# The Wall Street Journal
AUGUST 10, 2009, 7:19 P.M. ET
The president shouldn’t worry about the protestors disrupting town hall meetings. He should worry about the Americans who have been sitting at home listening to him. y DOROTHY RABINOWITZ
It didn’t take chaotic town-hall meetings, raging demonstrators and consequent brooding in various sectors of the media to bring home the truth that the campaign for a health-care bill is, to put it mildly, not going awfully well. It’s not hard now to envision the state of this crusade with just a month or two more of diligent management by the Obama team—think train wreck. It may one day be otherwise in the more perfect world of universal coverage, but for now disabilities like the tone deafness that afflicts this administration from the top down are uninsurable.
Consider former ABC reporter Linda Douglass—now the president’s communications director for health reform—who set about unmasking all the forces out there “always trying to scare people when you try to bring them health insurance reform.” People, she charged, are taking sentences out of context and otherwise working to present a misleading picture of the president’s proposals. One of her key solutions to this problem—her justly famed message encouraging citizens to contact the office at flag@whitehouse.gov if they got an email or other information about health reform “that seems fishy”—set off a riotous flow of online responses. (The word “fishy,” with its police detective tone, would have done the trick all by itself.)
These commentaries, packed with allusions to the secret police, the East German Stasi and Orwell, were mostly furious. Others quite simply hilarious. Ms. Douglass, who now has, in her public appearances, the air of a person consigned to service in a holy order, was not amused.
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Neither has she seemed to entertain any second thoughts about the tenor of a message enlisting the public in a program reeking of a White House effort to set Americans against one another—the good Americans protecting the president’s health-care program from the bad Americans fighting it and undermining truth and goodness.
She intended no such outcome, doubtless. That this former journalist, now a communications director, failed to notice anything amiss in the details of that communiqué is a bit odd but not altogether surprising.
Crusades are busy endeavors, the enlistees in this one, like those in every undertaking of this White House, concerned with just one message. Which is that the Obama administration is in possession of vital answers to ills and inequities that have long afflicted American society (whether Americans know it or not), and that those opposed to those answers and that vision are cynics, or operatives of the powerful vested interests responsible for the plight Americans find themselves in (whether they know it or not), or political enemies bent on destroying the Obama administration.
It shouldn’t have been surprising, either, that the tone of much of the commentary on the town-hall protests was what it was. There was Mark Halperin for one, senior political editor for Time, bouncing off his chair, Sunday, in agitation over all the media coverage of this rowdiness—“a horrible breakdown of our political culture, our media culture” and so “bad for America,” as he told CNN’s Howard Kurtz. “I’m embarrassed about what’s going on, as an American.” The disruptions and coverage thereof distorted serious discussion, he explained. Mark Shields said much the same on Friday’s PBS NewsHour, if with less excitation, pointing out that these events were “not good for the democratic process,” and were a breakdown of civil debate.
There was no such hand-wringing over the decline of civil debate, during, say, election 2004, when cadres of organized demonstrators carrying swastika-adorned pictures of George W. Bush routinely swarmed about, and packed rallies. There was also that other “breakdown of our media culture,” that will dwarf all else as a cause for embarrassment, the town-hall coverage included, for the foreseeable future. That would be, of course, the undisguised worshipful reporting of the candidacy of Barack Obama.
That treatment, or rather its memory—like the adulation of his great mass of voters—has had its effect on this president, and not all to the good. The election over, the warming glow of those armies of supporters gone, his capacity to tolerate criticism and dissent from his policies grows thinner apace. His lectures, explaining his health-care proposals, and why they’ll be good for everybody, are clearly not going down well with his national audience.
This would have to do with the fact that the real Barack Obama—product of the academic left, social reformer with a program, is now before that audience, and what they hear in this lecture about one of the central concerns in their lives—his message freighted with generalities—they are not prepared to buy. They are not prepared to believe that our first most important concern now is health-care reform or all will go under.
The president has a problem. For, despite a great election victory, Mr. Obama, it becomes ever clearer, knows little about Americans. He knows the crowds—he is at home with those. He is a stranger to the country’s heart and character.
He seems unable to grasp what runs counter to its nature. That Americans don’t take well, for instance, to bullying, especially of the moralizing kind, implicit in those speeches on health care for everybody. Neither do they wish to be taken where they don’t know they want to go and being told it’s good for them.
Who would have believed that this politician celebrated, above all, for his eloquence and capacity to connect with voters would end up as president proving so profoundly tone deaf? A great many people is the answer—the same who listened to those speeches of his during the campaign, searching for their meaning.
It took this battle over health care to reveal the bloom coming off this rose, but that was coming. It began with the spectacle of the president, impelled to go abroad to apologize for his nation—repeatedly. It is not, in the end, the demonstrators in those town-hall meetings or the agitations of his political enemies that Mr. Obama should fear. It is the judgment of those Americans who have been sitting quietly in their homes, listening to him.
Ms. Rabinowitz is a member of the Journal’s editorial board.
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http://www.washingtonpost.com/wp-dyn/content/article/2009/08/10/AR2009081002521.html?wpisrc=newsletter
washingtonpost.com
Health Reform's Hearing Problem
Both Sides Are Deaf to the Real Debate About Consequences
By Danielle Allen
Tuesday, August 11, 2009
In his debates with Hillary Clinton in the winter of 2008, Barack Obama flatly denied that his approach to reforming health care would require an individual mandate requiring everyone to buy health insurance. Events have proved him wrong.
His administration now agrees with the analysts who argue that only by ensuring that no one games the system can reform be made to work. The mandate serves to ensure that individuals do not buy insurance only when they are ill. Other elements of the reform similarly serve to ensure that neither insurance companies nor employers will game the system. As Paul Krugman has argued in the New York Times, each of these strategies to prevent gaming is necessary to make the whole thing work. The point, though, is that the push for implementation has turned Obama's policies into something other than what he promised.
This change in Obama's position goes a long way toward explaining the objections to the new reforms that are being raised vociferously through grass-roots action by citizens on the right. The issue here is not that these citizens consider Obama untrustworthy -- though they do. The issue, rather, is that they recognize that the stated goals and structure of a policy may not fully capture its full range of outcomes in practice. This is why these citizens, including professionally briefed participants such as Sarah Palin, can continue to maintain, in the face of a barrage of insistences to the contrary, that the reforms will (1) result in rationing and (2) establish "death panels."
These activists do not claim that the proposed reforms include policies whose explicit purpose is to ration, nor do the more careful among them claim that the policies will establish panels to help people decide when to die. They are not arguing about the semantic content of the policies; that is, they are not arguing about the meaning of the words that are actually in the relevant drafts of bills. Instead, they are considering, as the pragmatist philosopher William James put it, "what conceivable effects of a practical kind the [policy] may involve -- what sensations we are to expect from it, and what reactions we must prepare."
Their claim is that, whatever the stated goals of policymakers, the concrete outcomes that will flow from the policies on the table will include experiences that feel like rationing and conversations that sound like "death panels."
In asking lawmakers to consider not merely the goals of their policies but also the experiential meaning of concrete realities that those policies may bring, they have a point. One can't answer them by saying: "These policies won't ration; there will be no death panels." If these reforms do either of these things, they will do so as a matter of unintended consequences. The appropriate answer, therefore, is to explain the institutional checks that will prevent the emergence of such unintended consequences.
Can we say that under the new regime one will always be able to pay out of pocket for any procedure one desires, subject only to the limitations of triage practices that have always established priorities for who receives care when and that have, therefore, always provided an ethic for how to ration a limited good in the face of unlimited desire?
And perhaps the counseling sessions meant to help us all think about end-of-life issues should be conducted when each of us is in the prime of life. To demystify such counseling sessions, the president held up as examples himself and his wife, who have living wills. But they have set these up when the natural end of their life seems remote. In the context of such counseling sessions, this distance surely provides a certain psychological protection. Perhaps if we developed a practice of expecting these counseling sessions to occur in our 40s and 50s, we would view them, like financial counseling, simply as a necessary step toward being able to enter retirement with peace of mind.
There is a real debate going on in what appear to be crazy town hall meetings. If only both sides had ears to hear. Would somebody please call the otologist?
The writer is the UPS Foundation Professor of social science at the Institute for Advanced Study in Princeton, N.J.
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