How To Make Enemies on Health Care

Barack Obama hoped to unify the nation, and he is making impressive progress toward that goal. Last week, he created common ground between Howard Dean and conservatives. They agree on one thing, which is that the health care reform package produced by the Senate and endorsed by the president richly deserves to be voted down.

Conservatives have always opposed ObamaCare because it involves too much government. Now liberals are abandoning the administration's plan because it involves too little. Dean and Co. are bitter that the bills in Congress offer neither a "public option" — a government-run insurance program — nor a provision letting those from age 55 to 64 buy Medicare coverage.

It's OK to alienate people at each end of the political spectrum if you please those in between. But the so-called moderates on Capitol Hill are proving no help to the president. On the contrary, they have discovered that the middle of the road is an ideal place to block traffic.

Sen. Susan Collins, R-Maine, once thought to be open to supporting the plan, now says she probably won't. Sen. Joseph Lieberman, I-Conn., got his way when the Senate dropped the government-run options, but even he is not a sure "yes" vote.

Sen. Olympia Snowe, R-Maine, denounced attempts to use "artificially generated haste" to get the bill through, which doesn't make her sound like she's on Obama's side. Sen. Ben Nelson, D-Neb., is holding out unless he gets tighter restrictions on abortion coverage.

Even proclaimed supporters make it clear they are settling for a pale facsimile of what they really want. Obama seems to have created a split between those who are critical of his efforts and those who are ungrateful.

So he may not get an overhaul passed at all. If he does, it may cost him control of Congress in next year's elections. In the worst (or best) case, it may help unseat him in 2012. In any case, it won't make him a lot of friends anytime soon.

But Obama has no one to blame except himself.

He made the mistake of thinking that because Americans elected him on a promise of overhauling health care, they agreed on what that means. If Americans were unified on a plausible change in the system, however, they probably would have gotten it long ago.

The reality is that either they don't know exactly what they want or they want things that are incompatible — more benefits and lower costs, more regulation and less government, lower premiums and life eternal. They demand change while demanding the preservation of everything they like about the status quo.

Health care "reform" is hard because a given goal is likely to come at the expense of another. According to a recent George Washington University Battleground Poll, 41 percent of Americans think the main goal should be lowering costs. But they don't really mean it.

Lowering costs is easy: Just reduce benefits. But try that, and you'll be charged with plotting to ration treatment and set up death panels. What people generally mean when they say they want lower costs is that they want to pay less without getting less. Heck, yes.

The latest ABC News/Washington Post poll found that 51 percent of Americans don't want Congress to pass a health care bill this year, with only 44 percent favoring legislation. The longer the debate goes on, the less support there is.

Granted, many of them may have only the vaguest idea of what the legislation would actually do. Ignorance about government programs is often bliss, but in this case, complexity and impenetrability work against change.

Major changes in our economy and social welfare system need a broad public consensus, which does not exist on health care. Given that most Americans are happy with both the quality of care they get and their own insurance coverage, they see more to lose than to gain from any alteration they don't understand. Doing nothing is the default option.

Everyone regards the bill too hot or too cold, too big or too small, too soft or too hard — never just right. When it comes to changes in health care, Obama is discovering, the average American is not Goldilocks. More like the princess and the pea.

Steve Chapman blogs daily at newsblogs.chicagotribune.com/steve_chapman. To find out more about Steve Chapman, and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.

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