The contrast between the President’s approach to the Afghanistan War policy and his approach to health care reform could not be greater and in that contrast is a fascinating glimpse of a man growing as President.
No matter where you stand on Afghanistan, you have to respect how President Obama has considered the issue. I have worked in White Houses and watched the process of the last few months from the point of view of at least a semi-professional interest of over 30 years, and have never seen anything like his focus on Afghanistan. President Obama was boxed in from the beginning: during the presidential campaign all democrats had seen Afghanistan as the clean and necessary war; he carried out a strategic review last March and reconfirmed that view; he changed battlefield commanders for the first time in 60 years to a man whose point of view was quite clear; and he faced the almost certain resignation of that battlefield commander if he had not concluded this review with a significant troop increase. Given all of that, he carried out a painstaking and detailed review: I don’t think there was any dithering about it. He took the time he needed to take. He assumed direct responsibility for assuring that the right questions were asked and the right strategy reached. I noticed that this effort was not outsourced to the Armed Services committees of the Congress.
I am personally deeply ambivalent about our chances of success. There are four stated pillars for success, all of which together are the necessary and sufficient conditions: sufficient troops; training that significantly increases the size of the Afghan police and military; a economic development surge; and an end to the deep culture of corruption in the Afghan government. I think the odds of three of the four are very, very low. And experts in the field tell me that any view that success can be quick — i.e. a couple of years — is a fantasy. I think the odds are close to zero that any significant withdrawal is going to begin in 18 months or so.
But I also think the President’s review has probably forged the best possible strategy that can be reached within the limitations he faced. A withdrawal was never anywhere on the table; and even if we had the resources, an overwhelming increase in forces and a quick victory — whatever that would be — is not possible. My own sense is that we are embarked on a strategy on containment, but it will take us a long time to acknowledge it. We are going to stay in Afghanistan in a messy, complicated, unsatisfying way for a very long time. We will probably keep some very bad things from happening to us and to others by doing so. And some good things will continue to happen. For example, this may be the only politically acceptable way of helping Pakistan keep its nukes out of the hands of truly awful people without saying so. For another example, another 10 years of classes (yes, my guess is we are there for 10 more years) of girls will graduate from school and some of them will help change Afghanistan’s government, culture of corruption, and civil society. And you can be sure there will not be 10 more years of girls graduating from school if the Taliban take over. Apparently, some of the Taliban, when captured, say to us, “you may have the watches, but we have the time.” This strategy of containment buys time.
Consider the contrast with health care reform. Health reform efforts began immediately, without even a pause after the election. There was no “painstaking and detailed” review. The President and the White House did not take direct responsibility for assuring the right strategy was arrived at.
The entire effort was outsourced to the Congress, which is simply not capable of the kind of review that is needed.When an executive branch led by a good and serious president considers a big problem, that deliberation tends to be deeper, more analytic, longer run, and is capable of seeing a problem as a whole. Congress simply cannot do any of this. Problems are avoided; choices are elided; and there is an instant dive into the weeds. Big issues are not examined because the examination isn’t convenient.
I was re-reminded of this by a Charles Krauthammer column in the November 27 Washington Post. I know he is not a progressive, I’ve disagreed with a very high percentage of the positions he has taken over the last 25 years and I thought he was wrong to the point of nuttiness on Iraq. But he is a very smart and serious man. In his column he says, straight out, that insuring the uninsured is a moral imperative and then wonders why neither the House nor the Senate was willing to consider changes in the current state of health care and health insurance: (1) tort reform; (2) interstate insurance competition; and (3) limitations on the tax break for employer provided health insurance. I think he is right on all three counts. None of these are inherently right wing positions, although at least tort reform has been labeled that. Interstate competition would provide the competitive element progressives have said they want without the damage of a public option. And taxing employer-provided health insurance in some way would provide real revenue and end an inherent unfairness. If I as an individual cannot get employer-provided care and have to buy my own, why is it just or fair that my purchase of health insurance gets no tax protection, while every penny of every benefit plan offered to an employee is tax protected? Not one of these issues ever received serious consideration in the Congress; all three would have been seen as important in any real strategic review.
The result of the non-process in Health Care Reform is a legislative horror. The Senate bill now on the floor is slightly better than the House bill, but it is very hard to avoid the conclusion that the nation would be a lot better off if there were a “do over.” This is an effort to reorganize 17% of U.S. GDP in one convulsive step. It cannot be done well. And it is an absolute certainty that no senior person has given the same focused attention to health care reform as the President gave to the Afghanistan strategy. If the President Obama who just spent at least 19 meetings on the Afghanistan policy — which has to be a high percentage of his available time during that period — had given the same focus to health care, the result would have been better and different.
My own guess — which will only be confirmed one way or the other years after President Obama leaves office in 2016 — is that President Obama agrees with this. The White House is in a position in which it has to sign literally anything passed by the Congress and labeled as health care; and it will profess to love it, whatever it is. But the serious people in the White House and Administration don’t love it and they haven’t loved the policy process we have gone through.
At a deeper level, I think we have watched, through 2009 and these two completely different policy efforts, President Obama grow immensely and learn what it means to be President. In my view, we saw in these two processes a man learn the difference between being a senator and being THE PRESIDENT. Two important facts about senators: (1) “doing something” as a senator means telling a 20 or 30 year old staff assistant to write a speech; (2) no one listens very much to that speech, and certainly no one at all thinks anything will happen because of that speech. President Obama acted like a senator throughout the health care debate, and as a result the debate was rudderless.
“Doing something” as President is a different dimension. It involves forcing out the real views of the executive branch and its parts; demanding evidence; balancing views; visualizing consequences; moving a Congress that in general would prefer to avoid most choices; convincing an American public that is always divided on big issues. Above all it involves taking the right risks, sometimes even betting your job. And when you decide, actual real things happen. Money is spent, generals change battle plans, whole units of the State Department begin to plan a “civilian surge,” and large numbers of young Americans are put in harm’s way. President Obama became a president during the Afghanistan strategic review; and one who could be more than just good.
None of us know the outcome of the decisions President Obama has made. I think that for a while the decisions will use up his political capital, take away the budget resources he had hoped to use for other purposes; and block other policy initiatives he has wanted to take. But a president cannot recommit to a war he underlines as consequential for American security without spending himself on the effort. President Obama’s decision may consume his first term. But whether it does or does not, we now know how very fast this president learns.
Roosevelt Institute Braintruster Bo Cutter is formerly a managing partner of Warburg Pincus, a major global private equity firm. Recently, he served as the leader of President Obama’s Office of Management and Budget (OMB) transition team.