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Learning from Obamacare
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A historic deadline beckons Monday. Most Americans without health insurance must have started to apply for coverage by that deadline or face a financial penalty. It's the first time health insurance has been extended to virtually all Americans, and it marks a landmark in American cultural and economic history.
The Monday deadline also brings to an end a frantic period during which the Obama administration struggled to perfect its insurance-application process and then struggled to persuade Americans to use it.
This deadline also offers Americans a health care breather. The next enrollment period doesn't begin until November. It is a good time to take stock of what the health care debate has meant and what lessons can be learned:
-- Vast social change is best accomplished in a bipartisan way.
From the start, this was the Obama administration's principal error. It grew in part out of the Obama team's determination to slam a health care bill through Congress at the time of the new president's greatest appeal, but it diminished Obama's appeal.
The blame isn't Obama's alone. The Republicans swiftly and shrewdly identified this as the signature Obama initiative and were determined to deny him his triumph.
-- Politics is a matter of sales as much as substance.
Obama surely should have known this, he being one of the masters of this discipline. He, after all, was able to sell the American people on the notion that a little-known U.S. senator only four years out of the Illinois statehouse was a plausible candidate to break a 22-decade racial barrier to the presidency.
-- Be honest.
Here is a fundamental Obama failure, in two dimensions. The first was the claim, perhaps disingenuous, perhaps sloppy, that Americans could keep the health care plans they had under the new legislation. This was demonstrably false.
The second: One of the flaws of Obamacare is it promised more than it delivered. "This plan was designed to make people feel good, but not to solve the problem," says David W. Scott, president of Ohio Valley General Hospital in Kennedy Township, Pa.
-- Sell to the middle, not to the extremes.
This is the guideline the administration has mastered best. The liberals who demanded a single-payer system and the conservatives who were going to oppose on principle, or out of habit, anything the president proposed are stewing. But at the end of the day, the president has a health care overhaul worthy of the name, if not of everyone's best hopes.
It would have been better had the software worked. It would have been better if the national consensus were broader. It would have been better without bureaucratic delay.
But critics are going to have to concede that history will attach health care overhaul to Barack Obama's name. That may be the biggest lesson of all.
David M. Shribman is executive editor of the Post-Gazette (dshribman@post-gazette.com).