Why the Health Care Debate Is So Important Regardless of One's View of the "Public Option"

The New York Times today has a discussion from several contributors, including me, on the politics of the health care debate. My contribution, which focuses on the role the White House has played and the ample evidence that they have been quite active in shaping the course of events, can be read here.

The New York Times today has a discussion from several contributors, including me, on the politics of the health care debate. My contribution, which focuses on the role the White House has played and the ample evidence that they have been quite active in shaping the course of events, can be read here. I want to elaborate on a couple of points I referenced in passing.

Over the past decade, the Democratic Party has specialized in offering up one excuse after the next for its collective failures. During the early Bush years, the excuse was that they endorsed Bush policies because his popularity and post-9/11 hysetria made it politically unwise to oppose him. In later Bush years when his popularity plummeted, the excuse was that Democrats were in the minority and could do nothing. After 2006 when they won a Congressional majority, the excuse was that Bush still controlled the White House and had veto power. After 2008 when a Democrat won the White House, the excuse was that Republicans could filibuster.

Now that they have a filibuster-proof majority, a huge margin in the House and the White House, the excuses continue unabated, as Democrats are now on the verge of jettisoning one of the most significant attractions to progressives of the Obama campaign -- government involvement in the health insurance market. The excuses for "compromising" are cascading more rapidly than ever: We need Republican support to ensure it's bipartisan. The Blue Dogs won't go along with what we want. Centrist Senators will filibuster. There are similar excuses being made to defend Obama from accusations that he deserves some of the blame for the failure of the "public option." Matt Yglesias makes the typical case for shielding Obama from any responsibility:

I think there's something perverse in the very strong desire I see among liberals to make problems in congress be about anything other than congress. It's just not in the power of Barack Obama to make the senate anything other than what it is.

I'm really surprised that there's anyone, especially Matt, who actually believes this -- that the Obama White House is merely an impotent, passive observer of what the Democrats in Congress do and can't be expected to do anything to secure votes for approval of the health care bill it favors. As the leader of his party, the President commands a vast infrastructure on which incumbent members of Congress rely for re-election. His popularity among Democrats vests him numerous options to punish non-compliant Democrats. And Rahm Emanuel built his career on controlling the machinations within Congress. The very idea that Obama, Emanuel and company are just sitting back, helplessly watching as Max Baucus, Kent Conrad and the Blue Dogs (Rahm's creation) destroy their health care legislation, is absurd on its face.

When it comes to defiant progressive members of Congress -- as opposed to supposedly defiant Blue Dogs and "centrists" -- the Obama White House has proven itself extremely adept at compelling compliance with the President's agenda. Consider what happened when progressive House members dared to oppose the war supplemental bill which Obama wanted passed:

The White House is playing hardball with Democrats who intend to vote against the supplemental war spending bill, threatening freshmen who oppose it that they won't get help with reelection and will be cut off from the White House, Rep. Lynn Woolsey (D-Calif.) said Friday.

"We're not going to help you. You'll never hear from us again," Woolsey said the White House is telling freshmen

When progressives refuse to tow the White House line, they get threatened. Contrast that with what the White House does with Blue Dogs and "centrists" who are allegedly uncooperative on health care -- they protect them:

The Politico's Jonathan Martin reported this morning that Rahm Emanuel warned leaders of liberal groups in a private meeting this week that it was time to stop running ads attacking Blue Dog and "centrist" Dems on health care.

I'm told, however, that Emanuel went quite a bit further than this.

Sources at the meeting tell me that Emanuel really teed off on the Dem-versus-Dem attacks, calling them "f-king stupid." This was a direct attack on some of the attendees in the room, who are running ads against Dems right now.

What does that vast disparity reveal? If anything, Blue Dogs -- virtually all of whom represent more conservative districts -- are more vulnerable and thus more dependent for re-election on the White House and Democratic Party infrastructure than progressives are. If health care fails and the Obama presidency weakens, they will bear the brunt of the voters' desire to punish Democrats. The White House would have at least as much leverage to exercise against Blue Dogs and centrists. They just aren't doing so. In fact, they're doing the opposite: they're protecting them even as they supposedly impede what the White House wants on one of Obama's signature issues.

This isn't to say that Obama can single-handedly control what Congress does. It's possible that even with maximum leverage exerted, a President can still lose. But there isn't any leverage being exerted against anti-public-option "centrists" and Blue Dogs. There's just no effort being made. The White House seems perfectly content with what the centrists and Blue Dogs have done thus far; the only anger they have shown, as usual, is towards progressives who are demanding robust reform.

* * * * *

A related (and in my view equally unpersuasive) excuse was offered by The Washington Monthly's Steve Benen, who seems to take seriously the claim that Democrats have been compromising so much because they wanted to attract substantial GOP support for health care. Steve correctly points out why such an expectation is ludicrous: "Senate Minority Whip Jon Kyl (R-Ariz.) announced that Republicans will reject reform no matter what's in the bill. . . . Negotiating health care reform with politicians who oppose health care reform doesn't make sense. Negotiating reform with politicians who've vowed to vote against reform under any circumstances is insane."

That's obviously true. In fact, it's so obviously true that no matter how dumb one might think Democrats are, they're certainly not so dumb that they failed to realize that the GOP was highly unlikely to help Obama pass health care reform no matter what the bill contained. From the start, it's been obvious to everyone -- the Obama White House and Senate Democrats included -- that the GOP would not help Obama pass health care reform. Why would the GOP want to help Obama achieve one of his most important and politically profitable goals? Of course they were going to try to sabotage the entire project and would oppose health care reform no matter what form it took. Everyone knew that from the start for exactly the reason that it was so obvious to Benen.

The attempt to attract GOP support was the pretext which Democrats used to compromise continuously and water down the bill. But -- given the impossibility of achieving that goal -- isn't it fairly obvious that a desire for GOP support wasn't really the reason the Democrats were constantly watering down their own bill? Given the White House's central role in negotiating a secret deal with the pharmaceutical industry, its betrayal of Obama's clear promise to conduct negotiations out in the open (on C-SPAN no less), Rahm's protection of Blue Dogs and accompanying attacks on progressives, and the complete lack of any pressure exerted on allegedly obstructionists "centrists," it seems rather clear that the bill has been watered down, and the "public option" jettisoned, because that's the bill they want -- this was the plan all along.

The Obama White House isn't sitting impotently by while Democratic Senators shove a bad bill down its throat. This is the bill because this is the bill which Democratic leaders are happy to have. It's the bill they believe in. As important, by giving the insurance and pharmaceutical industries most everything they want, it ensures that the GOP doesn't become the repository for the largesse of those industries (and, converesly, that the Democratic Party retains that status).

This is how things always work. The industry interests which own and control our government always get their way. When is the last time they didn't? The "public option" was something that was designed to excite and placate progressives (who gave up from the start on a single-payer approach) -- and the vast, vast majority of progressives(all but the most loyal Obama supporters) who are invested in this issue have been emphatic about how central a public option is to their support for health care reform. But it seems clear that the White House and key Democrats were always planning on negotiating it away in exchange for industry support. Isn't that how it always works in Washington? No matter how many Democrats are elected, no matter which party controls the levers of government, the same set of narrow monied interests and right-wing values dictate outcomes, even if it means running roughshod over the interests of ordinary citizens and/or what large majorities want.

* * * * *

That's why this debate has now taken on such importance -- regardless of whether you think a public option is important or even if you think it's a good idea. Thanks in large part to the months-long efforts of Jane Hamsher and her FDL team -- who spent enormous amounts of time and resources getting large numbers of progressive House members to emphatically commit on video to opposing any health care bill that lacks a robust public option -- there's actually a chance this time that the outcome could be different. If those progressive House members actually adhere to their pledge, they can and will block any health care bill that lacks a public option. They can actually thwart industry demands and the dictate of Beltway leaders; can empower a new faction in Washington (themselves) beholden to different interests (ordinary citizens); and can vest some actual significance in the outcome of the 2006 and 2008 election.

Along with several other blogs, Jane and FDL are sponsoring a fundraiser to reward, and embolden, those progressive members who have made that pledge, and it raised an extraordinary sum of close to $150,000 in just a couple of days. Those interested can donate here. Rachel Maddow's lead segment last night was a discussion with Jane regarding the political significance of the health care debate and the possibility that progressives could actually prevail on something of significance for once.

The Washington Post today quotes an "anonymous White House official" excoriating what he calls "the left of the left" for petulantly demanding a "public option." That article notes that the Obama White House is surprised by the intensity of progressives' insistence that the bill include a "public option," and who can blame them for being surprised? Ordinarily, progressives are told that they cannot have what they want because Blue Dogs and Republicans (on behalf of the industries that own them) must get what they want, and progressives meekly accept that because it's "better than nothing" (don't let the Perfect be the Enemy of the Good, they are lectured). More than anything else, it's vital that this dynamic change. Such a change would be far more consequential even than the specific health care policy issues at stake in this debate.

© 2023 Salon