The big challenges facing the country must be solved by cooperation from both parties, and the Fiscal Cliff can only be averted by a bipartisan Grand Bargain, championed by a strong president. The voting math in the next Congress will require it. It will also be better for the country if Democrats and Republicans alike have a stake in passing and implementing what will be a messy deal with many unpopular provisions.
The media coverage and political rhetoric about what will happen with health care in January is maddening and depressing. The outcome is presented as a binary choice. If Obama wins, the Affordable Care Act gets implemented and that’s that. If Romney wins, he brings a Republican Senate with him and uses budget reconciliation and executive orders to eliminate (or at least maim) Obamacare.
The all-or-nothing scenario may be a convenient narrative, but it doesn’t serve the nation well. We need a Grand Bargain. A Grand Bargain will require reforms in Medicare and Medicaid, as well as some sort of restraint on spending in those programs. The country must also find a way to reduce the number of uninsured and control medical spending overall, regardless of who ends up in the White House.
Therefore, whoever wins the election is going to have to accept input from both parties, regardless of the current rhetoric, to make health care work.
I will say it again (and again): Obama and Romney, as well as all the candidates running for office this year, have got to talk about their positions and debate the real challenges surrounding health care so the American voters can make clear, reasoned choices in November.