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Those Pesky Details


HHS Secretary Kathleen Sebelius takes to the op-ed page of the Washington Post this morning to make the case for the Democrats’ health-care reform. The case she makes helps highlight why that effort is in such trouble. This bit is certainly the most fun:

President Obama and I are working closely with Democrats and Republicans in the House and Senate and health-care experts to make sure we get the details of health reform right. But we can’t let the details distract us from the huge benefits that reform will bring.

Can’t let those “details,” like what the plan will actually consist of and what it will cost, distract us from the huge benefits. The striking thing about her case as a whole is actually the utter lack of details. It’s clear the phrase “health reform” has tested well, as she asserts that this vague concept will perform all manner of impressive feats. “Through health reform, we can give every American access to quality, affordable health insurance so that if they do get sick, they have the best chance possible of getting better without bankrupting their families,” she writes. “Reform will close the gaps in our current system.” “Health reform means unleashing America’s entrepreneurs to chase their big ideas.”

But what is “health reform”? What specifically does the administration support or oppose? How in particular will any of this happen? Those are just distracting details, apparently.

Of course, we know in general what President Obama wants to see in a health-care reform, but the language of this op-ed sheds light on the peculiar situation the administration has worked itself into: sticking to generalities as the process on the Hill gets to some very detailed particulars, which the public increasingly finds disconcerting. Administration officials can’t defend those details from attacks because they haven’t said which of them they’re for and against exactly, so it’s hard not to seem like they support everything the public worries about and don’t care about the worries.

Obama’s health care tour around the country in recent weeks reminds me of George W. Bush’s social-security tour exactly four years ago: an effort to get people worked up about a problem while remaining exceedingly vague about the solution and leaving the details up to Congress. The effect then was to make the public question the true seriousness of the problem, and of the president. Something like that seems to be happening now, as public confidence in our existing health-care system has actually increased in recent months, while public confidence in the Obama administration has begun to decline.


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