This is Plan B?

A mostly political weblog.
Aug. 17 2009 5:26 PM

This is Plan B?

Everything's Under Control! I missed Ezra Klein's latest optimistic spin last week on the health care debate. Klein notes that Obama isn't talking about "bending the cost curve" on the stump, and that Republicans have gained traction, not with arguments about cost and the long-term deficit, but with fears of cost-cutting and rationing. So far, so good. 

But Klein says the administration always intended its "curve bending" arguments as a means of building "Washington support" and passing a bill by August ("the plan was to keep this in Washington"). Now that this effort has failed,** "the argument moves to the country" where the administration's pitch will be different, focusing on stories of insurance injustices.  "You don't win appealing to the wallet, you win by grabbing the gut."


This reeks of making-the-best-of-a-bad-situationism:

1) Did the administration really think it was going to pass a bill reforming the entire health care system without winning the "outside" battle for public support? If so, someone drew the wrong lesson from the "stimulus" bill. (The stimulus bill was intended to address an acute crisis.)

2) Did the administration think that Obama could run around talking obsessively about his plans to "bend the curve" of health costs (including in a nationally televised press conference) , giving  interviews to the New York Times about the need for a "very difficult democratic conversation" on restricting end-of-life care and the news would stay in Washington? Note: They've invented the telegraph!

3) Most important, does the adminsitration think it has plenty of time now to move on to win the argument in "the country" --as if this were a stately, well-ordered two-stage fight, a formal legal appeal to a higher court of public opnion? Does anyone really believe this? I doubt even Ezra Klein believes it--though I guess every great spinner believes his own spin. (And Klein, unlike Ambinder, seems like a spinner rather than a spinnee.)

What he breezily glosses over is the possibility--increasingly, the actuality--that they've already lost the public opinion battle for the near future . If they now need public opinion to pass the bill in the fall, they aren't going to pass a bill . It turns out you may only get one chance to roll out a giant legislative initiative. You can't roll it out with a cost-cutting rationale and then switch cunningly and seamlessly to a security-providing rationale without addressing the fears raised by the first set of arguments. 

Specifically, a few "gut"-grabbing insurance horror stories aren't going to calm the "rationing" fears of those now covered by Medicare (who don't worry about their insurance, or didn't until Obama came along). The best defense is not always a good offense ( cf. Dunkirk). In this case, what's required would seem to be more a dramatic repudiation of the administration's own cost-bending, treatment-discouraging rhetoric.

Obama can't fire himself, but he can fire the curve-bending wonks who convinced him that talking about end-of-life issues was a good way to sell universal care . He can find himself a health-care Petraeus. And he can ditch the closest thing to a "death panel" in the legislation--the IMAC board . The more traumatic and high-profile the intra-administration upheaval, the more space Obama buys to relaunch his plan as a rationing-free coverage extension.

That would be a Plan B. ...

P.S.: Maguire mocks the NYT 's effort to bury, under a layer of anti-yahoo sneering , the evidence in its own pages of Obama talking about restricting end-of-life treatments to save money. ...

**--See Lori Montgomery's wildly unconvincing argument that health care reform has to drive down the long-term cost curve (not just be "paid for") in order to pass. Maybe if the vote was taken by the respectable, responsible newspaper editors who order up hothouse pieces like Montgomery's. As Klein notes, the "curve-bending" argument didn't even carry the day inside the Beltway, while provoking active hostility outside. ... 3:49 P.M.




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