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Obamacare's Threat to Liberalism

Illustration by HR-FM

There’s a term of art that the Obama White House uses to describe its neurotic supporters who instantly race to the worst-case scenario: They are known as “bed-wetters.” Two months into the dysfunctional life of, however, that seems a perfectly appropriate physiological reaction.

Liberalism has spent the better part of the past century attempting to prove that it could competently and responsibly extend the state into new reaches of American life. With the rollout of the Affordable Care Act, the administration has badly injured that cause, confirming the worst slurs against the federal government. It has stifled bad news and fudged promises; it has failed to translate complex mechanisms of policy into plain English; it can’t even launch a damn website. What’s more, nobody responsible for the debacle has lost a job or suffered a demotion. Over time, the Affordable Care Act’s technical difficulties can be repaired. Reversing the initial impressions of government ineptitude won’t be so easy.

When the modern liberals first emerged in the early twentieth century, they conceded that they began their ideological race with a severe disadvantage. As Herbert Croly, the founding editor of this magazine, diagnosed: They were living in Thomas Jefferson’s country, not Alexander Hamilton’s. The prevailing ethos was leave-us-alone libertarianism—or, as Croly put it, “licensed selfishness.” The country wasn’t accustomed to thinking of itself as a national entity, and it certainly wasn’t ready to be governed by one.

The onus, in other words, was on liberals to prove the concept of government. And while their ideas for what the state could accomplish were often quite vague, they made confident claims about their capacity to implement them. Back when Woodrow Wilson was a professor at Bryn Mawr, he published a seminal essay extolling “the science of administration.” His case was characteristic of the times and the ideology he helped shape. Wilson imagined technical experts, the new breed of social scientists emerging from the universities, who could help steer the economy. He would come to see these experts as a bulwark against the predations of corporations and protectors of the “man on the make.” Government efficiency became something of a slogan for the movement. When Teddy Roosevelt thumped his fists before the Progressive Party convention in 1912—the moment he pandered hardest to the nascent liberalism—he invoked efficiency 22 times, rallying the throngs of reformers behind what he called the “cause of human rights and of government efficiency.”

There was an unstated reason liberalism embraced these concepts: If liberals wanted the federal government to take on big new projects—more to the point, if liberals wanted taxes to pay for them—they needed the public to believe that the money would be well spent. It was more comforting for people to feel as if disinterested technicians, not party hacks, were going to be running the show.

And, for a while at least, the rhetoric helped firm up the legitimacy of the growing state. Nor did it hurt that the mobilization for World War II provided one of the great demonstrations of government prowess in human history—and that, after the war, even centrist Republicans paid obeisance to the accomplishments of the New Deal. In 1964, the government registered its highest popularity in the polls. That was followed by two of the most fecund years in the history of social policy: Both Medicare and Medicaid were born then. (Wilbur Cohen, the social scientist who engineered Medicare, liked to quip that his work was “one percent inspiration and ninety-nine percent implementation”—an aphorism worth tacking on the doors to the West Wing.) This moment evaporated quickly and faith in government soon began a long downward slide in the polls. Vietnam and Watergate hardly reflected well on Washington, stagflation seemed the product of incompetent economic management, and the rising racial resentments of the white working class created an ungenerous mood.

The more people lost faith in the power of the state, the more the party of government suffered. A generation of Democratic electoral losses spurred a cottage industry of makeover artists who urged liberals to try on new ideological suits. Of course, the most successful of these was Bill Clinton.

On its surface, his Third Way seemed a rejection of the old technocratic impulse. He talked endlessly about personal responsibility and his aides emphasized their deep respect for markets. This opened the president to criticism from the left, which believed he had coldly abandoned the basic tenets of liberalism. That wasn’t quite right. Despite “ending welfare as we know it,” Clinton still believed in activist, redistributionist government. It’s just that the political landscape had changed too much for him to be direct about it. The only way he believed he could help the working poor was through unorthodox measures—tax credits, partnership with the private sector—all of which unintentionally increased the complexity of the state and made it hard to know when the government was actually working on the citizens’ behalf.

Before he became president, Barack Obama professed to disdain this style. He removed his name from a list of Democratic Leadership Council supporters. Ronald Reagan, he later told a Nevada newspaper, had changed “the trajectory of America . . . [in] a way that Bill Clinton did not.” But his allergy to the Third Way turned out to be more of a talking point than a governing reality.

Although the Affordable Care Act has transformational potential, the guts of the legislation contain as much Bill Clinton as Lyndon Johnson. A two-page bill could have extended Medicare and provided universal coverage, but by relying so heavily on the private market, and straining to avoid the taint of Big Government, the Affordable Care Act is the Russian novel of social policy, now totaling 20,202 pages. Loopholes and exemptions abound. As Ezra Klein has grimly warned, “Far from introducing innovation and efficiency into the system, the decision to build a complex, 50-state public-private hybrid has introduced towering complexity into the project, and seems, potentially, to be beyond the government’s capacity to do well.”

Liberals rallied around the Affordable Care Act because it was the best bill that could clear the Senate. But they also took comfort in the history of social policy. In the winter of 2009, Paul Krugman wrote: “Highly imperfect insurance reforms, like Social Security and Medicare in their initial incarnations, have gotten more comprehensive over time. This suggests that the priority is to get something passed.” Success was supposed to beget success, demonstrating the efficacy of reform and building support for future expansion.

But even in the absence of immediate results, liberals were once able to tolerate a bungled policy—so long as it was done in the name of accumulating governmental know-how. Louis Brandeis urged testing programs in “laboratories of democracy.” Franklin Roosevelt bragged about his “bold, persistent experimentation.” Fortunately for the New Deal, Twitter didn’t broadcast every farmer’s sad encounter with the Agriculture Adjustment Act. But the culture of modern Washington, with its hyperventilating media and legislative saboteurs, takes pornographic pleasure in magnifying failures—which in turn erodes the public’s willingness to give liberalism another shot.

This means the earliest days of a policy’s existence have acquired even greater significance. Just as Clinton had to tweak the traditional liberal formula to advance progressive aims, so will whoever follows Obama. Her challenge will be to ensure that her biggest legislative achievements—curbing carbon emissions perhaps, or expanding the Affordable Care Act—are impeccably implemented with the precision that her ancestors celebrated. She must contend with the new expectations that technology has set, with all of those devices that arrive in our hands seemingly glitch free. That’s what the Obama administration somehow failed to grasp and what liberalism requires if it ever wants to replicate its greatest victories.

Franklin Foer is the editor of The New Republic.