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Viewing: Blog Posts Tagged with: health-care reform, Most Recent at Top [Help]
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1. Why we need “mystery shoppers” directly observing health care

Considering the well documented problems of medical error, it’s remarkable that it’s rarely observed. Of course there is much scrutiny of the data that is generated during the health care encounter, but that is not the same thing. For instance, while quality measures track data on how well blood pressure is managed, there are not measures of whether blood pressure is actually measured accurately.

The post Why we need “mystery shoppers” directly observing health care appeared first on OUPblog.

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2. Still don’t understand the Affordable Care Act? You’re not alone.

I recently stumbled across the site Act of Law, on which an anonymous woman is reading the entire ACA aloud. "I will read the law for two hours each week and post videos of each reading here on this site," she writes. "It is 906 pages long (table of contents included) and I estimate that it will take about 60 hours to read." The most recent video she posted covers hours 23 and 24 of this project. It appears below with permission.

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3. Does Obama See a Silver Lining in Losing the House?

By Elvin Lim


The “Summer of Recovery” has failed to materialize, and with that, the White House has had to start planning for 2012 earlier than expected.

After all, White House Press Secretary Robert Gibbs had already conceded this summer that the House may fall to Republican hands. (Nancy Pelosi didn’t like the sound of his prescience then, but Gibbs was merely thinking strategically for his boss.) The one thing Democrats have going for them is that nearly every political commentator believes that an electoral tsunami awaits Democrats this fall, which means that they have low expectations on their side. And because the Democrats currently have a healthy majority, it would be nearly impossible that the flip will generate a Republican majority bigger than the one Democrats now enjoy. Victory for the Republicans would not taste so sweet because it would be fragile.

There is a silver lining inside this silver lining for the White House. If Republicans take control of the House, then at noon on January 3, 2011, President Obama will finally be able to do what presidents do best – blame the stalled progress on his domestic agenda on congressional intransigence, and switch to the domain in which presidents are able to act (and receive credit) unilaterally – foreign policy.

About a week and a half ago, Obama appeared to be embarking on this strategy, when he met with Israeli Prime Minister Benjamin Netanyahu and President Mahmoud Abbas of the Palestinian Authority. Whereas his second Oval Office address started with foreign policy issues and meandered awkwardly toward the economy (because the President was still hoping for a “summer of recovery”), the President’s first press conference inverted this order of priorities.

This press conference was delivered in the middle of the work day. It was directed to Washington elites and insiders, not the American public, for whom more talk of the economy would have been politically appropriate this election year. But the president began with the economy, but then ended with the Arab-Israeli conflict – displaying not only the agenda-setting power of the media to determine what presidents talk about, but also the instinct of presidents (even liberal ones) to withdraw to foreign policy as the presidential domain when domestic policy is not producing political credit for them.

It is no coincidence that very few Democratic candidates are campaigning on healthcare reform, even though it is the signature accomplishment of the Obama presidency and Democratic congress and the topic which headlined the political discussions of 2009. This is why Obama did not mention healthcare reform at all in his first and second Oval Office addresses, and he only brought it up haltingly and defensively in his first press conference last Friday.

With unemployment still at about 9.6 percent, everyone knows that the preeminent issue for Election 2010 is the economy. But Obama actually has, by a 10-point margin, higher approval numbers in his capacity as Commander-in-Chief than his handling of the economy. The White House realizes that the lack of results or higher casualties in Afghanistan doesn’t matter. What matters is that Obama is doing exactly what a Republican president would have done in Afghanistan and when there is nothing to fight about, the public approves.

After spending half of his first term on an ambitious domestic agenda for which he has gotten no credit but only blame, Obama may fin

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4. Parliament and Congress in 2010

Parliament and Congress: Representation and Scrutiny in the Twenty-First Century offers an insiders’ comparative account of the procedures and practices of the British Parliament and the US Congress. In this original post, the authors – William McKay, who spent many years working at the House of Commons and is now an observer on the Council of the Law Society of Scotland, and Charles W. Johnson, who is a Consultant to the Parliamentarian of the US House of Representatives - discuss procedural and institutional developments in both countries over the last few months: in the UK, the new Parliament and coalition government, and in the US, the procedural complexities of the heath care reform bill.

Though the expenses scandal which dominated the parliamentary scene in the UK during 2009 is out of the headlines, it has not gone away.  Some of the consequences of the public’s loss of confidence in Parliament are still to be worked out. The new coalition government has brought forward fresh ideas, and parliamentary reform is one of them. Some of these notions are interesting, others more worrying.

The mainspring of the UK constitution is parliamentary democracy. Some recent suggestions seem to diminish the ‘parliamentary’ aspect. One of them, a hangover from the expenses affair, would permit 100 constituents to bring forward a petition which, if signed by 10 percent of a constituency electorate, would vacate the seat of a Member found guilty of wrongdoing, so precipitating a by-election. No one wishes corrupt legislators to retain their seats but existing law already provides that Members of the Commons who are imprisoned for more than a year – those guilty of really serious offences – lose their seats. Secondly, the appropriate way for a parliamentary democracy to deal with offending Members is not for their constituents to punish them but for the House in which the Member sits to do so. The Commons has ample power to expel a Member (the Lords is a more complex matter) though it would be wise to devise more even-handed machinery for doing so than presently exists. Finally, if such a change is to be made, the legislation will have to distinguish very clearly recall on grounds of proven misdoings from opportunist political attacks. It will not be easy.

A further diminution of the standing of Parliament is the proposal for fixed-term Parliaments. It is intended that a Prime Minister may seek a dissolution only when 55 percent of the Commons vote for one. Politically, such a provision would prevent a senior partner bolting a coalition to secure a mandate for itself alone. Constitutionally there are serious disadvantages. A successful vote of no-confidence where the majority against the government was less than 55 percent would not be enough to turn out a government. It might simply lead to frenzied coalition-building, out of sight of the electorate. Governments which had lost the confidence of the Commons could stagger on if they were skilful enough to build a new coalition – for which the country had not voted. During the latest election campaign, concern was expressed that every change of Prime Minister should trigger a General Election. The idea was not particularly well thought-out – how would Churchill have become Prime Minister in 1940? – but nothing could be more at odds with the proposed threshold. Untimely dissolutions happen in two circumstances – when a Prime Minister thinks he can improve his majority and when a government loses a vote of confidence. This proposal tries to restrict the first (which may be a good thing) but does so by interfering with the second, which certainly is not.

In America, the House Committee on Rules drew much attention during the prolonged health care debates in Congress. An understanding of its composition, authority and function

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5. The Obama Presidency 2.0

Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he looks at Obama’s diplomacy. See Lim’s previous OUPblogs here.

If September 11 reset the George W. Bush presidency, the passage of health-care legislation has reset the Barack Obama presidency. After an entire year in which health-care reform dominated the agenda of the Obama White House, the President has now been presented – now that perhaps the most divisive issue on the Obama agenda has been temporarily settled – with an opportunity to reset the emerging narrative and priorities of his administration, and the tone of political debate in Washington.

Obama’s emerging blueprint for the next couple of months indicates a chastened president aware that he spent more political capital than he had expected to spend on an issue that was never at the top of his list of campaign promises of 2008, only to end up with a compromise health-care bill that repulsed Republicans and failed to amuse not a few liberal Democrats.

Obama now intends to find compromise between issues, not within them. The game plan now is to give some to the Republicans on some issues, like off-shore drilling, and some to the Democratic base on some issues, like nuclear disarmament. But to give to both sides on the same issue, Obama will likely no longer do. One thing the President has learned is that compromise on the same issue leaves a bitter taste in everyone’s mouth; patronage is most rewarding when it is distributed at different times to all parties, not simultaneously shared.

So this Thursday, the President meets with Russian President Dmitri Medvedev in Prague to sign a nuclear arms control agreement for both countries to reduce their arsenals by 30 percent. Later this month, Obama will host a Summit for world leaders on nuclear security. And Obama has installed union counsel Craig Becker to the National Labor Relations Board, much to the chagrin of business leaders.

Similarly, Obama is making overtures to the Republicans, though in smaller quantities. He has thrown in his support for oil drilling in parts of the Atlantic and Alaskan coasts as part of his “comprehensive energy policy.” And the administration looks set to reverse its position that 9/11 mastermind Khalid Sheik Mohammed and his henchmen be tried by a civilian court in New York and not in a military tribunal.

Whether or not Republicans appreciate the bone Obama has thrown to them, Obama appears to have learned a deeper lesson about politics and bipartisanship in Washington. American presidents typically do not thrive on single-issue politics, in part because bipartisanship is very difficult to achieve on the same issue because the best outcome that could be achieved is that no one gets what they want. When presidents put all their eggs in one basket, they appear parochial are unable to dodge blame when they fail to deliver on their signature issues, or

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6. On the Republican Politics of Reaction

Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he looks at the Republican party. See Lim’s previous OUPblogs here.

American presidents do not have the luxury of savoring victories, but this is also an asset because they have a multitude of areas to prove their worth to the American people. Following the House’s historic vote on health-care last Sunday, President Barack Obama met with Israeli Prime Minister Benjamin Netanyahu on Tuesday, and made a surprise visit to Afghanistan on Sunday. Next month, he will attend a summit on nuclear security with 40 heads of state. The President is attempting a pivot to show that he is the president on domestic policy and health-care, and he can also be a president abroad.

And this is why the Republican campaign strategy of repealing the Democrats’ health-care bill for this November cannot be enough. Republicans have been playing catch-up all year, reacting to events rather than creating them. For a while, the Republican message-of-the-day was that the Democrats were tone-death on the jobless rate and misdirecting their energies on the health-care debate. But the jobless rate isn’t the central concern of politicians or economists as it was last year. Now the Democrats have passed health-care reform, Republicans have shifted their focus to wanting to repeal it. Not only is this a mere politics of reaction, it is also the politics of delusion. Republicans running on repeal are running on something that can never happen – because President Obama will wield his veto against 67 Senators should it come to that – and when Republicans fail to do what they promised to do, their base would only become disenchanted.
At the heart of the Republican search for a positive and not merely a reactive agenda for campaign 2010 is the search for its soul. And even in this, Republicans have been reactive, for many were too slow to recognize the phenomenon called the Tea Party Movement. This movement has the potential of making or breaking Republican dreams this November. Conservative candidate Doug Hoffman didn’t merely force Republican Dede Scozzafava out of the race in the special election in NY23, but he ended up splitting the vote on the political right and giving the election to Democrat Bill Owens. Similarly, Sarah Palin may be the brightest political star of the Tea Party Movement, but she polls poorly with moderate Republicans. To decipher what they are for, Republicans need to sit down and think about what to make of, and what to do with, the Tea Party Movement.

If Washington Democrats know what they are for, Republicans haven’t settled yet on anything other than what they are against. “Hell no” will give a Republican primary candidate the Tea Party Movement’s vote, but it doesn’t guarantee anything come the general election, not least because major provisions

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7. A Monumental Achievement

Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he looks at the effects of health-care reform. See Lim’s previous OUPblogs here.

House Democrats have passed the health-care reform bill. Assuming Senate Democrats pass the accompanying reconciliation bill, this is a punctuating moment in the history of the American state, and a game changer for the politics of Elections 2010.

Since the New Deal, Democrats have embarked on a state-building enterprise. Democrats have expanded the functions of the state because they believe that individuals left by themselves and markets do not give us optimal levels of economic rights, civil rights, or health-care rights. Some Republicans were on board for a while, but today most see the accumulation of governmental responsibilities as the road to serfdom.

I am not sure that health-care reform takes us one step closer to socialism, but the Republicans are correct in their public statements that health-care reform will effect a major reconfiguration of citizens’ relationship with the state, and in their private sentiments that it is very difficult to roll back the state once it has been bloated. There was a time when bills calling for federal funding of roads between states were vetoed, when a federal income tax was unconstitutional, when investment banks were not regulated. None of these federal prerogatives are controversial today. Ted Kennedy and Barack Obama are correct that health-care reform is about the character of our country, though it might be fairer to say that it is about the evolving character of our country, because the developmental history of the expanding American state has paralleled America’s steady transition from pluribus to unum.

There are now 32 million new constituents of the (health-care) state, even if many will end up purchasing insurance from private exchanges. They are going to be committed to the state as wards are committed to their patron, and as seniors have come to love Medicare. Americans may not like the state, but our appetite for government tends to increase once we have been touched by its largess. Barring catastrophic implementation failure (because Medicare isn’t exactly a perfect program and it remains popular), the Democratic Party has just earned itself a sizable new constituency, not unlike what it did when FDR passed pro-labor legislation, or when the Republican Party handed out pensions to civil war veterans. At least some of these 32 million will go to the polls in November, and Republicans who have been fighting very hard to kill health-care reform know this. But because health-care reform has passed, Democrats have at least a fighting chance of keeping their congressional majorities when this seemed all but impossible a few weeks ago. For the first time since Scott Brown’s election to the Senate, the momentum is back in the Democrats’ court.

Barack Obama’s poll numbers are going to go up too. He lost many independents over the past year because he was seen to be too liberal, but he lost just as many  because he was seen to be incompetent in delivering change. When members of congress were chanting “Yes, We Can” on the floor of he House on Sunday night, we know that some of the old magic is back. He has done something that the last popular Democratic president, Bill

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8. A Week of Politics

Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he looks at political wrangling in D.C. See Lim’s previous OUPblogs here.

This week will be the most challenging week of Nancy Pelosi’s Speakership to date. With the President postponing his overseas trip and scheduled to give a healthcare speech in Ohio on Monday, one could be mistaken to think that it is the bully pulpit that could/would save the day for health-care reform.

It is not. Public opinion is very fluid in this moment, and in any case the presidential office is ill-suited toward convincing individual congressional districts and individual House members. At a time like this, votes in Congress and not votes in town halls are what count. More specifically, Nancy Pelosi cannot afford to lose more than 37 Democratic members of the House of Representatives assuming that every member votes and every Republican votes against the Senate’s $875 billion health-care bill passed on Christmas eve and coming up for consideration by the House next week. Right now, about 34 members (according to the Hill’s Whip ) are either on the firm or leaning “no” column.

Obama’s pulpit may at best change the national sentiment on healthcare reform, but he cannot change the majority opinion of individual districts with a public speech, much less an individual lawmaker’s mind. To do that, the Speaker and her whips operate behind the scene, conducting the business of what Ronald Reagan called the second oldest profession of the world, hoping that the magic she worked to get the 220 Democratic votes for the House version of the health-care bill in November will work again.

Obama, for his part, is not hanging around the country just to give public speeches. He knows (or should know) that styrofoam corinthian pillars aren’t going to be enough this time. His real challenge next week is to convince nearly every one of the 72 or so undecided or publicly unpledged Democratic representatives that the Senate will indeed live up to its promise to pass a reconciliation bill amending the provisions of the bill (such as the “Louisiana Purchase”) that House members find objectionable. When push comes to shove, the Constitution is quite clear that the public doesn’t matter, because only lawmakers have the vote to make law.

So who are these undecided or publicly unpledged members that Obama and Pelosi need to convince? The truth is the liberals who want a public option will ultimately come on board, and those who oppose the abortion language in the Senate bill have already been lost when the Speaker decided to go without most of them. (That the Speaker is no longer talking to Bart Stupak and his 11 colleagues suggests that Pelosi is either at the end of her tether with the abortion folks or confident that she can get her votes elsewhere.) So the biggest chunk of undecideds are the moderate Democrats who worry about the cost of the reform package. This is why all are awaiting the CBO scores on the cost of the health-care bill, which are expected on Monday afternoon. Expecting that more time will be needed to cajole the faint-hearted, the Speaker has provisioned three extra days from the original March 18 dea

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9. Reconciling Republicans and Democrats on Health-Care Reform

Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he looks at health-care reform. See Lim’s previous OUPblogs here.

Ideological purists do not believe in reconciliation. Conservatives would rather rely on private acts of kindness than the state to deliver health-care services. Hence their characterization of bureaucrats as cold and remorseless (such as when they’re on “death panels”). Liberals, for their part, believe that it is heinous to make a patient in need of care wait for private charity. Hence their tremendous faith in the helping hand of the state. For the conservatives, the market is benign but the state is monstrous; for liberals, the state is virtuous and the market is immoral.

Partisans and political parties, on the other hand, must reconcile themselves to median voters and therefore to each other if they are to have any chance of survival. That is why in their discussion of health-care reform, most Republicans and Democrats have ceded fundamental tenets of their ideology. In their concurrence with the Republicans in addressing a social issue in cost-cutting and job-creating terms and in eschewing a single-payer system, Democrats have proven that they are not really socialist. In reminding seniors of the potential cuts to Medicare should the Democrats try to cover the uninsured, Republicans have shown that they are not pure laissez faire anti-statists either.

It is in this muddied ideological context that we should view the parliamentary measure called Reconciliation which Democrats are bracing to deploy in the weeks to come to pass health-care reform. Reconciliation may be procedurally draconian because it bypasses the Senate filibuster, but it crystallizes the idea shared by Congressional leaders who pushed through the Budget and Impoundment Control Act in 1974 that legislative output (sound or unsound, one might add) is more important than consensus. It is no wonder that Reconciliation has often been used to pass legislation on the divisive issues in American politics which typically straddle the state/market-solution divide. These include health insurance portability (COBRA, 1985), expanded Medicaid eligibility (1987), welfare reform (1996), the Children’s Health Insurance Program (CHIP, 1997), and Temporary Assistance for Needy Families (TANF, 2005). Perhaps the Democrats could have saved themselves a year of trying to make history and a lot of political capital if they had realized that almost every welfare and health-care bill passed in the last three decades was achieved via Reconciliation.

Although Republicans say it is the nuclear option, no real destruction followed after each of the 22 times the measure has been used (with two-thirds of the time by Republicans.) Reconciliation doesn’t only reconcile items on the federal budget, but its supporters on either side of the aisle (when it suits them) also believe that the measure also reconciles the Founders’ sometimes contradictory commitment to deliberation and debate and their desire for legislative output and government. Reconciliation has been used before, and it will likely be used again, rather soon.

10. Health-care Reform is Making a Comeback

Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he looks at health-care reform. See Lim’s previous OUPblogs here.

After attempting a pivot to jobs, the Obama administration has realized that a hanging cadence on health-care will not do. Perhaps they should never have started it, but closure is what the administration now must have. An encore after the strident audacity of hope on health-care reform was temporarily dashed after the election of Scott Brown to the Senate.

In the immediate aftermath of that election, Democrats were in danger of exchanging over-confidence for excessive humility. After Obama’s historic election the year before and Arlen Specter’s party switch, Democrats were overtaken by hubris that Obama’s tune of change could be used to overturn Washington and to compel it toward a Progressive utopia. But just as Democrats were foolhardy to think that 60 votes in the Senate gave them invincible power, they somehow thought after the Massachusetts Senate election that 59 made them completely impotent.

In the media, we hear, conversely, about the conservative comeback in hyperbolic terms. On Saturday, Glenn Beck, not Sarah Palin or Mitt Romney, delivered the keynote speech in the largest annual conservative gathering, the CPAC conference. If Beck’s stardom exceeds that of the winner of the CPAC straw poll this year, Ron Paul, it is because the conservative movement, charged as it is, remains a movement in search of a leader. It is also a movement, as Beck’s criticism of Progressive Republicans in his speech reveals, which is not exactly in sync with the Republican party – the only machine capable of taking down liberal dreams.

And so a Democratic comeback on health-care reform is afoot. With one vote shy of a fillibuster-proof majority, Senator Harry Reid has opened the door to the Budget Reconciliaton process that more Progressive advocates of health-care reform like Governor Howard Dean have been pushing for a while. While it is not clear that there are 50 votes in the Senate for the public option, assuming that Vice-President Biden will cast the 51st, what is clear is that Democrats are much more likely to push through a liberal bill with the veto pivot sliding to the left by ten Senators.

In the White House too, we see a coordinated move to bring Reconciliation back as an option. Obama used his weekly address on Saturday to lay the ground work when he warned that “in time, we’ll see these skyrocketing health care costs become the single largest driver of our federal deficits.” He said this because in order to use Reconciliation, Democrats must show a relationship between health-care reform and balancing the federal budget.

No one in Washington believes that Thursday’s Health-care Summit will magically generate a consensus when in the past year there has been nothing but partisan bickering. If so, the President is not being naive, but signali

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11. On the Louisiana Purchase and the Cornhusker Hustle

Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he looks at political bargains. See Lim’s previous OUPblogs here.

To those disheartened by the compromises tagged unto the health-care bill before Congress, I say, c’est la vie.

When there is politics, there are bargains. To bargain is to attempt to purchase or acquire something at a steal or at a lower cost than usual. Because a bargain is by definition a transaction that would not normally have occurred without negotiation or haggling, all political bargains are corrupt to some extent. The Connecticut Compromise, the “corrupt bargain” of 1824, the Missouri Compromise, the Compromise of 1876, today’s “Cadillac” Compromise – you name it – they all had something shady in them, though shadiness is in the eye of the beholder (usually the loser).

And so it is on the road to healthcare reform in 2010; among them are the new Louisiana purchase ($300 million for Mary Landrieu’s vote) and the Cornhusker hustle or the Nebraska Compromise (Ben Nelson got Nebraska exempted from Medicaid increases). Ironically, the reason why these deals had to be brokered in the Senate is directly attributable to the Connecticut Compromise of 1787, which had proposed proportional representation in the House according to the population size of districts and equal representation of each state in the Senate in order to secure the support of the Constitution from delegates from states big and small. Out of the Connecticut Compromise was born the idea of a minority veto, and that’s in part why the Senate has become the preeminent institution it is today even though the Founders had intended that the House be the first legislative branch.

One compromise always begets another. This is the story of politics. Consider the Bill of rights – the deal-making compromise or condition that allowed Anti-Federalists sitting on the fence to come on board with the new Constitution. The Bill, of course, wasn’t so much a Magna Carta as it was an instrument to defend states’ rights and peculiar practices such as slavery and segregation. One compromise begets another.

The Democrats will do whatever they need to to pass health-care reform before the president’s State of the Union address. And the solution will be imperfect and tainted by compromises. It cannot be otherwise because we desire more to lead than to be led, and compromise allows us to find the tolerable medium between the two.

Whatever health-care legislation we pass will lock into place a peculiar settlement that is a reflection of the contingent set of circumstances that had to be addressed to deliver the current solution but in so doing it will also set up the conditions for a future political debate. And perhaps this is as it must be, for our founding document itself had paved the way in being little more than an elaborate list of compromises, article by article.

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12. To Howard Dean: It is 2009, not 1965

Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he looks at Howard Dean. See Lim’s previous OUPblogs here.

The year is 1964, the high watermark of Liberalism. Lyndon Johnson takes 61.1 percent of the popular vote in his election contest against Barry Goldwater, an electoral feat that was bigger than Franklin Roosevelt’s 60.8 percent in 1936 and one that has not been surpassed in the years since. The Democratic tsunami sweeps down Pennsylvania Avenue to the Capitol, where Democrats would out-number Republicans two to one in the 89th Congress, and in the Senate they take 68 seats – the biggest supermajority held by any party to this day. The era of Liberalism had entered its Golden Age.

Unified by the inspiring memory of John Kennedy, Democrats were able to enact health-care legislation that even Franklin Roosevelt, the father of modern Liberalism did not have the stomach to attempt as part of his New Deal. It would be Lyndon Johnson, not Harry Truman, not FDR, and not his counsin, Theodore Roosevelt (running as the Progressive Party candidate in 1912) who would enact the single biggest health-care legislation in US history, offering single-payer, comprehensive health-care benefits to seniors over the age of 65 (Medicare) and an option for states to finance the health-care of the indigent (Medicaid) in the Social Security Act of 1965.

We remember the New Deal, and perhaps the Fair Deal, but it is the Great Society that is the apotheosis of 20th century Liberalism. And if 1965 is Liberalism’s high water-mark, then those who would stymie health-care reform today because of the lack of a robust (or indeed, any) public option have gravely gotten their decades mixed up.

There was a time when Liberals did not have to call themselves “Progressives.” That was four decades ago, when Lyndon Johnson attacked Barry Goldwater for wanting to roll back social security and openly campaigned for a further expansion of the welfare state. Times have changed. Today’s Progressives must cagily wrap their Liberal agenda with talk of choice, competition, and bending cost curves. And if the era of Liberalism as FDR and Johnson knew it is over, The Age of Reagan lingers on in the Tea Party Movement. Despite his aspiration to build an even Greater Society than Johnson, Barack Obama’s electoral mandate is 18 percent short of what Johnson possessed in 1965; the Democratic majority is the House is much smaller; and, despite the new cloture rules post-1975 in the Senate which has reduced the fraction of votes needed to end debate from 2/3 to 3/5, Joe Lieberman et al remind us every day that the Senate is anything but filibuster-proof.

To Governor Dean and his compatriots, it is 2009, not 1965.

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13. On The Disrupted Sequence of Health-Care Reform

Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he looks at the health-care reform bill that the House passed. See his previous OUPblogs here.

Democrats must be thinking: what happened to the halcyon days of 2008? It is almost difficult to believe that after the string of Democratic electoral victories in 2006 and 2008, the vast momentum for progressive “change” has fizzled out to a mere five vote margin over one of the most major campaign issues of 2008, a health-care bill passed in the House this weekend. If you raise hopes, you get votes; but if you dash hopes you lose votes. That’s the karma of elections, and we saw it move last Tuesday.

Democratic Party leaders scrambled, in response, to keep the momentum of “Yes, we can” going, by passing a health-care reform bill in the House this weekend. But despite claims of victory, Democratic party leaders probably wished that their first victory on the health-care reform road came from the Senate and not from the House. President Obama and Speaker Nancy Pelosi have always hoped to let the Senate pass its health-care reform bill first, initiating a bandwagon effect so that passage in the House would follow quickly and more easily, and a final bill could be delivered to the president’s desk.

Instead, the order of bill passage has been reversed, making a final bill less likely than if things had gone according to plan. If even the House, which is not subject to supermajority decision-making rules, barely squeaked by with a 220-215 vote, then it has now set the upper limit of what health-care reform will ultimately look like. Potentially dissenting Democratic Senators see this, and there might now be a reverse band-wagoning effect. Already, we are hearing talk from the Senate about the timeline for a final bill possibly being pushed past Christmas into 2010. This is just what Nancy Pelosi and Barack Obama were hoping against, by pushing the Senate to pass a bill first. Unfortunately for them, the Senate took so long that to keep the momentum going (and amidst the electoral losses in NJ and VA last week), they felt compelled to pass something in the House to signal a token show of progress.

But the danger is that the move to regain control may initiate a further loss of control. The less than plenary “victory” in the House bill has only made it clearer than ever that if a final bill is to find its way to the President’s desk, it will have to be relieved of its more ambitiously liberal bells and whistles. Even though the House Bill, estimated at a trillion dollars, is more expensive than the Senate version being considered, and it has added controversial tax provisions for wealthier Americans earning more than $500,000, what the House passed was already a compromise to Blue Dogs. On Friday night, a block of Democratic members of Congress threatened to withhold their support unless House leaders agreed to take up an amendment preventing anyone who gets a government tax credit to buy insurance from enrolling in a plan that covers abortion. If even the House had to cave in some, there will have to be many more compromises to be made in the Senate, especially on the “public option.”

Sequencing matters in drama as it does in politics. It is at the heart of the Obama narrative, the soul and animating force behind the (now unraveling) Democratic majority in 2009. “Yes, we can” generates and benefits from a self-reinforcing bandwagon effect that begins with a whisper of audacious hope. From the State House of Illinois to the US Senate, from Iowa to Virginia – the story of Barack Obama is a narrative of crescendo. “They said this day would never come” is a story of improbable beginnings and spectacular conclusions. The structural underpinnings of the Obama narrative are now straining under the pressure of events. To regain control of events, the President must first regain control of his story.

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14. On the Balloon Side Show, The Infotaining Media, and Representative Democracy

Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he argues that the coverage of Balloon-Boy wasn’t all bad. See his previous OUPblogs here.

Last week, America came to a stand-still as we stood enraptured by television images of a runaway balloon carrying, so we thought, a six-year-old boy. Flimsy as the silver contraption appeared, we gladly suspended all disbelief that the balloon contained enough helium to be carrying a boy within so we could enjoy the side show. (Just as we did for Pixar’s animated movie, “Up,” which featured an old man who used balloons to move his house to a South American paradise.) So for almost two hours, most of the major news networks displaced all coverage of “hard” news to cover what Latimer County Sheriff Jim Alderman has now concluded to be a “publicity stunt.” And I’m going to argue that this was not a bad thing.

As the Balloon Boy story continued to dominate the weekend news cycle, the president and his advisers continued to deliberate on whether or not to send more troops into Afghanistan, and Senators worked behind the scenes to reconcile two different bills on healthcare. So let it be said that our “watchdog” media will switch its attention as soon as it is thrown an infotaining bone. But this is not necessarily a bad thing as long as we are clear-eyed about the media’s priorities. Instead, I think there is something strangely comforting that we allow ourselves such trivial pleasures. If we do not need an ever-vigilant watchdog, it is because we believe – by revealed preference – that government will mind government’s business, and we can tend to our own. Better no coverage of “hard” news than bad coverage, I say.

And this is exactly what the media did at least momentarily last week even as the President and Congress debated world and country-changing policies. Instead of another round of predictable punditry, or fact-checking of the CBO’s estimates of heath-care reform, we were fed images of a helium-filled balloon shaped like a UFO traversing the Colorado landscape. As we are with car chases, we, and therefore the media, were drawn to the balloon chase like flies are drawn to a light. We weren’t so much interested in the outcome – indeed knowledge of the outcome would have waken us up from our trance – as we were in the process, which was visually enrapturing.

For over a year we have watched a presidential campaign turn into a permanent campaign, and the American public is fatigued. We see this in Barack Obama’s dwindling approval numbers; and we also see it in our captivation by a drifting balloon. We are tired, and we are withdrawing from the public political sphere. The infotaining media detected this, and gave us a welcome reprieve.

And perhaps this is as it should be. Ours is a representative, and not a direct democracy. We vote and delegate; they, the elected officials, decide. The constitutional calendar is very clear that the people speak only every 2, 4, and 6 years. As far as the US constitution is concerned, our voices do not matter when we speak at any other time at the federal level. (Though our voices do matter at the state level where such devices as recall and refederanda are sanctioned by state constitutions.) If we didn’t believe this, than we have to deal with the conundrum that if last year’s elections were held in the second week of September, John McCain would have won. Clearly then, what you and I believed on November 4, 2008 matters much more than what you and I believe in October, 2009 (or September, 2008). Opinion polls may capture majority or minority sentiment at any moment in time, but these sentiments (should) have no import on constitutionally sanctioned officers exercising their delegated powers.

The deliberation of troop increases and health-care reform involve complex proceedings in closed-door war room meetings and conference committees reconciling details many Americans know and care little about. Such decisions make bad television, so maybe we shouldn’t try to force a message into an unreceptive genre lest we alter the message. Maybe those we put in charge should simply be let alone to do their job, for our constitution envisioned and sanctioned a low-effort, Rip Van Winkle approach to citizen participation. Sometimes we care a lot and we participate, but other times we tune out; and perhaps that is just as it should be. Last week, as we sat enraptured by the alleged antics of Balloon Boy, we embraced the implicit satisfactions of a representative democracy.

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15. Speeches are about Strategy, not Poetry: Obama’s Prime-time Challenge on Wednesday

Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he looks at President Obama’s attempts to pass health care reform. See his previous OUPblogs here.

President Obama is finally attempting to take charge of the health-care reform debate with an address to a joint session of Congress on Wednesday.

It comes down to this. If he does not pass a health-care bill – whatever its provisions may look like – he will indeed face his political Waterloo, because health-care reform has become the defining issue of his 2008 campaign on which the president has staked all his remaining electoral mandate. That this is open knowledge to every member of congress does not bode well for the president, because just about the worst bargaining position one can have is the one in which everyone knows that the bargainer not only cannot have what he wants, but must make compromises to get even some of what he wants. Because everyone knows this, everyone to the left and right of Obama will make their demands, and his only hope of coming out unscathed is if one or the other side is willing to shift their bottom line (on what Democrats call the “public option” and what Republicans call “government-run insurance”.

The bargaining game ahead of the president is enormously complex, but there are few ground rules that he could follow to maximize his returns. First, he must absolutely decide in his mind if he wants a bipartisan bill or not, and there are many Democrats who don’t. I will assume that he must at least present the public facade of wanting a bipartisan bill.

Second, he must pull all sides away from the fault-line of the debate - whether or not to have a “public option” - because health-care reform is rather more than just about “government-run insurance.” The
president must find a way for us to see the bigger picture, if only so that we do not continue our microscopic attention to our differences.

Third, Obama needs to create face-saving conditions and incentives for one or more dissident factions in the health-care debate to capitulate. It seems to me his best bet is to try to change the minds of members of his own party, in part because the president seems doggedly committed to at least a semblance of bipartisanship. An electoral mandate (or whatever that is left of it) is nothing without the coat-tails effect of the president, and on this the president can try to call in a few favors in return for future ones. As I think it has become very clear during the August congressional recess, capitulation from the Republicans seems all but unlikely now. If anything, Republican members of congress have become emboldened by the president’s falling approval ratings.

Senator Olympia Snowe’s idea that a public option would only be “triggered” if certain conditions are set is one such face-saving possibility for the president to try to woo the more liberal members of his party. In privileging the status quo, the conditional triggering option concedes that median congressional position on the debate has shifted to the right of where the president initially stood. But by specifying what the triggering conditions are, liberal democratic members of congress can tell their constituents (like the AFL-CIO) that they are still achieving their initial goals but with different means. If the president can just shift the debate to what these “triggering” conditions should be - and the devil will be in the details - he would have earned a significant victory. Such a compromise will not unite the country, but it could make us less divided, ironically, because no one is getting what they want.

It is too late now for the president to tell us what he wants on Wednesday, not only because he won’t get it, but also because he has allowed the debate to fester and the battle lines are now drawn. His
job on Wednesday is to muddy the battle lines again. As he is already starting to do, Obama should try to convince all negotiating parties that there should be no bottom lines, no veto points, no categorical
demands. The erstwhile professor of constitutional law will have the unenviable task of bringing together what the constitution pulls asunder. Not the Great Communicator, but the Great Umpire he must be.

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16. How Barack Obama can Pacify the Ghosts of Anti-Federalism to Advance the Health-care Debate

Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he looks at the health-care debate. See his previous OUPblogs here.

As America goes into intensive partisan-battling mode this summer over health-care reform, it may be helpful for President Barack Obama and his advisers to sit back and understand the basis of the rage against their plan. An understanding of the resurrected ghosts of Anti-Federalism in today’s conservative movement may offer him some strategies for bringing the Republicans and Blue-Dog Democrats back to the discussion table.

The rage that is out there among conservatives may seem excessive and irrational to liberals, but it is based on an ancient American quarrel. The differences between the “Birthers” and angry town-hallers and Obama precede the Democratic and Republican parties; they precede the Progressive, the Whig, and the Jeffersonian-Republican Party. They were there from the beginning. For the biggest fault-line in American politics was also the first political debate Americans ever had between themselves. It was the debate between the Federalists and the Anti-federalists about the need for a consolidated federal government with expanded responsibilities.

In 1787 and 1788, Anti-Federalists hurled charges of despotism and tyranny against those who proposed the need for a stronger federal government with expanded responsibilities than was envisioned in the Articles of Confederation. Today, the analogous charges against the neo-Federalist Obama are of fascism and socialism. As Federalists reviled the Anti-federalists for their shameless populism, Obama has likened the angry protests staged by his health-care opponents as mob-like thuggery. Conservatives, in turn, have recoiled at liberal condescension; just as Anti-Federalists fulminated against the Federalist aristocracy.

The Anti-Federalists envisioned a small republic because they could not conceive of their representatives - sent far away into a distant capital and surrounded by the temptations of a metropole - would ably be able to represent their communities. The fear of the beltway and of faceless, remorseless bureaucrats directing the lives and livelihood of honest workers and farmers struck fear into the heart of every true republican (lowercase is advised), as it does the modern conservative. Death-panels weren’t the first Anti-Federalist conspiracy theory.

Today’s “birthers” and “enemies list” conspiracy theories are not new stories in themselves other than the fact that they reveal the visceral distrust conservatives have of Barack Obama, just as many Anti-Federalists turned (Jeffersonian) Republicans accused Alexander Hamilton of illicit connections with the mother country, England. Today’s “Tea Parties” are but the modern conservative articulation that they are, like the Anti-Federalists were, the true bearers of the “spirit of ‘76.’”

As Cecilia Kenyon observed decades ago, the Anti-Federalists were “men of little faith.” This characterization is both accurate and one-sided at the same time, so it is no surprise that contemporary Democrats have taken the same line of attack, calling Republicans the “party of ‘No.’” The Anti-Federalists, like today’s conservatives, cannot bring themselves to trust the federal government or Barack Obama. Conservatives are using “scare tactics” because they are scared.

But their fears are not entirely unfounded and certainly not illegitimate, because a measure of distrust of government is the first defense against tyranny and the first implement of liberty. Liberals who have been so quick to trust the federal government should not only have a look at Medicare and Social Security, but acknowledge the mere fact that with one half of the country unconvinced (legitimately or not), the country’s faith in its government has been and will almost always be a house divided. This is a given fact of a federal republic; it is the blessed curse that is America. That is why in all areas in which there is concurrent federal and state responsibility - such as in education and immigration policy - lines of authority and execution are invariably confused and American lags behind almost every other industrialized country. In areas in which federal prerogative is clear and settled - that is to say in areas in which the federal government acts like any other non-federal, centralized government in the world - such as in foreign policy, the president can typically act very quickly (if not too quickly).

The conservative grassroots movement (staged or not) is a real threat to Obama’s health-care plan. But if the movement doth protest too much, it should ironically also be a source of comfort to the president. That there is so much anxiety and push back suggests that conservatives feel genuinely threatened. With Democratic control of all branches of government (and the open possibility of passing the health-care bill via the reconciliation process which will only need a simple majority in the Senate), conservatives believe that the liberals can transform their America into something their parents and grandparents would no longer recognize.

Here then, is the lesson to be learned. If the president wants to get anything done - he must strike at the heart of the problem: it is one of a fundamental, thorough-going(dis)trust. Barack Obama must convince Republican and Blue-Dog dissenters that he is one of them. Bowing before foreign Sultans and mouthing off about racial profiling did not endear him to conservatives, who only want to feel assured that the president is for them, not against them. These are minor gestures, which is why it won’t be tremendously costly for the president to present them as a peace offering. And calling protesters to his health-care plan a “mob” is definitely not a peace offering. It invokes the very perception of condescension the Anti-Federalists felt in 1787, reinforcing the ancient and original “us” versus “them.” To unite the county, he must transcend not only party, but ideology, and history itself. Barack Obama must break the legacy and transcend the language of our 222-year-old, bimodal politics. Quite simply, he must convince conservatives that he too can feel, and talk, and protest, and hurt, and fear, and agitate like a latter-day Anti-Federalist; and he is no less intelligent, no less rational, no less compassionate, no less constructive,  and certainly no less American for trying to do so.

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17. The Power of Reconciliation in the Health-Care Reform Debate

Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he looks at reconciliation. See his previous OUPblogs here.

There is a lot of hushed talk about using the Reconciliation procedure to pass health-care reform in the Congress these days, so Americans need to know something about this obscure parliamentary procedure, and what is at stake.

Reconciliation is an optional, deficit-reducing procedure that was created in the 1974 Congressional Budget Act. The Reconciliation process is a two-stage process. First, Reconciliation directives must be included in the annual Budget Resolution (as they were in the 2010 Budget Resolution passed on April 29). These directives instruct the relevant Congressional committees to develop (in this case, health-care) legislation by a specific date (in this case, October 15) to meet certain spending or revenue targets. The instructed committees then send their legislative recommendations to their respective Budget Committees, who then package all recommendations into one omnibus Reconciliation bill. Enter Stage 2, when this bill is then considered on the floor of both chambers of Congress under expedited procedures; of greatest political note is the 20-hour limit on debate on any Reconciliation measure, which effectively strips the minority party of the filibustering option in the Senate. That means the Democrats can pass health-care reform with a simple majority.

But there is an attendant cost to the majority party for using Reconciliation. The Byrd rule, passed in 1985, sets out the rules for what Reconciliation can and cannot be used for. In particular, it specifies that Senators will be allowed to raise a point of order against “extraneous” provisions in a Reconciliation bill which, among other things, “would increase the deficit for a fiscal year beyond those covered by the reconciliation measure.” Critically, cloture must be invoked to overcome a point of order. So the filibuster power is back.

Here’s the bottom line. Since the Budget Act states that the Reconciliation measure covers the next ten years, the Byrd Rule had the effect of allowing a point of order to be raised against any spending increase (or tax cut) that does not contain a ten-year sunset provision. That’s why the Bush tax cuts, passed via the Reconciliation route in 2001, 2003, and 2005, had sunset provisions written into them. If Democrats use Reconciliation, they will get a health-care bill, but it will expire.

Now let’s talk politics. There’s a debate within the debate that only seasoned politicos know about. Since the actual benefits of Reconciliation are mixed - a health-care bill can be passed with a simple majority in the Senate but it must have a sunset provision - the real power of Reconciliation is not in its actual usage, but in the mere threat of its usage.

The benefits of issuing the threat of going the Reconciliation route are akin to the threat of a presidential veto. The threat of a presidential veto sets the boundaries of permissible legislative action; it lets Congress know what is out-of-the-question and therefore powerfully guides legislative outcomes in the direction of the president’s preferences. By letting it be known that they will resort to Reconciliation if they had to, Democrats in Congress are incentivizing Republicans to be part of the making of a bi-partisan bill rather than be shut out of a purely partisan one. In making the threat, Democrats are specifying the costs of Republican non-compliance to the tune of: “if we let you stay in the kitchen, at least you can determine some of the ingredients in the cake. Make us shut you out and you won’t have even the slightest say.”

Like the presidential veto, the power of Reconciliation is maximal at the level of a threat. For between the time a threat is issued and the time when a bill is passed (via Reconciliation or not), there is a powerful incentive for Republican Senators to come back to the bargaining table because there is the distinct possibility that they could be shut out. Reconciliation is the Democratic antidote to the Republican Party becoming the “Party of ‘No’” For if Republicans keep saying “No,” then they box themselves into the plea of Nolo Contendere.

That is why different spokespersons for the Democratic Party are keeping the Republicans guessing and making sporadic and cryptic references to the Reconciliation possibility. And Republicans are trying to minimize the power of the threat by characterizing it as a no-go “nuclear option.” Unfortunately for Republicans, theirs is an empty threat because there is no Mutually Assured Destruction in this asymmetric power situation, and it is both a legal and political fact that, as the White House says, the Reconciliation option “is out there.” It is a win-win situation for Democrats to issue the threat, for if Republicans are unmoved by the threat, Democrats could materialize the threat and get what they wanted having known that an effort at bipartisanship had failed anyway.

What is missed in the debate out there now is that the effect of Reconciliation is already underway, for its power lies in its threat.

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18. Professor Gates v. Sargeant Crowley: A Rush to Judgment that Informs our Healthcare Debate

Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he looks at what happens when you judge too quickly. See his previous OUPblogs here.

In his press conference on July 22, President Obama’s knee-jerk reaction to call what the Cambridge police department did “stupid” was poor form. The president thought he was avoiding the hot spot when asked about the Gates arrest by saying that the controversy offered a “teachable moment.” But having admitted that he had imperfect knowledge of the facts, he went on and assumed that this particular incident invited a lesson about racial profiling and made the very indictment that his conversational segway was intended to avoid. In so doing, Obama confirmed conservatives’ belief that minorities love to whine about their beleaguered status (also another knee-jerk belief, incidentally) even if Obama could have made a case had he marshalled the evidence appropriately. Obama spoke like a liberal before he thought, and that was his mistake.

In so doing, he repeated the same mistake that Professor Gates made. Like Obama, Gates, too, jumped to the conclusion that Sgt Crowley was racist. I do not know if Sgt Crowley acted hastily in arresting the Professor for allegedly exhibiting “tumultous” behavior, so I won’t jump to conclusions but simply note my suspicion that there was probably a contest of egos on both sides. Those who have rushed to Crowley’s defense should ask themselves if they do not also have a knee-jerk reaction to give the benefit of the doubt to a law enforcement officer (or a soldier or a partisan affiliated with the Commander-in-Chief.)

Gates, Obama, and possibly Crowley were not the only people who have been jumping to conclusions, substituting unreflected intuition for a careful weighing of the evidence. Frank Luntz and his political students are encouraging Americans to become thoughtless automatons responding to carefully researched code words like “government takeover” and “health-care rationing.” The issue domain is different, but the error is the same.

It is very difficult to prove racial-profiling, for it demands an investigator to go inside the head of the alleged perpetrator. It is equally difficult to prove that the president’s and Democratic Congress’s plan for a “public option” is a precursor to a completely government-run health-care system. If it is not appropriate to rush to accuse someone of being racist, then it is at least premature to rush to accuse of someone of being socialist (assuming that that is a bad thing).

Those who are accusing Obama and Gates for rushing into judgment should look into the mirror to see if they too have not rushed to conclude that liberals are whiners and socialists who want a government takeover of health-care. At some level, we all have the instinct to cherry-pick the evidence to come to the conclusions we want.

Ideologies, like stereotypes, are cognitive cues or heuristics. They help us to “think” before we get the facts. They allow us to abdicate our duty to make sense of the world with our own independent judgment. They do the easy but intellectually dishonest work of guiding our reactions to the conclusions we want without us having to do the hard work of getting to know a person or a proposed policy before we came to a judgment. The people who are reinforcing such behavior in our politics are destroying our democracy and robbing us of our first freedom - the freedom of independent thought.

So the Gates controversy is a teaching moment, and the lesson is quite simple. Look before you leap; think before you conclude. It is probably the first lesson  of critical thinking, but two professors forgot it last week. If Obama wants us to learn this lesson, he should have been clearer about what the nature of his lapse was. It wasn’t that the president miscallibrated his words - for the question wasn’t about the intensity of what he said, but the very fact that he said something at all. Obama should have apologized for expressing what he felt and intuited without having first perused the evidence. If he had done that, he would have claimed the moral ground to shame some of his opponents in Congress into admitting that they too are doing the same thing in their knee-jerk opposition to what they call “Obamacare.”

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19. Talking About Health Care

Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he looks at Obama’s health care debacle. See his previous OUPblogs here.

As the wise saying goes “if you’ve nothing good to say, don’t say anything.” But President Barack Obama went ahead anyway with a prime time press conference, and as Bill O’Reilly was right to observe on Wednesday night - he said practically nothing specific about what the shape of the health-care bill would look like and viewers were left scratching their heads.

President Obama wanted to let Congress take ownership of the bill, rather than hand them a fait accompli (as Hillary Clinton did back in 1993/4), I hear Democrats chant in his defense. But if Obama wants to stay on the side-lines, then he should do so consistently. Either be genuinely deferential to Congress and stay out of the picture until a consensus emerges, or take complete ownership of the agenda - don’t try to do both. Yet the president is back in the limelight doing prime-time press conferences, and attending town hall meetings in Cleveland and such. Obama should decide which way he wants to go. If he is the salesman-in-chief, then he has to have something to sell, if not his consumers would be left completely befuddled as to why he’s putting on a show for no particular reason at all.

Liberals are mad that Obama didn’t throw a few more punches at Republicans. I think many are unwilling to admit the more pointed fact that he just didn’t do a very good job at all, because he didn’t have much to say.

So Wednesday’s press conference was a squandered opportunity. We are not in 2008 anymore when Barack Obama would announce that he is giving a speech and the whole world would stop to listen. The clock is ticking on his presidential luster, and the next time he says “hey, listen to me,” it’s going to be that much harder.

Let us be clear why health-care reform has stalled, at least till the Fall. Because the Congress, and in particular the Senate Finance Committee could not agree on a way forward. I don’t see why the President and his advisers thought that a prime time press conference last Wednesday night would have gotten things moving. In fact it probably achieved the exact opposite, when we heard on Thursday morning from Senator Harry Reid that a Senate vote before the August recess would not be possible. The president’s time would have been better spent persuading his former colleagues up on the hill in private conversations to compromise on a bill. When they’ve got a bill and all/most are united, then go out and do the media blitzkrieg, by all means. Wednesday night just wasn’t the time for that.

So it looks like the Permanent Campaign is back. The President has chosen to go back to campaign mode, selling himself. Because without a specific plan to sell, all his public appearances amount to going public for the sake of going public. This strategy belies a serious misunderstanding of American politics. Personal approval ratings do not translate to public support for specific policy proposals (not that they were forthcoming) - the president should have known this by now. They barely even translate into congressional support for presidential policies.

This error - of going public with nothing specific to sell - was compounded, and probably encouraged, by a complete underestimation of the push back from the conservative wing of the Demcoratic party (the “Blue Dogs”) worried about spiraling deficits. These were the people Obama should have been talking to. And given he’s still out town hall-ing and speechifying, I’m not sure he fully understands what came over him.

To make matters worse, Obama had to pour fuel over the fire of the Henry Louis Gates controversy during the press conference, accusing the Cambridge police of of a “stupid” arrest when he had incomplete possession of the facts. Have something to say about anything all the time has become the rhetorical ethic of the modern presidency. Obama’s observance of this ethic was a disastrous distraction to what little point he had to make at his press conference. The news cycles are now spending more time covering the Gates controversy than they are covering the health-care debate.

I’m afraid to say - though this is water under the bridge - that Hillary Clinton would have known better. This week, for the first time in his fledgling presidency, Obama looked like a total novice in Washington. His 4th press conference was a waste of time, and probably the first time since Obama broke onto the national scene in 2004 that his rhetorical wizardry had fallen so flatly on death ears. He seems to have bought the bad conventional advice - whenever you’re in trouble, just go out and give a speech - wholesale. The president should take heed:

1. The public is less attentive between election years and he must have something meaningful to say if he wants to keep their attention.
2. Especially on a complex issue like health-care where there are too many details to cover, the media is much more likely to jump at an opportunity to take the path of least resistance to cover something juicier, like Henry Louis Gates and racial profiling.
2. Just because the public (still) loves Obama doesn’t mean that they will love what he is doing as president (and not as presidential candidate).
3. It is often more important to talk to members of Congress - the people who actually pass legislation - than to deliver speeches around the nation where the only tangible return of applause is a fleeting sense of psychic gratification that one is loved.

President Obama, it’s crunch time. Stop yakking.

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