In his speech today in the White House East Room, President Obama clearly indicated that he is going to press for a comprehensive, and not a piecemeal or “skinny,” health care reform bill. He also made it abundantly clear that he will accept, if necessary, a party-line simple majority vote in the House and the Senate in order to get the bill through. Reconciliation here we come.
Obama’s speech represents a major departure from the politics of his presidential campaign and of his first year in office. In his campaign, Obama pledged to defy partisan gridlock and to “change the way Washington works.” During the campaign, some liberal commentators believed that he was merely employing a clever tactic to highlight the rigid partisanship of his opponents. “If we understand Obama's approach as a means, and not the limit of what he understands about American politics, it has great promise as a theory of change,” Mark Schmitt wrote in The American Prospect.
But it is now evident that Obama’s approach was what he understood about American politics—it was the guiding light gleaned from his years as an Illinois state senator—and he planned to apply it to Congress. And it was, of course, nonsense. Republicans were able to use Obama’s naiveté about their motives to undermine his initiatives. As Noam Scheiber explains in his profile of Rahm Emanuel, the principal obstacle to getting health care reform through Congress last year was Obama’s dogged insistence last summer that Senate Finance Chairman Max Baucus continue to plug away at nailing down a bipartisan agreement. What Obama got was not an amicable agreement but a summer of discontent, highlighted by Senator Charles Grassley’s denunciation of Democratic “death panels” and by the emergence of the Tea Party movement.
But it’s not an easy job being president. It took Bill Clinton most of his first term to figure out how to do domestic and foreign policy. Like Clinton, Obama has stumbled, but his slip-ups have been more dramatic because, with the economy cratering and two wars raging, the stakes have been higher from the first.
However, in Obama’s speech today, and in his artful performance at the health care summit last week, he showed that he has learned something from his first year in office. Obama is now using the rhetoric of bipartisanship as Schmitt and other liberals thought he was doing in 2008: He is using it to paint Republicans as intransigent. He clearly no longer believes that a bipartisan agreement on health care is possible.
Moreover, he is now drawing clear lines between the politics of Democrats and the politics of Republicans. "Republicans," he said, "believe the answer is to loosen regulations on the insurance industry--whether it's state consumer protections or minimum standards for the kind of insurance they can sell. I disagree with that approach. I'm concerned that this would only give the insurance industry even freer rein to raise premiums and deny care.” And in summing up, Obama said that that if Republicans “truly believe that less regulation would lead to higher quality, more affordable health insurance, then they should vote against the proposal I’ve put forward.”
Those are strong words. They make clear that Democrats and Republicans don’t share the same politics. Obama portrayed Democrats as the patrons of a “middle class that gets squeezed” by higher insurance costs. Republicans, on the other hand, were tarred as friends of the insurance industry who are willing to let the WellPoints of the world run amok.
Where the speech still rang somewhat hollow was in Obama’s presentation of his own policy. Here’s how he put it:
I don’t believe we should give government bureaucrats or insurance company bureaucrats more control over health care in America. I believe it’s time to give the American people more control over their own health insurance. I don’t believe we can afford to leave life-and-death decisions about health care to the discretion of insurance company executives alone. I believe that doctors and nurses like the ones in this room should be free to decide what’s best for their patients. The proposal I’ve put forward gives Americans more control over their health care by holding insurance companies more accountable.
Well, yes, I suppose, we don’t want a government bureaucrat—one of those evil fellows with a green eyeshade sitting behind a desk piled high with unread complaints from angry citizens—to have control over our health care. But this kind of formulation concedes too much to the anti-statist rhetoric of the Tea Parties.
Let’s be clear about what national health care reform does. It narrows peoples’ choices, and limits their control over their health care, in one very important way: It requires them to buy health insurance. That is how social insurance works. You couldn’t have Social Security or Medicare if everyone eligible didn’t have to sign up. But by virtue of this requirement, the government—bureaucrats and all—improves, and in some cases, vastly improves, the choices Americans have in obtaining health insurance. Health care reform doesn’t bypass government; it enlists it on the people’s behalf.
Obama has now adopted a strategy that will allow him to get his programs through Congress, but he doesn’t yet have the vocabulary that will allow him to convince wide swaths of Americans that these programs are essential. And that’s not an uncommon failing. It’s not as if he lacks a vocabulary that other liberals or Democrats (like the writers on these pages or his fellow politicians) possess. How to frame government initiatives in a way that acknowledges but also overcomes American anti-statism has been, and remains, a major political challenge for Democrats. But in beginning to draw clear distinctions between the Democratic and Republican approaches, Obama has taken the first important step toward meeting that challenge.
And let me say one other thing. I hate political predictions, and I have certainly heard my fill of them lately. The recent Conservative Political Action Conference echoed with predictions that the Republicans would obliterate the Democrats in November 2010. And the esteemed Charlie Cook has recently pronounced the Democrats to be toast in 2010. But—and there are some “ifs” coming—if Nancy Pelosi and Harry Reid can get the health care bill through Congress and on to Obama’s desk, and if Obama has truly learned his lesson and begins to draw a sharp distinction between the Democrats’ approach and the Republican approach, and if he begins to propose initiatives that highlight this distinction, the Democrats will retain the House and Senate in November. They will probably lose seats, but they won’t get obliterated.