The pundits have been speculating on how and when President-elect Obama will tackle health care reform. Will his approach be evolutionary, going slowly seeking incremental change, or revolutionary, going full bore with bold policy strokes? Whichever approach he takes, it seems like things are beginning to move quickly-- with the imminent nomination of former Sen. Daschle as HHS secretary, who wrote on Huffington Post last March, "The time is now for us to take this [health care] challenge head-on;" with the introduction of a health care bill this month by Sen. Max Baucus; and with Sen. Ted Kennedy's expected roll out of his own proposal.
The political environment certainly favors action sooner, not later. There already exists a remarkable consensus -- unlike in 1993 -- among the Democratic Party on a broad framework for more universal coverage, which is reflected in Obama's health care plan. It includes a mandate that large employers cover their employees, or pay a percentage of payroll into a health care fund to subsidize coverage for the uninsured; and a requirement that insurers have open enrollment policies with12 no exclusions for pre-existing conditions.
There is also a broad public agreement that reform is needed, unlike in the past. The public has already been primed on the need for health care reform, thanks to the enduring presidential campaign and their own personal, often horrific, experiences with the health care system. A CBS News/New York Times poll this past September showed that 85 percent of people believe the health care system should be either changed fundamentally or completely rebuilt.
Communications will be crucial if the administration decides to dive right in. Fresh off of a decisive election, the president-elect has the charisma and credibility, as well as dogged message discipline, to move the people he needs to move -- whether skeptical parts of the public or conservative lawmakers. He could use his rhetorical asset to his advantage early on when selling bold, new policy proposals. His brand arguably will never be stronger than it is right now. And Democrats, also unlike in '93, now have their own 24/7 message machine -- from hugely popular blogs and news sites to primetime programs on MSNBC -- that offers progressive views on politics and government.
Conservative critics of the president-elect's reform package will not be silent, even if they are focused on trying to rebuild their own struggling party. Right-wing media figures and ultra conservative policymakers will use their megaphone to blast the plan and the people behind the plan. What is unclear at this point is where industry will be on whatever new legislative package the Democrats come up with.
Pharmaceutical companies, for instance, must recognize that the giant wave that is coming will flatten anyone who stands there and tries to stop it; far better to surf the wave and steer in the direction you want to go. It's much more productive to sit down at the table with leaders of the new administration and Congress to ensure that the industry's concerns are addressed, proposing, for instance, a better way to go in the same direction, such as replacing mandatory requirements with voluntary incentives.
It's a real struggle for all the elements in the sausage-making process of policymaking in Washington to come together. Plenty of hard work still needs to be done, but the external political environment for health care reform is pretty promising. Social security was enacted in the midst of the Great Depression. Obama, and the strengthened Democratic Congress, could argue that tough times make reforming health care that much more urgent.
Jeffrey M. Sandman is CEO of Hyde Park Communications. He can be reached at jsandman@hydeparkcomm.com.