Matt Miller - The Archives

Obamacare and the character question
The Washington Post, March 28, 2012

Whatever the Supreme Court decides in June, the fight over Obamacare has already taught us tons about the character of the president and the men who seek to replace him. Call it the Good, the Bad and the Ugly. We'll take them in turn.

The Good. The "good" is President Obama. The decision to go big and stay big on health care has been the most revealing act of Obama's tenure. Treasury Secretary Tim Geithner and former economic adviser Larry Summers both told the president early on that, given the economic disaster he walked into, his legacy would be avoiding a second Great Depression. "That's not enough for me," Obama replied. At another critical juncture, when health care was stalled in Congress, Rahm Emanuel urged the president to scale his plan way back. Just cover all children, Emanuel counseled. It would be an important first step. Obama said no.

The president's foes say this means the man is on an ego trip, out to secure his place on Mount Rushmore. But there's nothing wrong and everything admirable in the quest for worthy fame; Lincoln talked about this impulse in his earliest speeches. That's what motivates great leaders. I've always thought Obama's persistence on health care was his finest hour.

Obama came to power determined to tackle some of the biggest challenges the country faces. Any catalog of these would include being the only wealthy nation with 50 million uninsured and thus the only advanced society where serious illness routinely means financial ruin. Fixing this is the kind of thing we should want presidents to do. If Obama hadn't aimed high on health care, his entire first term would have been devoted to cleaning up a mess he inherited. Why would anyone want that to be the outer limits of a president's ambition?

Is Obamacare flawed? Of course. Show me anything that emerges from Congress that isn't. We'll be tinkering with it for the next two decades—that is, if five unelected justices (who, by the sound of the audio files, don't fully understand how insurance markets work) don't throw the country into turmoil by tossing it out.

Despite all the shouting, Obamacare's signature achievement is poorly understood. The law creates a way for nonelderly Americans to get access to group health coverage outside the employment setting. The United States is the only advanced nation where this ability doesn't exist. If the insurance exchanges get up and running, they can in time become the place where most of us get coverage that's not tied to our jobs, with those who need help receiving subsidies. This would help the economy even as it makes America a more decent society.

The bad. The "bad" is Mitt Romney. Let's stipulate that anyone with a serious shot at becoming president believes above all in his or her own fitness for power and thus everything else—such as steadiness and honesty, to name two virtues—becomes subordinate to ambition. Even by this standard, Romney's choices and behavior are extreme, and his treatment of Obamacare distills his extremity to its purest essence.

Simply put, Obamacare has forced Romney to reveal how much 100-proof drivel he'll swallow and spit out with a smile if that's what it takes to get to the Oval Office. The man passed a great health reform in Massachusetts that inspired Obama's and he pretends otherwise every day. I'm no purist about what it takes to win elections. But at some point the total denial of your record, your sincere views and your problem-solving instincts takes you into soul-destroying territory. If there were a health-care version of "The Picture of Dorian Gray," Romney's portrait offstage would be a hideous thing to behold.

The Ugly. Which brings us to Rick Santorum, who caught fire by arguing that Obamacare "is usurping your rights. It is creating a culture of dependency. Every single American will be dependent on government. ... It magnifies all that is wrong with what this president is trying to do." What is Santorum talking about? The freedom to go broke when you're ill? The liberty to be denied health coverage because you have preexisting conditions? We're "dependent on government" for roads, bridges and sewers, too. Should we stop investing in infrastructure lest we be drawn further into Barack Obama's socialist trap?

I wish Santorum would finally tell us exactly how he and his family get health coverage themselves—the coverage he would perversely deny to millions of others "on principle." (It can't be easy for the former senator to arrange, when he's got a big family and a daughter with preexisting conditions). After that, it's fine by me if he crawls back into his cave.