WILLIAM GALSTON JANUARY 22, 2010
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In the wake of Massachusetts, President Obama faces two urgent decisions. One concerns his agenda for 2010 and beyond. I offered my advice on this last week, have not changed my mind, and won’t repeat myself.
The president must also decide how to proceed with health care legislation. Here I find myself in a paradoxical position. In this publication and elsewhere, I have argued since October of 2008 against beginning the new administration with an ambitious agenda that included comprehensive health reform. Nonetheless, I believe that the president and congressional Democrats would be ill-advised to shelve the effort at this point. Here are my reasons.
First: At the most basic political level, turning tail and running for the tall grass is bound to fail. Democrats who have already voted for health reform (and that’s most of them) can’t take their votes back. Whatever they do between now and November, they’ll be called on to defend what they’ve done. Are they going to say that they’ve changed their minds? Who would believe them?
Second: The American people won’t support representatives they don’t respect. The people respect sincerity, consistency, and strength of purpose. It is often the case that constituents will respect positions with which they disagree—if they think their representatives really mean it. One thing is clear: They won’t respect vacillation and weakness. Does anyone?
Third: The president and congressional Democrats have spent the past year arguing that health reform is in the national interest—that it will broaden coverage, begin to contain costs, increase disposable income, and help improve the government’s long-term fiscal outlook. Which of those arguments ceased to be true between Monday and today?
Fourth: The Founders designed a representative republic, not a plebiscitary democracy. Officials are elected to make judgments on behalf of the people, and the people get to judge those judgments. Large changes are always more uncertain than is the status quo, which is why change is so hard. At some point, elected officials have to tell their constituents, “I’ve done my best to think this issue through, and this is the conclusion I’ve reached. Now it’s your turn.”
There are two cogent arguments against the position I’m defending. The first is that there’s not nearly enough trust in government to sustain comprehensive health reform, and ramming it through in the face of public disapproval will only intensify mistrust and make matters worse. The shortage of trust was a compelling reason not to go down this road in the first place--especially in the context of necessary but expensive and unpopular measures needed to ward off a second Great Depression--but it doesn’t resolve the question of what to do now. It’s a judgment call: Are you more likely to begin rebuilding trust by sticking to your guns--or by in effect saying that you weren’t really that serious about the most important piece of social legislation in decades?
The second counterargument is that elected officials have involved the people in a year-long discussion about health reform, and the people have rendered their judgment, first in public opinion surveys, then in Massachusetts. Proceeding in the face of this judgment, the argument goes, is a gross violation of small-d democratic norms. This brings us back to the issue of the nature of our political system and the principles of conduct it embodies. One might argue that by the fall of 2006, the American people had rendered a negative judgment on the Iraq war and that George W. Bush’s decision to double down with the troop surge was undemocratic. Well, speaking as someone who publicly opposed that war well before we entered it, I have to say that I respect President Bush for making the decision he did ... and that it was probably right on the merits. Yes, it’s one thing to be the chief executive, another to be a member of the House. But that difference doesn’t mean that it’s always wrong, or undemocratic, for Congress to exercise independent judgment.
So what is to be done? President Obama’s opening post-Massachusetts gambit--his interview with George Stephanopoulos--was not helpful. Consider the following statement: “I would advise that we try to move quickly to coalesce around those elements of the package that people agree on.” Which people? If he means the American people as a whole, I’m not sure what that proposal amounts to. Sure, everyone would like restraints on insurance companies and constraints on costs increases (the two areas the president cited), but you can’t get them without other things that many people don’t like, such as costly coverage expansion and increased regulatory bureaucracy. If he means Democrats and Republicans in Congress, the zone of agreement is near zero and likely to remain there until November. Given the success of their obstructionism so far, why would Republican leaders change course? And after the failed negotiations in the Senate Finance Committee last year, who believes that Republican moderates would break ranks now? As for focusing on areas of agreement between House and Senate Democrats, I thought that’s what the discussion up until Monday was all about.
If the president sounds such an uncertain trumpet, who will follow? If he still wants legislation, he should invest the full authority of his office to persuade the House to endorse the Senate bill, accompanied by a package of amendments to be considered separately under the reconciliation process. If he has concluded that he has no choice but to take the issue off the table, he should say so. If he continues to utter hopeful banalities devoid of concrete meaning, the fragile reform coalition will collapse within days, with consequences that will endure for decades.
21 comments
Yup. The Dems have already taken the plunge, and trying to change that halfway down will only result in a bigger belly-flop. This is clearly gut-check time for the party. I can't imagine anything they might do to gain Republican support at this point, but that doesn't automatically mean a wipeout in November. Like they say, "never murder someone who's committing suicide". The Repubs are now liable to violate this rule and mitigate the scope of the disaster. But any way it goes it's hard to see how Dems can avoid the charge that they are congenitally incapable of effective governance.
- Robert Powell
January 22, 2010 at 5:20am
"But any way it goes it's hard to see how Dems can avoid the charge that they are congenitally incapable of effective governance." They certainly are within a hair's breadth of convincing this loyal, lifelong progressive Democrat. Nearly as I can tell, the Democratic Party is not a political party, it's a rabble sharing a name of convenience. Do either the blue-dogs, or the left wing of the party, even recognize the CONCEPT of leadership? That governing as a party requires them to compromise their own pet ideological positions a bit in order to be effective? That following your leadership, and thinking about how shooting off your mouth before the the leadership articulates a party position, compromises EVERYTHING you might want to do? Unfortunately, the answer appears to be no.
- sdemuth
January 22, 2010 at 8:06am
While I disagree with Galston's statement that it wasn't the right time to tackle health care reform (seriously, if it isn't the right time when you have the Presidency and the largest Congressional majorities in decades, then the right time will NEVER arrive), I agree with his assessment here. Congress and Obama need to screw their courage to the sticking point and pass this thing. They already taken the political hit; they need to show a policy success.
- zardoz67
January 22, 2010 at 8:22am
Ame to everything above. The US House of Representatives needs to Grow A Pair and pass the Senate bill. The Democratic party will be fast-tracked to a permanent minority status if they fail, especially after being so fricking close.
- desperjm
January 22, 2010 at 11:29am
1- No, he WAS correct to pursue health care. 2- Yes, he can NOT abandon it now. 3- Sometimes you have to lead. Don't be defeatist, please--enough of the instant gloom and regret--even if your analysis has some wise things in it about how American opinion gets herded, (And PS The Mass Senate race was NOT a plebiscite about health care or Obama. People are overlooking potent irrational personality factors that played out there.)
- atlasqq
January 22, 2010 at 11:35am
Galston's article is a textbook case of whats wrong with TNR---as well as the Democrats. I've subscribed for over 40 years. TNR used to be one of two or three publications reliable advocating sensible Progressive positions. No longer. Advocating Lieberman fior Pres, invading Iraq, escalating Afghanistan, and no decent health care reform (for starters) sure says a lot about TNR. The small number of readers comments compared to other publications further indicates tnr's lack of relevance. As for Democrats, if they don't break the filibuster NOW, they're toast with respect to passing and reform of health care, greenhouse gas emission, banking practices, whatever. And don't give me BS about "can only do at beginning of Senate sessions -- or needing 67 votes". The nuclear option is available any time for 50 Senate Dems + the VP that have at least one set of cojones to share among them. Maybe Pelosi has an extra pair to spare? If there are not 50 votes to end a filibuster, then passing bills or amendments to really reform or improve health care, climate change, judicial nominations, whatever, are going to be dysfunctional exercises in "pass inadequate bills and pronounce those bills as ground-breaking". And hope the American voters don’t notice. Voters on average may be generally uninformed, but they are not THAT dumb. In health care and other issues, Obama and Senate Democrats , most Pundits, and many Broderesque -bloggers constantly reinforce a meme that liberal or progressive Democrats are easily rolled by those making intransigent demands. This reinforces a long-standing meme to which Galton refers that Progressives/Liberals are wimps, wusses, chumps-- pick your term. McCain, Coker, DeMint and most Republicans may be batshit bonkers pushing insane ideologically-based solutions, but they appear very willing to take a lot of flack to push their agenda. With respect to (say) Iran, do you vote for a military solution that probably wont work advocated by insane ideologues who will stick to their guns-- or a more nuanced position advocated by those who will fold at the slightest pushback?? And your surprised that lots of voters chose the former??
- gdbittner
January 22, 2010 at 11:59am
Democrats are going to get hammered in the fall (and take seat losses) anyway so they might as well coalesce and drive the truck to its destination. Given the cards he's been dealt Obama has not, in my view, done all that badly. To let this evaporate now creates a new two-party system: the Reckless Party v. the Feckless Party. Many, many people will prefer the former to the latter. House Democrats: pass the Senate bill, like yesterday!
- cforeman
January 22, 2010 at 12:03pm
"TNR used to be one of two or three publications reliable advocating sensible Progressive positions. No longer." "No decent health care reform (for starters) sure says a lot about TNR." A minor point: we're not talking about a statement made by TNR editors but by William Galston on his personal blog. "The nuclear option is available any time for 50 Senate Dems + the VP that have at least one set of cojones to share among them. Maybe Pelosi has an extra pair to spare?" Correct. But in that case, let it be a real health care bill and not an insurance companies rent for life bill.
- luispc
January 22, 2010 at 12:29pm
gdbittner, not that I give a hoot about Corker, but he and nine other Rebubs were co-sponsors, along with ten or so Dems, of the Wyden-Bennet Healthy Americans Act. Maybe they just think it would have been good policy. Obama chickened out, saying it was too radical - a bill with bipartisan sponsorship from 1/5th of the Senate.
- ds111
January 22, 2010 at 4:07pm
Mr. Galston says, " . . . elected officials have involved the people in a year-long discussion about health reform, and the people have rendered their judgment, first in public opinion surveys, then in Massachusetts." In public opinion polls, respondents have indicated support for meaningful reform following a proven cost-effective model: A Kaiser Health Tracking Poll of July 2009 found that 58% favored "Having a national health plan in which all Americans would get their insurance through an expanded, universal form of Medicare-for-all." Only 38% opposed. Middle America and progressives in the House oppose the Senate bill because it's a product of backroom deals and is designed to pass taxpayer funds to insurers. As for the Mass results, I am convinced that health care was not the issue. The Democratic leadership simply dropped the ball. There's a certain insular arrogance in Washington (witness Sen. Baucus' treatment of single payer advocates, and Rahm Emanuel's treatment of just about everyone.) One senses a disdain for the electorate, and unfortunately the feeling is fast becoming mutual.
- hmseil01
January 22, 2010 at 7:24pm
It's feckless analyses like Galston's that make me want to hit the 'unsubscribe' button.
- ed.maguire
January 23, 2010 at 3:22am
It's feckless analyses like Galston's that make me want to hit the 'unsubscribe' button.
- ed.maguire
January 23, 2010 at 3:23am
Tip of the hat to ds111. Wyden-Bennet was my preference at the beginning of this, and has many excellent features. Not least, significant bi-partisan support.
- Robert Powell
January 23, 2010 at 11:51am
I suspect rp that you meant to post that over on "The Abyss" where ds11 was discussing Wyden-Bennett and where I said this in response: ds111, My very quick internet search on the Wyden-Bennett bill suggests that it was a decent alternative, probably a better alternative, to what emerged. So, you explain to me, as I cannot see on the face of things, why this bill did not move forward. What was the source of the political opposition? I don't believe for an instant that it was because the Republicans would share credit, as you suggest, since that is what the Democrats have been desperately trying to get the Republicans to do. To believe your story, one has to believe that the Democrats spent six-months trying to get even a single Republican supporter in the Senate with the real agenda of alienating all the Republicans so that the bill could only be passed with 100% Democratic support that required some hideous compromises that no one could stand. Not plausible.
- roidubouloi
January 23, 2010 at 6:50pm
I don't think, and didn't imply, what you describe as "my story" roi. I frankly don't know why Obama didn't get behind Wyden-Bennett, but ds111 says it was because he thought it was "too radical". Hard to see how that's possible for a bill with such widespread support, so maybe it was because he deferred to Reid and Pelosi. In any case, I'd advocate getting behind this bill right away and running with it. One possible silver lining here would be to dump the current Dem Congressional leadership while there's still time...
- Robert Powell
January 24, 2010 at 3:04am
He was absolutely correct to pursue health care. Where he screwed up was during the campaign, where he started getting people to think that we could cover more with better coverage for less. Of course, the man has never managed anything substantive prior to the election, so it's not like he has a lot of experience to fall back on. A great first effort would be to get the entire country covered with a $10,000 high deductible policy without any limitation on pre-existing conditions. Something like that would cost perhaps $1500/person/year, or $45B annually to cover the 30M citizens without coverage. Those with insurance already have it. It could be financed with a ~$450 tax on every taxpaying household. The wealthy could pay $900, the poor pay nothing. With that, we ensure 1) Everyone is covered for serious illnesses 2) Nobody loses their house due to cancer, diabetes, heart disease, etc. 3) We have a framework to bring the $10,000 limit down each year. 4) Those that are above medicare could get a modest "matching" subsidy such that for each $1 they are billed, they co-share 50/50 with government. 5) We have a serious mechanism in place for cost control. As the system savings kick in, the $10,000 limit can be lowered. If the savings don't materialize, the $10,000 limit is raised. It could have been so simple. So straightforward. So helpful to so many families. Instead, they went for the big enchilada and screwed everything.
- SeattleEngineer
January 24, 2010 at 4:35am
From above: A Kaiser Health Tracking Poll of July 2009 found that 58% favored "Having a national health plan in which all Americans would get their insurance through an expanded, universal form of Medicare-for-all." Only 38% opposed. If you aren't asking the person how much they will pay, then the poll is irrelevant. Other polls have asked "How much are you willing to pay for health care reform" and the answer is "about $800/year". Medicare for all would cost quite a bit more than that.
- SeattleEngineer
January 24, 2010 at 4:44am
I was describing ds111's story, RP, not yours. I do not find it plausible, as ds111 suggested, that the Democrats spurned a plan, Wyden-Bennett, little different in broad outlines than the one adopted for the purpose of getting the GOP to oppose it lest the GOP then take credit.
- roidubouloi
January 24, 2010 at 7:31pm
To this day, it is absolutely obscure what the GOP "wants" other than to eliminate subsidies, eliminate cost controls, and eliminate anything that would create more competition in the insurance market -- that is, what the GOP wants is to eliminate anything of consequence in the health care bill. Do you suppose that if the GOP said, cut down the cost by mandating a high deductible for subsidized policies that the Dems wouldn't leap at the chance? What should be obvious is that no one has the foggiest idea what the GOP thinks would make sense because the GOP has been careful never to propose anything -- only to tell the most outlandish lies about what the Democrats have proposed.
- roidubouloi
January 24, 2010 at 7:34pm
It seems to me that one main difference between Wyden and the Senate bill is that the former is much more oriented towards administration by the states. The Reid/Pelosi "strategy" seems to have been to peel off a few easy Republican votes in passing this bill, yielding more power to Washington and more credit to "their" Congress. Obama seems to have concluded that Clinton's healthcare proposal failed because much of it was done in the back room, and the Democrat Congress felt cut out and sabotaged it. So he turned the bill over to his Democrat Congress, which went into the back room, cut nearly everyone else out, and sabotaged it.
- Robert Powell
January 25, 2010 at 1:30am
This notion that Reid and Pelosi or any of the Democrats sit around rubbing their hands together and licking their lips over just how much of the US economy they can "centralize" in Washington in order to "get credit" is just Republican propaganda. That's there meme: "The Democrats don't care what they do so long as all power is centralized in Washington. We Republicans want personal freedom and local control, except when the locality or the individual wants to do something we don't like. Then we Repblicans in Washington want to tell them what to do and how to live, how to run their schools, their sex lives, whatever." Even if you were absolutely right about Reid and Pelosi, do you suppose that the country would give them more "credit" for a successful plan "yielded more power to Washington" than a successful plan that didn't? At least when I say the Republicans have a strategy of obstructing Obama and the Demcrats, I can give a plausible account of their motivation -- to prevent Obama from doing anything that would be popular so that the will be easier to defeat and to "demonstrate" that the Democrats are incapable of governing by making it impossible to govern. This canard that the Democrats place "yielding more power to Washington" is really just silly. There is no plausible motivation for them to think more "power" in Washington in the form of more bureaucracy or more money flowing through the Treasury is to their advantage. It not only is not to their advantage, but it is ridiculous to suppose that they think they will be more popular for doing so. It is tough to know because there aren't three people who understand all the implications of these various bills. My case is that W-B had elements the were politically unsalable, regardless of the fact that there were Republican supporters (such as detaching insurance from employment which we certainly should do) and was probably also the legislative equivalent of a perpetual motion machine -- a declaration of all things good and wonderful that could not possibly be implemented at a manageable cost. Hence, easy for people on both sides to sign onto. Who wouldn't want free energy?
- roidubouloi
January 25, 2010 at 7:36pm