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CAPITOL PERSPECTIVES assist with the rollout of a product they abhorred and campaigned against. But bipartisan consensus could have been forged to delay implementation of the exchanges and its subsidies because that would produce savings in the 10-year budget window, which could be devoted to other priorities, such as repealing the fatally flawed physician payment formula, minimizing certain incorrigible ACA provisions, or reducing the deficit as part of a debt-ceiling compromise (a proposal later proffered in the House of Representatives' second attempt to raise the debt ceiling). And more strident Republicans could have viewed a delay of Obamacare as an installment toward repeal. But finding common ground between the parties on a controversial area like healthcare — and Obamacare in particular — actually requires dialogue between key policy makers. A conceivable conversation between key Republican and Democrat policy makers could sound like this: "You get a more orderly rollout of your signature achievement; we get a policy win on repealing an offensive aspect of that bill for which there is consensus — e.g. the medical device tax or the Independent Payment Advisory Board." Real, substantive discussions between policy makers of the two major parties should be initiated by the executive office — people running the country. For the administration to commence an uncomfortable and potentially embarrassing conversation of this nature, it must first examine the hard facts in a sober and analytical fashion. This requires the shelving of rote talking points designed to further political advantage and, instead, properly diagnosing a problem and starting to seek solutions. Likewise, the Republican fixation on repealing Obamacare in the face of intractable odds has also deterred effective oversight of the program and a bipartisan dialogue on how to reform it. Instead of holding congressional hearings and focusing the public's attention on the unfolding implementation debacle of Obamacare, Republicans chose to tie Obamacare defunding to funding the rest of government operations precisely on the day that enrollment commenced — Oct. 1. It was a remarkably poor decision and terrible timing. For all who can perform basic second-grade math, it was clear that Republicans needed not just 218 votes in the House and 51 votes in the Senate to defund Obamacare, but 290 votes in the House and 66 votes in the Senate. This two-thirds super-majority vote is what the Constitution requires to overcome a presidential veto. Even the most ardent opponents of Obamacare should acknowledge that President Obama was not going to sign a law repealing his signature achievement in which his name is now embedded. Senator Cruz's approach to defunding Obamacare was fundamentally flawed from its inception because there was no endgame. Republicans should not take unwarranted glee in the implementation challenges of Obamacare, as it indicates a very strong public interest in signing up for the new coverage, and the open enrollment will last for six months. But they should refocus on proper oversight of the program and be open to reforming the program, which will certainly have huge implications on their constituents and the fiscal health of the country. However, President Obama is the sole leader of the country. Flatly stating he will not negotiate, and refusing to acknowledge or comprehend the true disaster that is unfolding on his signature achievement, are no way to run the country. Republicans should not take unwarranted glee in the implementation challenges of Obamacare. John McManus is president and founder of The McManus Group, a consulting firm specializing in strategic policy and political counsel and advocacy for healthcare clients with issues before Congress and the administration. Prior to founding his firm, McManus served Chairman Bill Thomas as the staff director of the Ways and Means Health Subcommittee, where he led the policy development, negotiations, and draft of the Medicare Prescription Drug, Improvement and Modernization Act of 2003. Before working for Chairman Thomas, McManus worked for Eli Lilly & Company as a senior associate and for the Maryland House of Delegates as a research analyst. He earned his Master of Public Policy from Duke University and Bachelor of Arts from Washington and Lee University. He can be reached at jmcmanus@mcmanusgrp.com. 12 LifeScienceLeader.com November 2013