Who could imagine that the battle cry of "health insurance reform" would fail to ignite a political brushfire? And so we see an entropic story unfolding: It's a tale of not only political enervation, but also an epic tale of policy defeat.
And that's what happens when a well-meaning leader follows a bad political model. The American people want Serious Medicine, and they would tolerate a certain amount of arcane process reform if that's what it took to get that Serious Medicine. But make no mistake--they do want the Serious Medicine, even if they can't necessarily articulate what they want. So it's a grave error--not to mention a missed opportunity--to lead with process reform, and to ignore Serious Medicine.
But don't take my word for it: Ask The New York Times. The headline atop Jeff Zeleny's piece in the Times on Saturday is a study in punch-pulling politeness and understatement: "Health Debate Fails to Ignite Obama’s Grass Roots."
But the harsher hard-hitting reality, which is hard to overstate, is captured by the Times' accompanying photograph of a quiet room (see above) used by Barack Obama's group, Organizing For America. Yup, at a time when Democratic clubhouses should be beehives of activity, they are mostly worker-bee-less. And this is in Iowa, the state that propelled Obama to the Democratic nomination last year, by giving him a crucial victory in the Hawkeye State's presidential caucus.
As the Times explains:
More than a dozen campaign volunteers, precinct captains and team leaders from all corners of Iowa, who dedicated a large share of their time in 2007 and 2008 to Mr. Obama, said in interviews this week that they supported the president completely but were taking a break from politics and were not active members of Organizing for America.
Whoa. "Taking a break from politics"? Excuse me, but that's not how political activists operate. They get into politics because they like a campaign, or, if one prefers, a crusade. And they get out when they don't have such an energizing effort to throw themselves into--or when their eager hearts are broken. And yet that's what Obama has given Democratic activists--a heartbreaking, de-energizing argument.
This is the price Democrats are paying for a plan that Mary Frances Berry, a veteran lefty, described as "bloodless." As in, being focused on the pale pastels of financial processes for health care, as opposed to the bright bold colors of an ambitious plan to make Americans healthier, and to help them live longer and enjoy more productive lives.
But such a pro-health plan not what they got in the "health care policy" that was handed down to them from Ezekiel Emanuel & Co. No, Americans didn't get a plan for making health care better. Instead, they got a plan for rationing and income transfers. And the folks didn't like it, because, among other concerns, after TARP and all the bailouts, they didn't think America could afford it.
So that's the main reason why Obama has pretty much dropped the idea of the "public option"; as the President said in May, in a moment of candor, "We're out of money."
But of course, we are out of money for health care because Obama chose to spend that money on other priorities--Tim Geithner's friends. As I myself argued in the pages of US News & World Report back in June, Obama shot his financial wad in the Wall Street bailouts. Given a choice between investment bankers and non-masters-of-the-universe, Obama and his investment-banker-ish advisers chose... investment bankers. Maybe Goldman Sachs and J.P. Morgan can make those grassrootsy phone calls in Iowa.
Such a failure of vision might seem ironic for The One. But Obama was merely reflecting the distilled conventional wisdom of most health care "experts" across the field, and it never seems to have occurred to him to look outside the circle of their wisdom. Big mistake.
So for now, in the meantime, fans of Serious Medicine will just have to wait--wait for a visionary leader who will wrestle with the great issues of medicine and life, not settling for a wonky working of "health care policy."
Obama and his team all failed to grapple--"chose not to grapple" is probably a more accurate sum-up--with any attempt at solving the challenges of premature death and fearful disability. You know, seek real cures. Just like we did with smallpox, or TB, or polio, or any of a hundred other killers. Some would say that fighting illness is not the true measure of "health care policy." And in Washington DC terms, they might be right. But in American terms, they are wrong. The American people want to fight for their own health, not fight for "health insurance reform."
Shrinking away from the true stuff of medicine, the Obamans settled for mere shadows of the more vivid reality, like the prisoners in Plato's Cave. They failed to grapple with the agony and ecstasy of medicine and life. And that's why activists are enervated, not energized.
But if a U.S. leader would take on the fullness of health issues, the way Americans--and people everywhere--experience that fullness, he or she would grab the energies of not only activists, but voters, and victories concerning "process" would fall into his or her lap.