Wednesday, September 02, 2009

Is health reform ready to have its plug pulled?

If you believe the media coverage you probably think that the health reform effort is on its last legs and simply waiting for somebody to pull its plug. Unfortunately, the media is not providing us with an accurate assessment of the state of the health reform effort. Sure, there has been plenty of criticism and scorn heaped on the health reform effort. True enough. But, criticism is only one side of the equation and the media does revel in focusing on drama. Sure, polls do show that public support for "the" health reform "plan" has slipped and now only a minority support "it." True enough. But, there is no well-defined "it" yet, with four different plans and various negotiations and talks underway to finalize what "it" might be. And, polls are notorious for being influenced by media coverage. So, in short, the media is giving plenty of details, but not anything resembling "the big picture."

The other major problem with the media coverage is that each politician has multiple audiences to cater to, multiple regions "back home", multiple demographic sectors, multiple categories of backers, and then multiple audiences in Washington, D.C. Some of these audiences are public and some are private. Each audience has its own interests, issues, agendas, and "language." The point is that each public pronouncement, or each leaked private statement, is usually intended for the target audience. Sure, every audience hears every statement, but in general most audiences only pay attention when the politician is speaking directly to them. The media of course pays attention to all statements to all audiences, but that ends up giving us an extremely distorted view of a politician's views on any topic or issue. Each audience has to be addressed on its own terms and in its own "language." Trying to transport a message literally from one audience to another is usually a fool's errand. So, just because politicians did a lot of posturing for various audiences back home is no indication of their attitude on various issues back in Washington, D.C. To wit, Senator Grassley's office reaffirmed today that health reform talks are continuing, despite a media message to the contrary and impressions that Grassley may have given back home.

August is traditionally a rather slow time in Washington, D.C. That give people plenty of opportunity for political mischief. We still have the traditional Labor Day weekend coming up. Congress will not be back in the saddle in force until the middle of next week. And now we hear that Pres. Obama has been "invited" to address a joint session of Congress on... health reform. So, real soon the health reform process will be heating up in earnest again, but right now it is simply sputtering through the lazy end of summer. No surprise there. At least it shouldn't be any surprise, except that the media has made a big deal about it.

My hunch is that within two or three weeks a lot of the puzzle pieces will be brought together and there will be greater clarity about the "plan".

On process, it is okay for the House to pass its own plan and then the Senate passes a somewhat different plan. That would result in formation of a "conference committee" which would resolve the two different bills. In practice, that means that the leaders from both sides and from both the House and the Senate would get together in the proverbial "smoke-filled back room" and engage in the proverbial "horse trading" to come up with a compromise bill which could be quite different from either the House or Senate bill. So, don't get too excited in the Senate talking about one plan while the House is voting on a different, seemingly incompatible plan.

In any case, health reform is still on track and still very likely to be completed within the next two or three months.

-- Jack Krupansky


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