Comprehensive Failure

In yet another interview in connection with a major sporting event—this time, the Super Bowl—President Obama proposed yet another unorthodox manner of addressing a political problem: this time, a bipartisan half-day health care summit on live TV. Why hold such a meeting nearly a year into the health care debate? “Well,” he told Katie Couric, “I think that what I want to do is to look at the Republican ideas that are out there.”

This would seem to be a good, if grossly overdue, idea. Unfortunately, the prospects for a real back-and-forth exchange look bleak. Couric asked Obama if he’d be willing “to start at square one,” and he took pains not to answer. Subsequently, White House aides made it clear that the president would be bringing his own health care bill to the table. Then, the day after the president’s interview, his secretary of health and human services, Kathleen Sebelius, stated that the president’s proposal wasn’t really conducive to being accepted in part or rejected in part. Sebelius said, “I think the president remains committed to the notion that we have to have a comprehensive approach, because the pieces of the puzzle are too closely tied to one another.” She added, “Pieces of the puzzle are necessarily tied together if you have a comprehensive approach.”

So if the president already has his own comprehensive bill in hand, and its interlocking pieces are not really subject to refinement, revision, or removal, one wonders exactly what Republicans’ role at the summit is. Is it to convince President Obama that they have a better plan, which he should therefore substitute in its entirety for his own? Sebelius offered another possibility, noting that the president is willing to “add various elements” to his bill. In other words, while his bill cannot be redesigned or made smaller, it can be made bigger—provided that the Republicans have what he thinks are good ideas to add.

This bizarre combination of claims is revelatory of the president’s outlook on politics. “Incremental gains” is a phrase foreign to his vocabulary, as is the notion of having Washington solve problems by getting out of the way and unleashing the initiative of individuals or communities. Rather, problems must be solved all at once, comprehensively, nationwide, from the top, by the federal government. This approach is largely divorced from practical considerations or, as Sebelius notes, from compromise. It is the approach of the theoretician, not the practitioner; of the academic, not the statesman; of one who prefers to decree or to gain acquiescence, rather than to negotiate or to persuade.

Obama is far more comfortable with such roles. In a moment of candor, he essentially said as much to Couric:

Look, I would have loved nothing better than to simply come up with some very elegant, you know, academically approved approach to health care [that] didn’t have any kinds of legislative fingerprints on it, and just go ahead and have that passed. But that’s not how it works in our democracy. Unfortunately what we end up having to do is to do a lot of negotiations with a lot of different people.

With the possible exception of Woodrow Wilson, can you imagine any of our prior presidents having said that?

Our democratic process, our separation of powers, and our federalist design frustrate Obama. But, far from being unfortunate, the negotiations and multiple levels of approval that they require, from a myriad of different citizens, is largely what secures our liberty—protecting it from those who would otherwise impose their own comprehensive goals from their lofty theoretical perches. The Founders were surely not Obama’s intellectual inferiors, but they were practical men. The Constitutional Convention was nothing if not high-level give-and-take, tinkering and refining. One imagines Obama showing up at Independence Hall with his own plan in hand (probably adapted from Rousseau’s in The Social Contract, with Obama cast in the role of the Legislator) and being surprised when the other delegates resisted his eloquence and, correspondingly, his proposal.

The academic mindset—which is not necessarily synonymous with intellectual inquisitiveness—is also conducive to a disconnect from the real world in other ways. Take the following exchange:

Couric: A lot of people, including Democrats, wrote to me saying you campaigned on the slogan “Change you can believe in.” But their lives and the ways of Washington, they wrote, haven’t changed at all. What would you say to them?

Amazingly, Obama replied:

Well, it’s not true that they haven’t changed at all. Let’s just take—we’re sitting in the White House here. Every single person who comes into the White House now is posted on a website, so you know every visitor to the White House. That’s never happened in the history of the Republic.

Seriously? To be fair, he went on from there, but that was his first response. The “change we can believe in” is that the names of White House visitors are now listed online.

The comprehensive approach to problem-solving is at best ineffective and at worst dangerous. When was the last time you heard President Obama talk about local or state solutions? When was the last time you heard him talk about the federal government solving problems by scaling back its role?

The president would stand a better chance of success if he could bring himself to consider sensible, targeted solutions designed to achieve incremental but tangible gains. Take the “one-page” alternative for health care reform that has appeared in these pages (“The Small Bill,” February 8, 2010). At least three of its seven proposals—ending runaway malpractice lawsuits, allowing Americans to buy insurance across state lines, and allowing companies to offer lower premiums for healthier lifestyles—could be implemented independently, with or without the rest of the bill. All three involve having the government or the legal system get out of the way, thereby enabling health care costs to decline.

Two of the other small-bill proposals could be implemented in tandem. We could finally end the unfair tax on the uninsured (and self-insured), giving them a tax-break similar to the one already available to those with employer-provided insurance. And we could pay for this by reallocating some of the federally administered funds that help cover the costs of treating the uninsured, and converting the rest into block-grants to the states.

The small-bill approach shows that governing this country need not invite the constant frustrations of crafting “academically approved,” federal-government-centered, comprehensive solutions to nearly every imaginable human problem, and then having to face the dispiriting struggle of getting these “elegant” solutions through our “unfortunately” democratic institutions—especially when the people, for some reason, don’t want them.

Jeffrey H. Anderson, a senior fellow at the Pacific Research Institute, is director of the Benjamin Rush Society.