As a salute to the historic passage of health care reform in the United States, a story that this blog has been tracking, I want to recall something that Senator Barack Obama ( as he then was) said in 2008. It was in the course of his epic battle with Senator Hillary Clinton (as she then was) for the presidential nomination of the Democratic party. You will recall that the two of them debated health care reform interminably in those months. The issue was: was health care reform merely a problem of technical design?
"There is no shortage of plans out there. There is no shortage of policy papers. This is not a technical problem. It's a problem of politics. It's a problem of getting a big enough coalition of people who are organized, inspired, mobilized and will then put pressure on those who are elected in order to get it done." (Governance Reform Under Real-World Conditions, p. 2).
Now that health care reform is passed we can reflected on the power of that statement, and think about how governance reform is typically pursued in international development.
I am confident that when Obama said that health care reform was not a technical problem he did not intend to denigrate the fundamental importance of the technical work you need to do. What he was saying was: people have done that, we know what the fix is. The problem is how to get it done in the face of a powerful blocking coalition, and an electorate a large section of which can so easily be persuaded to vote against their own interests. He was saying: reform is not merely a technical problem. Reform is a problem of politics. And we can all see that, at the long end of the struggle, the political skills of the leaders of the reform coalition delivered the historic change. It was a brutal, noisy struggle. A few weeks ago the effort appeared to have failed utterly.
The current president of the United States in unique in many respects (to put it mildly!), but one of the ways in which he is singular is in being both a technocrat and a master-politician. Most governance reform efforts are not so blessed. So, when, as we still mostly do, we treat governance reform as a technocratic challenge, we are paying mere lip service to pro-poor social and political change. We become serious about reform only when we take politics seriously and support the coalition building efforts necessary to improve the chances of reform efforts around the world. May that day come.
Photo Credit: Flickr user Alex E. Proimos