In the fourth quarter Obama finally comes out to play

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The Gazette, Wednesday, March 17, 2010

The U.S. ambassador to Canada, David Jacobson, a friend of Barack Obama's from Chicago, is fond of quoting the U.S. president saying of himself: "I'm a fourth-quarter player."

Well, in the great American health-care debate, it is very late in the fourth quarter, and about time Obama got into the game as he has in the last week, hitting the campaign trail, ditching his teleprompter, taking off his jacket, rolling up his sleeves, and returning to the ringing rhetoric that took him to the White House.

Rather than talking over the heads of the American people, as he has for the last year, he's asking them to send a message to Washington: We want health reform now.

The messenger of hope and change is back, and Obama's barnstorming of the American heartland might be enough to deliver a health-care bill to his desk when Congress votes on it this weekend. Then again, maybe not, because as of this moment the Democratic House leadership admits they don't have the 218 votes needed to pass the bill. Obama is trying to leverage the moderates and conservative members of his own party by taking the presidential bully pulpit on the road.

For Canadians, the logic of the U.S. health-care debate is impenetrable and the structure of the legislation - different bills in the House and Senate that need to be reconciled - is incomprehensible.

In Canada, it's comparatively simple: Health-care coverage is universal and portable, with a single insurer - government. There are gaps in the system, such as unacceptable waiting times for elective surgeries, and a flourishing private health-care industry attests to that. But the principle of universal public health care in Canada has been settled public policy for two generations.

In the U.S., they've been talking about this since Teddy Roosevelt was president, a century ago. Franklin Roosevelt, the father of Social Security, failed in his efforts to secure public health care. John F. Kennedy, in 1962, famously told a Madison Square Garden rally that 14,000 people could look after their interests through lobbyists in Washington, "but the rest of the people depend on the president of the United States." Lyndon Johnson, who knew how to get things done in Congress, got Medicare and Medicaid, but not universal health care. Bill and Hillary Clinton tried for a health-care bill in 1993, and the ensuing fiasco was a major reason the Democrats lost both Houses of Congress in 1994.

Now it's Obama's turn to try to roll the health-care rock up Capitol Hill. Well, he ran on it, didn't he, so why wouldn't he? The problem is that when you plant a flag on a hill, you sometimes die on that hill.

And for what? Neither the House nor Senate versions of the health care bill provide for what's known here as "the public option"- the equivalent of universal coverage. This should be the heart of the matter: Nearly 50 million people living in the richest country in the world have no health coverage. Stated another way, one American in six has no health coverage, and the rest rely mainly on private insurers.

And as Obama has discovered, the insurance companies are very big players with huge vested interests in this debate. They are the very people Jack Kennedy had in mind nearly half a century ago.

Something else happened between the 2008 campaign season and the beginning of the Obama presidency in 2009. Not the economy, stupid, but the stupid economy. No one foresaw the meltdown of global markets in September 2008, the $800-billion bailout of Wall St., and the resulting Great Recession, which necessitated Obama's first and most significant legislative achievement - the $787-billion National Recovery Act.

The current U.S. federal deficit of $1.6 trillion is equivalent to the entire economy of Canada. The health-care legislation would add another trillion dollars of debt over the next decade.

Obama clearly thought that after winning on infrastructure spending, he could turn his attention to health care. But two things happened. First, things got worse before they began to get better, with unemployment rising from eight to 10 per cent. It looked as if Obama had taken his eye off the economic ball.

And then he unwittingly unleashed some hostile, even sinister, forces. The Tea Party movement was born out of this debate, and has scared off any Republicans who might have joined in a bipartisan effort sought by the president.

So, very late in the fourth quarter, here comes Obama's two-minute drill, no timeouts remaining.

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