Selling Omnibus Bills: The Health Care Example

Omnibus bills - enormous pieces of legislation that include numerous and often unrelated issues - have long been vilified for containing countless amounts of pork. They've also been criticized for being so long that no congressperson could reasonably read them in their entirety.

Now those in Congress - who benefit from omnibus spending bills precisely because of those vilified earmarks - may have to think twice about using them for other issues. The Health Care bill - once a lavish package of health care reforms (and still so, to a lesser extent) - has become a certifiable public relations disaster. To be sure, the latest Washington Post/ABC News poll indicates that a majority of Americans believe we're better off with no change in health care at all than with the Democratic proposal - whatever that is. So is the large, pre-packaged "reform" bill a poor public marketing tool?

The final, pared down bill - if it passes - will apparently contain individual elements that are fairly agreeable to most Americans and their elected representatives. An end to lifetime coverage caps and to refusal of coverage based on pre-existing conditions. Expanded healthcare to 30 million who might otherwise seek out emergency rooms for less serious health problems. Incentives for employers to offer health care to their workers.

Could the Democrats have been better served by tackling these issues separately?

An end to lifetime caps, the removal of pre-existing condition criteria and tax incentives for employers who offer health care would certainly have passed as isolated bills. Score three public affairs wins for the Democrats. Tack on some Republicans who would undoubtedly feel pressured to support these populist ideas, and the specter of crowd-pleasing bi-partisanship is a genuine possibility. Expanding health care would be a more intense fight, but would easier to handle with the other issues off the table.

Would decoupling the health care debate also lead to Democratic victories on now-dead agenda items? Though less clear, there are good reasons to believe it would. Take the example of drug importation. Several Democrats - who were among the largest recipients of pharmaceutical dollars - attacked an amendment to allow drugs imported from Canada as a menacing health risk, a position that most find preposterous at best and self-serving at worst. Though the amendment was a bipartisan effort, enough Republicans found refuge within their party's general stance against the health care package to vote against it. Yet the issue of drug importation - held separate from other considerations - is easy to sell to the American public; everyone understands dollar signs.

Democrats may have also fared better on a public option or single payer system by making a more precise case, and arguing it in a less amount of time. In June of 2009, over 60% of Americans favored a public option plan (Washington Post/ABC News poll); in October, 57%. The public option was still popular with a majority of Americans, but decreased as time - and with it Republican scrutiny - dragged on. Could a narrowly focused public option moved swiftly enough to avoid the doldrums of the omnibus Health Care bill?

The framers designed Congress to frustrate the majority and account for the minority will. Sweeping changes is not what they had in mind, but rather limited increases in government based on generally agreed upon principals. Combining these items into massive proposals only enlarges the general number of dissenters, increasing strife among members and alienating the public.

To the point, the omnibus health care bill taken up by the Democratic Congress has managed to exacerbate partisanship, alienate members within the Democratic party, cut into approval ratings, and disaffect a majority of Americans. The potential result: several generally agreeable items that could have been tackled in their own right, on their own time, and on their own strong merits.

Same outcome, sold much better.