The rest, we could say, is history. But in this historic week for health reform, that history remains contested.
As we mark the law’s second anniversary—even as the Supreme Court hears arguments on its constitutionality—we should pause to consider what the law reveals about the leadership of this president, and about the qualities of strong leadership in general.
At its core, the debate about health care in America is a deeply political and ideological disagreement over the proper role of government. Democrats say the government must remedy what is fundamentally a market failure. Republicans say the solution to our health-care crisis lies in freeing the market further. With the ideological chasm that exists today, how does one govern? How does one lead in such a poisonous political environment?
In answering these questions, we should consider three measures of leadership: approach, resolve and results.
The most important approach a political leader can take is committing to finding common ground with those on the other side of the argument. Good governance is best served by negotiation and compromise. As Senator Henry Clay declared, “all legislation, all government, all society is founded upon the principle of mutual concession.” History is filled with examples, from Clay’s own efforts to preserve the Union to the modern legislative compromises that brought us the Civil Rights Act, Social Security and Medicare.
So how did President Obama do?
While many in his party called for a government-run system like Medicare, or a ‘public option’ insurance plan, President Obama—in the interest of finding common ground and much to the chagrin of his liberal base—agreed early on to a crucial compromise approach originally proposed by the conservative Heritage Foundation. That approach builds on private health-insurance markets to guarantee health-care access for all, with government intervention to make those markets work effectively.
President Obama also strongly encouraged bipartisan cooperation in Congress. The Senate health committee accepted 161 Republican amendments to their health reform bill before final passage. Senate committees held 30 bipartisan hearings, while 6 bipartisan working groups met informally a combined 72 times.
In spite of these efforts, the president was spurned in his efforts to achieve common ground. But his response exemplifies the next quality of leadership: resolve.
Winston Churchill once offered the most famous piece of advice when it comes to resolve: “Never, never, never give up.”
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