Using power

What William Saletan said:

Politicians have tried and failed for decades to enact universal health care. This time, they succeeded. In 2008, Democrats won the presidency and both houses of Congress, and by the thinnest of margins, they rammed a bill through. They weren’t going to get another opportunity for a very long time. It cost them their majority, and it was worth it.

Yes, I think that is right. So are a couple of his other points: Power is not about simply retaining it at the next election, but using it; and not only will Republicans be unable to repeal the health-care bill in the short run, in years to come the law likely will be popular enough that they won’t want to repeal it.

And, this just in: the country is divided. Forty eight percent of voters said in exit polling that they wanted the health-care law repealed. Sixteen percent like it as it is. Then there are the 31% who want it expanded. So that’s 47% that see it as either good as is or something to build on. Not exactly the repudiation of the policy that is being so widely spun as the voters’ alleged verdict.

28 thoughts on “Using power

  1. And of those who want it repealed, I can bet that most of those don’t even know what was enacted. I am struck by the rank ignorance of those who think we have some sort of communist dictatorial system set up in health care or health insurance when in fact all Obama and his cohorts passed was a bill that will make Blue Cross more money in the next several years, even if they have to take people with preexisting conditions (with no limit on what Blue Cross can charge such persons).

    Some socialism that is…:-(

    The thing that most frustrates me is that Obama should have earned the socialist label at least a bit by pushing for the public option. Instead, he bargained it away and watched from the sidelines while Blue Dog (Scorpion) Democrats, most of whom lost the other day, refused to support the public option.

    And pundits are still blaming the liberal left base, which, it turns out, did vote for Dems this time. The loss of votes between 2008 and 2010 were from “independents,” i.e. low information swing voters.

  2. I am reasonably certain that no matter how hard Obama might have pushed for a “public option,” he was not going to get it. Such pushing, however, might have created an even earlier and bigger backlash (if that’s possible).

    The thing about the various bills or provisions that Obama should have pushed for–by which I assume we mean “going public” with speeches about how this was what he meant by “change”–I just don’t know what one additional Senator would have changed his mind. And the only valid argument for a President pushing for a policy and getting it is an argument that can identify legislators who would have come to the President’s side on account of the President’s public persuasion. I just don’t see it, as much as I wish I did.

  3. Could the Republicans repeal the ACA? Probably not. But could they instead sabotage the new system? This remains to be seen…

  4. I agree with most of Saletin’s argument, but I think the Democrats made the same error in 1994 and 2010, though at least in 2010 they at least got legislation enacted.

    The Democrats are going to get attacked for favoring “socialized medicine” no matter what they do. That means there is no marginal political cost, in terms of winning elections, in actually enacting “socialized medicine”. I honestly don’t think any minds among the voters would be changed if the Democrats had simply copied the legislation establishing the NHS in Britain, line by line, the people who would oppose that would oppose any alteration of the health care system.

    This means the two proper courses for the Democrats are to simply put in place the health care legislation they want, or a policy of benign neglect of the issue. And also a policy of benign neglect would have been appropriate in this Congress, considering what it had on its plate with the financial crisis, the two wars, and climate change.

    Now what is ignored is that the Democrats, at least the politicians and the donors, don’t want “socialized medicine” either. The Democratic policy preference seems to be for a system dominated by a few large regulated insurance companies, with some publically provided service for a few favored consituencies. The recent legislation, if I understand it correctly, essentially codified that and covered a few gaps, mainly caused by the slow collapse of the employer-provided health care model (employers have tended recently to not live up their side of the bargain, either dropping health care coverage or their workers).

    Democrats have used rhetoric to get the 20% or so of the electorate that favors expanding publicaly provided health care coverage, but this isn’t to be taken more seriously than the comparable Republican rhetoric on the other side.

  5. Matt,

    The polls say the public supported the public option (most of them, anyway–who knows whether Rasmussen is believable on anything anymore…). If Obama pushed for it and campaigned with the public about it, it would have won. He didn’t because he had cut his deal with Big Pharma and Big Insurers. That is the betrayal. That is what angered folks like me.

    The main point though and I think you agree is that the majority of Americans polled who say they are against “Obamacare” don’t know what it is…other than what Rush and FoxNews and people who they listen to at bar-be-ques or football games who listen to those sources say. That is the sad thing above it all, the insult to the injury.

  6. I would also submit that the majority of people polled about “a public option” did not know what it was. The connection between public opinion, as reflected in opinion polls, and the policy stances taken by politicians is a complex one.

    Note that my statement is not at all inconsistent with yours, Mitch, about how interest groups entered into the process early on. I would only add that it does not follow that there was ever a persuadable Senate majority for a “public option.”

    Such a view overstates the potential “transformative” power of a president, especially one for whom electoral separation of purpose (see the post after this one) is so low, and in the context of a majority party that is not by any measure a “social democratic” party, but rather one with a far broader umbrella (for better or worse). Obama did not in any sense have a mandate for a public option, nor the credibility and support with people who had voted for Senators who favored a different approach.

    Ultimately, I do not think terms like “betrayal” to describe the approach taken by Obama and Democrats is fair. To commit a betrayal, someone had to have been on your side in the first place. And, in legislative politics, has to have had a chance of making the policy happen, but turned back from it. I do not think either position stands up to scrutiny.

  7. One problem with dismissing words like ‘betrayal’ is that if one compares what the White House agreed to about the public option with the insurers in private, back before the start of the legislative process, and Obama’s own claim to support the public option during the legislative process, they simply do not match up.

    9 September 2009I continue to believe that a public option within the basket of insurance choices would help improve quality and bring down costs.

    Alas, the insurance industry says they had a White House promise to drop the public option long before that and similar speeches.

    Saying one thing in public while advocating something else in private usually leads to quite strong electoral separation of purpose, indeed to the electorate separating itself from the purposes of the president.

    Electoral disquiet in the face of broken promises, particularly, core promises, is not limited to US politics, as the Rudd-Gillard government discovered on the issue of climate change.

  8. “I would only add that it does not follow that there was ever a persuadable Senate majority for a “public option.””

    Are you talking about a 50-seat (+VP) majority, or a 60-seat supermajority?

  9. Alan, I invoked Electoral Separation of Purpose in this discussion only to illustrate that a president who lacks a mandate that is significantly broader than that of his party is unlikely to be successful at persuading otherwise-inclined legislators to fall in line with the president’s publicly articulated policy priorities. This is especially those of another party, but also often true for co-partisans.

    Norwegian Guy, if not 60 votes in favor of the public option, than 60 votes in favor of ending debate and voting on a public option. But in such a polarized context, that is practically the same thing. Let’s not forget that, for a while, Democrats had 60 Senators, suggesting that the problem was intra-party more than anything.

    Presidentialism tends to divide parties into separate executive and legislative “branches,” and it is often difficult for a president to reunite those divisions. (Again, this is a core theme of the Samuels-Shugart book). As the first graph in the “Obama and ESP” entry (posted hours after the present one) shows, Obama had no mandate even from his own party. He ran behind most Democratic House members.

    I have not looked at the Senate ESP pattern, but it is probably similar even for those elected with Obama. Of course, most Democratic Senators were elected before Obama ran for President, which only exacerbates the ESP problem. Some of them were up for reelection at the midterm. We now know how that turned out for them. (Does anyone have the breakdown of swing-state Senators’ tendency to be reelected in 2010 as related to vote on provisions of the healthcare bill?)

  10. My take on this is that the Obama administration did not want the public option on policy, not political grounds. The political support thing is a smokescreen. In other words, even if Obama was dictator and could implement a health care system by fiat there would be no public option. This might be too cynical.

    Still, it has occurred to me that Obama did manage to avoid the debacle of the first two years of the Clinton administration. He actually got most of his agenda enacted into law, and the Democrats keeping the Senate, even by accident, means that bills passed by the Republican House can be strangled there and the President doesn’t have to be in the position of vetoing potentially popular legislation. He is also fortunate politically that the new House majority has nothing like the program for governing that Gingrich had in 1994. The new House leadership is overweighted with the same tired hacks that the voters threw out in 2006. This isn’t good for the country but could be good for the President.

  11. Alan said: “Electoral disquiet in the face of broken promises, particularly, core promises, is not limited to US politics, as the Rudd-Gillard government discovered on the issue of climate change.”

    Except in Australia voters concerned about the issue had the option of voting Green, and actually getting Greens elected. In the US, people appear to have stayed at home.

    I do find it strange that people are seriousky claiming this election expresses the will of the “american people”. Isnt turnout down about 20% from the 2008 elections? I know its normal, but still.

  12. When Obama did not try, and in fact lied to supporters about his deal with Big Pharma, it is wrong to state there was never a persuadable majority in the Senate. We never knew for sure because of the inaction from Obama.

    Surely there are lots of things Congresses and Presidents have passed over the objection of the American people because Presidents pushed for it to pass. One thinks of the NAFTA under Clinton for starters.

    The public option would have gone a long way to making a majority of the Americans to really, emotionally be tied into supporting the reforms overall. The President has been tone deaf politically, and looking for consensus when the other side has brought a knife and saying this is a fight.

    Good riddance to Blue Dogs who lost. Good riddance to the ultimate Blue Dog, Blanche “The Scorpion in the Frog and Scorpion Story” Lincoln. That’s my only solace nationally outside our civilized state. A slender reed indeed…

  13. DC, you are exactly right about the existence of other options in Australia (or most other countries). That makes a big difference, and I will come back to it.

    As for Clinton and NAFTA, he passed it with support from the opposition party, whose president had been the one to negotiate it. Also, a free-trade agreement brought forth under “fast track” is not subject to a Senate filibuster. Finally, Clinton negotiated “side agreements” on NAFTA to win over some votes from his own party.

    The difference from the health-care bill, which was clearly going to require unanimous support from Senate Democrats, plus at least one Republican in the Senate, should be clear. It also barely got through the House, with just one Republican vote. (That Republican was one of two defeated in 2010.)

    Many people seriously over-state the ability of leadership to make a difference in the US presidential system, and under-state the institutional constraints. What good would it do Obama to go on a public campaign for something and lose, when his own party failed to support him? In fact, such an effort might have produced an even bigger backlash. Would it be worth it to get nothing?

    Remember when Clinton took out a pen during a speech and said he would veto any bill that did not have universal coverage? He never even got the chance to follow through on that threat. As Ed said, Obama avoided the mistakes of Clinton and other predecessors, and got a progressive policy change that has been on the left’s agenda for decades.

    Serious people can disagree on whether the bill that passed was an accomplishment worthy of praise by advocates of bigger reform. But, given the constraints, it looks pretty good from here. And I say that as someone who would prefer a fully non-profit insurance health system.

    Those who feel like Mitchell should support the development of a stronger Green Party, and above all, support the cause of fundamental political reform. Without a strong Green Party and the political institutions to translate “progressive” voices into seats in Congress, what you saw these last two years in progressive policy reform just may be the best you will ever see.

  14. “What good would it do Obama to go on a public campaign for something and lose, when his own party failed to support him? In fact, such an effort might have produced an even bigger backlash. Would it be worth it to get nothing?”

    The thread is drifting a bit, but I can think of a contrary historical example. FDR’s “court packing” plan failed to get through Congress in 1938, largely due to opposition from his own party, but may have prompted the Supreme Court to start ruling differently on economic regulatory cases (“the switch in time that saved nine”).

    I think that if a populist president proposed a reform that both was easy to understand and which polled well, but which was shut down because a majority of Congress opposed it, he would acquire a useful tool to convince the voters to turf out Congressmen and Senators who would be likely to oppose his policies in other matters. But we don’t know this because this situation simply hasn’t existed for decades in American politics.

    Also, the absurd 60 votes to pass legislation requirement in the Senate is a rule, that could have and should have been changeable by the Senate majority.

    I would like to see a party’s presidential nominee, and his party’s leaders in the House and Senate, hammer out a simple joint legislative program and campaign for it in the election. Also a mixed debate featuring the presidential and vice-presidential candidates, as well as each party’s leaders in the House and the Senate. But we are a long way from getting that. But I think American politicians have been starting to abuse the lack of accountability built into the “checks and balances” system.

  15. I absolutely agree that blocked political systems need fundamental reforms. I would not think Australia exempt from that requirement. If the House were elected by proportional representation we would have 17 Green MHRs rather than 1. Nevertheless, the need for fundamental reform is not a get out of gaol free card.

    The opposition set up a parliamentary situation in which a cap-and-trade scheme could only be enacted in a joint sitting after a double dissolution. The rationale by which Julia Gillard and her allies forced abandonment of cap-and-trade was that a double dissolution would not necessarily lead to Labor gains in the Senate and would enable the election of Green senators. The bill could still pass a double dissolution, but Labor could lose Senate seats. Retreat seemed good politics to the Labor opponents of a double dissolution, but it destroyed the extraordinarily high standing Rudd and his government enjoyed in the electorate.

    Hugh Mackay, probably our most eminent social researcher, wrote at the time:

    As an issue, climate change was a big contributor to the euphoria surrounding the 2007 election of the Rudd government. People generally accepted there was a looming environmental crisis and they were expecting to be recruited into the war on global warming in the same way they are recruited into the battle to conserve water, via restrictions on consumption.

    But it was clear, even then, that climate change would rapidly fade as a political issue if this recruitment of individuals didn’t quickly occur. Human nature being what it is, people must be engaged directly and behaviourally in an issue if their commitment and interest are to be sustained.

    Because voters were so impressed by Rudd’s apparent passion and conviction on climate change, they were expecting to be called on to reduce their own carbon emissions and to take positive action to reduce their demand for energy – drive less, fly less, turn off unnecessary lights in the house, wear clothing that would minimise our reliance on heaters and air-conditioners, etc, etc.

    Mackay wisely notes that a double dissolution would itself have been a risky strategy because the failure to recruit individuals had already weakened the government’s hold on the issue. (The ETS bill itself implied that individual action was entirely irrelevant)

    I am not arguing that the Obama administration failed to make the right proposals on healthcare, climate change or even DADT and that purer bills on these topics would have passed. I am arguing that an entirely disengaged administration that failed to mobilise the electorate for change, and whose private actions contradicted its public stances, was always going to end up trapped in the fierce urgency of some time real soon now ummm maybe.

  16. Good points, Alan. The Mackay quote is excellent.

    I lament the loss of opportunity on climate change in the USA. I am not sure there really ever was one, given the Senate opposition. But if there was an issue in Obama’s first two years where leadership and taking risks might have had a fighting chance, I suspect this, rather than health care, was it. However, I have spent this thread making the point that institutional blockages trump even the most “transformative” leadership. So I had better not push this thought too far. I still can’t see who the persuadable Senators would have been on cap-and-trade. But policy progress on this front would have been less obviously a pushing of traditional Democratic interest-group demands than was health care. So it might have been better politics. I don’t know, and we never will know now.

    I said it on this blog back in 2008 more than once: I voted for Obama in the primary, after initial skepticism, because I thought he had a chance to rattle some cages, to “transform” politics as we know it, by using the vast network he was building as something more than a top-down rallying system to be used when it suited the President and the party leadership. So, in this sense, one can make the case for a failure of leadership or even a betrayal. However, the problem I have with this strand of thinking is, as I have said before in this thread, I can’t imagine who the persuadable ones were, no matter how much public clamor and individual “investment” the President might have been able to enlist with a more transformative leadership style. The system really is blocked and polarized–a lethal combination.

    (And if only we could re-set the entire Senate, as you can in Australia–even if you rarely do.)

  17. I’m not sure if I agree with this reasoning, but here’s one potential reason to focus on health care before/rather than climate change. Health care subsidies and regulation are entitlements, for which individuals can point to specific benefits. That makes it much harder to imagine a repeal than for cap-and-trade, for whom the beneficiaries are mostly children, who of course can’t vote.

  18. > “(And if only we could re-set the entire Senate, as you can in Australia – even if you rarely do.)”

    Four of the six double dissolutions happened within one (admittedly, turbulent) 13-year period, May 1974 to July 1987. No Senator elected between 1967 and 1990 got to serve a full 6-year term.

    Since this was my formative years in learning about politics, I rather simplistically assumed that DDs would keep occurring indefinitely, much as (say) an American baby-boomer coming of age in the decade between Kennedy’s assassination and Watergate might have taken it as read that Presidents vacating office and new Vice-Presidents being confirmed was the new constitutional order.

    What happened, of course, was that the party hardheads and numbers persons eventually noticed that a DD meant a lowered Senate quota, cut by almost half, and that far from being an opportunity for the voters to kick out an obstructionist opposition majority (as the Founders might have expected), it had become an opportunity for the voters to elect even more minor-party and independent candidates than usual. So Howard blinked on Native Title in 1998, just as Rudd blinked on an ETS this term. Neither wanted to hand One Nation/ the Australian Democrats, or the Greens/ Family First, respectively, an extra seat for another 6 years.

  19. More correctly, neither saw their legislative programme as having any significance at all compared with the central goal of ensuring the maximum number of places in the Senate for their party. Even more correctly, Rudd appears to have been the blinkee rather than the blinker.

  20. I actually think Obama did the right thing with healthcare reform-in terms of the mechanics of getting it passed, whatever the merits of the proposal.

    He seems to have correctly recognised that trying to dictate the detail of the reform to Congress, when the ability of the congressional Democratic party to bring a reform even to a vote was doubtful, would have been a mistake.

    You might argue that (owing to the absurd expectations Americans have of presidential power-thanks Woodrow) he was perceived as having ceded control of the process to a cabal of legislators and thus opened himself up to effective political attack. You might also argue that too many concessions were made to the insurance companies.

    But the former prevented legislators of his own party who were basically against reform, either out of principle or out of fear of the consequences, from hiding behind the excuse that the President was bullying them, and the latter disarmed the most potent opponents of change in the American healthcare system.

    On the latter incidentally, keep in mind the words of Aneurin Bevan, the father of the British NHS, which is an actual socialist healthcare system. To overcome the resistance of the doctors in nationalising healthcare, he “stuffed their mouths with gold”. The Tea Parties might flatter themselves that they won the House for the GOP, but they didn’t stop the reform even after the MA special election.

  21. DC: Another spot-on comment about the politics of the policy!

    Vasi: Point taken, although that problem applies to ETS or other carbon-reduction policies everywhere, and is not specific to the US political system. Moreover, it is not clear that the health-care bill, as passed, delivered tangible benefits to middle class voters in the short run. If it had, I would find your argument more compelling. But it seems that a fundamental problem was that many voters saw their existing benefits as threatened, and too few saw sufficient new benefits. The main short-term beneficiaries look to be either people who don’t vote in large numbers, or Democratic-aligned interest groups. That’s a political problem, even if the underlying policy is still arguably an aggregate improvement.

  22. Then again, most of the provisions are already popular! Part of the political problem may simply be that so many of them didn’t kick in right away (which is all that much harder to achieve when dealing with 2-year electoral cycles).

  23. On policy, it may also be noted that the reform as enacted more or less mirrored the consensus that had emerged among many centre-left health care experts since the last effort failed. Preparations for this kind of reform was begun by the new Democratic majority in 2007, most notably by the chairman of the crucial Senate Finance Committee, Max Baucus, and the new head of the CBO, Peter Orszag (who later moved directly to the Obama White House). All their major presidential candidates endorsed something like this.

    So the core of the reform was always going to be the exchanges, made workable by the individual mandate, heavy regulations, and large subsidies for lower and middle income people. Medicaid would be expanded to others. Reform would be financed by new customers, new taxes, and cuts to Medicare (partly through the legislation itself, partly by quasi-fiat after studies). Compared to this complex structure, the struggle was really over relative details, like the public option, which can be fixed later by Congress or even by the states.

    On repeal, perhaps it is a good thing, now, that the real money only begins to flow in the 113th Congress. There is a small opportunity then, however a lot of Republicans probably like Obamacare on policy grounds but have simply taken care to reap maximum political benefit so far. They should be advised to not obstruct at the state level, where much of the reform is implemented, since it will possibly be very obvious before the end of the decade which states are under good government in this field and which are not.

  24. I think the difference between Matt’s view and my view comes down to whether the president can use the office as a bully pulpit, as Teddy Roosevelt used to say. I believe it can be so used, and Matt is more of a structuralist than I am. I am not saying one can persuade about anything and everything, but I am saying, within the system, there was a way to push Blue Dogs into supporting the public option. It had the element of fairness in the way that regular folks agree with when they first encounter the argument, “Why not give equal time to creationists in school?”

    Our nation has developed a deep sense of equal protection sorts of analyses and the public option fit within that analysis.

    Obama has failed the leadership test, Matt. That’s my overarching point. He has acted like Jimmy Carter or Herbert Hoover, who had their defenders in their time saying a president cannot be transformative, only to be followed by…transformative presidents.

  25. One wonders about the metrics of arm-twisting. Would it have been harder to get the Blue Dogs in line for a public option than it was, say, to get civil rights legislation past the Southern Democrats in the congress faced by the Johnson administration?

  26. It stands to reason that the more the politics are polarized along partisan lines, the less presidential leadership will make a difference.

    “Blue Dogs” were barking against the tide of polarization and were hardly going to enhance their survival prospects if they voted for a liberal priority.

    I think the answer to Alan’s question is clearly and resoundingly “yes.” Then again, more fundamentally, the question rather misses the point. The Civil Rights Act passed with a higher percentage of Republicans voting in favor than of Democrats. There were 66 Democratic Senators back then, 22 of whom felt sufficiently free of the great arm-twisting leadership of LBJ to vote against the cloture motion on their president’s prize legislation.*

    By the way, I call myself an institutionalist, not a structuralist. The latter has a rather different connotation in the academy, but that’s just a semantic point.

    * See the summary at Wikipedia. (I don’t like citing Wikipedia, but the footnotes on the relevant part of this article look solid.)

  27. And so we followed the Blue Dogs’ advice, which was “Let me vote against the Democratic Party’s position so I can get re-elected…” and…oh wait, most of the Blue Dogs were defeated anyway.

    My feeling is that had the Blue Dogs adopted a true populist, instead of a corporate fealty position railing against “Washington DC”, more of them had a better chance of being re-elected. The only exception was Grayson in Florida, who sadly revealed himself as Nixonian in his misleading attacks on his opponent, and who was already in a district that had long been Republican (his 2008 victory was being in the right place at the right time on the Hope & Change Train).

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