20 January 2010

No Mandate on Health Care

I was one of those people that thought reform of health care would be a good idea. We certainly need it. Really, we do. And what the Republicans are proposing is inadequate. So how did the Democrats make such a hash out of it?

You could argue the timing (bad), and you could argue the details of the proposal (worse). But there is a more fundamental reason: lack of a mandate.

What am I talking about? One of my first predictions on this blog, was that health care would be an important, or even vital issue in 2008. 28Apr08: McCain's Health Care Proposals, and 6May08: Candidates and Health Care Plans. But by 1Oct08, I was posting this: Candidates Fail to Address Health Care Issue.

It turned out, that health care reform was not a big issue on the campaign trail. The issue was not extensively discussed, and while the candidates did provide some ideas, there were not detailed proposals like Hillary Clinton developed during the primary. The result was that health care reform was not a primary motivation of voters in November 2008.

However, once Obama took office, he made passing a health care bill his domestic legislative centerpiece. Since he did not develop a detailed proposal during the campaign, he turned the details over to Congress, as he had nothing he could point to and show that is what the people endorsed when they voted for him.

Two questions for you: what were the details of Obama's healthcare policies during the campaign? Even harder: what were your member of Congress' detailed ideas about health care reform when you elected them in 2008? Don't know? Well, who did? (But you may know now!)

And that is exactly the problem. Without a mandate from the public, the health care legislation was too exposed to pressure from big money, and big interest groups, and caught up with private deal-making, with the public feeling they had been caught off guard on the whole issue.

To remake such a large hunk of the economy, on an issue that directly effects every single person, you need to have your ducks in a row before starting. You need to have your mandate. The public had to be already engaged on the issue during the campaign, and they were not.

So when the Democrats started talking about health care reform, and acted like that was why they were in Washington, the public thought they were there because they were not the Republicans, and not George Bush. That was their mandate, a negative, not a positive charge.

No comments: