Health Reform and the State of the Union Address

While it is true that the Affordable Care Act is the law of the land, lingering political resentment, second thoughts and inconvenient truths promise to distract President Obama from his new "jobs" agenda over the next two years. Last night's State of the Union (SOU) not only gave the Disease Management Care Blog a preview of the strategy that will be used by the Administration to counter this, but was a lesson on the use of the kind of self-serving rhetoric that the DMCB can use to get its way.

The relatively brief 209 words specifically devoted to health care reform were tucked away in the latter half of the speech. It acknowledged that there were concerns, made use of humor, offered vague concessions, pointed to some favorable anecdotes, concocted a villain, portrayed Mr. Obama's positions as principled and held out the possibility of compromise. In other words, change the subject while trying not to burn a lot of political capital, confound the opposition with time-consuming as well as unsubstantive negotiations outside of the public spotlight and always, but always, take the high road.

The DMCB likes the approach so much, it's adapted the speech to a recent favorite topic:

Now, I have heard rumors that you still have concerns about the DMCB purchase of a multi-media surround sound system with a 3D HDTV. (Laughter.) So let me be the first to say that anything can be improved. If you have ideas about how to improve this situation by making our cable TV viewing better or more affordable, I am eager to work with you. We can start right now by correcting a flaw in the set-up that has an unnecessary wire dangling out the back of the screen. (Applause.) What I’m not willing to do -- what I’m not willing to do is go back to the days when room acoustics could deny us of adequate audio because of cheapo speakers..... (Applause.)

The DMCB also looked into the "skutnik" SOU anecdotes.

One involved a Texan brain cancer patient. According to this link, the DMCB believes the patient didn't buy insurance (or, rather took a big chance) until he developed headaches. The other apparently involved an Oregon businessman who used tax breaks (which generally has bipartisan support) to purchase commercial insurance (that is becoming arguably unaffordable due the lack of any spending restraints as well as mandates). Hardly fair, says the DMCB.

How will the Republicans counter this? The DMCB predicts by forcing the White House speak a lot more words about health reform. By holding noisy hearings and passing unacceptable legislation. By demanding big concessions, finding other anecdotes, portraying big government as the villain while also appearing pleasant, humorous, principled and reasonable. The Republicans have the additional advantage of arguing that a moribund job outlook and scary government deficits are linked to the ACA.

Let the games continue.