Maybe I’ve just been beaten down by the wonks, or mugged by reality … Maybe I’m uncomfortable with the idea of being on the same side of any issue with the odd combination of Jane Hamsher, Grover Norquist and Fox News … Or maybe I understand enough about politics to know when a fight is over. But I can say today, with complete certainty — the fight over liberal versus “moderate” healthcare reform is most decidedly over. And it’s time we progressives learned to accept it.
I don’t say that lightly. I first ruminated on whether it would be better to kill the healthcare bill in order to save it (and the public option) back in September. And as the bill has wound its way slooooowly through the Senate, from the laudable HELP Committee bill to the Baucus “Max Tax“, to the Lieberman-Nelson hostage crisis, I have been of the opinion that it has gotten progressively worse, and by that I don’t mean it’s gotten more progressive. Even the House bill, while preferable to the Senate’s final mark-up, falls far short of what I would have thought of as “reform” back in the heady days of “yes we can.” But as any student of politics knows, there’s campaign messaging, and then there’s governing.
President Obama is governing at a time of a resurgent Congress — held down by the throat for eight authoritarian years during the “lost decade” piloted by George W. Bush, but now liberated by the presence of a young, green president. With Republicans engaged in what can only be described as a right wing media fueled, full-on insurgency designed to bring down the Obama administration, you’d think Democrats and their caucus brethren would hang together. Instead, the moderate Democrats who know how to play the game are flexing their Constitutional (and extra-Constitutional) muscle, and riding roughshod over the dwindling number of true liberals in the Senate. As the first branch of government, Congress was always meant to be the collective equal of the president. We just haven’t been used to seeing it operate that way, having experienced the slavish congresses that attended Mr. Bush’s reign. That’s not to say that Obama should bow before the vaunted Senate. He should, as the framers intended, fight for every prerogative of his branch, just as Congress should fight for theirs. (On matters like secrecy, and the war on terror, he appears to be doing just that.) That dynamic tension is what’s supposed to make the system work. What’s rankling our system at present, is not Obama’s weakness in the face of his former colleagues, it’s the inability of the upper chamber to function at all, under the tyranny of the small but determined minority of Republican refuseniks, conservative Democrats, and Joe Lieberman.
In that environment, this bill, this most unloved and unappreciated bill, is probably the best we could get.
The public option was a hell of a good idea. It was probably also unrealistic, and in the watered-down form that it was distilled down to at the end, it probably wouldn’t have done much anyway. A better approach would have been to start the negotiations with a public option every American could opt into (the Wyden-Bennett option,) even if they currently receive their insurance form an employer. That would have produced greater potential cost savings, and really shaken up the system. Of course, it never would have passed through the Senators from Aetna, Cigna and Blue Cross, Blue Shield, either (for a good distillation of why, click here) and Wyden-Bennett never even stood a chance as an amendment, and was hated by liberals even more than the current Senate bill, and he didn’t exactly get a ringing endorsement from the right.) And we likely would have wound up about where we are today. Other provisions, like the individual mandate, were also inevitable. When Obama hired Nancy DeParle, who had been a Clinton administration staffer and veteran of the “Hillarycare” wars to head his office of healthcare reform, he brought on board a strong advocate of the mandate, and she is far from alone among health reform experts.
And then there’s this: the Washington media establishment, like liberal Senators who are voting for this bill, get that the big fights on healthcare reform (other than over abortion and taxes) are over. The public option isn’t coming back, because to bring it back would kill the bill in the Senate. The individual mandate isn’t going anywhere. So at a certain point, the left’s continuing to harp on these two things will be read in much the same way the tea party movement is — as a somewhat hysterical reaction to a “fantasy Obama” — who gets more evil by the day, because every day, people realize more and more that he is a politician. Politicians make compromises. That’s what they do. Obama has made mistakes in this process — being too hands-off in the early negotiations, then too ham-fisted in throwing the public option, and seemingly his liberal base, overboard. But in the end, politically, he needs to be able to claim victory on healthcare, and move on. For God’s sake, wouldn’t we all like to move on? And as Jonathan Chait points out, decrying the fact that health insurance companies are going to make money on reform is problematic in that they are going to make money with or without this bill. Lots of money. In perpetuity. Unless and until Democrats gain an 80-seat majority with 70 liberals in it (and Joe Lieberman retires,) single-payer healthcare, which is the only thing that really would prevent insurers making money, ain’t gonna happen.
So there it is. Those of us who favored more progressive reform have a decision to make. We can either get out there with our pitchforks and join the tea party movement, fighting this bill until the last dog dies, and severely damaging this flawed, but still potential-laden presidency, or we can suck it up, take the loss, and figure out how to fight smarter next time, or to increase the leverage that the left has indeed gained in the major policy debates of the day, in order to fight for the things we (if not necessarily the president) prioritize.
That could be read as a resignation to defeat. But I prefer to read it as a pragmatic response to reality.
That said, Merry Christmas, happy Hannukah, happy Kwanzaa or whatever it is you celebrate at this time of year. Enjoy it, and on to the next fight.