Barack Obama: President of Policy Ends, Not Ideological Means

Health care is not about Democrats versus Republicans or the left versus the right. Rather, health care reform is about decency, security, and as the late Senator Kennedy wrote in his letter to President Obama, it's about the 'character of the country'.

Right now, health care costs are a drag on the economy and a burden on American families. Our lack of universal coverage is as morally abhorrent as it is inefficient. Further, while Americans have the best medical care in the world, even those who are fully covered are not always completely secure and too often, insured Americans don't have access to the kind of care they need.

The President gets it. The President gets that health care is bigger than politics and that's why his speech was such a success and he has since seen support for his plan go up 14 points.

The President said the major health care challenges were controlling rising costs, expanding coverage and doing so while not adding to the deficit. To do that, he highlighted the need to make the insurance industry more competitive, to mandate insurance coverage and to create meaningful incentives for better care, rather than just more care. To pay for his plans, the President said he will target wasteful, inefficient care, and gave a nod to centrist Republicans by promoting a tax on gold-plated health insurance plans and highlighting malpractice reform.

While the policy specifics in the speech were important (and I'll talk about them in more detail in an upcoming post), the speech itself was, in many ways, larger than health care. In the speech, the President defined his presidency. He announced to Congress and to the American people that he is the President of ends and not the President of means. The President made it plainly clear that he cares vastly more about the results of his policies and their impact on Americans than he does about whether the policies are liberal or conservative or are the brainchild of friend or foe. This is precisely the kind of mindset a President needs if he is going to be successful in tackling the challenges we're facing -- climate change, two wars and a struggling economy.

And not only is being a President of ends better for the country, it's also politically expedient. President Obama is developing a new kind of bi-partisanship. He is willing to use Republican ideas that will work, even if Republicans themselves won't vote for his policies. This is trouble for Republicans. If the President can co-opt their best policies, enact meaningful legislation and leave Republicans holding up banners, screaming no and failing to offer practical solutions, then the Democratic Party is in pretty good shape.

Congressman Joe Wilson is the new face of Republican ideological entrenchment. His guttural reaction revealed a great deal about his desire to help Americans who get priced out of buying health insurance. While it was commendable that senior Republicans, like Senator McCain, chastised Congressman Wilson, Wilson's actions will define the Republican response to health care. Rather than unifying the Republican party, Wilson's cry of 'you lie' is going to drive any Republican who truly cares about getting health care costs down and expanding coverage towards working with the President, lest they be seen as a partisan zealot.

So what needs to happen now?

First, the President must lead the health care reform process from the White House. He needs to corral the House and Senate and bring into the fold legislators from both parties who are committed to meaningful reform.

Second, the policy-makers need to iron out the specific policy implications from the President's speech and present a clear, detailed plan to the American public, available and accessible for discussion. With health care reform, the devil is in the details and the upcoming legislation drafted by the President and other lawmakers must be explicit.

Third, every American needs to do their part to keep the debate honest. Any time a politician on the right howls about death panels or a politician on the left throws unmitigated rage at the insurance industry, we need to remind them that we're all in this together, that sound-bites don't make policies and that we're going to all work together to fix the health care system.

Finally, Senator Kennedy's letter provides the perfect name for the upcoming health care reform bill. From here forward, the health care bill that the President will sign should be named 'The Character of Our Country Health Care Reform Plan'.

The battle for meaningful health care reform was certainly not won last night, but the President's speech set the stage for significant progress in the months ahead. It will certainly be interesting to see what impact the President's speech will have on the tenor of the health care debate and specifics of the upcoming health care legislation.

Addendum: There's a point I do want to make slightly more clear that I didn't articulate perfectly the last time around. When I talked about ends and means, what I was trying to refer to were political means and the President's willingness to use policies from both the left and right, as long as it improved the ends (population health, access to insurance, etc). I certainly agree with the posters who said that ends don't always justify means. However, I do think that with complex problems, we need to avail ourselves of every policy tool at our disposal, and not simply stick to the traditional left/right policy options.