Health Care Passage Thoughts
Because the passage of one of the most significant bills in history should not go unnoted here:
I’ve been silent here about the health care issue since this entry on January 20, primarily because I didn’t have a thing to add to it, in particular this portion:
…contrary to apparently popular opinion, health care isn’t quite dead yet. Now the real interesting thing is to see what the Democrats do next — whether they curl up in a legislative ball, moaning softly, and let their health care initiative die, or whether they double down, locate their gonads and find a way to get it done (there are several ways this can be accomplished).
From a purely strategic point of view, I’m not sure why they don’t just ram the thing through the House as is, fiddle with it a bit during reconciliation and get to Obama to sign it. To put it bluntly, the Democrats will look better by flipping the GOP the bird and then using the ten months until the 2010 election to get voters back on their side than showing to the voters that despite a large majority in both houses, they collapse like a flan in the cupboard at the first setback. We’ll see what happens now, and I suspect what happens in the next week or so will make a significant impact on what happens in November.
And, well. It took the Democrats several weeks longer to find their gonads than I thought it should have, but then again I thought the health care process should have been accomplished several months ago to begin with, back when they had 60 senators. But the Democrats have an apparent structural problem, which is that when they have everything going their way, a lot of them feel that means they should immediately go another way. It took losing their senate supermajority and the GOP overwhelming the public discourse on the health care process to get enough Democrats in line, with many I suspect motivated by the simple fear that what the GOP would do to them if health care passed was less painful than what would the GOP would do to them if it failed.
Basically, I find what passes for Democratic legislative strategy absolutely appalling. Decades from now, when they make the ponderous Oscar-bait movie about the struggle for health care (with Jaden Smith as Obama and two-time Academy Award winner Snooki as Speaker Pelosi), it will make for exciting twists and turns in the plot, but out here in the real world, you shouldn’t have to let your organization get the crap beat out of it in order to motivate those in it to do the thing everybody knows it wants to get done. What the Democrats have managed to do with health care isn’t a Pyrrhic victory — I’ll get to that in a moment — but it surely was taking the long way around: over the river, through the woods, down into the landfill, into the abattoir, across a field of rabid, angry badgers. Next time, guys, make it easier on yourselves.
That said, the Democrats were magnificently fortunate that, as incompetent as they are, they are ever-so-slightly less incompetent than the GOP, which by any realistic standard has been handed one of the largest legislative defeats in decades. The GOP was not simply opposed to health care, it was opposed to it in shrill, angry, apocalyptic terms, and saw it not as legislation, or in terms of whether or not health care reform was needed or desirable for Americans, but purely as political strategy, in terms of whether or not it could kneecap Obama and bring itself back into the majority. As such there was no real political or moral philosophy to the GOP’s action, it was all short-term tactics, i.e., take an idea a majority of people like (health care reform), lie about its particulars long enough and in a dramatic enough fashion to lower the popularity of the idea, and then bellow in angry tones about how the president and the Democrats are ignoring the will of the people. Then publicly align the party with the loudest and most ignorant segment of your supporters, who are in part loud because you’ve encouraged them to scream, and ignorant because you and your allies in the media have been feeding them bad information. Whip it all up until health care becomes the single most important issue for both political parties — an all-in, must win, absolutely cannot lose issue.
It’s a fine plan — unless you’re on the losing side, which the GOP now is. And while the folks in the GOP will be happy to tell you that they are going to ride this baby into majorities come November, they have a very simple problem in that now they’re running not against a bill, but a law, some of the benefits of which will immediately come into play, and which removed from overheated nonsensical rhetoric are almost certainly going to be popular. In the first year of the bill being signed into law, insurance companies will be barred from dropping people when they get sick. Do GOPers want to come out being for insurers dropping people when they need their health insurance the most? The new law will let parents keep their kids on their insurance until their kids are 26, keeping a large number of otherwise uninsured young adults covered. Do GOPers want to run on depriving millions of young Americans that health care coverage? In this economy? Seniors will get a rebate when they fall into that prescription drug “donut hole,” and the law will eventually eliminate that hole entirely. Do GOPers think it’ll be smart to tell seniors that closing the “donut hole” is a bad thing?
So this is the GOP’s problem going forward: people love to hate “socialism” in the abstract, but they love their benefits once they have them, and now the GOP will have to go from saving people from “socialism” to taking away benefits, and that’s a hard row to hoe. I don’t credit the Democrats with a surfeit of brains when it comes to tactics, but if the GOP really wants to run on repealing health care law this year or in 2012, even the Democrats can manage to point out to millions of voters that this means letting insurers drop you or your children from their rolls and making it harder for seniors to buy the prescription drugs they need to survive. Yes, yes: who’s killing grandma now?
There’s another problem for the GOP. While I think it’s likely the Democrats will lose seats this election cycle (as often happens to the party of the president — any president — in mid-term elections), I think the idea that the GOP is going to retake either the House or Senate (or both) is optimistic at best, and the idea that they would be able to retake both with the majorities needed to overcome a presidential veto is the sort of magical thinking that usually indicates either profound chemical imbalances in the brain or really excellent hashish. So Americans will have two and a half years to get used to their new-found health care rights and benefits, most of which in the real world are perfectly sensible, beneficial things, before we all get to vote on who is going to be the next president. Now, perhaps Obama will be voted out of office and perhaps he won’t, but if whomever is the GOP candidate in 2012 plans on running on repealing the health care laws, well, you know. Good luck with that. I’m sure Obama would be delighted for them to try.
And yes, what about Obama? Well, all he did was manage to do something no other president has managed to do, a thing upon which other presidencies have foundered, against opposition that was total, persistent and fanatical. I wish he had managed to do it sooner and with less damage to his standing, and that his own inexperience and aloofness had not been a proximate cause to its delay, which it was. I wish his allies in the legislature had not been appallingly disorganized; I wish his opponents in the legislature were more interested in the good of the people they represent than in playing tactical games. What’s gotten passed isn’t 100% of what I would have wanted to have passed, not just for what’s in it but also for what’s not.
But in the end, it got done. We have health care reform. We have it because Obama decided that it was going to get done, one way or another, and that it was worth risking his presidency over — and worth risking Democratic control of the House and Senate as well. Like the GOP, he went all in, but unlike the GOP, he didn’t do it just for tactical advantage or for short term advantage of power and party; he did it because when all and said and done I think he really does believe that health care reform is to the benefit of the American people, and that it in itself was more important than just being president for as long as Constitutionally possible.
To be clear, and contrary to GOP thinking, I think this is the act that will make him a two-termer, the poor bastard. But even if by some chance he’s one-and-done, I think he can say he did the thing he came to Washington to do, and that he did something that was the right thing to do. As it happens, I agree with him; I think it makes moral, philosophical and economic sense for as many Americans as possible to have access to regular, competent health care. It was a reason I voted for him, and in itself is worth my vote for him.
Mind you, there is more I expect from him before he leaves office, whether that’s in 2013 or 2017. The fact he got this done — despite everything — gives me confidence that he’ll get those things done too.