• The Real Lesson of Massachusetts

    Until last night I thought the lesson of Massachusetts for health reform stemmed from the experience of its state-wide version. The real lesson seems to be less about policy and far more about politics. If health reform fails it will not be due to Coakley’s loss. Rather, her Senate bid and health reform will both be victims of an Administration so focused on the ball they didn’t clearly see the field or the other team.

    When Obama won in November 2008 he switched from campaigning to governing. His cool, hands-off style made considerable sense for health reform. With it he avoided the mistakes of the early Clinton presidency and let Congress do the work they must. That approach worked well through last summer.

    But when House and Senate bills emerged from committee the broad structure of health reform was clear. Congress had done 90% of the policy work. What remained was largely politics. By Thanksgiving, if not before, Obama could have and should have shifted from governing to campaigning. A national “health security” tour might have helped confused and skeptical Americans understand reform and what’s in it for them. In truth, he’d have had to also work in a “job security” message as well, not an impossible task.

    Josh Marshal looks back to President Bush’s response to Republican defeat in the 2006 mid-terms centered on dissatisfaction with the war in Iraq. Bush countered aggressively (too aggressively some might say) with the Iraq surge. Marshal’s point is he fought and fought hard for his agenda. In contrast Obama has not, or at least not in a way that resonates with Americans. (Private meetings with members of Congress has all the resonance of a wet rag.)

    I recall Bush’s Social Security tour in 2005. He took his message to town halls to speak directly to Americans about his vision for reform. It didn’t work for Bush and Social Security but in part that’s because the idea made no sense and there was no impending crisis. Health reform, in contrast, does make sense, and the coverage and cost crises are with us and have been for years.

    Had Obama been campaigning on health reform in late fall and into this winter he might have had better control of the message, not just in Washington but nation-wide. Instead he has left a large opening for Republicans to exploit the populace’s confusion and discontent, with tangible electoral results, at least in Massachusetts. Obama was playing an inside-the-beltway game when the real threat to his agenda was elsewhere. In this I agree with Josh Marshal:

    What the Democrats — and a lot of this is on the White House — have done is get so deep into the inside game of legislative maneuvering, this and that ‘gang’ of senators and a lot of other nonsense that they’ve let themselves out of sync with the public mood and the people’s needs.

    The president needs to find way to say, we’ve heard you. We’ve gotten so focused on working the Washington channels to get this thing done and we need to be more focused on the public’s mood and urgency. Well, we’ve heard you. We’re going to stop playing around and get this thing done. And then we’re going to work on getting Americans back to work. We know the urgency of the moment and we know you expect results.

    From far outside-the-beltway it appears that the Administration forgot about the people, forgot about the broader fight, and failed to notice the election in Massachusetts, until there was little time to do much about it. Obama showed up last weekend to campaign for Coakley, but it was far too little, far too late. His chance to make a difference in that fight was earlier. Has he already missed the chance to deliver the winning message on health reform? We will soon find out.

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