Washington Post columnist Steven Pearlstein made a few waves last month by deeming ObamaCare opponents to be "political terrorists". That's me, dear readers, and maybe you too.
So Pearlstein is fond of equating people who don't agree with him
to murderers of the innocent.
<satire>Ah, but what else would you expect from a
</satire> Let's see what he has
to say today, in a column headlined "Time
for Obama to Stand Tall."
In his speech to Congress on Wednesday night, President Obama will try to regain control over a national conversation on health care that has been hijacked by ranters and ravers of all stripes and members of Congress who don't know their own minds and cower before their own constituents.Summary: Free speech is a bitch. Legislators are stupid and cowardly.
Fortunately, Barack Obama (and, coincidentally, also Steven Pearlstein) are smart and brave. They'll try to rise above it all.
Anyone else out there failing to meet Pearlstein's standards? Why, yes:
It's disappointing that Obama must also overcome the timidity of some of his own political advisers who seem to have succumbed to the dreaded Washington disease, whose symptoms are a fixation on polls and an unnatural gullibility for conventional wisdom. It is one thing to accommodate political reality but quite another to sacrifice first principles, embrace bad policy in the name of compromise and capitulate to political thuggery.Yes, even some of Obama's own advisors are trembling under their desks. Because of polls.
I also like the phrase "unnatural gullibility for conventional wisdom." Is there a natural gullibility for conventional wisdom? If so, is that better, or worse, than the unnatural variety?
We are left to wonder: just exactly how smart can President Obama be, when (after all) he hired all these timid, gullible advisers? I guess that puts him a couple steps below Steven Pearlstein, smartwise. Steven Pearlstein would never have made that mistake.
At the memorial service for Ted Kennedy in Boston last month, Vice President Biden remarked that Kennedy's strength as a leader was that he never acted in a small or petty way, so "people didn't want to look small in front of him -- even the people who were small." Obama's task Wednesday is to demonstrate the same sort of leadership, not only by laying down the moral and economic imperative of health-care reform but by coming clean on some of the tradeoffs that will be necessary in achieving it.Ah, we're getting to something here. Because in fact, Obama has been babbling about the "moral and economic imperative of health-care reform" for months. If you include the campaign, for years.
But Pearlstein has a new demand: that Obama also begin "coming clean on some of the tradeoffs".
Well first, why just some of the tradeoffs, Steven? Why so timid? Why don't you demand that Obama come clean on all the tradeoffs?
But never mind that quibble: what Pearlstein is implicitly saying is what we on the other side have been yammering about for weeks now: President Obama has not been "coming clean" on tradeoffs during this debate. And for our troubles, guys like Pearlstein have been smearing us as "political terrorists."
What makes reform such a difficult puzzle is that the fundamental policy goals of universal coverage and cost containment are inconsistent with the political instincts to assure Americans who already have health insurance that they will be able to keep everything they already have, to assure that nobody will get a tax or cost increase and to assure those in the health-care industry that there will be no reduction in their income. Obama's mistake so far is not that he left it to Congress to hammer out the details of competing reform plans, but that he failed to give Congress political cover by helping people understand that there can be no gain from reform without at least some fairly apportioned pain.Short version: (1) there ain't no such thing as a free lunch; (2) Obama has been (so far) pretending otherwise.
What Pearlstein doesn't say: it's no surprise that ObamaCare opponents ("ranters and ravers") are irate about this phony and dishonest salesmanship.
Deals negotiated with doctors, hospitals, health insurers and drug companies represented a good running start on the path of shared sacrifice, but the president failed to follow through with other key players.You'll notice another funny thing (for sufficiently small values of "funny") when you compare the above with Obama's rhetoric from just last month:
Because the history is clear - every time we come close to passing health insurance reform, the special interests with a stake in the status quo use their influence and political allies to scare and mislead the American people.But, as Pearlstein admits, Obama and congressional Democrats have no problem with the "special interests" they've already cut deals with.
Again the dishonesty and hypocrisy revealed in the conflict between Obama's rhetoric and reality might just be another factor in why we "political terrorists" are so pissed off. Just sayin'. But Pearlstein's OK with it, the only problem is that Obama wasn't dishonest and hypocritical enough:
From a business community that wants to preserve the employer-based system, he failed to get a commitment that all employers should participate.(Comment: as if there were a unified "business community" with a leadership that could make such an agreement on behalf of its constituents. That is delusional.)
He kowtowed to organized labor by backing away from a reasonable cap on the favorable tax treatment of health benefits.… to the great surprise of nobody. Except, perhaps, Steven Pearlstein.
And he folded like a cheap suit when right-wing attack dogs scared the elderly with talk of euthanasia and death panels rather than aggressively defending the logic of living wills and evidence-based medicine.As near as I can tell, Pearlstein thinks that Obama shouldn't have said he wasn't gonna "pull the plug on Grandma". He should have left that option open.
Another problem with Pearlstein's argument: whenever Obama does talk about "evidence-based medicine", he invariably descends into delusional howlers about surgeons overeager to perform $50K leg amputations and tonsillectomies because they make more money that way.
Those are just more cheap quibbles though: run back though Pearlstein's list of groups Obama either did or should have cut deals with: doctors, hospitals, health insurers, drug companies, "business", and organized labor. (But not "right-wing attack dogs")
Notice anyone missing from that list?
You got it, smart reader: (probably) you and (certainly) I are missing from that list. Taxpayers, aka the "political terrorist" schmucks who are going to pay for the grand scheme, directly and indirectly.
By signaling that he was willing to stand up to some interests but not others, Obama gave up the moral and political high ground that would have made the opponents of reform look "small" by contrast.Dang! Turns out Obama's not that smart after all. It was so simple! If only he'd listened to Pearlstein!
Bend the 'Cost Curve'And, not coincidentally, government policies, tax codes, regulations, subsidies, and programs are more concentrated in this ostensibly "private sector" health care area than any other. But Pearlstein somehow thinks that—this time for sure—government will bail us out of the mess it largely put us in.
The president's approach needs to be simple and direct: The health-care system we now have is wasteful and expensive and leaves the United States with the moral stain of being the only rich country to ration medical care on the basis of income. Runaway health spending is the main reason the average American worker hasn't gotten a real pay raise in a decade. And it is the big reason the government is looking at huge budget deficits for years to come.
That's why the "cost" figures being tossed around are so misleading: The money needed to subsidize health insurance for low-income workers is supposed to more than offset by the savings in Medicare and Medicaid and additional taxes. If reform doesn't "bend the cost curve," as the budgeteers like to say, then it's not worth doing. And if it does, then there is no need to scale back the program and compromise on universal coverage just so the annual subsidies can be reduced from $110 billion a year to $70 billion.Pearlstein blithely assumes massive "savings" in Medicare and Medicaid. Virginia Postrel had a good rejoinder to that a few months back:
Think about this for a moment. Medicare is a huge, single-payer, government-run program. It ought to provide the perfect environment for experimentation. If more-efficient government management can slash health-care costs by addressing all these problems, why not start with Medicare? Let's see what "better management" looks like applied to Medicare before we roll it out to the rest of the country.Pearlstein will, I'm afraid, not embrace Ms. Postrel's proposal. Neither will Obama. Because it would demonstrate the utter vaporousness of their "savings" proposals.
An equally silly compromise comes from the Senate's "Gang of Six," which seeks to avoid riling the local chamber of commerce with a mandate that all businesses contribute something toward health insurance for their workers. Instead, the centrists would only dun employers for whatever subsidies their low-income workers need to help them meet their new obligation to buy health insurance. Aside from creating an administrative nightmare, this provision would have the perverse effect of encouraging employers to fire, or not to hire, low-wage workers with children or spouses who are unemployed. Republican Olympia Snowe is said to be particularly enamored of this idea. I'd bet a two-pound lobster and bowl of Maine's best chowder that she can't find a labor economist back home who thinks this is a good policy.Yes, it's a stupid idea. It's heartening that Pearlstein can recognize at least one stupid idea.
Start With the BasicsRight. And if those "promising ideas" prove ephemeral—well, that's just too bad. Sorry! To quote Animal House:
While there are no silver bullets in health-care reform, there are plenty of promising ideas on the table for reforming insurance markets and bending the cost curve. It will take time to test and implement these ideas on a national scale.
… you can't spend your whole life worrying about your mistakes! You f****d up - you trusted us! Hey, make the best of it!Pearlstein continues:
What the president needs from Congress is succinct legislation that guarantees that every American will have a basic health insurance policy and sets reasonable caps on the growth of government health-care spending. The details should be left to the regional exchanges and a new board of independent health experts to oversee Medicare and Medicaid. Their recommendations could be subject to an up-or-down vote from Congress, as advocates of entitlement reform have long suggested.Again: We'll give you the details later. Trust us. Note that the legislators Pearlstein previously—just a few hundred words back—derided as stupid and cowardly are now going to make the "up-or-down" final call on that. I'm sure nothing could go unexpectedly wrong there.
After a summer that exposed a virulent strain of public cynicism and distrust, the president's challenge is to rededicate himself to restoring faith in government and rekindling the "yes we can" spirit that swept him into office. And at some point he needs to look straight into the eyes of those who would have him fail and promise to do whatever it takes to break the partisan stranglehold and make health-care reform a reality.Pearlstein's own brief account tells us that it would be more accurate to say that the president's behavior (and that of Democrats in Congress) caused "public cynicism and disgust." Pearlstein's promising demand (in paragraph three) that the president should be "coming clean on some of the tradeoffs" turns into vagueness and hand-waving at the end: let the "independent health experts" figure that stuff out.
If Obama's looking for speech advice at this late date, I'd recommend avoiding Pearlstein and instead going with John Stossel. Just read the whole thing, Mr. President. Verbatim.