It didn't go so well the first time around, when a president assigned his wife to reform health care. But instead of mucking things up with intrusive, expensive health care "reform," President Barack Obama could do a lot worse than putting Michelle in charge of wellness promotion. Michelle Obama understands wellness, choosing to grow fruits and vegetables—not just roses—on the White House lawn.
"Eat food. Not too much. Mostly plants." That admonition, the first words of Michael Pollan's enlightening In Defense of Food, could be the bumper sticker promoting MichelleCare. Pollan makes it clear that America's high levels of heart disease, cancer, and diabetes—which trigger the heavy medical care costs of late-life sickness—are the result of the "western diet," with its food-like processed products, much of which is synthesized from cheap corn and soybeans. We are obsessed with "nutritionism," but the sum of the unpronounceable substances on content labels don't equal the benefits of real food, like grains, nuts, fresh fruits, and vegetables. Don't eat anything your grandmother wouldn't recognize as food, Pollan counsels. I haven't done justice to the 200 pages of Pollan's cleverly-written wisdom. Read it yourself. In fact, a free copy to every American who wants it (or DVDs for those averse to books) should be a part of MichelleCare.
The political stand-off certain to develop between cost cutting on the one hand, and expanding coverage to the 47 million uninsured Americans on the other, will make reform a chimera sure to please no one. The resulting legislation is likely to be a grab bag of unfunded government goodies spawning bigger deficits, just as Medicare and Medicaid have done over the past four decades.
To understand why "reform" is more an exercise in political theater than a serious attempt to cut costs and improve care, consider how we got here. It started during World War II, when wage and price controls led to a labor union-government agreement allowing tax exempt employer-paid health care to act as a substitute for pay raises. That tax exemption was the genesis of much of the problem we now face; it divorced decisions about consuming care from consideration of price, making doctor and hospital visits appear free.
The next big step was Medicare and Medicaid, which have grown like fat kids, especially with George W. "LBJ" Bush's free prescription drug benefit, a Karl Rove legacy of big government conservatism.
But the most important development in the politicization of health care came in 1991 in the special election of Sen. Harris Wofford (D-Penn.), an interim appointee after the helicopter crash death of Sen. John Heinz. Two little-known consultants took charge of Wofford's seemingly hopeless challenge.
The fast-talking pair was Paul Begala and James Carville. When they signed on, Wofford was 40 points down—he won by 10. Begala and Carville became the geniuses-du-jour among hired political guns, landing them jobs as gurus to the faltering 1992 Clinton campaign. Their formula: Focus on "the economy, stupid" and create a populist clamor for "health care reform," tapping into resentment of big bad insurance companies, over-charging hospitals, rich doctors, and evil pharmaceutical companies.
This eventually came back to bite the Clintons after the election, leading to the "HillaryCare" that pegged Clinton—a "New Democrat"—as another big spending liberal. That begat Republican control of the House in 1994. The wily Clinton dropped health care and took up another issue from his campaign, welfare reform, signed a House GOP bill, and took credit for it.
Health care reared its head again in 2008, when initial presidential front-runner Hillary Clinton made it her signature issue, forcing competitors—including Obama—to come up with their own "reform" plans. The rest is (contemporary) history. With a disastrous recession and two wars to contend with, Obama still allowed himself to be maneuvered into "reforming" health care.
Like McCain-Feingold campaign finance "reform," something called health care reform may pass Congress and get signed into law. But it won't be effective reform, anymore than attacks on free political speech managed to suppress the influence of political money. Whatever gets past the phalanx of insurance and provider lobbyists—not to mention liberal politicians ready to federalize more health care as another free lunch—will bloat the budget like the processed foods that have added tons to the American waistline.
So give Michelle Obama a bigger platform to promote health and wellness-producing meals. That's reform we can live with. And our lives will be longer, healthier, and we'll be billions richer, too.
Executive Director of the Washington Center for Politics & Journalism (WCPJ), Terry Michael writes from his perspective as a "libertarian Democrat." His opinions here and at his personal web site, www.terrymichael.net , are his own, and not those of WCPJ or its board.