The Perils of High Public Office: II

National Review Online just posted a piece that I did on the Medicare Catastrophic Coverage Act, and its implications for our latest efforts at health (insurance) reform.

Here's the conclusion of the piece:

No one can predict whether the latest effort at health-care reform will meet a similar ignominious defeat. But this story does hold lessons for the current debate.

First, health care is personal. If you mess with people’s health coverage, they won’t just write a nasty letter to the editor. They will show up at demonstrations with home-made signs, scream at you, chase you down the street, and maybe vote you out of office. So you’d better have a good reason for doing what you’re doing, and a compelling explanation of how your plan would personally benefit your constituents.

Second, framing is critical. The Obama administration has shifted ground several times, trying to find a frame that will persuade voters. It remains to be seen whether the latest frame — it’s about providing people with insurance; insurers are evil, and the reforms will make them behave — will stick. Update: today's new framing is that health reform is "a core ethical and moral obligation."

Third, don’t assume that people who disagree with you are stupid, misinformed, greedy, or evil. They may just have different preferences about health insurance, taxes, income redistribution, or the role of government in health care. If preferences differ, telling people they can’t understand the complexities won’t help matters. Such condescension just makes aggrieved citizens angrier.

Fourth, be lucky. The administration had better hope that the elderly don’t figure out that reform will be paid for, in part, with hundreds of billions in “savings” from cutting Medicare. (In past years, Democrats routinely savaged Republicans for proposing far smaller Medicare cuts.) If seniors figure this one out, support from AARP’s national office won’t be any more help this time than it was last time — even if AARP stays on board, and there are already indications that it won’t.

Finally, embrace your sense of humor and irony. The administration of a former teacher of constitutional law complains about Americans exercising their constitutional right to petition the government for redress of grievances. A party that elected a community organizer president complains about organized communities. One of the architects of the Democrats’ current health-care strategy (Rep. Jan Schakowsky) is the very community organizer responsible for the horde of seniors that surrounded Rostenkowski’s car. Last year, dissent was the highest form of patriotism. Now, dissent is un-American, and reporting dissent is suddenly patriotic. Who knows what fresh irony tomorrow will bring?