Once More into the Health Reform Breach

Once more into the breach, dear friends, once more.

Shakespeare (1646-1616), King Henry V

Once upon a time, Rahm Emanuel, President Obama's  chief of staff during Obamacare’s passage,   warned the President not to overhaul  the health system all at once.   Emanuel had learned that  lesson the hard way during the Clinton administration.   But once forewarned was not enough for the President .

The President was a man who thought he had onc- in-a-lifetime chance to transform the nation’s health system all at once.   He had the House and Senate in his pocket. He was President.  To control three branches of government all at once happened only once in a great while. 

He was, above all,  a transformational  President. He might have this opportunity only once. So he decided to  deal with the  health care crisis all at once.   Once to every man and nation comes a moment to deal with a singular truth: health care costs too much and denies care for the poor and the sick.  At the same  time,   he could  deal with what he deemed  a falsehood, namely, that  free enterprise and self-serving markets could deliver care more efficiently and effectively than government.

So he stuck out at once  to  immediately drive a stake into the heart of the capitalistic beast.  He would at once protect the minorities and all the common folk by making their care more affordable.  He would once and for all, all at once,  make everyone equal by redistributing health, and in  the process, wealth.

But alas, the capitalistic pygmies rose and sought to smite him  down, the Goliath of Government..  Their leaders gave him not one iota, not one ounce,  not one vote, of support.  They influenced the common folk to resist his noble once-in -a- lifetime cause.   

The odds against him grew.  A national election in 2012 swept into the House his beastly opponents.   Businessmen,  physicians, and patients, satisfied with their health plans, groused and bellowed. He gallantly fought back, promising all at once, not once but more than 30 times,  he told  people they could keep their physicians,  plans,   and hospitals. Period. once and for all.  He promised costs would fall,  more people would gain access , and quality would rise.

But costs rose,  numbers of uninsured grew, and perceptions of quality fell.  Health plans betrayed him by cancelling health policies to comply, they said, that existing policies did not meet his minimum essential benefits requirements. E-mails and documents and stories circulated that he and his wonky band  knew beforehand that people would lose their health plans, doctors, and hospitals,  Public trust in him fell like the proverbial  rock. 

Obama struck back at once.  He unleashed his storied website, based on computer technologies that had served him once so well in his two successful election campaigns.    He rolled out his website onto which he believed  the masses  would sign and who would lock into place his magical, masterful plan and cement his legacy. 

Under his plan,  health plan members could pay all at once for all ten essential benefits in  bronze, silver, gold, and platinum plans, at greater costs, and  at less choice, but nevertheless showing  a vivid  example of federal munificence for the the common good,   What was essential to him was providential for all,

But as cruel  fate would have it, recalcitrant, misinformed citizens intervened. Opposition hardened. Unwittingly, his associates botched the website. Numbers of cancelled policies exceeded  those enrolling by 10:1.  Those joining Medicaid, outnumbered those signing private plans by more than 2:1  - 800,000 to 364, 000.

What to do?   Once more into the breach he and his forces rushed.   He launched a multi-million dollar PR campaign.   He sought out and hired thousands of navigators to steer the multitudes to his treasured site. He enlisted the aid of  countless celebrities to re-sell his promises. 

Health reform has failed under multiple times under his predecessor, but not this time, not this once in a lifetime opportunity.  

Once more into the breach he and his merry crew stepped.  An inevitable political cause, they believed, must sometimes die a thousand deaths  before it succeeds.  This time once will be enough. One giant push will suffice. 

The dream never dies. It is elemental.  There is nothing incremental about health reform.  It's all at once, and once for all, or none for all. .

Tweet:     Once upon a time, a President was forewarned not to reform health care all at once; it faltered, and now it’s once more into the breach.