I was never a Deaniac. I supported him for DNC chair precisely because I thought his reckless rhetoric would work well for the leader of an opposition party, and that his fifty-state strategy had merit. But I most certainly did not support him for president, because the tools that serve one well in opposition do not necessarily translate into the ability to govern, and I have never felt that Dean was particularly adept at the more mundane, serious aspects of governance.
So it doesn’t surprise me to see Howard Dean declaring that “If we were Republicans, this [health care] bill would be done.” It’s just the sort of half-assed thing Howard Dean would say, without any regard for the reality of the situation.
First off, as John Cole notes, the Republicans would never try to create a bill to provide $100 billion a year in health care subsidies for the nation’s poor and working class. But ignoring that, and taking Dean’s statement in the spirit it was intended — that Republicans have so gosh-darned much party unity that things would automatically get done — let me remind the former DNC chair once more, with feeling, that no, they wouldn’t.
Social Security privatization is to the conservative domestic agenda what health care reform is to the liberal domestic agenda — the brass ring, the piece de resistance, the thing that the party most wants to get done. And the GOP and George W. Bush, with majorities in the House and Senate — and after an election in which said majorities increased — was not only not able to get Social Security reform through, they weren’t even able to get a bill up for a vote in the House. Compared to how well things went for the GOP on Social Security reform, Democrats are a virtual juggernaut, crushing all in their path on their way to passing a reform bill that is more robust than the one Dean proposed in 2003 and 2004, when he was running for president.
That last link, which goes to an article by Ezra Klein, is important to read, because it makes a point that we have lost sight of. Not only is the health care reform bill before the Senate still worth passing; it’s a reform bill that would have been beyond the wildest, most optimistic dreams of Democrats just five years ago. Is it perfect? No. But it is a huge step forward, even if it leaves several huge steps to go.
Ultimately, the people who are calling for this bill’s demise are the kind of Democrats — and indeed, the kind of activists in general — who have always frustrated me. I understand that it would be nice if we could get reform passed that was perfect. Believe me, if I were God-Emperor of America, I’d make a lot of quick changes that would make most progressives happy. Indeed, I suspect if Barack Obama was God-Emperor of America, he’d do the same.
But we don’t have a God-Emperor. We don’t even have the Westminster system, which would allow us the possibility of more rapid, sweeping change, for good or ill. We have a Presidential system, one designed with Madisonian checks and balances which make sweeping change all but impossible. In our system, change has to come bit by bit, step by step, agonizing compromise by agonizing compromise.
Now, some activists — left and right alike — will say that’s not good enough. That change should be perfect, or it shouldn’t happen. They will draw lines in the sand, punish the heterodox, and declare that it’s better for us not to pass a bill than to pass this imperfect one. That’s a very satisfying, very pure sentiment, and I understand it.
But in our system of government, abandoning change because it’s not sweeping enough doesn’t end with us getting all the changes we want. It ends with change not happening at all. Social Security privatization is dead until the GOP takes back both houses of Congress and the presidency. That could be as soon as 2013 — but that would mean eight years of no change in the status quo, and it’s pessimistic to think the GOP would retake all three that quickly. The last time Democrats had a shot at passing meaningful health care reform was 1994, and we failed; almost 16 years passed before we got another shot.
Reconcilliation is not an option — starting over puts us back eleven months, and if you think that things will sail through easier using reconcilliation, you’ve obviously never studied the U.S. Congress. Quite frankly, 2010 is an election year, and Democrats don’t want to be debating health care reform in the weeks leading up to the election — not to mention that all the items sitting on the back burner right now, including DOMA and DADT, will keep sitting on the back burner so long as the health care debate is open.
No, it’s this bill or nothing. If you take the position that we need to kill the bill, then you are dooming health care reform for, at minimum, another two years. Realistically, you’re dooming it for another decade or two. As we’ve noted many times, 40,000 people a year are dying for want of health care. If you are comfortable condemning 400,000 of your fellow Americans to death simply because you don’t find this bill ideologically pure enough…well, you can call yourself whatever you want. But I sure as hell don’t see that as “progressive.”
could you pass this bill and then do reconiliation for a public option/medicare buy-in later?
nice post. good realpolitik. i was never impressed with dean either. too hysterical. obama’s the opposite, though he has a dual personality with the soaring rhetoric inspired by the civil rights movement. but his true character is careful, deliberative, and thoughtful. i’ve even seen a streak of burkean conservatism (like when he explained why we couldn’t just nationalize the banks like sweden did one time b/c “our traditions are different.”).
probably in an ideal world he would go for single payer, but he’s deeply aware of the role America plays in global healthcare, like pretty much being responsible for the majority of drug development, and to upset the system too dramatically could be disastrous.
sounds like this bill is just about where he wanted in the first place. the left is going crazy, with one idiot comparing him to tiger woods, but lost in the hysteria is the fact that we’ve avoided a depression, we’re in a recovery, the banks are saved, and we’re making a profit on tarp which can be used for other stuff.
could you pass this bill and then do reconiliation for a public option/medicare buy-in later?
Yes, which if I were the Democrats would be exactly my plan.
That Ezra Klein article was written in August. Does it still apply to the actual bill that is being debated in the Senate now, the one that includes an individual mandate but no regulations on what the insurance companies can charge the individuals who are forced to buy insurance from them?
I would be okay with a bill that wasn’t perfect. I’m not asking for perfection. I’m asking for a bill that’s not worse than nothing. And I’m not convinced that this bill isn’t worse than nothing.
KJ-
It does – Ezra was pointing that article out today. Mandates have to be a part of any feasible plan (at least one that ends recission and requires insurance companies to cover all, as this bill does), and the bill provides subsidies that will cover most (though not all) uninsured.
Why they’re worse- from a leftist no less: http://www.distantocean.com/2009/12/why-theyre-worse.html
And why not dismiss this health care bill? It doesn’t fund abortions and only the people who have money can afford it.
There’s this too: http://www.openleft.com/diary/16492/joe-liebermans-healthcare-bill-is-worse-than-nothing-kill-it
s we’ve noted many times, 40,000 people a year are dying for want of health care. If you are comfortable condemning 400,000 of your fellow Americans to death simply because you don’t find this bill ideologically pure enough…
This logic chain takes for granted that you believe that the current bill will save these 40,000 lives per year. I don’t believe that, as a matter of fact, and though I’m not the progressive you’re addressing this “suck it up and pretend to love the insurance companies for Barry” missive to, I wouldn’t think it unreasonable for a progressive not to believe it either.
This is a quote from a working class friend, since y’all don’t seem to know any:
“I am FUCKING SICK of “progressives” talking about how this bill is “good enough.” Let me be more specific. I am FUCKING SICK of middle class, white, work-from-home, overeducated Democratic “progressives” talking about how this bill is good enough. Fuck all y’all. It’s not good enough. It’s a piece of shit and we’re going to be stuck with it for a long fucking time, and the people who NEEDED – as in actual need, like for purposes of continuing to be alive – things to be better than this aren’t going to have them be better.
Not good enough. It’s not good enough for my mom’s situation, it’s really not good enough for my situation, it’s definitely not good enough for the working class on the whole, and therefore I could not give less of a fuck whether it’s “good enough” for the fucking middle class.”
You know, I’ll stack up the lowness of my income — and the direness of my ongoing medical needs — against most people. (There are some people who have worst ongoing conditions and less income than me — and, to be honest, many people who are much worse off than me because they don’t have the great support system that I do. Nonetheless, I’d bet that the vast majority of working Americans make more money than me, and most don’t have a serious chronic condition.)
But I agree with Jeff.
Compared to what progressives want, this bill isn’t good enough. But it’s better than no bill at all, which seems to be the only realistic alternative at this point.
I am not so sure that from a progressive POV, the bill is better than no bill at all. For one thing, passing this bill means that for the next ten years at least, the chances of doing ANYTHING more on health care reform is zero. As well, the political fallout from this bill is going to be devastating to Democratic control of Congress in 2010.
Whereas, if this bill dies today and Democrats dodge the incoming electoral bullet, then next year you can introduce the Incremental Health Care Reform bill that does one or two things that progressives like, and it might have a chance on its merits.
I know you are a big advocate of the “our political culture requires dealmaking and dealmaking requires big comprehensive bills” approach, but I really don’t think it’s impossible to get incremental reforms through. It’s largely people like me who have spiked this bill, delaying its implementation and forcing the removal of features that progressives wanted. But, as one example, present me with a bill that closes the donut hole in Medicare’s drug benefit, along with the taxes that it will take to pay for that, and there’s a modest chance that I’d support it; there’s NO chance that I’d go to Washington and march, or engage my Blog Fu against such a proposal.
Whereas, against Obamacare, you have such opposition. It might be harder to put together a string of deals to get the support needed for such a reform (“I’ll vote for your donut-hole closing bill if you’ll vote for my submarine base”) but it would be much easier to overcome the unofficial but equally potent friction from the chattering class.
I’m surprised fewer people don’t mention it as an argument. Seems to me people are finally tired of getting rolled. If the argument’s basis is, “don’t let the perfect be the enemy of the good”, people aren’t fools, this is all about where people’s line in the sand for good is.
it’s easy to trade away the cost of growing a spine because that price is paid on other future issues. this price has been paid for 3-4 compromises. But over time, it’s just not economical which the republicans know and I believe Obama will (hopefully) figure out.
Part of the art of political compromise to create a situation where your choice is the most “practical” choice. But any noodnick can see that once you start with the position, “anything called a bill is better than nothing”. You better have all your ducks in a row to hold the line in the sand, because it’s almost a guarantee you’re going to get rolled over it.
suppose the a tiny anti-abortion clause got put in. one that wouldn’t affect many people, and had a somewhat convoluted loophole to avoid it. wouldn’t your argument defend that as well? It’s not about whether all the +/- line up right now, it’s about where people’s line in the sand is.
It’s also easy for Rahm Emmanuel to have overlooked the people as a party to the negotiations. It’s easy to trade away the constituent’s interests, because while he’s used to horse trading with large stakeholders, it’s easy to forget that he’s NOT an disinterested dealmaker. He’s supposed to be representing the interests of the people.