The Question

A Bitter Pill?

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Sunday, August 2, 2009

With the health-care initiative stalled, what general strategy should President Obama follow? Dramatically reduce the ambition of the reform effort? Try to muscle it through Congress with only liberal Democratic votes? Launch a full-blown national campaign, including attacks on the opposition, to build public support? Other ideas?

Kurt Schmoke, a former mayor of Baltimore, is the dean of Howard University School of Law.

The leadership challenge that President Obama faces at this stage of the health-care policy debate is to simplify complexity in a persuasive manner. Most Americans can probably repeat the broad goals that the president is attempting to achieve because these goals have been stated like a mantra in town hall meetings, press conferences and formal speeches. Unfortunately, the unstated message conveyed each time he speaks is that, on health-care reform, the devil is in the details. Clarity and simplicity have eluded him in addressing the details.

Patricia McGinnis, former president and chief executive of the Council for Excellence in Government, teaches public management and leadership at the University of Maryland's School of Public Policy.

The president and leaders in Congress should dispel the myth that containing costs and covering the uninsured are mutually exclusive.

The opposition to health-care reform is coming from many directions -- partisans who see this as a possible Waterloo for Obama, lobbyists for a variety of special interests who want to be exempt from any sacrifice for the greater good and fiscal conservatives who are not convinced that costs can be contained if coverage expands. Engaging this last group is critical to enacting meaningful reform.

A full-blown campaign has to be as substantive as it is tactical. People across the country need to understand in practical terms what comprehensive reform would mean for them and their families, in addition to how the overall system would improve.

This means stepping up to counter the arguments of crass partisans and special interests, and working with those in Congress, including fiscal conservatives, who are willing to roll up their sleeves.

Doing nothing or taking another incremental step toward reform should not be an option for those who are more concerned about shaping a better future for Americans than winning political points.

Barry Salzberg is chief executive of Deloitte. He also is a member of Deloitte's U.S. board of directors, the Deloitte Touche Tohmatsu global executive committee and the DTT global board of directors.

As one of the central issues in his campaign and presidency, from a political perspective, Obama has to take on health care, especially given his belief that it is essential to restoring the nation's competitiveness.

Still, I would counsel more patience. Obama could win support by educating others about his proposals. At the same time, he could strengthen his coalition by taking more recommendations and comments from the many constituencies involved.

Measured haste, you might call it. My advice to the president would be to find that balance of urgency and patience. Too fast and constituencies do not feel consulted or, worse, feel railroaded and dig in their heels. Too slow and you miss an opportunity to transform the nation on a key issue.


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