The Plank

Health Care Reformers -- Don't Despair!

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We're going to take a moment from the debate about individual mandates in health care reform -- a topic to which I shall return soon enough -- to bring you some unambiguously good news.  If, that is, you think universal health care is a good idea.

Today the Service Employees International Union (SEIU) announced it would be launching a $75 million election-year campaign on behalf of universal coverage. According to the union's press release, which doesn't seem to be available online, the effort will feature paid advertising to "draw sharp distinctions between the Republican and Democratic presidential nominess' approach to health care, and what those differences will mean to working families." But it's not just a bunch of television and magazine spots the union has in mind. They're also planning to finance what sounds like a pretty substantial ground effort, including a rolling publicity tour to stage events across the country and an outreach effort designed to collect stories of hardship -- which, surely, will help spread the word about reforms, as well.

I honestly don't knokw whether $75 million counts as a lot of money for this sort of thing.  But, according to this old 60 Minutes story, the entire drug industry spent about $100 million on campaign contributions and lobbying during the fight over the Medicare drug benefit a few years ago.  So $75 million certainly sounds like a lot.

What's more important than the dollar amount, though, is the show of commitment -- and, in particular, the timing of it.  As veterans of the 1993-94 Clinton health care fight know, that effort failed was the fact that the political pressure came overwhemlingly from one side.  When the drugmakers, small insurers, and others opposed to the Clinton bill started running their advertisements -- which, yes, look suspiciously like an advertisement Barack Obama has been using lately -- the administration was largely left to fight back on their own. Expected support from unions and other sympathetic groups didn't materialize until it was too late.

The administration had itself partly to blame for this; a big reason unions didn't fight early was that they had spent most of 1993 fighting with the Clinton administration over the North American Free Trade Agreement (NAFTA).  The resources -- not to mention the desire -- to support the administration immediately afterwards just wasn't there. (For more on this story, see Ezra Klein's article here.)

This time, fortunately, it looks like the interest groups in favor of reform are getting an early start.  Probably no single organization has invested in the cause of health care refrom as much as SEIU.  And few, if any, have the combination of money and grassroots strength to have a serious political impact.  At a time when all of the fighting over universal coverage has many people (myself included) worried that its prospects are suddenly diminishing, this is a reminder the political pressure for it is only going to get stronger in the coming months.

--Jonathan Cohn

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