In making his case for health care reform, President Obama has mastered one of his favorite rhetorical strategies: declaring interdependence. Fixing our health care system wouldn’t just fix health care, he says. It would help us fix a bunch of other problems, too.
In early June, the president’s Council of Economic Advisers released a paper touting the economic benefits of health care reform. Cutting costs and covering the 46 million uninsured Americans would, according to the report, create as many as 500,000 jobs a year and increase annual income for the average family of four by $2,600 over the next decade. Then, in his speech before the American Medical Association Monday, Obama linked health care reform to the auto bailout: “A big part of what led General Motors and Chrysler into trouble in recent decades were the huge costs they racked up providing health care for their workers; costs that made them less profitable, and less competitive with automakers around the world.” Spending less money on health care would also rein in the deficit, presumably freeing up cash for other projects, such as education and energy technology, not to mention reducing dependence on foreign creditors. About the only thing left for Obama to cite is some statistic showing most terrorist attacks are the result of high premiums.
This rhetorical technique—claiming that a proposed policy would solve not just one pressing problem but several others—is nothing new. But Obama seems especially fond of it, and also has a knack for it. Whether it’s health care reform, closing Guantanamo, or cap-and-trade, he rarely sells a new policy just for its own sake. Instead, he presents it as part of a broader vision, in which each piece of the puzzle depends on the rest. The practice carries risks as well—but so far, at least, it is working for Obama.
Look at his case for fuel-efficiency standards. Making cars more efficient wouldn’t help just the environment. It would save drivers money, reduce America’s dependence on foreign oil, and help U.S. automakers compete once again by putting them at the forefront of new technologies. Same with cap-and-trade and reducing demand for electricity: Obama said it would save $130 billion on energy bills, reduce carbon emissions by 80 percent by 2050, and slow global warming: “And we will create five million new jobs in the process.” Same, too, with converting to solar, wind, and other renewable energies. As Obama likes to put it, “Everyone wins.”
In Cairo, Obama cited interdependency as a reason for increased cooperation with the Muslim world: “When a new flu infects one human being, all are at risk. When one nation pursues a nuclear weapon, the risk of nuclear attack rises for all nations. When violent extremists operate in one stretch of mountains, people are endangered across an ocean.”
The interdependency argument has several advantages. For one, it broadens the appeal of any specific policy by making it sound more beneficial to more people. Weatherizing homes doesn’t just reduce emissions—it helps out the troubled home-construction industry. Greater accountability for teachers doesn’t just help students learn—it saves money. Bailing out mortgage holders doesn’t just stop foreclosures—it can reduce crime.
It also allows Obama to sell several policies at once. By linking health care reform with the auto bailout, for example, he tacitly makes the case for both. Diplomacy might help speed nuclear disarmament, but it could also reduce antipathy toward the United States, which could in turn reduce the threat of terrorist attacks back home. When each policy depends on the other, each one seems more essential. It’s like a political Jenga tower. That makes opposition all the more difficult, explains former Gore speechwriter Jeff Nussbaum: “Pull on one thread, and you could unravel the whole thing.”
Most important, the interdependency doctrine helps Obama paint his policies as part of a unified vision rather than a set of unrelated ideas. Compare his web of interwoven policies—the stimulus, health care, efficiency standards, the auto bailout—with George W. Bush’s legislative patchwork. Bush did not lack for vision. Many of his policy goals, such as invading Iraq and privatizing Social Security, were part of a larger narrative of “expanding freedom.” But others, such as No Child Left Behind and the expansion of Medicare, were stand-alones. He didn’t try to fit them into a story.
Obama’s hardly the first person to use the technique. When Franklin Delano Roosevelt was selling the New Deal, everything was billed as helping the economy, from ending Prohibition to subsidizing art projects. During World War II, many domestic policies were geared toward winning the war. Americans were even urged to grow “victory gardens” in their backyards to reduce the price of food for troops, and to buy war bonds. Since then, every president from Kennedy to Clinton has described their policies as somehow interdependent, part of a larger agenda. (For example, welfare reform, the Brady Bill extending waiting periods on handgun purchases, and reducing the deficit all fell within Clinton’s rubric of personal responsibility.)
But Obama has done it most effectively. One reason may be his background. As someone born in Hawaii, raised in Hawaii and Indonesia, and educated mostly in the Northeast—and who has family in Kenya—he speaks with some authority about how political and cultural shifts in the United States affect the rest of the world. And it helps that modern technology has made those shifts both more swift and more obvious.
But perhaps the biggest reason Obama can squeeze everything into one narrative is, ironically, the economic collapse. As he noted in his Cairo speech, the financial crisis reminded everyone just how codependent we are: “For we have learned from recent experience that when a financial system weakens in one country, prosperity is hurt everywhere.” That lesson has driven the administration’s thinking on a lot more than just the economy. When Chief of Staff Rahm Emanuel said the Obama administration should see the economic crisis as an opportunity, he presumably meant that it would allow Congress to pass laws that would not have been possible otherwise. What he probably didn’t realize is that the economic crisis would color the administration’s entire worldview.
Of course, there’s a downside to all this conditionality. Linking policies to one another is effective when you’re trying to shove a lot of bills through the door at once, as Obama is. In that case, you can plausibly say, Pass them all, or the whole structure will collapse. It’s less effective when you have to pick and choose. In addition, it’s often useful for a politician to be able to compartmentalize issues: OK, forget about Wall Street regulation for now. How about health care? Arguing that everything is related—that one policy’s success depends on that of another—may make it harder to peel off supporters for specific issues. It also risks alienating allies who aren’t onboard for the entire Obamagenda.
It’s inevitable that Obama will have to start the process of disconnecting. So far, however, he hasn’t had to decide which parts of his agenda to jettison. (Immigration reform was on its way to getting punted; then it wasn’t.) So for now, he gets to seem coherent and visionary. Americans understand better what their government is trying to accomplish—even if they don’t agree. And with a public insurance option, we prevent the next 9/11.