SEPT 28 — By the end of this year, US President Barack Obama would either be seen as a legislative genius, who achieved what many presidents before him have tried but failed to do; or as a promising president who peaked too early and faltered in this most crucial test of his presidency.
I am talking, of course, about the unfolding debate over health care in the United States. In August, pundits were lambasting Obama for his seemingly tepid approach to the health care debate, and for giving Democratic party leaders too much say in the direction of reform efforts. Conservative opinion leaders were making shrill proclamations, declaring that Obama was bent on nationalising health care. In other words, it seemed like Obama had lost control of the health care debate.
Earlier this month, when it seemed as though the cause was headed towards a whimpering end, Obama came roaring back. Addressing a joint session of Congress, Obama gave a thumping speech which was certainly a new watermark for Obama oratory after the dazzling heights of his presidential campaign in 2008. He declared, to ringing applause: “I am not the first President to take up this cause, but I am determined to be the last.” Magnificent stuff.
Just as magnificent, if one cared to look beyond the rhetoric and scrutinise the substance of his speech, was his determined effort to strike a note of bipartisanship, to the point of singling out specific reform ideas posited by Republicans and adopting them into his corpus of reform proposals. And he was quick to cut through the fog of proposals and counter-proposals, by clearly announcing three basic goals of his reform initiative: to provide more security and stability to those who have health insurance, to provide insurance for those who don’t, and to slow the growth of health care costs.
Of course, some of the assumptions which underlie his speech are questionable. It is certainly not clear if the expected cost savings from eliminating waste within the existing health care system in America would materialise in the future. And while comparing his public option proposal with the existing system of public and private universities in the US is clever, it does not entirely assuage concerns among private insurance providers that a public option would have an unfair advantage through access to taxpayers’ money, or that a public option would be any more or less efficient than private insurance provision.
But overall, Obama’s recent health care push— encompassing the speech itself, the legislative Bill that is now taking shape and the grassroots campaign taking place parallel to the congressional outreach that is being run from the White House — makes for an interesting case study on how to push for reform, especially in complicated and hotly-contested issues such as health care.
Certainly, Obama has learnt from Bill Clinton’s disastrous attempt at health care, when a health care task force led by First Lady Hillary Clinton was declared dead on arrival in Congress, after having been drafted with very little congressional or public consultation. Obama is also studiously avoiding the Karl Rove approach of appealing to a committed base of supporters through divisive politics, choosing instead to reach out across the aisle to try and peel off enough Republican votes to craft a centrist model for health care reform.
Cheerleaders for reform around the world, especially in Malaysia, would do well to take a peek at the Obama reform playbook. Here in Malaysia, for instance, the Najib administration has taken a more liberal stance by enacting reforms in controversial policies such as the FIC and the teaching of English in science and mathematics (PPSMI), while a raft of policy changes to long-standing laws such as the Internal Security Act are also in the works.
Unfortunately, the current approach to reform in Malaysia still hews very closely to the “government-knows-best” mentality that continues to beset the mentality of government leaders, despite all the pronouncements made by Prime Minister Datuk Seri Najib Razak. A good example is the recent U-turn on PPSMI, which was announced by the Education Ministry with very little prior explanation provided to the public. Members of the public — including the former Prime Minister who hurriedly put the policy into place in the waning years of his tenure — were expected to put their trust in the government’s wisdom without clearly understanding the facts for or against the policy. As a case study on how not to implement reform, PPSMI — be it in the initial frenetic introduction of the policy in 2003, or its abrupt reversal in 2009 — is a salutary lesson in the acrimonies that can ensue when government pursues policy reforms with little planning or consultation.
For Obama, the jury is still out, as the health care debate rumbles on in the US. Meanwhile, Malaysian politicians and public leaders can do no better than to watch this man at work as he grapples with the challenge of enacting reform. Whether he succeeds or fails, the lessons could be invaluable.
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