Barack Obama Domestic issues Health care Politics

Organizing a Grass Roots Movement for Health Care Reform

[digg-reddit-me]About a week ago, I got an email from Mitch Stewart, the Director of Organizing for America, the organization that is tasked with marshalling the remnants of Obama’s campaign organization to create grass roots pressure for change. It read almost as if it were a campaign email:

Joseph –

The fight to pass real health care reform will come down to one thing: you.

That’s because the efforts in Washington, D.C., to fix our broken health care system and provide affordable coverage for all Americans are only part of the battle.

By teaming up with your friends and family and organizing for real reform in your community, you can make the difference in this debate. Together, we’ll make sure the President’s plan succeeds across the country…
In communities around the country, folks will be knocking on doors, making phone calls, and doing all they can to seize what may be our last opportunity to change health care in America forever – as the President has said, reform needs to “happen this year, or not at all.”

The goal of the email was to get people to buy “Health Care 09” t-shirts. But unlike the campaign emails – which often led to me buying whatever they were hawking to demonstrate my support, reading up on the issue (if I had not already) and blogging about it, this email prompted me to no action. A few months ago, I wrote about this issue in a post about the “Paradox of Organizing for America.” The problem I saw then was that while “Obama for America” had a clear, singular goal – electing Barack Obama president – and citizens were faced with the motivating factor of being directly involved in achieving this goal – voting, and convincing others to vote as they were – neither of these factors which were essential to the success of Obama for America are present for Organizing for America.

But this email demonstrates another problem, a problem inherent in the legislative-centered approach to policy that Obama has taken in general – and his rugby-scrum strategy for achieving health care reform in particular. How can he motivate the grass roots to back him if there is no clear bill or idea to rally behind?

Clearly, their strategy is to make this a binary question: Are you for or against health care reform? Everyone is for health care reform – as our system is quite obviously unsustainable. But there are many, many valid questions critics and supporters of the various progressive-type health care reform plans have:

  • Will this reform be sufficient to “bend the curve”?
  • Should medical malpractice awards be capped?
  • Should we be moving towards a single-payer system?
  • Would non-profit insurance organizations be a better approach?

On policy grounds, many of those who support health care reform disagree about how it should be done. Now, Organizing for America is asking them to push for reform, with details unrevealed and undecided. What they are asking for is, simply, a leap of faith – to trust that the Obama administration knows what they are doing, and that they will do the best they can.

They key fact that the Obama administration and Organizing for America are pushing is that this is the time. As the email quotes Obama: “[R]eform needs to ‘happen this year, or not at all.'”

The grounds for this claim are political rather than policy-oriented. As a matter of reflective policy-making, it would undoubtedly be better to gradually experiment with different approaches, testing them to see which are successful and gradually building support for a wholesale reorganization of health care. But politically, this is untenable. First – with the retirement of the worst generation of Americans and the exponential rise in health care costs, our federal deficit is set to explode in the next thirty years. The longer we wait, the harder it will be to reign in costs and “bend the curve.” This is a problem that should have been dealt with while the Baby Boomers were in power, when the problem first became evident – but, as usual, they abdicated their responsibilities. Second, Obama now has more going for him domestically than he likely will at any other point, including if he were to win a second term. Obama’s popularity is high; he has 60 Democrats in the Senate and a sizeable majority in the House (and the president’s party has traditionally lost seats in the first midterms after the presidential election); he has several key Republicans willing to compromise – and various business and other interests willing to support some legislation.

The difficulty Organizing for America faces is motivating the many policy-oriented and otherwise savvy Obama-supporters to support the administration on this issue without having set its position in advance. Organizing for America seems to have a clear idea of what it wants from the grass roots: pressure for the idea that we need reform now. What’s less clear is how to get the grass roots to buy into their part of the strategy. Buying t-shirts is what you do after you buy into the strategy – not before.

It’s not clear to me that Organizing for America has realized its job is no longer to preach to the converted – but to convert bystanders into activists.

[Image by tandemracer of her baby’s six-month doctor visit licensed under Creative Commons 2.0]

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