challenging the lobby as both potentially futile and perilous. President Obama should make use of the current political climate. While he is being called a socialist, fecklessly populist icons are seemingly overrunning the GOP. Rather than embracing championing market-based reforms, many conservative politicians are shamelessly using fear mongering and name calling to wholly oppose any reforms. Congressional conservatives have pandered themselves into a corner, and Obama could possibly out the moderate conservatives by extending the olive branch of pragmatism and simplicity to the conservatives in congress.
Unfortunately, the Bush administration sought an apparent political victory over effectual reform—choosing instead to include fixed, non-negotiable prices for pharmaceuticals, thusly increasing the actual cost of healthcare and the continued crowding-out effect in the healthcare market. Likewise, President Obama faces a similar choice; he may either seek actual reform—change, or perceived political victory. The ever-changing healthcare bill grows more massive and loses efficacy by the day.
The US healthcare system is fraught with ever-increasing costs and institutionalized inefficiency. Whether feckless “conservative” pundits fail to see or willingly ignore it, the fact is that healthcare reform in the US is needed. This is not an indictment of physicians, insurers, the pharmaceutical industry, or, for that matter, current politicians. Rather, it is just yet another unfortunate byproduct the American political climate. Unlike “fighting terrorism” or “cutting taxes”, healthcare reform does not pay immediate dividends in political capital. Traditional conservatives, who are being drowned out by their populist usurpers, favor pragmatic and specific reforms. ObamaCare is growing increasingly hapless and costly. Presidential hopeful Obama championed “Change” as theme of his campaign. While large-scale change and, moreover, broad reforms are purposefully nearly impossible achieve, healthcare is in dire need of meaningful reform.
An American solution
I took a class once with man who uttered seemingly Marxian statements ad nauseum. I usually braced myself for extremely ideologically leftist comments every time I heard his voice. But one day who put forth a wonderfully insightful statement. “We don’t a Canadian, French, or German solution to healthcare. No, no, no. Our system is too awesome. We need a thoroughly American solution.” This statement was not only pragmatic, but also prophetic. The states he mentioned, as well as many others, face crippling healthcare and entitlements costs in the very near future.
The US is still the lone superpower in the international political economy. Despite the astonishingly rapacious economic rise of China, the US remains the most important power-player on the planet. In many industries, the US either sets the standard or is the envy of much of the world. Concurrently, the US should not be surprised to find out that skyrocketing healthcare costs are becoming an international pandemic. Many states that have managed to institute universal healthcare are now burdened with potentially exponentially increasing healthcare costs. The US should actually seek a pragmatic and systematic approach to healthcare reform. This may difficult, due to the face that political dividends may not be immediately forthcoming—at least from a domestic standpoint. But the US has been admired throughout most of the world for its ability to quickly change to meet challenges. Moreover, effectual and meaningful reforms in the US would only reaffirm American reverence throughout much of the world. For better or for worse, the rest of the world looks to the US for policy directives. Americans should not extrapolate such admirations into validation that perpetuates ignorance, but, moreover, as the breadth of opportunity and responsibility the US can meet in the international political economy.
As with global climate change, the US still has a tremendous opportunity reassert itself has the sole hegemonic power. It is unfortunate but true; the extremely fickle US political system is reflected worldwide; making effectual change in many areas difficult—but not impossible. It is not solely inherent greed that drives corporations; on the contrary, it is sustainability. Much as energy conglomerates will seek out possible new reserves and government protections or subsidies, corporations within the healthcare field will seek out policies that help protect their respective sustainability. As with many issues, from local to state to national levels, it is tangled web of complex and, what’s more, massive policies that have contributed to extremely exorbitant healthcare costs in the US. In the current American vernacular “business” or “finance” may be frowned upon, but unless we treat healthcare as a business, we may never decrease the inefficiency that is truly crippling the American tax-payer. Whatever populist figureheads from either side of the perceived political spectrum say, failed healthcare reform will cost American taxpayers. David Goldhill wonderfully illustrates the breadth of the inefficiencies, as well as the challenges to healthcare reform in the title article from the September 2009 issue of The Atlantic.[2]
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