By Robert Nelb ’08
If there is an Achilles’ heel in Barack Obama’s rock star presidential campaign, it’s health care. Poll after poll shows that health care reform is one of the top issues on voters’ minds, but poll after poll gives Hillary Clinton, not Obama, a double-digit edge on her perceived ability to carry out this job.
On the surface, Obama and Clinton’s health plans are not that different. Both shy away from a (more efficient) single-payer system, and choose, instead, to expand existing programs while creating new options. In both cases, a new public health insurance plan, like Medicare, would be made available as an option for more affordable, higher-quality health care that would not discriminate based on pre-existing conditions. While not perfect, these policies are a major improvement over Republican plans, and they offer the potential to be stepping stones for future reform.
Looking at the details, however, Hillary Clinton’s health-reform plan is objectively better. The key difference is a requirement for everyone to have health insurance, a mandate which will ensure that everyone is covered and will help lower premiums for families who already have health insurance. Like it or not, without this mandate for coverage, Barack Obama’s plan is estimated to leave about 15 million Americans uninsured.
Last month, Obama tried to defend the lack of a health insurance mandate with an unconvincing comparison to the inefficacy of car insurance mandates. But just because a law doesn’t work perfectly doesn’t mean that it shouldn’t exist in the first place. Meanwhile, he still hasn’t changed the section on his Web site that states “My plan begins by covering every American.” Hopefully, he will get some help from his health policy advisors before the Republican flip-flop machine comes knocking. The Clinton machine already has.
Last Tuesday, after a sobering second-place finish in New Hampshire, Obama changed his tune. Indeed, he was the one who found his voice. Instead of continuing to distinguish himself from the other Democratic candidates on his policy positions (the intricacies of which will likely be obfuscated by Congress anyway), he focused on his unique potential to build the kind of movement that’s needed for broad-sweeping change. “All the candidates in this race share these goals,” he said, “but the reason that our campaign is different … is because it’s not just about what I will do as president. It is also about what you, the people who love this country … can do to change it.”
I listened to his speech in person in Nashua, N.H., and I admit it was electrifying. For all my wonkish concerns about the lack of mandates in his health plan, I could not help but get a chill down my spine when he responded to Hillary’s remarks that he was peddling false hopes with the bold claim that “there is nothing false about hope.” How can you say no to idealism?
History, as Glenn Hurowitz noted correctly in the News yesterday, may give us some cause to doubt. “Yes we can” does not always translate into “Yes we will.” Sixteen years ago, Bill Clinton energized his audiences just like Obama; but in the end, he failed to deliver. Indeed, nowhere was this more apparent than then failed attempts at universal health care in the 1990s.
So, perhaps ironically, the Clintons have been arguing that Hillary is better suited to turn rhetoric into action. I appreciate the argument, but I’m not convinced. Does her failure to secure universal health care then make it inevitable that she’ll succeed this time around? If anything, her years in Washington have only garnered her more enemies, which will limit her ability to win the election in November and bring in the kind of Democratic majority that’s needed to actually pass comprehensive health reform.
Obama may be a blank slate in Washington, but with this blank slate comes a real potential to bring the kind of new majority that can get comprehensive health legislation passed. Moreover, his extensive experience in organizing may be just what we need to bring together the many interest groups in our broken health care system. Policies are only as good as the ability to implement them — here, contrary to what the pundits say, I think Obama has the upper hand.
The rest of the primary campaign won’t be easy, and it certainly will become more bitter in the weeks ahead. When any politician is peddling for votes, it is hard to trust what they say about their policy proposals.
But there’s something about Obama that gives me faith — his campaign is not about him, it’s about us. Together, we can hold him to his promise to cover every American, and we can create a new majority for progressive change. You can’t say no to that.