Has Obama overlearned the Clinton lessons? That’s what some on the left, liberal, center-left and center are debating.
Karen Tumulty in Swampland rounds up three op-eds. Jonathan Cohn:
Bill and Hillary Clinton are off saving the world, he through his global foundation and she via the State Department. But their presence looms over the health care debate as surely as if they were running the White House. Their epic failure to pass reform in 1994 has become the defining object lesson in how to botch health care legislation–a lesson President Obama has obviously taken to heart. Push for reform right away; let Congress hash out the details; and, above all, don’t threaten people’s current insurance arrangements. You can sum up Obama’s strategy for health reform as “WWCD”: What Wouldn’t the Clintons Do.
And it’s working well so far. Notwithstanding the predictable fits-and-starts of the legislative process, it seems likely that Obama will have a bill to sign by year’s end, thereby accomplishing what the Clintons famously could not. But then what? Having crafted a bill that can pass Congress, will Obama be signing a bill that people actually like?
E.J. Dionne in WaPo:
There are progressives (probably including Obama) who would trade the public plan for a strong universal-coverage bill if it included genuinely tough rules on the insurance companies. What should be avoided above all is a fake public plan hemmed in by so many restrictions that it would be doomed to failure.
My own preference is for a bill with a strong public plan financed by broader tax increases on the best-off Americans. Still, there are many routes to universal coverage — the recent proposal by former Senate leaders Tom Daschle, Bob Dole and Howard Baker deserves more attention than it has received — and some compromises will be necessary.
The key is that no compromise should be allowed to undermine the long-term goals of covering everybody and containing costs. Concessions made for purely political reasons could produce an unworkable monstrosity of a bill.
Obama’s lobbying helped to save climate change legislation, and he now needs to weigh in more forcefully on health care. He should toughen Baucus’s negotiating strategy, and he’ll have to mediate among liberals. He doesn’t need stone tablets, just an iron will.
David Brooks in NYT:
On health care, too, the complicated job of getting a bill that can pass is taking priority over the complicated task of creating a program that can work. Dozens of different ideas are being added, watered down or merged together in order to cobble together a majority. But will the logrolling produce a sustainable health system that controls costs and actually hangs together?
The great paradox of the age is that Barack Obama, the most riveting of recent presidents, is leading us into an era of Congressional dominance. And Congressional governance is a haven for special interest pleading and venal logrolling.
When the executive branch is dominant you often get coherent proposals that may not pass. When Congress is dominant, as now, you get politically viable mishmashes that don’t necessarily make sense.
Tumulty:
It’s also important to remember that a bill–if it passes–is only the beginning of the process. Implementing any kind of far-reaching health reform is going to take years, maybe decades. And that is an argument for making sure that it starts with both a broad base of support, as well as with its gain and pain in balance. Congress, with its two-year election cycles, is not exactly known for taking the long view.
Of course, as David Brooks points out, a firm hand with Congress is remembered as the defining mistake of the Bill Clinton’s first-term. As you can read in detail here, there was no mistake more consequential than the president’s decision to dictate every jit and tot of his health reform plan to the legislature. Obama’s congressionalist approach is an effort to avoid the mistakes of the Clinton years. Predictably enough, that’s led to a growing chorus flaying him for making the opposite mistakes.
And maybe that chorus is right. But the implicit assumption of these arguments about strategy is that there is, somewhere out there, a workable strategy. That there is some way to navigate our political system such that you enact wise legislation solving pressing problems. But that’s an increasingly uncertain assumption, I think.
Imagine a group of men sitting in a dim prison cell. One of the walls has a window. Beyond that wall, they know they’ll find freedom. One of the men spends years picking away at it with a small knife. The others eventually tire of him. That’s an idiotic approach, they say. You need more force. So one of the other men spends his days ramming the bed frame into the wall. Eventually, he exhausts himself. The others mock his hubris. Another tries to light the wall of fire. That fails as well. The assembled prisoners laugh at the attempt. And so it goes. But the problem is that there is no answer to their dilemma. The problem is not their strategy. It’s the wall.
Clinton’s health care plan was derailed largely because it was perceived as being cumbersome and complicated. They had to explain things like “managed competition” and “global budgets” and “premium caps.” Those things don’t exactly read well on a bumper sticker and the right was able to persuade people that the whole thing was a big mess that wasn’t going to work.
Times have changed. People have learned a lot about health insurance in the past 16 years — more than they ever wanted to know — and they have come to realize that the system is already complicated and that it’s not working for them a good part of the time. But using the public plan as a rallying cry keeps the pressure on the congress to at least see this through.
I recognize that there are people of good faith out there who believe that the public plan is a sham and that progressives are selling out their beliefs by backing it instead of insisting on single payer or nothing. I would just say that if there were any other path to getting reform in the next eight years, I’d agree. But I don’t see that there is. The politicians are already making the sausage. We don’t know yet what they are going to put together and for the sake of all those millions of people who have no insurance or are about to lose theirs, it seems to me that we at least try to get something passed. I wish it could be more perfect, but I have absolutely no idea how to make it better at this point. Standing in the way without a serious strategic alternative that could actually result in real reform seems short sighted to me.
Philip Klein in the American Spectator:
My sense of Obama is that if it came down to it, he would be willing to settle for pared down legislation so he could at least point to some sort of legislative accomplishment, as opposed to the political fallout of watching the whole effort go down in flames. That’s why he isn’t drawing any lines in the sand, because he doesn’t want to end up in a box like Bill Clinton did when he declared in his 1994 State of the Union speech that he would veto any health care bill that fell short of guaranteed coverage for every American. Yet even if Obama is willing to settle for less, he’ll have his work cut out for him explaining that approach to liberal activists.
And on what Axelrod said on MTP last Sunday?
Jim Geraghty in NRO
I’m glad that people are noticing that when Obama’s chief advisor David Axelrod won’t rule out the possibility of taxing employer-based health insurance, it’s a major reversal of Obama’s campaign rhetoric. I just wish more folks noted just how much of Obama’s campaign message was based on this — $44 million on 16 different attack-ad commercials ripping McCain for proposing the very same idea.
When a man won’t even stand by his attack ads, he’s really without principles.
RDemocrat in Daily Kos
1 Comment
July 1, 2009 at 7:25 am
for me as a Canadian it’s quite interesting topic; there have been a lot of talks before the election about US vs. Canada system and it seems a bit frozen