The Current Communicator
I recently visited the Ronald Reagan Presidential Library. One can question the whole “City on the Hill” imagery, but the Great Communicator was undoubtedly able to evoke a positive emotional response from me three decades after the original narrative. How does this compare to the Current Communicator?
Both Presidents inherited troubled economies– one could easily argue that Obama’s inheritance was much more troubled than Reagan’s. Both looked forward with a message of hope that captivated the electorate. Reagan, perhaps working from a much shallower economic hole, was able to oversee strong growth by two years into his first term.
Reagan’s enormous investment in defense played a central role in the fall of the Berlin Wall in 1989, following the end of Reagan’s second term in 1988. It is, of course, much too early to assess Obama at a similar point on his impact on the country. Let’s imagine, however, we are in 2017, looking back at Obama’s contributions. What might we see?
Better yet, what might my children and grandchildren find compelling when they visit the Obama Presidential Library in Chicago in 2039, twenty-three years after he leaves office after his second term? What messages would make them feel as I felt when leaving the Reagan Library last week?
Barring another 9/11 or a war, Obama’s claim to fame will be in terms of domestic accomplishments, and in all likelihood in healthcare. Thus far, he has accomplished insurance reform — millions of more people provided with government-paid access to an easily arguable inefficient and ineffective delivery system. This hardly sounds like a success, but it could create a tipping point.
Millions of additional people in the system will stress the system to such an extent that it will break. This will create the “burning platform” that will enable healthcare reform, not just insurance reform. Survival will require a move from fee for services to payment for outcomes. This change will require a fundamental change of how providers deliver care. They will have to eliminate activities that do not provide better outcomes — because no one will pay for them!
The key question is what is Obama’s equivalent to Reagan’s, “Mr. Gorbachev, take down that wall”. I think this requires that we see the nation’s health to be just as compelling and important as the nation’s defense. How can President Obama make this happen?
First, it requires transformational leadership. The President needs to articulate a vision, strategy and plan — and steadfastly hold to this message just as President Reagan held to the “evil empire” message. He has to lead, not just throw this idea “over the wall” to Congress as a notion that they need to pursue. He needs to bet the farm on this one.
Second, he needs to take the case to the healthcare establishment. Transforming healthcare will yield better outcomes for lower costs. The best providers will be much more profitable –and the poor providers will go out of business. Healthcare needs this “creative destruction” with the strong players prospering and the weak players disappearing.
Third, the senior leadership of the Obama administration needs to be relentless in embracing the overarching goal of a healthy, educated and productive population that is competitive in the global marketplace. Yes, healthcare is just one piece of the puzzle. Education is next. That’s needs to be the agenda of the administration following Obama. But Obama needs to stay on healthcare, and little else. That will be the highlight of the Barack Obama Presidential Library in Chicago.