Tuesday, August 10, 2010

Massachusetts: A Tipping Point for Abandoning Health Reform?

The magic of 2008 can't be recreated. It is in the nature of charisma that it rises out of thin air, out of need and distress, and then dissipates when the magic fails.

Fouad Ajami, The Obsolescence of Obama, Wall Street Journal, August 11, 2010

In retrospect, the Massachusetts election in March of 2010 of Senator Scott Brown may have been the tipping point for backing off or even abandoning health reform.

It's a fact, of course, that after Brown's election, Democrats went on to pass what is now known as Obamacare, or the Affordable Care Act. But the political victory may have been a hollow victory, a defeat in disguise. Public support has been going downhill ever since, and voters have increasingly questioned its premises and its promises.

Let me explain. In his 2000 book, Tipping Point, Malcolm Gladwell memorialized “Tipping Point” as a phrase to describe critical turns in human events.

The tipping point, according to Gladwell, is that magic moment when an idea, trend, or social behavior crosses a threshold, tips, and spreads like wildfire. A tipping point is like a virus. It spreads, reaches a critical mass, and blossoms into an epidemic. It is a moment when the momentum for change becomes unstoppable.

“Tipping Point” is an attractive theory, but with health reform, it omits a key point. When the political and economic environment deteriorates, or when promises made, e.g. health care will become “affordable” or current care will provide health consumer “protection” doesn’t look like it will pan out, the tipping point, in this case, the viral health reform epidemic, may become stoppable.

That may be what’s happening with health reform. When Obama became president, the economic crisis, soaring health costs, and decreasing access to care seemed to tip the political equation towards “progressive” government and sweeping health reform.

But in ensuing 18 months, the tipping point burned out. The economic environment and joblessness did not improve. Political events like the Massachusetts election of Senator Scott Brown, Republican victories in New Jersey and Virginia, the Missouri referendum defeating the individual mandate, polls showing mounting public disapproval of the health reform law, and multiple states challenging its constitutionality, pointed towards dire Democratic prospects for November.

Americans are having second thoughts about health reform, and another tipping point may be at hand.

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