Ways to fix the health care mess

President Obama went to the well of the House and the House welled up with discord.

Although his insistence on the moral imperative and economic necessity of overhauling the health care system was well received by Democrats, Republicans remain skeptical. (Most notably the boorish Joe Wilson of South Carolina who shouted that the president was lying about not subsidizing health care for illegal immigrants although he later apologized.)

Fact checkers say the president was correct about that point and about not setting up "death panels" to kill seniors as a way of cutting costs.

But the nation is now so polarized, too many people believe what they want to believe, no matter what the facts are, while demagogues hog the airwaves.

If the president wants to succeed in changing the way health care is handled in this country, Obama must do five things:

–1. Convince Americans that the status quo is a prescription for disaster. He has to explain more clearly that small and large businesses are less competitive because they are hamstrung by ever-soaring health care costs for employees that businesses in other countries don’t pay. U.S. jobs are not being created in part because of health care costs. If the status quo prevails, in a very few years health care will cost the government more than anything else, including defense.

— 2. Persuade Americans that although most have insurance and are not in crisis, the risk of bankruptcy or financial ruin is just around the corner. Jobs disappear overnight. Millions are passing on care they should get because it costs too much. Still others find that when they change jobs, they can’t get insurance because of pre-existing conditions. Some find their insurance cancelled when they get sick. Obama needs to tell more stories such as the woman whose insurance was cancelled when she got breast cancer because she hadn’t mentioned she had once had acne and the man who died because he didn’t get treatment when the insurance company said he didn’t disclose gallstones he didn’t even know he had.

— 3. Storm the country explaining that even though many, especially the young, don’t have insurance because they don’t think they need it, this drives up the cost for everyone. Who pays for the uninsured motorcyclist who ends up a paraplegic? We all do. Who pays for the uninsured 20-something who needs expensive care for mental illness? We all do. Nobody plans on getting cancer or being in a serious auto accident. Everyone needs affordable insurance.

— 4. Convince people that this is the make-or-break moment. We’ve been studying the problem, he noted, since 1943 when a reform plan was first offered in Congress. If nothing is done this autumn, nothing will be done next year because it’s a mid-term election year and legislators running for office don’t take big risks.

— 5. Obama must play for keeps. This is his legacy; if he fails, history will judge him a failure. He has to twist arms, curry favor and become a powerful persuader instead of a calm observer on the sidelines. He wasted too much time this summer hoping Republicans would hop on board. He has to be more definitive about costs, tort reform and how he’ll keep his promise that health care overhaul will not add "one dime to the deficit."

Just as he had the fire in the belly to win the election, Obama must rekindle that fire and go into full campaign mode to win over a skeptical public. He has to convince them that this is the right course for the nation on grounds doing nothing will mean permanent economic decline.

Obama let others define the battle. He has just a few short months to lead the charge to passage of a bill. His enemies, gleeful about blocking him, are many and massed.

Obama made one point that united both sides of the aisle. When he said many details remain to be worked out, everyone laughed.

(Ann McFeatters has covered the White House and national politics since 1986. E-mail amcfeatters(at)nationalpress.com.)