President Obama needs to become the educator in chief on healthcare reform. And he should start by telling Americans something most of them do not know: he and the Democratic Congress have saved the most popular healthcare program in American history, Medicare.
The White House should begin a campaign to remind Americans that because of the healthcare reforms Obama signed in 2010, Medicare is securely funded and monitored. The administration should also point out that the $455 billion reduction of Medicare spending will mostly affect unfair and wasteful taxpayer subsidies of private plans like Medicare Advantage. But it should be prepared to address other legitimate fears. Isn’t Medicare facing bankruptcy? Is this the start of formal rationing? How is the Independent Payment Advisory Board going to monitor and advise on cost control? How will state insurance exchanges lower costs and maintain quality?
These questions are important and must be dealt with in the implementation of the law. The Obama-led program could educate the public with town meetings, media briefings, interactive websites, blogs, TV and radio shows, and fireside chats. And the president should be backed up by the many allies for healthcare reform, including labor, some physician and hospital organizations, some insurance companies, senior groups and private-sector corporate leaders, MoveOn.org and doctor coalitions.
Why start with Medicare? Because it’s the easiest subject on which to begin educating people about what the administration has accomplished. The reform legislation is voluminous and complicated. Could it have been simpler? Maybe. But this is the best our officials could do after close to a year of deliberation.
Healthcare reform is worth defending, and the president had better do it fast. Why? Because it’s in jeopardy. The Republican victory in November was achieved in part by a commitment to repeal "Obamacare." The administration was confident the litigation by the state attorneys general was frivolous. But in December the Virginia attorney general succeeded in getting a federal judge to rule it unconstitutional for the government to compel Americans to buy health insurance. If the Supreme Court concurs, universal coverage and cost control will be severely jeopardized. Republicans have already introduced a bill in the House to repeal the law. If that is not successful, they threaten to "starve" it by not appropriating start-up costs.
In addition to the loss of the House, Democrats suffered major setbacks in the states, with Republicans now controlling twenty-nine governorships. Eighteen state legislatures converted from Democratic to Republican. These developments are critical in the implementation of the reform, since the law assumes cooperation by state governments. Those states dominated by the GOP may begin to thwart implementation.