Sunday, June 7, 2009

Health-care Reform: A Litmus Test for a President and his Proposed Epoch

Everything President Barack Obama has achieved legislatively up to this moment - even the much touted $800 billion economic stimulus bill - has been relatively easy; mostly expedited and achieved in the name of economic emergency. And the president has been upfront all along that these early accomplishments were but prologue to the health-care battle to come. Pundits have been saying for a long time that this president chooses his battles and knows well the importance of preserving his political capital. Well, the moment Obama has been saving up for is here, and the stakes are as high as the president is ambitious.

To put things more starkly - if President Obama's proposed health-care reform fails, then his presidential honeymoon is decidedly over. For all the euphoric talk of the era of Obama, if he fails to deliver on health-care, then he would have proven himself to be just another Bill Clinton. Obama would not be a reconstructive leader in the mold of Franklin Roosevelt, and the era of big government will still be over.

Conversely, successful health-care reform will be legacy-making. Generations of Americans will remember Barack Obama for what he did for them, and they will remain as loyal Democratic party constituents for decades to come. Successful health-care reform will be tangible proof that the era of ("better") government is back, and it would have been Obama (like FDR 80 years ago) who took us there.

The stakes then, could not be higher, and the task no more enormous. Overhauling our health-care system runs up against almost every institutional and structural pathology of American democracy: multifarious and over-zealous interest group politics, power struggles between Congress and the presidency, and the ideological chasm between the two major parties about the role of government. Health-care policy is one of those policies in which the public and indeed pundits know relatively little about. Very few people are going to peruse the hundreds of pages of bill(s) under consideration. So watch for it - this means reform will invariably be sold and criticized with generalizing slogans. The Obama administration will have to play a delicate balancing act of negotiating details with the experts on Capitol Hill and captains of the insurance and pharmaceutical industries (who are probably going to be the only groups who will be incentivized to keep track of the facts and figures), persuading lay persons with a clear and yet truthful account of what is at stake, while also deflecting the simplistic slogans dissenting organized interests will disseminate in media blitzkriegs.

Elections are just regularized signposts on the American calendar. The media focusses on it because viewers and voters like to keep up with a horse-race. But history is marked not by these regularly scheduled events, but by the passage of landmark legislation that durably alters the relationship (for better or for worse) between government and its wards. How historians will remember our era will turn on what happens in the next crucial months. As President Obama's audacity is about to be tested, so is America at the precipice of an epochal test.

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