The Corner

Can Someone, Anyone Explain Health-Care Reform?

Last week the president had a lengthy interview with Time’s Karen Tumulty. I’m somewhat surprised that more hasn’t been made of the interview — other than mostly sympathetic reactions on liberal blogs — because the president’s comments about the health care debate are revealing:

I think that there is a terrific case to be made to the American public. But it is — this is complicated, it’s difficult. Without giving you a hard time, Karen, because I think you’ve been terrific in reporting this, the press gets bored with the details easily, and it very easily slips into a very conventional debate about government-run health care versus the free market, et cetera, which is not at all what the real debate is about, but that’s a lot of times how it gets shaded or framed in the press — all of which feeds the public spheres, even though they know that the system we have isn’t working very well.

I was bit startled to realize the president doesn’t think that the health care debate isn’t at all about “government-run health care versus the free market.” Here’s the problem according to the president:

And I will say that this has been the most difficult test for me so far in public life, trying to describe in clear, simple terms how important it is that we reform this system. The case is so clear to me. And when I sit with our policy advisors — we had somebody here sitting right there this morning who is a medical expert, worked at McKinsey for a while, he’s now working on our health care team — and he just ran through: We pay 77 percent more on prescription drugs, we’re paying $6,000 more per individual on health care than any other industrialized nation; here’s all the failures in the delivery system that account for it. … And when you just start hearing the litany of facts, what you say to yourself is this shouldn’t be such a hard case to make, because the American consumer is really not getting a good deal.

Without going into the specifics of the McKinsey study he’s citing here and debating the root causes of rising costs in the heavily regulated health care market, it appears the president broadly thinks the problem is the American people don’t understand “how important it is that we reform this system.”

But I think the president has inadvertantly hit on the crux of the problem in selling his heath-care reform. Pointing out a problem doesn’t automatically suggest a solution — assuming it does is the only way Obama can make his credulous assertion that the health-care debate is not about “government-run health-care versus the free market.” I’m not sure that the American public is necessarily unaware that the health-care system has tremendous inefficiencies or that costs are rising at an untenable rate; it’s entirely possible the public is aware of the problems and still remain unsure Obama’s proposed solution of dumping 119 million people in government-run “public plan” and the accompanying increased regulation will necesarily make things better. And yet, the president seems hell bent on convincing people that there’s a crisis going to waste and something needs to be done rather than making a case for why his specific legislation needs to be enacted.

Of course, regarding that point it’s pretty telling that whenever the president does delve into the specifics of his proposed health-care policy he’s serially dishonest — see Rich’s great column on the subject here. In the same interview in Time, the president admits “I will confess: I don’t spend a lot of time looking at my polls. I do look at the polling on health care.” I wonder whether the dishonesty is a result of the White House never thinking there was a winning case to be made to the public about the merits of their specific health-care proposals to begin with.

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