August 24, 2009


On August 19, 2009 White House Press Secretary Robert Gibbs in a response about winning bipartisan support for health care reform said, "I think the president would orbit the moon if he thought it would help. We'll get in a rocket and fly around the moon if that's what it takes to get people together." The President doesn't have to go to the moon, but he can emulate the vision of President Kennedy on bringing a country together to achieve a national goal.

First, we need to be clear about who physically took astronauts to the Moon in 1969. If you said the President, Congress, or even NASA, you would be mostly wrong. The entities that built the suits, systems, and software that took the first humans to the Moon were North American Aviation, Grumman, Rocketdyne, IBM, Douglas Aircraft, ILC Dover, General Motors, Goodyear Aerospace, Whirlpool, and Westinghouse to name but a few. Of course, there were partnerships with government labs and highly talented government engineers and researchers as well as scientists and engineers from various universities.

The mission to the moon became a NASA priority on May 25 1961, when President John F. Kennedy announced, "I believe that this nation should commit itself to achieving the goal, before this decade is out, of landing a man on the Moon and returning him safely to Earth." In leadership terms, this is known as providing the vision. Once Kennedy put the 10-year stake in the ground, he then DID NOT turn to Congress, and ask them to build the plan to get to the moon. Imagine a body consisting mostly of lawyers figuring out the best way to carry out President Kennedy’s vision, and you quickly determine the ludicrousness of such a concept. Take note that this was a vision that went beyond any presidential terms in office that Kennedy could have anticipated – mostly due to the complexity of the problem.

What does this have to do with the health care issue we face today?

Nowhere can I find a statement from President Obama on his vision for health care as simple, clear, and elegant as the one provided by President Kennedy to inspire us to physically explore beyond the bounds of earth. There is mention of a vision on the White House Blog at http://www.whitehouse.gov/blog/The-President-Spells-Out-His-Vision-on-Health-Care-Reform, but I see no clear vision anywhere on this page either.

What I see is a Presidential concept turned over to Congress (read non-medical professionals) to determine some solution for the President. I have no issue with the President turning execution of a vision over to another organization; we just need a competent organization. John F. Kennedy did not, on March 26, 1961 say to Congress “Give me a plan to carry out my vision.” Rather, he wisely turned to existing government expertise embodied in the form of NASA and said “make it happen.” NASA formed the plan and asked Congress to appropriate and allocate funding based on the plan derived from experts.

One Small Step for [a] Man

One of the arguments for government-managed health care is the claim by the President and others that health care is already managed by the government. True – Medicare and Medicaid are both “managed” by the government. I will not disparage the good Americans who work at these organizations, as they look to take the tools and money provided to them to make a needed safety net work for Americans who need it. However, in its 2008 annual report to Congress, the Medicare Board of Trustees reported that the program's hospital insurance trust fund could run out of money by 2017. Additionally, the Government Accountability Office lists Medicare as a "high-risk" government program in need of reform, in part because of its vulnerability to fraud and partly because of its long-term financial problems.

In a letter from the Congressional Budget Office to Senator Charles Rangel of New York(http://www.docstoc.com/docs/8662052/CBO-Report-on-Cost-of-Health-Care-Bill), the conclusion by the CBO as well as the Joint Committee on Taxation is that enacting the current legislation before Congress would result in the net increase of the federal budget deficit by $65 billion over the next 10-years. I have heard the President’s supporters make the argument that this is acceptable because it is spread out over time. I fail to understand the logic of why going deeper into debt slowly is better than going in dept rapidly. Until the government derives new processes to eliminate the billions of dollars lost by Medicare each year due to fraud, Americans will continue to lose confidence in any new system that will add additional debt.

The reference made by the title of this article is two-fold. One – to use the concept of vision to execution by NASA of the 1960s to highlight successful government leadership and commercial industry partnership. Two – to emphasize the notion that any planned manned trip outside our solar system has to begin with a closer more achievable step; or rather, we have the government solve the financial and managerial problems within their own “managed” health-care programs before vilifying private industry and adding additional financial burdens to this country.

Health Care’s “NASA”

Once the President does come up with a clear vision for health care in this country, he should then take the responsibility for solutions away from the least capable entity (Congress) and give it over to a government agency that is qualified to understand the impact of medical care in this country – The National Institutes of Health. From there, I suggest that they work with private industry (pharmaceuticals, medical equipment, insurers, hospitals, etc.) and premier educational and research institutions to derive a real national solution in much the same way NASA worked with the research teams from universities as well as all major players in the aviation technology field to achieve President Kennedy’s clear and unambiguous vision.

Common Sense

I am a conservative, and as such, I firmly believe that health coverage for all Americans is important and necessary in the sense that if done correctly, I pay less in premiums and taxes, and I will see an improvement to the overall health of the people in my community leading to greater social and economic prosperity. I am also about fairness. Is it right to provide cancer treatments to a long-term smoker with lung cancer? Where does personal responsibility and accountability play in national health care? In the end, our compassion for our equally weak human brothers and sisters compels us to care and to eliminate suffering even due to our own unfortunate decisions, and most importantly to preserve all human life without the thought of expense.

This article is not really about health care; it is about the leadership required to achieve a national goal. An acquaintance of mine, George Owings, the former majority whip in the Maryland House of Delegates recently stated to me a wonderful quote, “we have had enough of ‘genius’, how about some common-sense?” Though he used this in the context of many other issues, his point is that those who believe that they think they know what is best for us due to their own perception of how smart they think they are seem to be missing the big picture. I will back George up with Ben Franklin who stated, “Genius without education is like silver in the mine.” Our “education” needs to start with a look back in history to a truly successful government-industry partnership. Only then will health care be truly universal.