Health Care Puts Progressives on the Verge of Changing the Power Dynamic

09/25/2009 05:12 am ET | Updated May 25, 2011

So, here's the deal, folks: Looking at the current state of play on health care through the multicolored lenses I acquired working on Capitol Hill and then working in politics out here in the West, I'd say it's a good bet that the House will pass a health care bill with a solid public option in it, and the Senate will pass a health care bill without a solid public option in it. I'd say it's also a good bet that the major reason -- though probably not the only reason -- Obama has gone back and forth on the public option is because the administration is solely focused on getting bills -- any bills -- passed through each chamber and into one conference committee for a final negotiation.

Once that happens, the health care shit hits the legislative fan. We won't have to speculate anymore about whether the president is really committed to the public option, nor will we have to speculate about whether top senators and House members on the conference committee are committed to the public option. At that point, their actions will be far louder than their words.

Obama will be forced to take a position on the public option as he either draws a veto line in the sand, or doesn't -- and if he doesn't on the public option, it means he's willing to sell out the public option. Similarly, conference committee lawmakers will either have to vote for a public option, or vote with the insurance industry against it.

A month ago, I would have said that the administration was planning to lay low while two templates got into a conference committee, and then sell out the public option in that committee, believing that ultimately, progressives will vote for a bad health care bill (ie. one sans public option but with a few regulatory goodies) rather than kill it outright. The White House is, after all, packed with staffers like Rahm Emanuel and Jim Messina who have made their careers coddling corporate lobbyists -- and the president himself is a guy who has often chosen to seek common ground instead of confrontation with moneyed interests when an avenue is available to do that. That's why, for instance, this administration has exhibited two different standards for dealing with progressive and conservative Democrats -- it tries to push progressives around while kissing the fat, mostly white and mostly southern asses of the so-called Blue Dogs.

A month ago, all of these forces might have made the "roll the progressives, sell out the public option" strategy a legislatively successful one, even as it would produce a bill that would likely be terrible public policy. I say that because let's be honest: the bloc of congressional progressives who the White House would be hoping to steamroll, while fighting the good fight in the lead up to key votes, has nonetheless capitulated on nearly every single do-or-die final-passage vote in recent memory (and I say that sadly, having served as an aide to Progressive Caucus leader -- and dear friend -- Bernie Sanders).

However, after the fantastic organizing/whipping/fundraising being done by Firedoglake, OpenLeft and Moveon and after the strong progressive media pressure on radio, TV and in newspapers, I believe the dynamic -- and therefore the White House political calculus -- could change.

Indeed, all the forces seem to be coming into line: Polls show local Democratic dissatisfaction with easily primary-able Democrats, putting huge pressure on those Democrats to get in line; the Paul Krugmans of the liberal punditocracy, often offering up "on the one hand, on the other hand" dithering at the end of legislative fights, have now come out pretty strong for a public option; mainstream Republican editorial boards like the Denver Post are saying the public option is necessary; the decline in Obama's poll numbers are being fueled by progressive -- not conservative -- dissatisfaction on health care; fundraising for the public option campaign is intensifying; and the organizing work to support the public option is in full gear.

Taken all together, the aimed at A) forcing House Democrats to pledge to vote against a public-option-free health care bill and B) getting Senate Democrats to state their support of a public option may be making the easier legislative path the one that squeezes the Blue Dog Democrats -- not the progressive movement that got Obama elected.

Obviously, the pressure on the House Democrats is the most important. The Senate is basically a wholly owned subsidiary of the insurance industry -- the best we're probably going to do is get enough members to say they support the public option, but it's probably too big a lift to hope to get many of them to pledge to vote against an insurance-industry sop, if that's what the final bill ends up being. However, that's less significant because enough House members taking that pledge -- and sticking to it, rather than publicly undermining it -- creates a veto power all on its own. That is, it creates a Ben Nelson Effect for the progressive movement.

What is the Ben Nelson Effect? Back in 2007 while reporting my book The Uprising, I wrote a post about progressives learning lessons from the Ben Nelsons of the world -- about us learning to use the conservadem tactics of threatening to torpedo a bill to further progressive goals. Back then, Moveon and many other progressive groups as well as many congressional progressives refused to play this kind of hardball, and, as The Uprising showed, our nation paid for it in substantial blood and treasure. So I'm absolutely thrilled that it looks like we're finally embracing the kind of tactics that could force legislative change.

And that's the key word -- "force." As Glenn Greenwald has said, this isn't about trust in Obama, or loyalty to Democrats or affinity for particular legislators because they happen to be nice people. This, like every political issue, is about raw power -- something many of us on this site have been saying for years, something that many progressives in the throes of Democratic Party/Obama sycophancy have refused to consider (and, indeed, many of us who have been talking for years about changing from partisan to movement psychology have been the target of more than a little anger/vitriol/hate from the sycophants).

We will get only what we force both the Democrats and the Republicans in Congress to give us, taking into account exactly how the Congress works. This is, once again, the "Make Him Do It Dynamic" -- and right now, that requires us to build the Progressive Block, as Chris Bowers calls it. We must focus laser-like efforts on constructing a group of House members who delivers on a promise to vote against a public-option-free health care bill. If we do that, we will change the power dynamic in the health care debate by forcing the administration to use its power to make the public option a reality in the final bill that is reported out of the conference committee. And even more broadly, it may change the power dynamic on every other issue by finally establishing the progressive majority in the Democratic caucus -- and not the corporate whores -- as the final "deciders" on other major bill.

These are the stakes, and they are high. While they aren't going to get us all the way to single payer (which I've long said was a huge missed opportunity), they may deliver us a public option that represents genuine progress. It all depends on us. If we can ignore the professional naysayers and power appeasers in the Washington Punditburo (especially the D.C. liberals who keep going back and forth with overwrought handwringing/bedwetting), if we can substitute real pressure for partisan apologism, if we can refrain from making our typical excuses for Democratic politicians, we can actually deliver this Progressive Block and have a real shot to be successful.

And remember, I don't say that very often.