Health Care: The Way Forward

The President sent a mixed signal about the future of health care reform in his State of the Union address. His words were clear: "Don't walk away from reform.  Not now.  Not when we are so close.  Let us find a way to come together and finish the job for the American people. Let's get it done." Clear enough. The problem is that those strong words came after the President had discussed everything from jobs to climate change legislation to trade deals to community colleges. That is how you dial back in Washington. At this critical juncture, we encourage you to exercise the full influence of your office to urge Congress to pass comprehensive health care reform legislation." The group, which included many of the members of the President’s own Council for Faith-based and Neighborhood Partnerships, spoke to the moral aspects of the issue, which were unchanged by the special election results in Massachusetts.

Faith leaders have continued to call on the administration and Congress to recommit themselves to reform. Two days ago, I mentioned the letter the USCCB sent to members of Congress. Yesterday, the Catholic Health Association echoed the bishops’ call and the President’s words. Sister Carol Keehan, DC, president and CEO of CHA said in a statement: "We understand the political realities and concerns with passage of such important and far-raching legislation. But we firmly believe that now is not the time to let those concerns derail what may be the last opportunity of our lifetime to address the continuing shame of allowing so many individuals and families in our nation to go without access to affordable health care."

Earlier in the week, a group of prominent religious leaders wrote to the President, saying, "At this critical juncture, we encourage you to exercise the full influence of your office to urge Congress to pass comprehensive health care reform legislation." The group, which included many of the members of the President’s own Council for Faith-based and Neighborhood Partnerships, spoke to the moral aspects of the issue, which were unchanged by the special election results in Massachusetts.

Of course, while we’re thinking of the Bay State, when John F. Kennedy wrote Profiles of Courage, he had to go back to the nineteenth century to find seven of the nine profiles and little has changed to increase the courage quotient within the halls of Congress. Clearly, both the White House and Congress recognize that they need to set health care reform aside and work on a jobs bill first. I suspect the White House will also seek to have a major bipartisan victory on some issue, any issue, before trying to tackle health care again. So, how to proceed?

The White House should steal a page from recent Vatican history. Vatican II called for greater collegiality among the episcopate and in response Pope Paul VI set up the Synod of Bishops. From all around the world, bishops would come to address critical issues in the life of the Church. The first synod, in 1967 treated the topic "Preservation and strengthening of the Catholic faith, its integrity, its force, its development, its doctrinal and historical coherence." The 1971 Synod focused on the ministerial priesthood and justice in the world. The problem developed, however, that drafting documents that reflected each synod’s work was cumbersome and unwieldy. So beginning with the 1974 Synod on evangelization, the bishops spent their time in discussion and left records of their talks, with suggestions and proposals, on the Pope’s desk and let him put it all into a single document. The Pope could, as needed, call back the authors of the varied interventions, or the synod’s relators, to clarify a point. Thus, documents like Paul’s Evangelii Nuntiandi and John Paul’s Ecclesia in America were joint efforts, the ideas coming from the synod and the synthesis and integration of the ideas coming from the Pope.

President Obama needs to pull together all the different proposals on health care. He need not limit his ideas to the two bills that actually passed both chambers, but the process by which those bills passed should guide his thinking about what can, and cannot, pass. Obviously, he needs to have some long talks with Senator Olympia Snowe and other centrist Republican Senators but he should meet with the leadership of both parties (put it on C-SPAN just to shut up the crazies!), solicit their ideas and embrace the ones he can. If Minority Leader Boehner says he wants tort reform, give him tort reform but then ask what he is going to give. If he says "Nothing," walk outside to the waiting cameras. The President needs to have some long talks with Joe Liberman and Ben Nelson, the two members of the Senate Democratic caucus who caused the most grief. He needs to sort through the abortion issue and he needs to start with the fact that the only health care bill to garner a single Republican vote so far was the House bill that included the Stupak Amendment. The President will need to sit down one-on-one with key senators, not rely on Sen. Reid to deliver the votes, and with key members of the House. He needs to look them in the eye and make them promise to support the bill. He may have to scale back his goals. But, the key thing is that he must take the leadership role at this stage. Letting Speaker Pelosi and Leader Reid continue to drive the process is to commit to more water-balloon handling: When the moderates squeeze here, the lefties will burst there, and nothing will happen. The President is not only head of state and head of government, he is the head of his party and he needs to exercise this latter role if he is to succeed in the first two.

The other thing the President must do on health care is remind independent voters that he is trying to make things better and the Republicans are not just obstructing his efforts, their obstruction amounts to a defense of the status quo. (It is imperative that he adopt one or two GOP reform suggestions as well, to be able to say that he is not trying to ram through an excessivley liberal program.) Independent voters are not leaning towards the GOP because they like the GOP’s proposals. They are leaning that way because they hate the status quo and the Dems are the party in power. They are registering their opposition to the way things are. The President needs to remind the country – every day and in every speech – that he is the one who is trying to deliver change and paint those who stand in his way as the defenders of the status quo.

Some have suggested that the House should pass the Senate bill. but Speaker Pelosi said she does not have the votes. So, there was a suggestion to pass the Senate bill as is, but with the simultaneous guarantee that the Senate, using reconciliation and thus avoiding a filibuster, will amend the bill to the House's liking. This smells of shanenigans and will only add to the perception that Washington is broken.

The battle for health care can yet be won. But, the methods of 2009 are best left in 2009. The President and Congress should work on a jobs bill. Then they should work on something bipartisan. But, come Eastertide, the President should take the health care issue by the horns and push, push, push for a successful reform bill. Only he can do it.

Michael Sean Winters