THE PLANK JULY 20, 2009
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Ed Kilgore is managing editor of The Democratic Strategist, a senior fellow at the Progressive Policy Institute, and a frequent contributor to a variety of political journals.
It's becoming increasingly obvious that not only wholesale Republican opposition, but Democratic divisions, are risking the enactment of health reform legislation this year. Some of those divisions are rooted in relatively narrow objections this or that bill--e.g., jurisdictional squabbles between committees or between House and Senate approaches--or this or that provision--e.g., union opposition to taxation of high-end employer-sponsored health benefits. But the bigger division which falls roughly along ideological lines involves "moderate" Democrats (sometimes, as in last week's Senate "gang of six," working with like-minded Republicans) who seem to prefer delaying action on health reform to enactment of anything that vastly increases federal budget deficits, fails to reduce health care inflation, or exposes Democrats to conservative attacks on "big government."
It's fair to say that the prevalent attitude among other Democrats towards these "moderates" is one of anger and betrayal, on the theory that only political cowardice or total submission to the health care industry could possibly explain their point of view. And one talking point heard often in denunciations of Democratic foot-draggers on health care is that as "everyone knows," the failure to enact health reform in Bill Clinton's first two years caused the Democratic midterm debacle of 1994. Steve Benen, for example, stipulates this assumption about 1994 and quickly goes on to suggest that maybe "centrist" Democrats don't really give a damn if their party loses seats or even control of Congress in 2010. This attribution of evil motives is also more-or-less incorporated by reference in an otherwise fine post today by TNR's Jon Cohn on the Democratic politics of health reform.
As someone with still-vivid memories of 1994 and of the raging and inconclusive debate that ensued about the origins of that electoral debacle, I have to say that no, it's not at all self-evident that the failure of a Democratic-controlled Congress to enact universal health coverage was the primary cause. For one thing, there was a lot going on in November of 1994--a vast number of Democratic retirements, the final stage of the ideological realignment of the South (exacerbated by racial gerrymandering in the House), and residual resentment of a Democratic majority in the House that had been in place since 1954. But even if you believe health care was the single largest factor in the 1994 results, it's not entirely clear that the failure to enact health reform, as opposed to the unpopularity of the reforms being proposed (not to mention the timing of the health care debate, which in 1994 was on the very brink of the midterm elections), was the predominant factor.
And even if health care was the predominent factor, it's not at all clear that the defeat of the Clinton health plan, as opposed to the composition and presentation (at least as perceived by the public) of the Clinton health plan, was the vote-killer. Yes, there has always been a point of view in the debate over 1994 that "disappointment" over the Clinton administration's strikeout on health care, compounded by other White House strategic decisions (most notably the promotion of NAFTA and GATT and the prioritization of deficit reduction at the expense of "investments" in the budget), "discouraged" the Democratic "base" and led to conservative-skewed turnout patterns in 1994, and depressed Democratic performance among those who did turn out. But it's just a point of view, not incontrovertible fact. A Kaiser Family Foundation election-night survey in 1994 that focused on health care reached a different conclusion:
The survey shows that the voters' vision of health care reform has shifted toward that held by many moderate Republicans and Democrats. Thirty-one percent of those surveyed said they were less supportive of major health reform than six months ago, with half of those citing as their reason that they did not think the government would do it right. More voters now want Congress to make modest changes in the health care system (41%), rather than enacting a major reform bill (25%). In addition, one in four voters favor leaving the system as it is. [Tables 4 and 5]
"These results say that voters want the new Congress to place health care high on their legislative agenda," said Dr. Robert Blendon, Professor and Chairman of the Department of Health Policy and Management at Harvard University. "But what the public means by health reform now comes closest to a more moderate vision: one which is more limited in scope, incremental, and that involves a much more limited role for government."
My point here is not to argue that this or that theory about 1994 is the gospel truth (though I personally think there are elements of truth in the "discouragement" and the "rejection of big government" theories, along with non-issue explanations). It's that I wouldn't buy the idea that go-slow Democrats today know their position on health care will produce an electoral disaster, and just don't care. For every good, loyal Democrat who has internalized the "discouragement" narrative about 1994, there's another good, loyal Democrat who "remembers" 1994 as a tale of an "over-reaching" White House and an arrogant congressional Democratic leadership who relied on a secretive process to produce a highly complex health plan that was then marketed as a giant new government entitlement, repelling swing voters.
In the end, motives for the current behavior of Democrats on health care only matter so far. As it happens, I favor the argument that Senate Democrats ought to be pushed (with real consequences) to support a cloture vote on health care--and on climate change--no matter how they feel about the underlying legislation, which would make it a lot easier to get something done.
But the intraparty debate will become an unfortunate dialogue-of-the-deaf if the contending factions base their political assumptions about the consequences of various courses of action on health reform are based on different interpretations of an election held fifteen years ago.
--Ed Kilgore
[Cross-posted from The Democratic Strategist]
13 comments
Jonathan Chait reminds us what it was like in the 1960s, when Ronald Reagan fought Medicare. Ed Kilgore
- Anonymous
July 20, 2009 at 1:59pm
50 million plus people uninsured and more underinsured, these are reasons enough for these "moderates" to get off their asses and allow and up or down vote on the package. I honestly do not understand why these people are even democrats if they are so conservative to spike health care reform.
- blackton
July 20, 2009 at 2:26pm
The acid test of health care reform is whether it will lower the cost. Pundits sometimes forget that the escalating rise in these costs is as much due to unchecked greed as is due to technological advances. The public knows this better than politicians who depend on the medical-industrial complex for campaign contributions. So far, Obama and his supporters have done a poor job in selling their plan as a means to dial down excessive costs, concentrating much more on payment arrangements than on lowering the overall bill.
- nbarry
July 20, 2009 at 2:51pm
Plus ca change, plus c'est la meme chose. The change is that in 1993-94 a liberal Democratic president cooked up a comprehensive solution and couldn't sell it to a more moderate Democratic caucus. Now a liberal Democratic president is passing the baton to a Democratic caucus that is far more liberal than in Clinton's time, and maybe more liberal than the president himself.
The meme chose is that the more da peepul look at congress's work, the less they seem to like it. Two massive bills have passed in the House without members having a meaningful opportunity (assuming they were so inclined) to find out what's in them. Clearly, the president and the leadership want to pass a third massive bill without time for prudent consideration. Voters are watching, and it has not been pretty to watch.
The Rs were decimated for fiscal imprudence, visibly including gross misuse of earmarks, and corruption. The Ds appear determined to appear at least as imprudent and corrupt. If, as now seems quite possible, unemployment remains above 9% as the midterm elections approach, expect to hear more and more grumbling about the pork content of the stimulus bill.
If it is true that 90%+ of the people aren't rich and got the impression that the Rs were too kind to the rich, might it not also be the case that somewhere around 90% of the people are not members of unions and are getting the impression that the Ds are too kind to unions? Voters understand that each party is solicitous of its base, but they react negatively when they get the impression that a party is "owned" by its base. Look at the Rs! The plaintiffs' bar is another untouchable group. Can't ask them to make any sacrifice on the altar of health care cost containment.
The Democrats political strategy is looking more and more like something a Karl Rove would conjure up.
- lsernoff
July 20, 2009 at 2:56pm
Amen Blackton. With thier greenlighting of Bush's stupid, useless spending, they have no business blocking something the country desperatly needs out of sudden concern about cost.
When did these mealy-mouthed cowards ever ask Bush once about the costs of his assinine bills? When did ANYone on Capitol Hill? Shame on them, how they sleep at night is beyond me. Those Senate seats must be blinding, people literally sell their souls to keep them.
- Wandreycer1
July 20, 2009 at 2:56pm
Blackton....the sad thing, for me, is that many of these Blue Dogs are trying to cater to the more conservative voters in their swing districts, but these are not the people who vote for them, anyway. They seem to be trying to seduce the woman at the bar who isn't interested in them, won't go home with them under any circumstances yet ignore the loyal one that is always waiting anxiously at home.
- desertdog
July 20, 2009 at 3:04pm
Folks, I suppose I should be enjoying this dialogue, but I'm not. One party--the one with which I am ostensibly affiliated--has all but driven moderates, social and fiscal, out of its ranks. Is the other party going to do the same? While in congress, Rahm Emmanuel, expended an extraordinary amount of energy in finding moderate and conservative Democrats to run against moderate and conservative Republicans. He succeeded brilliantly. Do you want Republicans back in those seats?
Remember, most of the historic legislative achievements of Democratic presidents in the 20th century came with Democratic congresses that were
far more conservative in numbers and politics than this one. At least wait for a concrete bill to emerge before you start thinking about excommunications.
From my perspective, I'd be delighted to see some of those old Rs back. But I fear our activist base would serve up more Jeb Hensarlings instead.
- lsernoff
July 20, 2009 at 5:04pm
Yawn.
Yet another rhetorical focus on the cardboard characters in Congress to explain the melodramatic tug of war unfolding on healthcare in Washington. You'd think Ed Kilgore was channeling Dr Phil as he delves [ever subjunctively] into the motivation behind the "Gang of Six" and the "moderate" Democrats and Republicans; those, for example, who dare to take a principled stand against "Big Government".
Wow!! Who will prevail!.....Who will blink!
You read this stuff and you keep wanting to tap Ed on the shoulder: "Ed, what about the insurance lobby and Big Pharma? what about the healthcare industrial complex? What are the 'principles' they are defending here? How about the nearly 400 men and women once employed as Congressional staff members who have been whisked through the revolving doors and now lobby for the folks who are, well, less than principled?"
For example, the folks who have situated the center of the universe around making as much money as they possibly can from the medical maladies of the masses?
Behind the scenes, I figure something like this is now unfolding in Washington:
Folks from the healthcare industry are going back and forth with their political ccounterparts [the Rahm Emanuels] to determine what the new medical model will look like when Obama passes out all the pens at the signing statement. If they are able to preserve...more or less...their own profitable priorities, sure, they'll make the necessary adjustments. But if the talks break down because they are convinced they can't, we will be reading a lot more "profiles in courage" as the narrative shifts back to Harry and Louise: "The Socialists are coming! The Socialists are coming!! The Socialists are coming!!"
Your call, Ed.
george walton
- iambiguous
July 20, 2009 at 5:57pm
lsernoff, Do you want Republicans back in those seats? To be honest, yes. Then we could know where we stand as a nation. I am a very big tent Democrat, you support the war in Iraq, fine. You are against abortion (Bob Casey Jr.) welcome. There are a million issues where I have no objections about what side of the issue you take, but it seems to me that Republicans run as the party of small government, Democrats as the one of big government. GWB tried to be a big government Conservative, that was insane, that is like trying to be a small government Democrat, it does not make any sense. A small government Democrat is a libertarian, there is a libertarian party, let them join that, or let them become Republicans, either way, they are not Democrats. So yes, I would rather a Republican be in those seats.
- blackton
July 20, 2009 at 6:44pm
blackton; Thanks for your candid response. I disagree with you, but I respect your forthright opinion. I do not agree that Blue Dogs are "small government" enthusiasts like libertarians, but if you don't want them send them to us. Who knows? There may come a time when we retrieve the Grand Old Party from the noisy, nativists, homophobes and other zealots.
- lsernoff
July 20, 2009 at 10:48pm
lsernoff, the sooner, the better. I agree that Blue Dogs are not so much "small government" folks as they are fiscally responsible, pay go and all that. Concord Coalition types. And yes, I'd love to see Republicans in those seats, to pull the GOP away from the hard right.
- butchie b
July 21, 2009 at 10:24am
I was an enthusiast of Clinton style new Democrat, which is indistinguishable from Rockefeller style old Republican. Both these moderates were hated by the hard core extremists in their respective parties. So now we have we have far right Republicans and far left Democrats, neither of whom really want to listen to the other side of any argument. We will get more done if the 2010 election is a rerun of 1994. Clinton and Gingrich got a lot done together even though they despised each other. Maybe if Obama has a loyal opposition, he will emerge as the Centrist the country thought it was electing.
- r.ennis
July 21, 2009 at 2:48pm
I encourage readers of this string to take a peek at the comments (162 as of this writing) to John Judis's "Make Them Pay" piece. Whatever you think of any one of them, I suggest that they go a long way to explaining why Rep. Clymer, of all people, is distancing himself from talk of tax rises. Bear in mind, that these are comments filed to a TNR piece. Allow for free riders, these are people who take the time to read a rather esoteric liberal journal and then to file extended comments.
So as not to bore people, I adopt my above comments on the political lay of the land without restating them. Here are some new observations: Republicans luuuuuuuuuuvvvv "small business". Democrats are far less enthusiastic. Why? I think a major reason is that small businesses are harder to unionize, and therefore apt to pay lower wages and offer fewer benefits. By itself, that is not irrational. But, unionization has been dying along with the old, oligopolistic manufacturing industries. The principal area of union growth is public employees. Is that group the springboard to economic growth? This Republican has no illusions that all small businesses are run in an enlightened manner. That said, I know that small business has been the major engine of economic growth in this country for decades. The new generation of big businesses were small businesses in the lifetime of most TNR readers.
Now a word about taxes. Let's put aside those who reflexively begrudge a marginal extra buck out of their hard-earned gains; let's also put aside those who always want them that's got to give more to them that's not got (for any number of reasons). We have had a progressive tax regime in this country for a century, generally with sufficient popular support. For more than two decades the top rate has moved up or down in relatively small increments. Even the most rabid partisans know big changes aren't possible in today's global competitive environment. The earnings to which the FICA tax applies can probably be raised without undue political turmoil. The income tax? I don't think so.
- lsernoff
July 21, 2009 at 7:17pm