The 2012 Presidential election is over. As with many great events, it leaves the world with some certainties resolved, and it highlights uncertainties that loom even larger.
Changes to The Affordable Care Act
First and foremost, the uncertainty of the election is over. We know that President Obama has been re-elected, and with that, and control of the Senate remaining with the Democrats, we know that the Affordable Care Act (ACA) will not be repealed. Companies that have been waiting and hoping for repeal, and healthcare organizations that have been dragging their feet in implementation, now need to start the process of coming into compliance with the law. States need to create their exchanges and individuals need to consider their personal responsibilities.
But what we also know is that no legislative action, including the US Constitution, exists forever without change. There are key elements of the Affordable Care Act that need examination and amendment, especially in light of the “fiscal cliff.” I am sure that teams on both sides of the aisle have now had time to read the ACA and have ideas on how to improve it. They should rapidly come to bi-partisan consensus on those changes and relate amendments to budget, deficit and growth.
Important areas to examine include the still large group of people who will be without insurance after 2014, the disparities in personal vs. family coverage and related subsides, the idea of “adverse selection” that seemingly encourages young people to pay a penalty rather than buy insurance resulting pools of insured that require more attention, therefore increasing costs, not reducing them. The issues of small businesses and the financial burden assigned to them also needs to be addressed. The ACA seems to encourage hiring part-time workers, which pushes the insurance costs back to under-employed individuals. And then there is the issue of physician salaries and productivity, which is much too complicated to get into here (I will write a separate post soon on this topic).
Work on the ACA is only a starting point. The President should also rapidly engage in the following activities:
- Fiscal Cliff. Immediate, bi-partisan meetings to converge on a deal that will avert the “fiscal cliff.” I would love to see many of these meetings held in the open on CSPAN so American’s can watch negotiations, understand the complexity of the issues, explore the nature of the disagreements and actually watch their leaders being leaders rather than hearing about leadership through self-description. Let the American people participate through observation, and certainly through social media and other forms of communication, in the sausage making that is legislative action. Yes, we elect representatives, but that doesn’t mean we absolve ourselves from participation after we leave the polling place. Television and the Internet provide some pretty good tools for monitoring the performance of our elected officials.
- Energy policy. Another opportunity for public debate and bi-partisan consensus. A fragmented, non-rational energy policy does neither party any good. Both parties benefit from coming together on this issue because American’s benefit from a rational policy.
- Tax Reform. There will be some tax reform necessary to stave off the fiscal cliff, but it should be a down payment on deeper reforms and simplifications. Part of the “fiscal cliff” “grand bargin” needs to include corporate and individual tax reform, with an eye toward keeping more money in the pockets of both, because corporate tax rates just become part the cost of doing business and get passed along in pricing. With the Great Recession remediation and its increase in money supply, keeping inflation low will be an important balancing point for tax reform.
- Education reform. As my readers know, this is an area of great passion for me. We treat education as budget ballast, while underpaying, threatening and under appreciating educators. Education reform does not necessarily mean more government standards at the national level, but it means leadership at the national level. Local governments can’t convene the dialog necessary to examine business models, accreditation, financial aid, standards, marketing and technology and the other issues facing education. There needs to be a national dialog that shines the spotlight education it deserves in a world where knowing how to think is more important than remembering facts.
- Immigration policy. Immigration built this nation and we need to remember that. The problem with immigration today is dysfunctional practice, not the immigrants. Providing the right message to the world, and the right position to illegal immigrants and their children, and the right policies for business, need to be a high priority.
- Infrastructure. I’m certainly watching infrastructure improvements, often from a stopped car behind a “Stop” sign held high by a construction worker. But we don’t just need more Federal spending on infrastructure (on Interstates, yes), what we need are better policies that encourage, and provide tax incentives to form, public-private partnerships that make those who depend on infrastructure for commerce help pay for it. Public-private infrastructure can provide revenue to both classes of investors.
Complexity and the “Next Economy”
There are two issues that only a second-term President can address, one is educational and the other is policy: complexity and the “next economy.”
Let me take the “next economy” first. When Presidential and Congressional candidates stand in “industrial states” and promise the return of high paying manufacturing jobs they are being disingenuous. Not only can’t they personally affect most business choices about where factories are built, but they aren’t being honest about the realities of modern manufacturing. In the US, productivity through automation has outstripped demand. We are a consumer-based economy that isn’t consuming as much as it once did, which is great for a more sustainable world, but bad for the current economic model. For years, the knowledge economy has been discussed. The US Government hasn’t actively created policies to smooth the transformation to knowledge and sustainability as economic pillars while easing away from manufacturing and physical goods consumption as the economic drivers. Only a second-term President can have a substantive discussion around broad economic transformation and lay the groundwork for that transformation.
Democracy can be messy and complicated, but these arguments we have are a mark of our liberty.
The “next economy” and all of the other issues are complex. They aren’t solvable with campaign promises, television commercial taglines, single-sided position papers from lobbying groups or PACs. They aren’t reducible to simple graphics that provide evidence for a few choice paths among clear alternatives. All of these issues are complex, and only a second-term President, without the threat of re-election, can afford to engage the American electorate in a conversation about how complex and inter-connected our realities, our policies and our choices are. Americans needs some Professor Obama along with President Obama to help create a framework for meaningful dialog going forward, perhaps as a penance for his campaign’s own often too pointed, too partisan, too terse rhetoric. The President recognized this in his acceptance speech when he said “Democracy can be messy and complicated, but these arguments we have are a mark of our liberty. ”
The Time is Now
These discussions need to start well before Inauguration Day. We know that the “fiscal cliff” will be invoked before the President is sworn in for his second term, and we know the “grand deal” associated with averting the “fiscal cliff” will require deep negotiations, complex agreements and actions based on many of the issued outlined above. Today, some parts of the future are clearer. We cannot eliminate uncertainty, but our national leaders can certainly recognize it, name it, engage it and navigate it more effectively. Businesses, along with state and local governments, need leaders, not to tell them what to do, but to tell them what they are thinking and what actions and sacrifices they are willing to make. That by itself will deliver more clarity, and demonstrate better leadership. The time is now.