God I hope David Broder is wrong. "The President has told visitors," the Washington Post columnist wrote last week, "that he would rather have 70 votes in the Senate for a bill that gives him 85 percent of what he wants rather than a 100 percent satisfactory bill that passes 52-48." The good news is that Chief of Staff Rahm Emanuel is now talking about how bipartisanship may need to be redefined downward if the Democrats are going to pass meaningful healthcare reform. In a meeting with journalists last week, Emanuel proposed that health-care legislation could be bipartisan without Republican votes. "There will be ideas from both parties, and individuals from both parties, in the final product," he said. "Whether the Republicans decide to vote for things they promoted will be up to them." ( David Axelrod seconded the emotion in his appearance on ABC's "This Week.")
The trick now is to ensure that "centrist" Democrats (who, as Paul Krugman notes, "are in fact way out in right field") pay more attention to the broad majority favoring a strong public option than to the wads of dough lavished on them by big Pharma and insurance lobbyists. As Joe Conason put it in his invaluable New York Observer column, "If Congress fails to enact healthcare reform this year---or it enacts a sham reform designed to bail out corporate medicine while excluding the 'public option'---then the public will rightly blame Democrats, who have no excuse for failure except their own cowardice and corruption." Blame could well be registered in ugly midterm election results in 2010.
It's time to part ways with obstructionist Republicans and pass a strong healthcare bill with a majority vote, which is possible if efforts cease to get a handful of Republicans to cross over. Redefining bipartisanship at a time when the GOP has become a male, pale and stale party committed to deficit demagoguery and fearmongering is the common sense and, I'd even argue, pragmatic course. Instead of wasting time on recalcitrant GOP holdouts, do what Drew Westen, author of the terrific book "The Political Brain," advises to pass meaningful healthcare change: "Focus on principles, tell compelling stories, move people emotionally and send clear messages."
Sure, there are legitimate issues raised by people I admire about the value of a public plan. Even President Obama once said, "If I were designing a system from scratch, then I'd probably set up single-payer." Like 59% of the Americans surveyed in January 2009 by CBS News and the New York Times, I would prefer, as would my colleagues at The Nation, to see Congress respond to this country's healthcare crisis by scrapping a failed-for-profit system and replacing it with a comprehensive national health insurance program.
But for now, the calculus of political viability has taken single-payer off the table. That doesn't mean we cease fighting to get it back on --but it probably means we need to balance our short and longterm goals. Let's assume some compromise in our political system is inevitable. The hard question is whether the compromise opens the door to greater progress or forecloses opportunity. A weak public plan will make it harder to get healthcare expenses under control while extending care to all. A weak plan may discredit healthcare reform for a generation. Real reform will cement strong attachment to the party which has shown it can pass legislation truly improving the condition of people's lives. (That's a key reason why former Dan Quayle adviser and Weekly Standard editor William Kristol fought tooth and nail to derail Clinton's healthcare reforms.) And for all the wrongheaded deficit anxiety circulating, do Democrats really think that if they pass major health care reform, and increase access--that voters will punish them for growing the deficit? (And the cost debate is forcing to the fore much-needed consideration of changes to our dysfunctional and unjust tax structure that will enable us to pay for these healthcare reforms.)
Congress is, of course, usually pretty skittish about reform, but with a President with high approval ratings and an historically unpopular GOP--if this isn't a time to pass sweeping reform with a strong public plan, then when is?
© 2009 The Nation
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