Obama Health Care Reform

It’s hard not to feel sympathetic towards the people occupying Zuccotti Park in lower Manhattan and their brethren who have mounted similar protests in cities and on college campuses across the United States. There is a pervasive sense in our country that something is wrong, and that Wall Street financiers have something to do with this sorry state of affairs. One of the charms of the movement is its lack of specific policy demands; once the occupiers come up with a manifesto they become just another interest group, hardly different from the “Republicrats,” whose pettiness and dithering have prevented Congress from enacting any sensible solutions to our current and future economic woes. But so far, the Wall Street occupiers have been eloquent, if misguided, about what they are against, and relatively clueless about what they are for. [click to continue…]


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We have all seen the moment in countless movies when the intrepid band of commandos or bank robbers runs into an unforeseen problem and one of the group says, “Maybe it’s time to go to Plan B.” Someone else says, “What is Plan B?” and someone else, usually the leader of the group, says, “There is no Plan B.” This heightens the tension and drama, always a good thing in a thriller movie. In real life, at least in the public spheres of business and government, tension and drama are not such a good thing. Recent events, however, have made me suspect that not only do we not have a Plan B, we don’t even have a real Plan A.

In the movies, if you remember, Plan A  involves meticulous and detailed planning, usually requiring big expenditures, advanced technology, painstaking practice and rehearsal, and a team of crackerjack experts, each one the best in his field. There is a specific and measurable goal and a clear, if sometimes flawed, plan of execution. But in the current political and economic crisis, though we have the big expenditures and advanced technology, we seem to have neither a goal nor a plan. I don’t want to single out the Obama Administration, since governments in many other countries are equally culpable and besides, President Obama has inherited the result of eight years of less than meticulous planning by the Bush Administration. But we do have a problem.

Richard Cohen, in today’s Washington Post says the main issue is “the President’s inability to simply say what he wants and why that’s good for us,”  and he cites health care reform and the war in Afghanistan as two cases in point. It’s true that for all his “town hall meetings” and press conferences the President has not clearly told the American people what the problem is, why it’s important, what he plans to do about it, and, crucially, what success will look like, with respect to health care, Afghanistan, or any of a half-dozen other issues. Mr. Cohen chalks it up to Mr. Obama’s “coolness, an above-the-fray mien that does not communicate empathy…the fear that this man in the White House does not appreciate the anxiety that middle-class Americans feel.” If you follow this line of reasoning, if only we could get Bill “I Feel Your Pain” Clinton back in the White House everything would be okay.

On the health issue, President Obama says he wants universal coverage, lower costs, no increase in the budget deficit, no rationing of care, and no tax increases, but he knows it is impossible to achieve all of these things. He fears alienating any part of his political base by admitting this, structuring a reform package built around the bits he thinks are most important, and then taking his case to the people. So instead we get something no one understands and almost everyone opposes. It has nothing to do with empathy.

On Afghanistan, the New York Times reported yesterday that the White House “has been concerned about declining support for the war among the American public.” As he called for an increase in troop numbers in Afghanistan, Admiral Mike Mullen, Chairman of the Joint Chiefs of Staff,  said, “the President’s given me and the American military a mission, and that focuses on a new strategy, new leadership, and we’re moving very much in that direction.” Excellent. Now if only someone could tell us what that mission and strategy are.

Seasoned counter-terrorism experts tell us it could take another 10 or even 20 years to end the Taliban insurgency, and historical examples from Kenya, Malaysia, the Philippines, and other countries support these estimates. Is President Obama prepared to commit the U.S. to fighting in Afghanistan for the rest of his Presidency and far beyond? If not, how do we decide we’ve finished the job and can come home?

For all his talk about being the one who makes the hard choices, it’s becoming distressingly apparent that President Obama can’t or won’t confront an issue and take a decision that might disappoint some part of his political base. This, more than the specifics of any particular problem of the day, is the tragic flaw likely to make Mr. Obama’s Presidency end in failure.



“In taking realms and administering kingdoms, although some things appear rational on the surface, one has to consider a hundred thousand things behind every act.” Babur, the founder of India’s Mughal Empire, wrote this in his epic autobiography, The Baburnama, some 600 years ago. It is worth paying attention to what Babur had to say. His armies took Kabul in 1504 and quickly conquered the rest of the country from Herat to Kandahar, and held onto the territory until 1540, ten years after his death. That is 25 years longer than the Russians and 30 years more than the British, who managed to hold on for only four years in the 1830s and another two years from 1878 to 1880. Babur, who pined for Kabul during his entire stay in India, did not return until nine years after his death, when he was put to rest in the Bagh-e-Babur garden with the Persian inscription on his tomb: If there is a paradise on earth, it is this, it is this, it is this! Kabul no doubt was different back in those days. [click to continue…]