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The Democratic Strategist

Political Strategy for a Permanent Democratic Majority

Damned If He Did

Over at TNR, Jonathan Cohn asks whether the Obama White House should have promoted a different message on health reform from the beginning, and makes a point that should be pretty obvious by now: administration efforts to respond to demands for cost control measures by deficit hawks earlier this year led to all the rationing talk that reform opponents are now using to scare Americans.

The trouble for Obama is that, in getting serious about cost, he gave critics lots of fat, juicy targets. Obama proposed to tie payments to quality; Betsy McCaughey said he would be giving doctors money for pulling the plug on grandma. Obama proposed to put a board of experts, using clinical evidence, to set Medicare payment rates; Sarah Palin interpreted that as creating a “death panel” that would declare the sick and disabled unworthy of treatment. The great irony is that by trying earnestly to craft a plan that could control costs, as well as expand coverage, Obama has provoked a political backlash that will make cost control harder in the future. He’s tried to tackle health care like a grown-up and, at the moment, he’s suffering for it politically.

The long-range political implications of what’s happened on cost control are, as Cohn suggested, pretty troubling. Right now it appears a lot of Americans can’t distinguish between quality-and-cost based second-guessing of doctors’ decisions, and euthanasia. If for years to come, any suggestions for questioning provider costs or treatments are greeted with shrieks of “Rationing!” Rationing!” we’re going to have a real hard time ever getting a grip on health care costs. It’s ironic that Republicans are the ones who have promoted the backlash against cost control, even as they still wail about deficits and costs.

3 comments on “Damned If He Did

  1. tLynn on

    Obama could be fairly criticized for launching competing health care reform messages that create logical inconsistencies. But health care reform isn’t being killed by logic but by gut punches. I would argue that “death panels” burrow into the psyche on many more levels than cost. Uncaring bureaucrats, anti-life liberals, big brother, etc. Obama struggles to keep the public discourse rational while the Republicans, Fox News, and conservative pundits counter with preposterous emotional attacks. The attacks are so provocative that the media just can’t help paying way too much attention. The Obama administration should have been ready with powerful evocative answers. Of course, this isn’t easy — I’m not sitting any fantastic rejoinders. But maybe someone should see if some of Jon Stewart’s writers might like to do a little moonlighting while their boss is on vacation.

  2. Mike on

    Isn’t the problem that Obama said he was focused on cost-controls and, also, that everyone would get to keep what they had, and that we’d insure the uninsured? Seems to me that it was of the administration’s “have-cake-eat-too” argument that raised suspicions. As the post says, I don’t know there was any way to avoid controversy on this difficult issue. But certainly the approach the administration took certainly doesn’t seem to have helped the administration win over the public…

  3. tLynn on

    Obama’s message on health care was going to be attacked, and attacked hard, no matter what it was. There is no such thing as an attack-proof health care messsage. Too often, Democrats succumb to something analogous to a “blame the victim” mentality which goes something like this: look how bad they’re attacking you – how dumb could you be! Well, guess what, the Republicans were going to attack no matter how carefully crafted the message. Instead, Obama deserves blame for an ineffective counter-attack. It appears that he, his administration, and the Democratic party were completely unprepared for the Republican’s fire storm of misinformation and distortion. Instead of wailing about the attack they’ve engendered, I wish the Dems would start thinking one (or more) steps ahead. Failing to anticipate the inevitable Republican onslaught is a good way to get beat everytime.


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