Obama’s Failed Leadership in Health Care Reform

A  New York Times front page article – “Democrats Put Lower Priority On Health Bill” – (Jan. 27, 2010) declared, “With no clear path forward on major health care legislation, Democratic leaders in Congress effectively slammed the breaks on President Obama’s top domestic priority … saying they no longer felt pressure to move quickly on a heath bill . . .”

Despite President Obama’s protestations in last week’s “State of the Union” address, any meaningful reform of the American health care system is, in all likelihood, dead. The cause of death was lack of effective leadership, care and attention. There may be some type of face-saving, watered-down health care legislation, but even that is now doubtful.

There are any number of villains in this story, but the real blame for the failure of health care reform can be placed at the feet of those who most favored reform. At the head of the line is President Obama who, while passionately well-intended in his efforts for reform, exhibited poor leadership strategies that constantly left the legislation on the critical list.

Obama is not the first to wear the horns of failed leadership at the highest levels of our government. Despite the efforts of many political leaders, no piece of significant social legislation has passed Congress since the Civil Rights Act, almost half a century ago. But Obama may be in line for a higher level of criticism, because he entered the fray riding a rousing mandate for action, bestowed upon him by an electorate fiercely passionate for transformation of failed systems. The stars in his populist universe were aligned for him to succeed—and yet he failed.

It is not my intention to be a “Monday morning quarterback” where hindsight is always perfect (Why did Farve throw that final pass?), but the fact remains that President Obama either did not understand or did not exhibit the ability to provide some of the most basic elements of effective leadership. Sometimes the best lessons of leadership can come from failure. It is not the intent of this blog to savage Obama, but to study his mistakes in leadership so that all of us – and hopefully President Obama – can learn from them.

Lessons in Leadership – Define the Vision and Make it Simple

One measure of an effective leader is the ability to take a complex subject (and certainly health care reform is complex) and express it in simple terms that everyone can understand. Obama failed in this area of leadership, because of his inability to simplify his vision for health care reform in terms that everyone could understand and few could rebut.

Obama passionately called for health care reform, but the concept was too broad and that made it too difficult for his supporters to coalesce on a single vision. Obama’s initial mistake was his failure to clearly and simply define what he meant by the term – health care reform. This is like a business leader who calls the troops together and announces that his vision is, “To build a successful company.” That is all well and good, but no one really knows for sure what that means; leaving the vision susceptible to multiple interpretations and, in all likelihood, failure. Obama’s failure to succinctly define the terms of the health care debate opened the door for those opposed to reform to offer their own negative definitions of health care reform.

As a result, healthcare reform supporters were constantly struggling to find a single, coordinated message and opponents were able to confuse the debate by offering a MIRV-like attack, with multiple warheads of specious dissents lobbed from a single missile spelled “N-O.” Because the target was not specific, opponents were able to define the issues to their liking, and throw up multiple, independently targeted attacks that made it difficult for those supporting reform to respond to effectively. The failure of a leader to effectively define his vision for the future immediately puts his followers on the defensive and opens an avenue for opponents to go on the offensive.

President Obama would have had a better chance for success if he had expressed his vision as, “What America needs is a system that recognizes the right of every American citizen to receive basic health care and those with the resources to purchase heath care should have competitive options available.”

If Obama had taken this approach, the debate would have focused on two issues: Does every American citizen have a right to receive basic healthcare? Should there be real competition among private heath care providers?

This approach to the health care issue would have immediately put the opponents on the defensive; forcing them to either go on record as opposed to healthcare for all citizens or as against competition in the health care market. (What tried-and-true politician would want to do that?) Forcing the debate to focus on these issues would have created an implied assumption that reform is needed and forced opponents to debate the solution, not the problem. This approach will always give the proponents of action the upper-hand.

Lessons in Leadership – Outline a Plan for Success

There is a fine line that divides strong leadership with empowerment and micro-management. The leader is obligated to effectively state the vision and set the tone, but in most cases success the objective will be achieved only if others are empowered to achieve the vision and when they are not hindered by micro-management that prevents the exploration of multiple solutions.

However, when a leader is passionate about an objective and when he is faced with what he knows will be strong opposition to his ideas, the best chance for success is to specifically lay out the parameters of his expectations. Under these conditions he will empower others to determine the way to implement the solutions, not the specific solutions themselves.

President Obama compounded his failure to concisely focus his vision with a serious tactical error when he delegated the development of the plan for health care reform to others. (This tactical error was made worse by delegating the design of the plan to 535 maniacally-egotistical, self-serving politicians in Congress!)

When a leader faces a challenging, controversial issue it is his right – really his duty – to lay out not only a clear vision of his objectives, but to offer potential solutions that others can develop and implement.

What Obama should have done was to be specific as to what he saw as the way to guarantee the right of every citizen to obtain basic health care, i.e. expanding Medicaid to the poor and offering everyone an option for competitive health care, i.e. ultimately making Medicare available to anyone who could pay for it. I am not saying these are the right answers to health care reform, but if Obama had focused the debate it this way, it would have marshaled his supporters and put those opposed on the defensive. Instead, Obama put himself in the position of having to constantly respond to multiple schemes offered by his supporters and a plethora of fear-mongering rumors spread by the opposition. This diluted Obama’s focus and strength as a leader and lead directly to the failure of his vision.

Lessons in Leadership – Know the Environment in which You Lead

Leadership is about motivating and inspiring your followers to accomplish the possible, not the impossible. It is the responsibility of the leader to understand what can be accomplished and what needs to be done to do so. The leader must understand that achieving the possible is never guaranteed, but that in attempting to do the impossible, failure is always guaranteed. This means that it is incumbent upon the leader to fully understand the environment – both in terms of opportunity and challenges – in which he seeks to lead.

President Obama clearly demonstrated that he did not understand the environment of Washington politics when he regularly set deadlines for passage of health care reform; only to have to constantly retreat from those deadlines. Each time he did, his power of leadership eroded. Of course, he was not helped at all by the erratic, arrogant and ineffectual leadership of Majority Leader Harry Reid and House Speaker Nancy Pelosi. Nevertheless, Obama did not have a plan to compensate for poor leadership in his own party and that is, in and of itself, a failure of his leadership.

What Obama as a leader failed to understand about Beltway politics is that often success is achieved by shifting focus away from what you actually want to achieve.

If, in 1961, when President Kennedy proposed that America spend billions of dollars to put a man on the moon by then end of the decade, he had positioned it as simply putting a man on the moon, he would have received vociferous criticism and opposition to the plan. Critics would have argued the money could be spent better on earth. However, Kennedy positioned the effort as a “race to beat the Russians to the moon to stop them from putting missiles there and as a way to defeat communism.” With this as the focus, the opposition never gained traction.

If, in 1964, President Johnson had promoted the Civil Rights Act as civil rights legislation, it most certainly – like all other previous attempts – would have failed. Believe it or not, Johnson did not push the civil rights legislation as a way to guarantee rights for Blacks, but as a way for Americans to “pay tribute to our martyred President.” The opposition stood no chance against this approach.

If, in 2002, when President Bush proposed the Homeland Security Act, he had positioned the legislation as a way for the government to tap phones, intercept e-mails and other ways to legalize the invasion of the private lives of all Americans, it is highly unlikely the bill would have passed. Instead, Bush positioned the legislation as the “Patriot Act,” a way to “protect Americans and stop terrorism.” With that positioning, Americans willingly gave up previously constitutionally- guaranteed rights to privacy, without so much as a whimper.

And now here is President Obama who proposes legislation designed to improve the lives of all Americans and it goes down to resounding defeat. It is a clear failure of leadership on the part of Obama for not understanding the environment in which he was leading. If he had really understood his environment, he would have diverted the focus in such a way as to appeal to the best instincts of Americans. For starters, perhaps, “The Right to Health Care for All Americans Act.”

And the Moral of the Story …

Leadership is not easy, but it is simple. Leadership is about understanding and applying fundamental principles of action that give the leader and his followers the best opportunity to succeed. Sometimes leaders fail to comprehend this and make things too complicated, both for themselves and their followers.

President Obama is a very honest, bright, articulate and passionate individual who, I believe, wants to do the right thing. Unfortunately, sometimes these positive attributes can get in the way of real leadership. Sometimes leaders are too confident in their ability and fall in love with their grand schemes and popularity ratings. Sometimes – in their mind – achieving an objective is so obviously the right thing to do (reforming health care) that they assume everyone understands and accepts it as they do. A leader cannot fall into this trap. It is one thing to inspire people – as Obama surely does – but it is another thing to know how lead them to action.

Obama’s failure of leadership in the health care debate demonstrates that he had not learned this lesson. Hopefully, as we can, he will learn from this failure. It is fair to repeat – Leadership is not easy, but it is simple. Leaders make things simple so people can simply do them.

2 responses to “Obama’s Failed Leadership in Health Care Reform

  1. Bob, Obama had tremendous momentum behind him and broad popular support. However, I think it was not just lack of leadership that caused failure with this issue.
    I think the a core problem with Obama is his ability to evaluate the situation properly. Just like with the bailouts, he assumed – simple solutions – moved forward would work. However, his soultions do not fix the root cause, of either the credit situation or health care. Your blog is good at looking at root causes.

  2. Great blog post, Bob, not only as an analysis of the health care reform issue, but a piece of instruction for anybody involved in business. Whether you manage one person or a hundred, there’s something to learn from all types of leaders in all types of professions. Insurance executives and wholesale brokers can learn how to be effective leaders, motivate the masses, and get backing on big ideas – and insurance producers can learn how to position themselves as strong leaders among clients, position their services, and narrow their focus. There’s really something here for everybody – nice.

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