Rhetoric for Show, Policy for Dough

The Disease Management Care Blog is still digesting President Obama's healthcare speech to the joint session of Congress last night. The recipe included sufficient rhetoric, a nice helping of eloquence, the right amount of rejoinders, some hardy swipes at the critics, comfort for the electorate, openings at compromise, a pull at the heartstrings and a surprising dash of heckling. Imagining itself as one of those haughty celebrity judges in a televised cooking contest, the DMCB awards 5 out of 5 points for plate presentation, 4 out of 5 points for originality but on taste, alas, points were lost. It thinks it needs more of the salty key ingredient of hard policy proposals. It tasted OK, but it suffered from a certain blandness.

That still may be OK. The DMCB is drawing on two political stories from its past.

The first was related by a medical school dean, who recalled being flayed at a local State Senate committee meeting by a powerful Chair, who criticized the way the institution was being funded with taxpayer dollars. When they were alone afterwards, the Chair told him to not worry about it and assured him the funding would be increased. It was all for show.

The second involved a State Medical Society President who was publicly attacked by a sitting State Governor. The Medical Society leadership was portrayed to the press in the room as obstructionist and shortsighted. Once again, once they were alone, the Governor warmed up and they worked things out. This too was all for show.

The DMCB hopes our former Senator and now U.S. President will take a page out of the playbook from the only past President that accomplished anything when it came to health reform: Lyndon Johnson. Like Mr. Obama, LBJ was a former Senator, He used the art of politics, not rhetoric, to get things done. Last night's speech, whether the President knows it not was all for show.

Now for the work of getting something that not only looks good but actually tastes good.