It would be difficult to imagine a more eloquent and timely case for health care reform than the one being made by Barack Obama. He has staked his early presidency on fulfilling one of his major campaign promises. Everyone agrees — not counting extremists — that his recent address to Congress was masterful. Yet an ABC poll quickly showed that 78% of respondents don’t believe the President’s proposed reforms will help them personally, and over 80% don’t believe it will lower their costs.
This fix-it President, who also has the gift of eloquence and an electoral mandate, has hit a wall. That wall has more to do with the future than just health care.
The wall has been put up by all kinds of people. Fear mongers on the right spoil for Obama to fail at anything and everything. Idealists on the left want far-reaching reform rather than a compromise plan. The indifferent middle doesn’t want to be bothered. There are a dozen rationales to hide behind: The government is intruding too much into the private sector, the cost of the new plan is too high, cost-cutting won’t happen, the deficit is already staggering, nobody wants to pay more for their medical care, and besides, we have two wars to contend with. I’m sure you can add more objections to the list, and we haven’t even arrived at what would be a good or bad plan yet.
Let’s say that all these objections have merit, since in fact they do. Even the extremists on the far right are trying to find a pulse in the moribund Republican party, and hating has worked well for them in the past. Whatever the merits for opposing health care reform, two points can’t be overlooked. First, the system is broken and needs fixing. We elected a fix-it president at exactly the right time, and the adult in each of us knows that he’s right to tackle this huge looming problem.
The second point is more dismaying. If the wall doesn’t give and Obama’s plan is watered down to the point that it turns into a giveaway for the insurance companies, what will that say about America? It will say that lobbyists own the government, that democracy has been sold down river. It will say that extremists, however absurd with their death panels and ” the government can’t run anything” have poisoned reasonable discussion. A double flaw in the national character was brought out during the Bush years: blind selfishness and moral indifference. That’s what Obama is trying to reverse.
Will he succeed? There’s no doubt that health care reform, in no small part, requires sacrifice. It also requires compassion, because the vast majority who already have health insurance are being asked to help cover the minority who don’t. Obama has rightly pointed out that this isn’t a subsidy. If you have medical insurance, you are already paying in boosted premiums for the uninsured. If a procedure costs $1,000 but some people get it for free (the indigent, the uninsured who rush to the ER, illegal immigrants, and the young, who have yet to think about insurance), then the extra cost gets passed along. To extend a compassionate hand is also to ask for justice. More people will be paying for their own health rather than depending on somebody else to foot the bill.
I hope these considerations of character and compassion make an impression. If reform fails, the presidency will survive. If reform is half-hearted, a victory will be claimed and everyone, except for a few harsh critics, will go back to the status quo. The economics will work itself out eventually, probably in a worse way than if we handled the problem today. But the failure of reform will prove that the era of fear-mongering, selfishness, extremist poison, and political hypocrisy is far from over. Let’s hope that the opposite happens. It might be just the kind of turn-around we hoped for when this President was elected.
Published in the San Francisco Chronicle

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