The late great newspaper columnist Mike Royko suggested that Chicago’s motto be changed from “Urbs in Horto” (“City in a Garden”) to “Ubi Est Mea” (“Where’s Mine?”). Unfortunately, Barack Obama and his Chicago political brain trust remembered this basic lesson when it came to cutting deals with Congress, but completely forgot it when communicating with actual members of the public on health care reform.
As a result, the fragile flower of reform may not have been completely plucked, but the manure dumped on it in Massachusetts was not meant as fertilizer.
Throughout this process, Obama and his Chicago-bred advisers have been intent on avoiding the mistakes that sunk reform during the Clinton administration. But their diagnosis was flawed. Yes, Bill and Hillary stiff-armed both the special interests and their Republican opponents, falsely believing that public opinion polls showing widespread support immunized them from the insidious need for compromise. But while the Obama administration cut early deals with doctors, hospitals, insurers and the pharmaceutical companies, attempts to bring moderate Republicans into the fold conspicuously failed.
When the inevitable counter-attack on reform emerged, it made the infamous “Harry and Louise” ads of the early 1990s look like a C-SPAN broadcast of a CPA convention.
It shouldn’t have a surprise: within just a few weeks of Obama taking office last year, opponents of provisions in the stimulus bill funding government research comparing the effectiveness of various medical interventions compared the effort to Nazi euthanasia policies What was surprising is that the Obama administration failed to realize that the campaign of deliberate distortions that successfully alienated the American public from the Clinton plan needed to be countered with plain-talking to the American public — as White House press secretary Robert Gibbs belatedly acknowledged only after the Massachusetts senate debacle was clear.
Put aside for a moment the analysis about widespread voter anger and look specifically at health care. Americans don’t hate big government; they hate big government when it’s not bestowing benefits on them. Asked by the Kaiser Family Foundation Tracking Poll whether they thought Congress passing health care reform would make them or their own family better off, worse off or have no effect, the number saying “Better off” stayed relatively stable, rising slightly from 38 percent in February, 2009 to 42 percent in November. But the percentage saying “worse off” soared from only 11 percent in February to 31 percent by last summer, declining slightly to 24 percent by November. Most of those who started off saying “no difference” defected to the “worse off” side.
Moreover, when you break down the numbers by party affiliation, the number of Republicans saying “worse off” started at only 22 percent — a surprisingly bipartisan beginning – before jumping to 61 percent by summer and nudging down to 54 percent by November. Just 11 percent of the critical independents, meanwhile, began by thinking that health care reform would make them worse off, but that percentage more than tripled by summer to 36 percent, before dropping to 29 percent in November. Even Democratic discontent, while modest, still went from a mere 3 percent to 11 percent in summer, before dropping to 7 percent.
Those numbers track my personal experience talking with many friends and neighbors in Chicago about the reform bill. They are confused and scared about warnings on cost, cost and more cost , yet seem ignorant of reform provisions that would actually save them money. So, for example, a well-read lawyer friend ranted about the way the health insurance benefits at his small family firm would be taxed as a “Cadillac plan” because illness by a few members had driven up the premiums. When I pointed out that the ban on pre-existing conditions could actually drive down his premiums so that he wouldn’t be paying so much money for a little bit of bad luck, he was completely dumbfounded; the thought had never occurred to him.
The poll results are even more disconcerting when you realize that they come at a time when one-seventh of the nation has no health insurance, many more have inadequate policies and unemployment remains high. In Massachusetts, however, with its universal coverage, even that thin veneer of “Where’s mine?” support for Obama’s plan disappears. Massachusetts voters are already paying taxes for universal coverage at home. Why subsidize “big government” that’s not giving anything to me?
In the movie, “The Untouchables,” federal agent Jim Malone famously explains how you bring down Al Capone and his gang: “They pull a knife, you pull a gun. He sends one of yours to the hospital, you send one of his to the morgue. That’s the Chicago way!”
The Republican right-wing pulled out the knives, guns and the lead pipe connected to the kitchen sink. The Democrats retaliated with Martha Coakley. Obama and the Democrats can either love their enemies like, say, one-term president Jimmy Carter, or they can practice the Chicago Way.