Editor's Notes

Obama chose the wrong battlefield on health care
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tredmond@sfbg.com

We were talking at dinner the other night about how — how? — Barack Obama, who is so good at communicating to the voters, who has a chief of staff with world-class political savvy and some of the best advisors in the business, who has from the start exuded this aura of competence ... managed to get so badly rolled in the health-care debate.

One of my friends, who has a background in business and finance, suggested that the president could have gone to the Republicans with a grand deal — in exchange for accepting some major changes in the health-care system, including dings for big pharma and health insurance companies, the Democrats would accept tort reform in the medical malpractice arena, sticking it to their traditional friends the trial lawyers. A few national opinion columnists have suggested the same thing.

Then we heard the argument that Obama shouldn't have let Congress set the terms of engagement, that he should have presented a specific plan of his own, or at least the basic outlines of a plan, and pushed for it. Or maybe he should have just accepted the fact that the Republicans would never go for anything he wanted and given up on bipartisanship from the start.

But all that misses an essential fact: there is still a climate of hostility toward government in this country, and the insurance industry is expert at using right-wing populist sentiment for its own political ends. Once the discussion was about the government deciding whether to kill grandma, the whole thing was in the shitter.

It didn't have to be that way. Suppose Obama had started off by accepting that populist anger and then did what the likes of ol' Huey Long used to do — turn it against not just the government, but big business? What if he'd started on day one saying that the issue wasn't health care reform, it was insurance company reform, pointed directly to the villains here — the big, rich, Wall Street-backed New York insurance giants — and asked whether you wanted not bureaucrats but high-roller greedheads in fancy shoes deciding that grandma had to die?

Play the outsider here — Obama's never had much dealing with the big insurance folks. Force the likes of Max Baucus (D-Mont.) into a corner. Make the plutocrats — and, yes, their captive Washington pawns — the target of that populist anger. It's like his line on the banks — I don't want to take them over, but the folks in charge have screwed up so badly that I have to.

Sun Tzu, the great Chinese general and philosopher, always said that the winner in a battle is not the one with the superior army, but the one who chooses the battlefield. Obama chose wrong here, and even all the power of the presidency and solid majorities in both houses might not be enough to turn it around.