The White House
If there were such thing as political malpractice, the president's people would be guilty of it.
How can a smart guy be this dumb?
Last week, I defended the Obama administration over what I consider to be overblown criticism of the admittedly botched rollout of the online system to help people choose among health care exchanges.
But while I believe the Affordable Care Act will soon become rooted as part of the American welfare state (and I mean that as a good thing) right along with Social Security and Medicare, there's no question that the president and his team have badly messed up the politics of this launch.
It is baffling. A political operation that is pristine when it comes to packaging and electing Obama the candidate turns bumbling or is absent altogether in selling the president's policies. If there were such thing as political malpractice, the president's people would be guilty of it.
Right from the start, the Republicans began pummeling "Obamacare" as a huge government "take over" of health care, when in fact it was nothing of the sort.
In fact, some of us did want a government take over of health care and were disappointed when it didn't happen. After all, we already have successful government run health care in Medicare and Medicaid, which are actually far more efficient than private insurance systems. But even a faint echo of the single payer system I preferred, a "public option" on the exchanges, was shot down.
If there was any overreach on Obama's part, it was his extended attempt to try and get any Republican support at all for his program to solve a problem that has nagged America for generations. In the end, the president settled for this cobbled together version of Mitt Romney's plan, and he got no GOP support at all in the end. In fact, he got relentless and effective opposition.
But here's the thing. Obamacare is likely to work. Or, at the very least, it will make health care one heck of a lot better than what we've had. Tens of millions of Americans who haven't had insurance will have it now. No one can be denied coverage for an existing condition. Because the healthy and not-so-healthy will be covered together -- which is why we need a mandate that everyone have insurance -- costs for most Americans will go down.
The one glaring fault in Obamacare is the lack of any real mechanism to control overall costs in the system. The U.S. will still spend about 16% of its gross domestic product on health care while much of the rest of the developed world with their "government-run" systems will spend about 10%.
Believe it or not, the ACA is even a popular program. Republicans like to point out that only 43% of Americans say they support Obamacare. They fail to point out that 16% would support something stronger like a government-run single-payer system. In other words, almost six of ten Americans support this plan or something more like the successful public programs in Canada and Europe.
And if you ask Americans about each of the components of Obamacare, support skyrockets to 88% in some cases, like the provision to help small businesses pay for health insurance for their employees. In fact, of eleven parts of the law, only one provision has less than 57% support. The problem is that that one provision -- the requirement that every person have insurance, which is supported by only 40% of Americans -- is the one aspect of the law that is known by the most Americans.
So, back to my original question. How can a president and his people who are so good at winning elections be so bad at selling the central accomplishment that is the result of winning those elections? Why is it that only 52% of Americans even know about the law's most popular provision while 74% know about its least popular? Whose fault is that?
You can't blame the Republicans (much) for doing what opposition parties do. You can blame the Democrats for letting them get away with it for so long.I can only speculate that this complacency comes from the man himself. Obama is as dispassionate and removed a leader as you will find. He seems to labor, even after five years in office, under the misconception that people are as informed and reasonable as he is, and that political fights, once won, will stay won without constant tending.
In fact, Obamacare has survived through the narrowest passages of luck and circumstance. The horrible government shutdown we have just come through would probably not have happened if Obama and his people had kept selling his health plan hard and continuously from the day of its passage. Why they didn't is as mysterious as the man himself.