Three Important Things That Are Missing From Healthcare Talks

The healthcare "debates" have been underwhelming. President Obama has behaved as if he: 1. is afraid to take a solid position; 2. lacks the passion on this issue suggested by his campaign; or 3. is so strongly committed to making everyone happy that he wants to keep an open and largely undefined position. Neither of these options, however, contributes to solid debate or to an effective marketing strategy.

Obama's amorphous stance on the issue has prevented him from delivering a coherent case for reforming the nation's healthcare system. As a liberal, I am inclined towards healthcare reform. Nevertheless, if had to rely solely upon Obama's marketing of this issue, I am not sure he would get my vote.

Over the weekend, the news wires reported that the White House was getting ready to ditch the public plan option, which was a part of Obama's campaign. Today, however, many of the same media are suggesting that Obama was simply testing the political climate or that the media misread signals from the Obama administration. Regardless of his intent, many liberals (in Congress, the blog world and elsewhere) have pushed back against a White House plan (real or imagined) to abandon the public plan option.

Changing the Debate
Because Congress will not vote on this issue in the immediate future, there is still sufficient time to conduct a useful debate regarding healthcare reform. Here are three ways that the President -- and the Republicans -- can do a much better job than they already have. It would be hard for them to do worse.

What Is Missing from Healthcare Reform Talks?

ONE: Medical Professionals
For the most part, politicians have led healthcare talks on behalf of the White House (and Republicans). Members of Congress and, more recently, Obama himself have held "townhall" discussions trying to market the idea. While some of these sessions were interrupted by protests, others were conducted smoothly.

The debate so far, however, lacks a strong contribution from the medical profession. Although doctors and nurses are represented in Obama's "consensus" group, they are not at the center of the townhalls, and politicians have not sufficiently utilized the medical profession's expert knowledge on the issue of healthcare. This is an absolutely inexplicable and damaging omission.

Doctors and nurses are at the frontline of the healthcare industry. They have keen insight on patient needs and their own professional requirements. Certainly, voters would benefit more it they heard the views of doctors and nurses than they would if they continued to hear primarily the voices of Sarah Palin, Charles Grassley, Kent Conrad, other members of Congress, and yelling protestors. Hearing medical professionals explain why they support or oppose various aspects of the proposed reform legislation could really improve the talks.

TWO: The Uninsured
During Hillary Clinton's unsuccessful presidential campaign, she often told the story of a young pregnant woman who died, along with her infant child, after a hospital denied her care. The woman was uninsured and owed the hospital $100. Several anti-Clinton journalists said that Clinton was "veer[ing] on the dark side." But it is easy for a journalist who has health insurance to dismiss stories about the plight of the uninsured as too gloomy. These stories, however, are not fictional (a falsehood the media floated); they represent real life in the United States. And even journalists who portrayed the stories as representing the "dark side" admitted that they were effective with voters.

The fact that the White House has not spent much time personalizing the issue of healthcare reform is perplexing. A compelling personal narrative could reach voters who are on the fence and embolden those individuals who already support the proposed reforms. As talks continue, the White House should definitely do more to portray the experiences of uninsured people.

THREE: Economists
The "bottom line" has driven many of the protests by opponents of the Democrats' healthcare proposals. Nevertheless, the talks have not prominently featured the views of economists who could talk about the macroeconomic impact of financing the various proposals and who could analyze the potential savings, if any, that the reforms could generate in the long run.

In part, the White House has not discussed the money issue too greatly because Obama is afraid of tackling the "T" word. But as Robert Reich recently argued, it is time to come clean. Healthcare reform will certainly cost money, and it will increase the deficit in the absence of new taxes in the shortrun. And unless GDP increases, tax revenues will continue to fall. These are serious issues, which complicate the Democrats' proposals. The public, however, can decide whether it wants to make the investment.

Also, the taxation issue is not as politically dangerous as Obama's behavior might suggest. Robert Reich advises Obama to confront this issue, but he says that:

[T]axes will be raised only on the very top. The President needs to decide whether he favors a surcharge on the top 2 percent, or a cap on tax-free employee benefits (which would affect only the very top), or some combination, and then announce which he prefers and why.

President Bush convinced the nation to spend nearly $700 billion dollars and to send thousands of Americans to their deaths or to serious injuries looking for nonexistent weapons of mass destruction and forcing "regime change" in a country that was not a threat to the United States. Given this recent history, I suspect that the nation could also decide, if given adequate information, to invest in healthcare reform. Paying attention to the bottom line will help the public assess the costs and benefits.

Former Labor Secretary Robert Reich has some great advice for Obama on this subject. See: How To Fight Heathcare Fearmongers and Demagogues.