On reading Obama’s announcement today of his plans for health care I was struck with three observations about what he’s saying to the American public.
First, there are no new ideas. What’s new apparently is just how creatively you put together the old ideas. Employer mandate, government subsidies, regulation of insurance companies, tax the rich — not new, but not necessarily bad either. What’s not in the plan is more revealing: no single payer and no individual mandate to have insurance here (like Massachusetts). There are a couple of other important no-shows as well.
That leads me to a second observation: Obama gunning for the big middle. He wants to build a popular consensus so that he doesn’t get torpedoed should he be lucky enough to actually win the election. He’s also a little shy on specifics, but that may be good long-term planning as well. Why paint a big target on your back when everyone else has bows and arrows? Like the other candidates, Obama cannot just change health care by fiat–he’ll need Congress, Congress will need the American public if they are to successfully navigate this political minefield. Washington has learned its lessons from the Clinton fiasco. To simply slash-and-burn the private sector, or further engorge a federal bureaucratic empire will simply not get the job done.
My third observation is that he may sense that more radical moves in health care involve substantial risk, not just political risk to his career, but a real and broader risk to the public. The political and economic heat of big changes could ignite major malfunctions in the health care system. And this could have disastrous consequences. While our health care system is robust, in many respects it hangs on some delicate financial treads. Pull one too hard and the web may start to unravel.
