Obama must to get physical for health-care reform

President Obama must take a hands-on approach to get health-care reform through Congress. (Charles Dharapak/AP)

President Obama’s hands-off approach hasn’t worked with his proposed overhaul of America’s health-care system, so it’s time for him to get physical — even heavy-handed.

The arena for that feat of muscle-flexing will be a joint session of Congress on Wednesday, where the president hopes to jump-start, or perhaps resuscitate, his signature domestic issue.
Obama needs to articulate exactly what he means by health-care reform, and how he wants to get there. That’s what Congress needs in order to get past the obstructionists who in recent weeks seized upon the president’s arms-length approach to legislation to manipulate public sentiment.
A State-of-the-Union-style address is an appropriate vehicle. The health-care industry represents one-sixth of the American economy, and the state of that part of the union isn’t good.
The ills are undisputed: Runaway spending on health care burdens companies and shrinks workers’ paychecks. Millions of people can’t afford insurance or find coverage due to past illness. Those with insurance are at risk of maxing out or losing coverage if they become critically ill.
Yet in regions locked up by one or more insurers, including Philadelphia, there is no meaningful competition to drive down costs. Even while spending $2.5 trillion this year, life-threatening medical errors are only the worst among many lapses in quality of care.
So, despite the distraction of Swift Boat-style attacks on “Obamacare,” reform isn’t optional.
Even for a silver-tongued orator, though, it’s a tall order to repair the p.r. damage. The partisan-fueled shouting matches at town hall meetings, and campaigns of misinformation, sapped earlier optimism that the nation finally would tackle its health-care woes.
The president deserves credit for trying a statesman-like strategy at first. He set out the right principles — expand coverage, tame rising costs, improve quality — and then stood back to let Congress draft actual legislation.
However, the resulting mishmash of proposals made it tough for average citizens to get a grip on reform, while easy for critics to take pot shots and make outrageous and false claims about “death panels” and rationing.
With Obama now promising to tell the American people exactly what he thinks should be in the health-care overhaul, it’s encouraging to hear Vice President Joe Biden pledge “to get something substantial.”
That means Obama should remain steadfast on fostering competition among private insurers — including a Medicare-style insurance option for those under-65 as a safety net.
It’s also clear the president must equip his crash cart for reform with better cost-control measures, such as scrapping fee-for-service payments, in addition to proposed Medicare savings. The public is rightly anxious over the federal deficit, so health-care reform’s tab has to be affordable.
At one point or another, the White House has embraced every feasible prescription. That just added to the confusion. Now, the imperatives of the legislative sausage-making process demand that Obama pick up the scalpel.