Not-So-Healthy Debate

We noted a couple of weeks ago that the Obama administration had run into the sand on one of its main campaign promises – to close the Guantanamo Bay detention centre. But next to the the liquidizer of political capital that is healthcare reform, the fate of the detainees in Cuba is small beer.

A David Brooks op-ed in the New York Times last week argues forcefully that, such is the endemic lack of trust in government in the USA, that a would-be reforming administration needs to move slowly and incrementally on a hugely contentious issue like healthcare to build the confidence of the electorate rather than attempting a 'big bang' approach. The Times now advocates a 'weak and feckless' strategy of retreat and regrouping, rather than a 'heedless and arrogant' drive to push the reforms through in the teeth of huge opposition.

Curiously, the assumption that trust in government is at rock bottom isn't borne out by our regular public attitudes tracking data. For ten years, we've been measuring the degree to which people across the world trust a range of institutions to act in the best interest of society, and recorded a twenty-two point jump in Americans' trust in government between late 2007 and late 2009. Certainly, 2007 represented the dog days of the Bush administration, and the shine has certainly come off Obama and his team since our poll was taken, but still. A net trust rating of +25 isn't the worst starting point for major reform.

What looks more likely is that Obama's problems getting healthcare reform through is less because Americans across the board don't trust their government, and more because the nation remains hopelessly, viciously, ruinously divided on a whole range of emotive issues. Despite a filibuster-proof majority in Congress, Obama in fact invested a lot of time and energy consulting on the shape of a reformed healthcare system, trying to forge a 'bi-partisan' plan with support from both Republicans and Democrats. It's far from clear that much common ground exists. The resulting fudge, as the Times correctly points out, hasn't satisfied anyone and the wrangling has in the meantime allowed the reforms to be painted – ludicrously - as something akin to a Communist takeover of the federal government. This is one instance where, ironically, a less inclusive approach might have proven less divisive in the longer term.