Autopsying Health Care Reform Mismanagement

Kimberly Strassel has a good piece in today's WSJ, analyzing the strategic missteps that led to the Obama administration's failure to navigate "high stakes" legislation into law. Despite spin from the White House and the Hill, missing the August deadline is a severe setback to the signature reform promised by the President. That he had a Democratic Congress with huge majorities at his disposal, the failure is all the more glaring.

Strassell, hits all the major points from the growing evidence the "stimulus" was not working as intended despite its enormous costs and even larger promises. The glad handing and crowing of the "don't waste a crisis" mantra struck me, honestly, of pirates raiding a newly conquered village. That this monstrosity of political plunder is at the heart of the eroding polls that began the unraveling of support for health care reform seems most appropriate.

Far from having learned a lesson after unleashing Nancy Pelosi et al to craft stimulus law, Strassel notes leaving this group to define the signature piece of legislation without guidance or parameters was a drastic mistake. Clearly the Obama administration was trying to avoid the micromanaging that led to the failure to pass health care reform in the Clinton years. Micromanaging is one thing, leaving this group to their own devices is suicidal.

While there may have been too little management, Obama's campaign promises and subsequent statements left options that would be useful in reaching consensus off the table. This was a major hurdle for Max Baucus in Finance as the tax exclusion on benefits was ridiculed by the campaign against John McCain:

Yet having slammed John McCain for that idea, the White House vetoed the compromise, derailing an agreement. “The President is not helping us,” bluntly stated Mr. Baucus. “He does not want [that tax]. That’s making it difficult.”

Reaching consensus was made even more difficult by allowing Nancy Pelosi to plow ahead with a vote on Cap and trade. Blue Dogs and fiscal conservative Dems were corralled to vote for controversial legislation with a variety of carrots and sticks, well a lot of carrots and a lot of sticks actually. After putting their necks on the line for a vote, the legislation will remain parked in the Senate possibly a very long time. The young representatives from largely right leaning districts were greeted with outrage when they returned home to their districts. This group was not likely to stick their necks on the line again especially since the President's approval began unraveling. Dick Morris notes:

When a president loses the approval of the majority of the voters and polls reflect that his ratings have fallen substantially below 50 percent, he loses his power. In this context, polls are like parliamentary votes of no confidence in European systems. While the government does not fall if it loses in the polling, it limps on until either its ratings improve or it is voted out of office at the next election.

Karl Rove points out in polls of adults Obama's numbers note sharp declines in support and suggests the numbers presage even further decline:

What many people missed is that those who strongly disapprove of the president’s approach on health care now outnumber those who strongly approve by 33% to 25%. That presages further decline. Already, 49% of independents disapprove of the president’s approach, up from 30% in April, a staggering shift in 11 weeks.

In short, what may have been the most serious misstep was the administration was misreading the public mood for a massive change in their health care particularly at a time of so much economic turmoil. The mood was ignored and once it was clear the deep slide was underway, there was too much spin, false deadlines and a growing sense of distrust for more promises and too few results. The public was paying attention and using their common sense as Peggy Noonan suggests:

His news conference the other night was bad. He was filibustery and spinny and gave long and largely unfollowable answers that seemed aimed at limiting the number of questions asked and running out the clock. You don’t do that when you’re fully confident. Far more seriously, he didn’t seem to be telling the truth. We need to create a new national health-care program in order to cut down on government spending? Who would believe that? Would anybody?

I haven't agreed with Peggy Noonan in a while but here she is dead on, nobody was buying the spin and distorted logic. Of course, political moods can change and we are far from out of the woods with health care or the ideological agenda of this administration, this is no time to let down our guard.