Politico Pulse pulls out this telling internal memo from Ryan Lizza’s New Yorker piece this morning examining the thinking of the Obama administration during the health care reform debate. Obama publicly flirted with the idea of making a greater investment in tort reform and pursued the proposals in order to secure Republican cooperation and support:
“On July 1, 2009, his top health care adviser, Nancy-Ann DeParle, submitted a detailed nine-page policy memo asking whether the White House should consider including medical-malpractice reform in the legislation. Most Democrats opposed the idea, but the American Medical Association was pushing for it. ‘Obviously, we shouldn’t do anything that weighs down the overall effort,’ Obama wrote back, in his characteristically cautious and reasonable style, ‘but if this helps the AMA stay on board, we should explore it.”
Ultimately, none of this mattered very much. The Affordable Care Act contains funding for tort reform demonstration projects — as well as a multitude of other Republican-backed initiatives — that the GOP ignored because they were more interested in preventing Obama from signing one of the most sweeping social reforms in a generation than addressing the nation’s health care crisis.
What the administration learned all to late is that the details of the policy had absolutely no bearing on the tone of the opposition. Republicans relied on the same “big government” talking points to combat reform even as the measure became more conservative and Democratic lawmakers stripped out initiatives like the public option, end-of-life counseling and a host of other provisions that Republicans found repugnant. But no matter how much the bill changed to resemble the Heritage-backed Romneycare solution that relied on private competition and private enterprise, the GOP still claimed that the government was taking over health care and rationing services to seniors.
Lizza reports that Obama still believed that he could win over the opposition and rejected good policy in order to make the bill more acceptable to conservative opinion makers. One memo reveals, for instance, that Obama turned down a pilot program “to study the most effective treatments for patients” within the Federal Employees Health Benefits Plan (FEHBP) because it was not “politically viable” and could prove a target for Fox News. The president wrote at the end of the memo, almost apologetically, “Unfortunately I think the political guys are right about how it would be characterized. Let’s go back at it in future years, when the temperature on health care and the economy has gone down.”
Almost two years later, the temperature is still at a boiling point and the GOP presidential candidates are crisscrossing the country accusing Obama and the law of everything from ending private enterprise to jeopardizing the livelihood of seniors. Given the partisan divide of modern American politics, Republicans and their supporters in the media will invent controversy where none exists and so it’s foolhardy to abandon good policy out of fear of inflaming the critics. They’ll burn you anyway, while you’ll have a harder time defending a decision that was made on political, rather than policy merits.