“Reform” is another word of cavernous uncertainty into which falls many a good idea, never to return.
On its face, we should expect anything that’s reformed to look different when we’re done but not be fundamentally different. To reform a thing is, after all, not to transform it.
But sometimes the vagueness of “reform” is used so as not to scare those who are potentially harmed by the details of systemic change.
Welfare reform in the 1990s reduced benefits for millions and denied benefits for many more. But it was politically popular, even among some who were demonstrably harmed.
This is because it’s much easier to sell “a necessary reform” than “a massive transformation.” “Massive transformation” sounds dire, even if it’s better.
Note how critics of the Affordable Care Act used terms like “radical restructuring” to describe a bill that, in the end, left most of our current health care system intact.
And it worked: the ACA, while dutifully serving millions of people, remains extremely unpopular.
Interestingly, when Hillary Clinton first spearheaded efforts to change health care during her husband’s administration, she used the word “reform.” And it terrified Newt Gingrich enough to begin torpedoing it almost immediately.
If the basic premise of this commentary is correct, Gingrich was scared because backed by the soothing ambiguity of the word “reform,” Hillary’s efforts just might have worked.
A market-based counter-proposal for health care reform eventually gained traction under Mitt Romney in Massachusetts, and, from there, became the inspiration for none other than the Affordable Care Act.
So, perhaps the most interesting outcomes of “reform” are the ironies it creates in the details it hides.
