Why Health Care Reform Will Fail.


The answer is complicated but certainly not beyond comprehension. Health care reform is a large and complicated undertaking and affects every American, not just the uninsured. The American people understand what a hastily constructed and thinly vetted plan can mean to their standard of care. For that reason it requires a great deal of confidence on the part of voters that the authors of any such legislation have the public’s best interest at heart. It requires that legislators can be trusted to keep promises and act in an honest open fashion.

Therein lays the crux of the problem. Politicians are not known for their abundant integrity, quite the contrary, most people fully expect politicians to act contrary to their word and solely in their own self-interests. But in November of 2008 voters believed that they were getting something new and heretofore unseen, the stuff of myths and legends; a new kind of politician.

Obama’s campaign was brimming with promises of hope and change, a new kind of government and a refutation of the old Washington ways. Obama made many other, more specific, promises as well; this too is part of the problem.

Since the election President Obama has worked hard to see his lofty agenda passed into law. In the beginning he had the support of the American people but that support has since waned. The reason is fairly straight forward; the people voted for a new kind of politician and got instead a new kind of deception; one called hope and change.

The fundamental stumbling block that has presented itself in the rush to health care reform is simply a credibility gap. The American people no longer believe that this administration is dealing with them honestly. This is a self inflicted, and possibly mortal, wound that resulted from as string of broken promises.

During the campaign Obama promised to provide transparency in government by reducing bills rushed through Congress and to the president before the public had the opportunity to review them, Obama "will not sign any non-emergency bill without giving the American public an opportunity to review and comment on the White House website for five days."

That promise was almost immediately forgotten. The most commonly cited example of the lot is the stimulus, it however was not the promise breaker as it was classified as emergency legislation and therefore exempt. Here are two examples that do quantitatively violate Obama’s promise:

The Credit Card Accountability, Responsibility, and Disclosure (CARD) Act of 2009 on May 22, signed only two days after the bill was finalized in Congress.

The State Children's Health Insurance Program, which provides health coverage for low-income children. He signed it on Feb. 4, 2009, just hours after it was finalized in Congress.

So much for giving the people a chance to weigh in.

President Obama promised to limit the power of lobbyists by restricting their service in his administration. In his own words: "No political appointees in an Obama-Biden administration will be permitted to work on regulations or contracts directly and substantially related to their prior employer for two years. And no political appointee will be able to lobby the executive branch after leaving government service during the remainder of the administration."

A few examples of how that promise quickly evaporated in the flames of subterfuge:

The nomination of former Raytheon lobbyist William J. Lynn to be deputy defense secretary was one violation of that promise.

The nomination of Jocelyn Frye, who is now director of policy and projects in the Office of the First Lady, was another violation of that promise. She previously lobbied for National Partnership for Women and Families from 2001 to 2008. The organization advocates for fairness in the workplace, access to health care and "policies that help women and men meet the dual demands of work and family." Many of the laws for which Frye lobbied are things Obama has supported. In 2008, for example, she was listed as lobbyist working for the Lilly Ledbetter Fair Pay Act, the first law Obama signed into law after becoming president. (Source: http://www.politifact.com/truth-o-meter/promises/)

And the last example that I will list is the nomination of Cecilia Muñoz, now director of intergovernmental affairs in the Executive Office of the President, managing the White House’s relationships with state and local governments. She has also been designated the administration's a principal liaison to the Hispanic community. Muñoz formerly lobbied for National Council of La Raza, a Hispanic civil rights and advocacy organization, between 1998 and 2008. Records show she lobbied on issues like the State Children's Health Insurance Program (SCHIP), improving Head Start and youth intervention programs. (Source: http://www.politifact.com/truth-o-meter/promises/)

With lobbyists so entwined in key positions within the administration is it unfair to associate this administration with those in the past who were influenced by special interests? It should at least give cause to question the motivation behind policy initiatives.

Perhaps most germane to the current furor raging over health care reform was the promise to construct this legislation in an open, televised, format. If the public were privy to the machinations that were responsible for forming such momentous legislation they may be more at ease with its support; or more opposed to its passage. But in either case Obama made the following pledge:

To achieve health care reform, "I'm going to have all the negotiations around a big table. We'll have doctors and nurses and hospital administrators. Insurance companies, drug companies -- they'll get a seat at the table, they just won't be able to buy every chair. But what we will do is, we'll have the negotiations televised on C-SPAN, so that people can see who is making arguments on behalf of their constituents, and who are making arguments on behalf of the drug companies or the insurance companies. And so, that approach, I think is what is going to allow people to stay involved in this process."

So far, substantial negotiations on health reform have been held behind closed doors. These include two agreements with the drug industry and hospitals to reduce costs over the next 10 years.

Obama promised transparency; he promised to remove lobbyists from the equation; and he promised to conduct the business of government in full view of the public eye. I suspect that these promises were made to garner the trust of a populace who had come to regard politicians with a weary eye. The promises would have provided a solid foundation upon which to build health care reform but they never materialized. This leaves Obama to build his legislation on the shifting, and unpredictable, sands of fading public support. The result will likely be a large resounding crash as it all comes tumbling down around him.

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