What It Will Take to Win the Health Care Debate

In a speech to a joint session of Congress on healthcare Wednesday night, President Obama briefly alluded to the age-old argument between the individual's desire for freedom and the need for security. He noted there has been a healthy skepticism of the federal government since the nation's founding. On occasion, in reaction to the destructive excesses of this or that Gilded Age, progressives have been able to overcome our natural Jeffersonian inclination to prefer limited government. It is only when levees burst, markets crash, or regulators fail us that there usually comes a brief burst of progressive action. That was what happened in 1935 when Social Security was enacted.

In 1993, the Clinton health care plan was undone by a series of ads featuring "Harry and Louise" who convinced each other that the federal government shouldn't play any role in the nation's health care system. That strategy worked then and the Republicans hope it can work again. They continue to parrot consultant Frank Luntz's line that the Democrats want nothing less than to accomplish a government takeover of healthcare.

We should be clear that the opponents of genuine reform have no comprehensive alternative they can claim as their own. Aligned with the private insurance carriers, their real goal is to maintain the status quo. Their real fear is the realization of a decades-old Democratic dream: low-cost, universal healthcare. They realize that should this dream come true, they will remain out of power for many years to come.

The anti-government crowd, embodied by Ronald Reagan, rode into Washington in 1981. At his first inaugural address on the steps of the nation's capitol, he said, "Government is not the solution to our problems; it's the problem." Today, all too many Americans believe that to their very core. According to data compiled by the Pew Research Center, an astounding 62% of Americans believe that when the government runs a program, it is usually inefficient and wasteful. That's what did in "Hillary care" in 1993. The outcome of the healthcare debate taking place in Congress today will determine if the 28-year conservative stranglehold on Washington is finally nearing an end.

There are two things holding us back as we stand on the precipice of enacting genuine healthcare reform, that is, one that includes a public plan as one among others. First, from 2000-2008, the Bush Administration showed us that it had little interest and limited ability to actually govern. In fact, the monumental incompetence of Bush and his cronies will make the job more difficult, for they failed in ways that have undermined Americans' confidence in the ability of government to solve the country's most pressing problems.

Second, when we speak -- as the President did the other night -- of our willingness to come to the aid of others in need, most people think of individual or organized charity or other acts of kindness. Alternatively, one thinks of "individual" giving and selflessness in times of a national emergency, as was the case with the nation's response to the destruction of the Twin Towers in New York City in 2001. "Government action" - other than a military response -- is not the first words that come to most people's lips at such times. Nor is it clear, as the President maintained on Wednesday, that most people think government should step in when someone is in need of a helping hand. Not yet, at least.

Here, then, are suggestions for the President's next speech if he really wants to change public attitudes on the proper role and size of government in American life.

He should remind us that it was the government of the United States that substantially reduced the number of elderly in poverty, landed a man on the moon, helped conquer fascism, built interstate highways, made loans to homebuyers and students, insured bank deposits, and led the most successful anti-smoking campaign in the history of the planet. And it continues such diverse tasks as making certain that unsafe drugs don't reach the market and providing financial assistance to victims of natural disasters.