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Looking at health care one president at a time

By
Senior Staff Writer
Sunday, September 20, 2009

If he wants to successfully pass health care reform, President Obama should move quickly and disregard his economic advisers. So says Professor of Political Science James Morone, author of a recent book on past presidents and their pushes for change.

The release of Morone’s book — which he co-authored with Harvard professor and Obama adviser David Blumenthal — could hardly be more timely. In “The Heart of Power: Health and Politics in the Oval Office,” the authors look at attempts at reform by each president since Franklin Roosevelt and explain why most of them failed. The retrospective ends with lessons Obama and future presidents should learn from past efforts.

Since the release of the book in June, Morone has done interviews with news organizations including CBS and National Public Radio. He and Blumenthal were also mentioned in a recent article in the New York Times.

Morone teaches the popular class POLS 0220: “City Politics”  and has extensive background in health-care policy. In fact, Morone said, he and Blumenthal foresaw the current controversial push for health care now dominating national politics.

“We had a sense that a Democrat was going to be elected (president), and we had a sense that the health-care crisis was going to come to the fore,” Morone said.

Based on their predictions, the authors came up with the idea for the book three years ago and timed its publication with the start of the new administration. Morone knew the book would be relevant, he said, but he still “didn’t expect it to hit quite this hard.”

After Morone and Blumenthal flooded the White House with copies of “Heart of Power,” Blumenthal was told that Obama had been seen reading the book at Camp David. But Morone said it was “just rumor and inside stuff.”

The first lesson Obama should take from the book is the need to act fast, Morone said. He cited President Lyndon Johnson, known for working well with Congress, as saying with regard to health-care reform, “Every day I lose some power.”

Morone said Obama must also brace himself for spectacular opposition. The president must rally his base as he did with his televised speech to Congress earlier this month, Morone said.

Morone’s final piece of advice to Obama is to “tell the economists to hush.” Medicare never would have passed under Johnson if the correct cost estimates had been available, according to Morone.

The advice to quiet inner-circle economic advisers has become the most controversial part of the book, Morone said, igniting a “media storm.” Former Secretary of Labor Robert Reich called it the “most provocative” part of the book, in a Sept. 6 review in the New York Times.

Wendy Schiller, an associate professor of political science who teaches POLS 1130: “The American Presidency,” disagreed with Morone’s advice for Obama to move quickly. She said Obama cannot accomplish all his policy goals at once and must “take incremental steps.”

“He’s got a bigger agenda,” she said. “He’s got the economy and two wars. Health care is one of the a few major policy spheres that policy is active in. He’s balancing more major policy initiative than Clinton did, so he’s less likely to suffer as much as Clinton.”

Because the administration is dealing with a plethora of issues, a failure in this one policy area would not be too crushing, Schiller added.

Schiller did not agree that past presidents have failed at health-care reform — saying only Clinton was damaged by his attempt to push a health-care bill through Congress. “He’s the only one where the health-care initiative was such a big part of his agenda that it made people think that he wasn’t that successful,” she said.

Each of the presidents studied in the book built on past presidential accomplishments, Schiller said, allowing for incremental progress.

Morone said he and Blumenthal initially wanted the book to look at the connection between presidents’ personal health and their attempts to pass health reform bills. But after preliminary research, they found no apparent connection.

“No president cares about their own illness,” said Morone. “But they are incredibly moved by the illness of loved ones.”

According to Morone, President Kennedy cared very little for health-care reform until his father had a stroke, when he made it one of his top priorities.

In preparation for the book, Morone and Blumenthal visited every existing presidential library. Their biggest find was tapes of Johnson’s phone calls while in office. Johnson was one of the only Democrats successful at health-care reform, Morone said.

Blumenthal declined to comment on the book, citing his government job.

Though media focus may make it seem that only the Democrats are under pressure, Morone says the Republicans, too, could be in trouble.

“Republicans today have not left themselves any kind of wiggle room, so if (the health care bill) passes and proves popular, they’re going to have a problem for a whole generation, and that’s something no one has mentioned,” he said.

According to Morone, there is cause for Republicans to worry. “I’ve got it at 91 percent that Obama will get something through and 53 percent that it will be something significant,” he said. “Although, my figures change daily, so check with me again tomorrow.”

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