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No Patient Left Behind By: Gary Andres
Weekly Standard | Friday, August 07, 2009

The Democrats' health-care overhaul stands at a critical juncture in Congress. With public opposition rising, President Obama faces some key strategic decisions to advance the bill through the legislative thicket.

Although he's been more apt to blame than listen to George W. Bush, Obama might gain some key insights from this unlikely source.

How the forty-third president ushered one of his first major legislative endeavors through Congress--No Child Left Behind--offers some important clues that might boost Obama's chances of success on health care.

The parallels between the education and health care measures are striking.

Both presidents doubled down on these respective reform measures. They talked about them a lot during their election campaigns and then wanted to deliver results in the first year.

Similarly, both issues include strong views on the left and on the right in Congress.

Moreover, both Bush and Obama decided to avoid sending detailed legislative language to Congress on the respective measures. Instead, they delivered broad principles to Capitol Hill and allowed lawmakers to fill in the details.

And in both cases, successful passage would signal managerial and political competence. Winning always boosts the chances of future legislative achievements; losing complicates other pieces of the White House agenda.

But the parallels only go so far. Bush outlined a clear strategy for legislative success from the beginning. Obama's approach is murkier. Bush indentified a bipartisan cadre of legislative leaders and created the political equivalent of an enduring Crazy Glue bond with them.

On the Senate side, Democrat Ted Kennedy of Massachusetts and Republican Judd Gregg of New Hampshire were the two leaders of the education panel. On the House side, Congressmen John Boehner of Ohio and George Miller of California were the chairman and ranking Democrat of the key House committee.

Bush worked hard from the beginning of the process to keep these four senior lawmakers in the tent--despite pressures from the polarized wings of the parties. Each lawmaker agreed and disagreed with various portions of the measure. But they all knew that if locked arms became clenched fists, the entire project would tank.

Political scientist Patrick J. McGuinn, who has studied the history of education reform, agrees. In his book No Child Left Behind and the Transformation of Federal Education Policy 1965-2005 he writes: "Some Republicans argued that the party should use its narrow majorities in the House and Senate to try to pass a conservative bill that Democrats strongly opposed. Bush declined to follow this strategy, and his pursuit of bipartisan compromise fundamentally influenced the nature of the final legislation as well as its long-term impact on the politics of federal education policy."

Ironically, while Obama talked a lot about bipartisanship during the campaign, his efforts to match words and deeds fall short. Health care is no exception. The House strategy has been hyper-partisan--brokering a series of behind-the-scenes deals with members of his own party. The president has rejected Republicans overtures for meetings, keeping them at arms length.

The Senate picture is more nuanced. It's unclear if the White House wants bipartisan negotiations to succeed or if President Obama thinks Senator Reid should just try to ram the bill through using procedural tactics such as budget reconciliation, which would allow the measure to pass with only 51 votes.

Obama has never established a team of rivals--a Kennedy/Gregg/Boehner/Miller-like group to help find consensus and navigate intra-party feuds on both sides of the aisle. "We spent hours and hours with these people and with the White House," a staffer intimately involved in the education negotiations in 2001 told me this week. "We also then had to do a lot of hard work on both sides of the aisle to keep Members in line." Making sure the four legislative leaders and Bush stayed connected at the hip was the bottom line--a commitment many believe helped avoid numerous partisan arrows that might have proved fatal.

Despite the early hype about Obama's "team of rivals" cabinet or his post-partisan style, he is missing an opportunity to fully engage the opposition, seemingly just wishing for the best.

"Hope" is a catchy campaign slogan, but it's not a sound legislative strategy and won't help him on health care reform. Instead of just playing victim by blaming Bush for today's challenges, Obama may want to tear a page from the former president's playbook.

Gary Andres is vice chairman of Dutko Worldwide.

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