UNC professor Jonathan Oberlander has spent years studying the politics of health reform. I recently came across this piece he wrote for Health Affairs after President Obama’s speech to a joint session of Congress. The entire piece is interesting, but the conclusion is instructive for those who criticize Obama’s strategy :
There is, in short, no perfect health reform strategy. No matter what you do, opponents will lie about your plan. No matter how much your plan costs or how much the federal budget deficit (or surplus) is, critics will say that it is unaffordable. No matter how much it relies on private insurance, opponents will decry reform as a “government takeover” or “socialized medicine.”
There will always be an ideological divide between the parties about the roles of government and markets. Insured Americans will always be anxious about how reform affects their medical care. It will always be difficult to navigate controversial legislation through Congress. And health reform advocates will always be disappointed with the inevitable compromises that must be made to get reform enacted into law.
Yet the sound and fury of the last month should not obscure the reality that while health reform has taken serious political blows, it still has much going for it. Give the Obama administration’s determination, Democrats’ majorities in Congress, and their political incentives to produce a bill before the 2010 election, there is still a good chance — though it is far from certain and this is an unstable environment — that legislation can pass this year.
Health reform is always a difficult fight, but in September 2009 it remains a winnable fight.