To pass healthcare reform, Obama needs to pitch the principled, passionate reasons why we need it, then answer the few big questions that everybody wants to hear.

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Jeffrey Feldman, Editor-in-Chief
Frameshop, 07/23/2009

Given the widespread fear that has spread throughout the national healthcare debate, I was surprised by the virtual absence of emotion in President Obama's press conference performance, yesterday.  As a candidate, his speeches about "change" were so powerful that they spawned a pop culture industry.  And yet, now that he is President and talking healthcare "change"--a national policy that will end the daily suffering and humiliation of tens of millions of Americans--Obama's rhetorical passion has been displaced by the soporific drone of a mid-grade federal accountant.  Where is the passion, Mr. President?

I bring up the question of "passion" because the facts that Obama presented to the nation in his press conference were ghastly and shameful:  47,000,000 Americans without healthcare coverage, 14,000 people losing their health insurance every day, dozens of letters each day from parents with children who are dying from cancer and cannot get treatment. The combined level of human pain and anguish hidden in those statistics should be enough to make anyone tear out their own eyes, let alone raise their voice.  Instead, the President gave us this:

This is not just about the 47 million Americans who don't have any health insurance at all. Reform is about every American who has ever feared that they may lose their coverage if they become too sick, or lose their job, or change their job. It's about every small business that has been forced to lay off employees or cut back on their coverage because it became too expensive. And it's about the fact that the biggest driving force behind our federal deficit is the skyrocketing cost of Medicare and Medicaid. (link)

It was dull stuff.  Ho, hum at best.

OK, sure.  Health care reform is about all those things the president described.  The cost of inaction is greater than the cost of action, true.  I agree.  But healthcare reform is also about:  the infuriating inhumanity of the current system all! 

People are living lives in fear--children are dying, for goodness sakes.  This is about injustice and the anger that tens of millions of people have been trapped in lives of fear as a result of  health insurance business model that Congress has been too cowardly to confront for decades. And this is about the very real, very legitimate fears that people have as a result of thinking about the social and cultural shift that will result from having a public healthcare system that did not exist before.

These are legitimate fears, and people are talking passionately about them all over the country. 

What worries me about Obama's "no drama" approach to the healthcare debate is not that he simply refuses to raise his voice when necessary.  The problem is that most Americans are engaged in a deeply passionate argument about this issue, but when we tuned in to the President's press conference, it was as if the President was completely outside those emotions. 

Obama's words seemed to be governed by the logic of balance sheets rather than the emotion of lives in the balance.

What are the emotions in the healthcare debate? They seem to fall into three main topics: denial, access, and money.

Tens of millions of Americans are outraged by the current culture of health insurance coverage and claim denial to the point that they can no longer speak in a reasonable tone about the issue.  While there are 47,000,000 people without insurance in this country, I would hazard a conservative guest that there are at least that many people each year who have legitimate health insurance claims denied each year.  These people are sick and tired of being fleeced by a system that makes them pay up front only to be denied coverage when they need it. They are shouting at the top of their lungs about healthcare reform.

But they are not the only people raising their voices.

There are also millions of people who are truly afraid that a new healthcare system dominated by a big public competitor will suddenly make it very difficult to see the doctors and get the procedures they need.  These people are very concerned about having to wait months just to see, for example, a kidney doctor should they need one.  They are scared to death about rumors they hear about other national healthcare systems where people die waiting for procedures that people with insurance in the U.S. get without waiting.  These people are sick and tired of being told that everything will work out fine for them in the new system without being told how it will work.  They are shouting at the top of their lungs about healthcare reform.

But they are not the only people raising their voices.

There are also millions of people who are truly worried that a new public option will bankrupt the United States government, leading to public deficits that will undercut any chance we have at a better life from better health insurance. These people are very concerned that the new public approach to healthcare will be a failed program like some of the over budget, overly bureaucratic failed public programs in the past.  They believe that a public option will just lead to the healthcare equivalent of million dollar wrenches and thousand dollar washers--the sort of government spending horror stories we used to hear so often.  These people are sick and tired of being told that the new system will not cost any money more than we are already spending.  They are shouting at the top of their lungs about healthcare reform.

Now, given all this shouting, the White House seems to believe that the best way for the President to chart a path through the noise is to focus on the relative cost effectiveness of reform versus the continued high cost of inaction. 

The White House has chosen, in other words, to turn the Commander in Chief into the Accountant in Chief.

Bad decision.  Very bad decision.

Listening to the President roll out massive, tangled descriptions of one set of expenditures "incentivizing" the cost differential of a second set of expenditures was the political equivalent of clipping off a birds wings and then pushing it out of plane and telling it to fly.

Obama's single greatest strength as a politicial has been his ability to speak in such a way that it makes Americans feel that we are soaring to new heights together.

Franklin Roosevelt had that gift.  John Kennedy had that gift.  And Barack Obama has that gift, too.  And needs to use it.

To find his passion again, this is where I suggest President Obama start: with his own words.

About midway through his press conference, the President was asked why he was in such a hurry to pass healthcare reform, to which he said the following:

I'm rushed because I get letters every day from families that are being clobbered by health care costs. And they ask me, "Can you help?"

So I've got a middle-aged couple that will write me and they say, "Our daughter just found out she's got leukemia and, if I don't do something soon, we just either are going to go bankrupt or we're not going to be able to provide our daughter with the care that she needs."

And in a country like ours, that's not right.

That is the scenario on which a passionate appeals to a caring nation can be built.  Helping parents provide care for their children and protect them from the injustices of the healthcare system--that is the essence of a passionate approach to the kind of reform we need.

And then, having set the stage with real voices expressing real concern, the President should drop the accounting rhetoric and state simply how much each of us can expect to have deducted from our paychecks to pay for healthcare coverage: 2 percent of our take home pay?  3 percent? 5 percent? 

Just tell us.

And then tell us what kind of social and cultural change we can expect in our experience of healthcare. If we take the new public option, will we be able to go to our current doctor or will there be new clinics and new doctors we need to see?

Just tell us.

Even all  the details are not in place, yet:  just tell us the basics. 

The President needs to lay out the principled, passionate reason why we need healthcare reform, and then he needs to answer the few big questions that everybody wants to hear.

When it comes to healthcare reform, we need more drama, not less drama, from Obama.

© Jeffrey Feldman 2009, Frameshop

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