An Open Letter To Liberals and Democrats

Posted by J. Alexander Mitchell on 09.02.2009

How can we have a discussion about Health Care Reform?

President Obama's plans for health care reform are in trouble. Those that want to see the plan succeed and would argue this point are fooling themselves. The public's opinion – specifically, the opinion of the independent segment of the population that was key to his election - on both health care reform and Obama's handling of domestic issues have both plummeted, and, as mentioned on this site, the majority of Americans are confused as to what is and is not on the table in the debate. The latest reports say that the President is willing to hit a "reset" button on the debate, this time laying out specific plans rather than simply allowing Congress to write legislation following his criteria. Like the President, I believe now is the time to hit the "reset" button on how those that support health care reform engage in our discussions about the matter. It is rather obvious that the current strategies are not useful, so it is time to modify the battle plan. As such, I have written, as inspired by Joshua White's "A Letter From A Conservative", my thoughts to the supporters of health care reform.

The first, and biggest, note I would make is to ensure that you have a discussion about health care reform. There are huge differences between an intellectual debate and an emotional argument. Many detractors to health care reform have viewpoints that originate from an emotional standpoint, and that is understandable. If you are 65, are on Medicare, and feel that the program is problematic already, are you going to want to chance any huge or sweeping changes, even if they are made in the name of efficiency? People's feelings are valid no matter what – that is what makes them feelings. It is very important to say "Yes, I understand your viewpoint. Moving in this direction does require a certain level of trust in the government".

Of course, that begs the question "How do we gain that trust"? It is at this point that we can begin an intellectual debate, and, in that arena, I firmly believe that proponents of health care reform will prevail. If we are yelling emotional talking points parroted by our favorite partisan talking head – be it Chris Matthews or Bill O'Reilly – reform will never take place. However, if we are in the midst of a genuine discussion about the facts ("No, the ‘end of life counseling' only lets those people that want to talk about options like living wills and potential funeral costs get that advice if they want it. It does not involve trying to decide who gets to live or die. It's just like counseling before you get married – letting you know the facts so you can make your own decision"), I firmly believe that reform will occur.

This segues into another huge point – it is very possible to inform someone that they are incorrect without insulting the person, and there has never been a better time to do so than now. Again, there is an emotional aspect to this. Calling someone that does believe that they will never be able to buy private insurance if they lose their private insurance after the bills get passed "an idiot" does not win over the hearts of the public (and that includes the behavior exhibited by Representative Barney Frank when confronted by a protester that compared Obama to Hitler).

As well, we should not be afraid to enter into fierce but respectful conversation about valid questions that the opposition wants answered. I greatly look forward to the President offering a specific plan towards reform, as I hope it will answer many of the very valid questions the opposition has (specifically, how we will pay for it without increasing the deficit). One very frequent question I have seen is "What is so great about the health care reform bill?" I think we, as proponents of reform, should be able to answer that question. I like to begin by establishing that both sides of the aisle want reform – this is evidenced by the Patients Choice Act sponsored by US Senators Coburn and Burr and US Representatives Ryan and Nunez, all Republicans. I would then mention that there is not one specific bill, so it isn't helpful to ask what is so great about it. Instead, the conversation should be about what aspects of the varying bills, including the PCA, would work best. There are many aspects of health care reform – such as the removal of limitations based on pre-existing conditions and the establishment of health care exchanges in each state to serve as "one stop shops" for information in the state – that both sides agree are great ideas that would help reform our system for the better. In addition, it is difficult to argue that the removal of inefficiencies in Medicare and Medicaid are problematic. I continually cite many things both sides of the aisle agree on because, to be honest, much of the reform packages include things that both sides agree on. I personally prefer to avoid discussion of having a public option because I believe, like CNN Senior Analyst Gloria Borger, that President Obama will drop the public option in favor of being able to say that the Democrats attempted bi-partisanship and the Republicans stonewalled it. This is a matter of conjecture at this point; however, if President Obama truly did not want to attempt bi-partisanship, he could have had Congress ram an incredibly liberal package through the Senate, provided the plans allow them to utilize reconciliation in the Senate. As a whole, though, I think that the public option is a radioactive topic that polarizes audiences and prevents true discussion – and, as such, keeps opinions on reform negative. Note that I am not saying that I am against a public option – I do believe it is a great idea and that our public/private universities, long distance mail carriers, hospitals, and even military (Blackwater anyone?) show that we can have a public option for our needs while still maintaining a viable, profitable private system. However, I recognize reality, and the reality is that, if one is going to sell reform, it is easiest to avoid the single biggest non-essential polarizing aspect.

As an aside, please do not be afraid to be wrong. Listen to the other side. There are solid arguments against individual aspects of reform that should be acknowledged. If you want someone to listen to you, you should begin by actively listening to them.

Finally, and this is perhaps the biggest point, ensure that discussion of health care remains discussion of health care. Many opponents to health care reform seek to defeat health care reform by making opposition to health care reform equivalent to opposition to the bailout, stimulus package, cap and trade, etc.. These issues have nothing to do with health care reform. Again – both sides of the aisle agree something must be done, and nothing will get done about health care reform as long as it is associated with a number of other controversial topics that aren't relevant to the debate at hand.

As I mentioned, I am very pro-health care reform as presented by President Obama. In the discussions I've had with conservative friends and associates, I have come to the conclusion that both conservatives and liberals want change in the system, and want a streamlined, efficient, cost-effective health care system. In fact, I would dare say that the difference between my viewpoint and those of the conservatives with which I've exchanged ideas is that I – like the President – also want to see coverage of some sort extended to the uninsured and underinsured, whereas those I've met that oppose President Obama's plans believe that it simply is not cost-effective to do so. If viewed from this slant, we can still get a considerable amount done to make health care more affordable for all and, while we are at it, have a true debate on the direction to move in. However, we – as those that seek reform – need to be very careful about how we pitch this reform if we want to see true change made.

Other thoughts:
Ashish has officially put the call out to new political bloggers. Shockmaster, JWestmoreland, Da Man, AdmChesterMyNutz, Chris Connolly (yes, I know you used to write for the site… wassupwitdat?), and the Spook… I am now officially waiting to read your new columns.