Thursday, June 01, 2006

Advise to a Future President on Getting a Program Passed

The paralells between Bill Clinton's attempt at universal healthcare and George W. Bush's attempt to modify Social Security are striking. Both initiatives addressed a real problem that nearly everyone would like to resolve (making health care affordable to everyone, keeping Social Security solvent as the population ages). In both cases, however, to actually address the problem would require some unpopular action. (To make healthcare affordable to all, we will have to introduce some form of rationing that means not everyone will get everything they want. Keeping Social Security going as the number of retirees keeps rising relative to the number of working people will inevitably mean paying in more or paying out less). Furthermore, there are people or organizations with a vested interest in preserving the status quo (insurance companies, the AARP).

This makes enacting necessary reforms difficult under the best of circumstances. But both Clinton and Bush made mistakes that doomed their attempts, and their mistakes were strikingly similar. I do not, on the whole, regret, that either Clinton's health care plan or Bush's private Social Security accounts were defeated; neither plan was a very good one on the merits. In both cases, however, the defeat was such as to poison all discussion on the subject for a long time to come, and both subjects really need discussing.

Both Presidents at least started right, by inviting public debate. Certainly any such dramatic initiative calls for public debate. But both men invited public debate on terms they were certain to lose. They began by proposing something much tom complex to be easily explained. Clinton, who went first, did the worst, calling a blue ribbon commission that proposed a plan that went for thousands of pages. How can there be reasonable public debate on a plan that runs for thousands of pages? Bush learned a little from his predecessor's experience and was not as complicated, but his plan of phasing in personal accounts and phasing out payment, with references to trust accounts and investment portfolios, was confusing enough. This made it very easy for people with a vested interest in the status quo (whether insurance companies or the AARP) to launch all sorts of inflammatory attacks that grossly misrepresented what was being proposed. Neither Clinton nor Bush was able to defend his proposal effectively because both plans were to complex to explain in a 30-second commercial.

Both Presidents confused the larger goal (making healthcare available to all, saving Social Security) with the narrower goal (adopting my pet program). By offering only their only complex and dubious proposals as alternatives to the status quo, both Clinton and Bush made it easy for people with a vested interest in the unsustainable status quo to conceal that fact. People attacking the plans did not have to argue for the status quo or even discuss it at all; they simply had to denounce the President's plan, and the status quo would triumph by default. Once again, Bush learned a little from Clinton's mis-steps. When it became clear that his plan was not going to pass, he said that he would be open to alternatives, so long as they did not raise taxes, but by then it was too late.

In both cases, the defeat of a dubious plan by upholders of the status quo so frightened politicians that the subjects of health care and Social Security reform appear to be off the table altogether, although both really need to be addressed. There is no shortage among think tanks of plans for reforming either health care or Social Security. I do not, at present, pretend to know which of the many plans out there is the best. But I can offer a future President some procedural advice on how to get some sort of reform passed:

1) Do not convene a blue ribbon commission to come up with an elaborate plan that crosses all the T's and dots all the I's. Get together with a few trusted advisors and assemble all the plans that are out there. Crunch some basic numbers to figure out which are feasible and affordable. Narrow them down to a reasonable number (I favor three as a good reasonable number, with the status quo as option four, but it does not absolutely have to be three). Do not flesh out the details of the plans; just keep the basic idea.

2) Preempt a suitable block of television time to announce your plan. Devote the bulk of that time to explaining why the status quo is not acceptable or sustainable. Put a human face on it. Then end by saying you are proposing these alternative approaches to the status quo and invite public debate on which one to adopt. Set each proposal forth in a sentence or two, a paragraph at most. Keep it simple, stupid. If you favor one proposal, it is okay to say so, but make it clear that this is just one person's opinion. Do not put the prestige of your office behind any one plan or make it a test of party loyalty. Do put the prestige of your office behind adopting something.

3) Buy up a huge raft of 30 second commercials explaining over and over again what your proposals are (this means the proposals must be simple enough to explain in a 30 second commercial). Throw in a few commercials reminding the public why the status quo is not acceptable. (If the President, in his public capacity, is not allowed to buy up commercials, then have your campaign fund or political party do it instead).

4) Allow a few months of public debate, but ask Congress for a vote for one plan or another before the current session adjourns. (Do not attempt to pass your proposal in an election year). Again, put the prestige of your office and party behind adopting something, but do not be dogmatic about insisting on one pet proposal. Remember, it is more important to acheive the broad overall goal of making healthcare affordable to all or saving Social Security than to have your way on all the details.

There are numerous advantages to this approach. Keeping the proposals simple permits actual public debate. Having more than one proposal means that people who are opposed to a particular proposal do not automatically default back to supporting the status quo. It is easier to attack one proposal than two or three. People wanting to uphold the status quo will have to come out and say they support the status quo, rather than just attack one proposal. (You need to constantly remind the public why the status quo is not acceptable). And, finally, constantly reminding the public of what you are actually proposing makes it much harder for opponents to misrepresent it.


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