Health Care Reform and the Democratic Party

The debate within the Democratic Party over health care reform generally, and the public option specifically, raises several bigger questions about the party. These questions predate the health care debate, but the controversy surrounding the extent of the Democratic Party's commitment to extend health care to as many Americans as possible brings this into sharp focus. If the Democrats do not pass a meaningful health care bill, with a public option it will be hard to answer the question of what the purpose of the Democratic Party is.

The Democratic Party has not been burdened by a unified ideology, or even vision, for quite some time. The last major legislative victories by a Democratic president occurred during the mid-1960s during the Johnson administration. Even the accomplishments of the Clinton presidency, the most successful Democratic administration in at least a generation, were products of good management and small scale legislative changes, not sweeping reform or major new programs.

During most of the last 40 years, the Democratic Party has defined itself primarily through opposition to the ascendant Republican Party. Never was this clearer, or more necessary, than during the eight years of the Bush presidency. Public anger at the Republicans by the end of the Bush administration was almost certainly the major contributing factor to major Democratic victories in 2006 and 2008. Being the party of opposition relieved the Democratic Party of having to initiate or agree upon any vision or policies. This worked fine, until the Democrats won control of both houses of Congress and the White House in 2008.

The failed policies of the Bush administration and the extraordinary desire for change during the last few years masked the reality that once again the Democratic Party was not unified around, and to some extent did not really stand for, anything. This was not a problem during the campaign or even the last two years of the Bush administration, because the Democratic Party could effectively define itself almost entirely relative to the Republican Party. However, it has become a big problem now.

Republican talking points notwithstanding, the biggest danger the 2008 Democratic election victory presents is not Nancy Pelosi, Harry Reid and other congressional Democrats steering the country to the far left, but of the Democrats failing once again to use their power to chart a new more progressive course for the country. While the Republican supported tactics including confrontational town hall meetings, rumor mongering, Nazi and red baiting, are repugnant, they are not entirely relevant to the health care debate, or any other part of Obama's program. At least until 2010, legislation will occur almost entirely within the Democratic Party. A united party will not be easily stopped, but powerful Democrats who want to weaken or stifle progressive legislation have a great deal of power in this process, far more than congressional Republicans.

The Democratic Party has always been an umbrella party representing a broad range of views. There is nothing new about this, but the overall political environment has changed. With the liberal wing of the Republican Party all but nonexistent in recent years, the Democrats need a greater degree of unity to be successful. The next few months will determine whether or not that unity exists; and health care will be the key issue where this will be tested.

It is evident by now that health care reform without a public option will represent minor change and not solve the major health care related problems facing many Americans. If health care reform with a public option is not passed it will almost certainly be due to some Democratic members of congress who oppose the public option. This will represent a failure of the Democratic leadership at an absolutely decisive moment in domestic policy making, perhaps the most decisive in a generation. Failing to pass health care reform because of Republican opposition is politics as usual and Democratic voters would have to accept that defeat and move on. Failing because of what happens within the Democratic Party is a categorically different problem, and a far more serious one.

A failure of unity at this moment will raise the question of why the Democratic Party exists. This is something of an overstatement because it is obviously important to have an alternative to the Republican Party; and even an unsuccessful Obama administration would be a great improvement over the Bush administration. However, if the Democratic Party, with sizable margins in both houses of congress and a popular president, manages to lose health care reform to internal fighting and to its own conservative wing, the question of what the Democratic Party can do, or what it is for, will be hard to avoid. The party will have demonstrated that it cannot be anything more than an alternative to the Republicans. This is not a good foundation on which to continue to build for the future or a good strategy for maintaining recent Democratic electoral gains.

Comments

[creolechild]

If you are concerned about receiving "real" health care reform in this country, please take the time to watch a video on our current system. The video was created by Oregon physicians who are advocating for the single-payer option. The video is very informative and helped me to gain a better understanding of various aspect of health care, as we know now it.

https://www.madashelldoctorstour.com/Mad_as_Hell_Video.html

These Oregon physicians are in the process of organizing a caravan designed to inform the public about the benefits of the single-payer option. At last count they will be stopping in approximately 23 states, on their way to demonstrate in Washington. They need volunteers and our support. Please spread the word.

[SRAC]

The business of Congress is running for Congress. Congress no longer writes or initiates legislation as the Constitution directs. Congressional legislation is often written by lobbyists not legislators: such as Enron writing much of Dick Cheney's energy plan.

As long as the voters and courts allow Congressional representatives to spend unlimited sums to run continuous campaigns, we will have this cycle of corporate interests controlling and being put ahead of the legitimate needs of the people and even the country. We are left with elected "superstars" surrounded by campaign staffs rather than legislative staffs. Our federal and state governments will continue in the same self-defeating, destructive cycle we now have as long as their primary job is fund raising. You cannot serve two masters with different needs.

[Arion]

The administration gave away the store when they chose not to go for single payer. Presumably why wanted to avoid a firestorm. Well, they got one anyway.

[FrankFurter]

"If the Democrats do not pass a meaningful health care bill, with a public option it will be hard to answer the question of what the purpose of the Democratic Party is."

Uh not really, you familiar with that Occam's Razor thing?

They're in on it.

Please, can someone remind me why I still go through the motions and vote these days, anyone?

[krocklin]

Obama must behave as though we are in a Depression.
Eventually it will become apparent that America is permanently weakened. Then we will have at least Universal Care. But it could take years. At that stage America is rich enough that it will show signs of revival.
We thought Obama brought promis that is would happen sooner.

[jmpurser]

At this point I think the question: "What are the Democrats good for?" is perfectly valid. They seem to represent the sane right wing of the nation.

[FrankFurter]

The Democrats are good for the Republicans. Not so much for their constituents.

[Polly]

Right On!!

[Northreader]

I'm afraid comedian Bill Maher is right when he says the United States does not have a progressive party. Watching from Canada, I find the timid Democrats somewhat depressing. The fact I live just north of Blue Dog Senator Kent Conrad's North Dakota and often see him in action, makes it worse.Part of the problem is obviously the fact that money fuels so much of American politics and the concerns of average people often get drowned out.

[NEWDEALTIME]

In all the discussion of revamping our health care system, the concerns of some involve the expense of change, but there is no talk of redirecting some of the bloated military and security budget to serving the urgent public needs of health and education.
The direct and indirect military budget for 2009 exceeds $1 trillion dollars, including the wars in the Middle East. Add to that the secret amounts spent on intelligence and the “black budget.”
These sums are far more than the rest of the world spends on such matters, and are basically devoted to maintaining America’s empire, with its thousands of foreign bases, and its threat of interference with other people’s lives and well-being.
Judicious trimming of military expenses would help pay for health care for all Americans, at no diminishing of our safety. The military, industrial, and congressional complex, against which General Eisenhower warned, should do its share for the good of the country.

[freddiefreeloader]

All the developed countries around the world all have universal healthcare except the U.S. My first question is Since the American healthcare system is the best in the world than how come the rest of the world does'nt use it?
My second question is, I've been married six times and have no children, What is the matter with all those women?

[wikwox]

The Democrats problem? Two words: Pelosi and Reid. They have been epic failures and need to be replaced.

[kimleehan]

I agree about Reid, He does'nt know how to use a super majority but Pelosi, no way, She told the President she could pass a public option and she will, matter of fact the house will not pass healthcare reform without a public option.

[glitz]

No, the Democrat's problem is Blue Dog Dems. Alabama elected Parker Griffith, who passed himself off as a Democrat. He replaced retired Bud Cramer..at least you could count on Bud to compromise.There is nothing about Griffith's voting record or his actions at "Town Halls" that meet any of the criteria of a Democrat. Money given, time given to Southern Democrats is lost effort. This man was a Doctor, so you would at least think he is for Health Care Reform...nope, he is backed by Pharmaceutical money. He doesn't even want to work with his own party...just takes their money to get elected.

[den1953]

It is not this complicated people elected the Democrats because they want change so Democrats it is obvious the Republicans aren't going with that program so if your passion for heath care reform is strong and you know the people need it vote it in grow a set and stop thinking about the next election. If you don't support the will of the people i bet you there will not be a seat for you next time!

[DavePalen]

If you are for health care reform, why is there no provision for tort reform? All the so called needless tests performed are mostly due to the fear of lawsuits. Until I see the Democrats call for restraining trial lawyers, I know most of this is a joke. Trial lawyers and labor unions give millions to the party and the party doesn't want to hurt their feelings. Yes, I know that someone will point out that the few states that have imposed tort reform haven't seen a significant drop in premiums--most likely because it has to be a nationwide effort, not just a few states.

[blueken]

While I agree that tort reform would be nice, it ain't the monster that needs slaying first. Litigation only adds 1% to the cost of health care. I admit that un-needed tests adds another figure, but I doubt it is substantial. The real villian is the drug and health insurance industry. Follow the money. Look how premiums and co-pays have risen lock step with profits. Look how the drug industry plasters TV with erictile dysfunction ads. I have seen very few cures come out of the drug industry in the last 40 years, but I see a whole lot of symptoms being treated. I see most of the other modern countries negotiating drug prices, and if a drug is to expensive and there is a comparable drug that costs less, those countries won't buy the expensive drug. Look at the profit and growth of the drug and insurance industry. How can you call it a free market when they have your health in thier hands? Take profit out of health care. Illness shouldn't be a business.

[TheIndependenceParty]

It i clear that the Democratic Party is simply the remainder after the Republicans clear their ever smaller tent. While that reality leaves no reason to hope there would be a cohesive party platform on anything, it is baffling to me how far that diversity can go under the influence of corporatists, lobbyists, greed, political self-interest and stupidity. My senator, Arlen Specter, comes to mind. The Democrats should have made him earn his new identity, and demanded some loyalty right up front.

Second case in point, ... the mad blue dogs, ... in particular the "Gang of Six", of whom three are wayward Democrats, and the other three, invited Republicans. Whoever told Baucus he should create a power sharing coalition on financing healthcare? What sort of third world mindset does he hold, that he would decide to abandon his party for the purpose of subverting its legislative goals. In short, who the F does he think he is, and where are party officers when they are needed to get his attention and apply the whip?!!!

This is not a party so much as a congregation. There are no cogent leaders, and there is no cohesive plan for what Democrats intend for America. Sad, ... They certainly had enough time in their own wilderness to formulate a few!

[SShaw490]

Democrats have never been cohesive like Republicans. Democrats actually LIKE people who think for themselves.

[BryanTheRegOps]

...and that's good and bad. In this case its bad. Dems need to get on the same page.

[SShaw490]

I agree the Democratic party needs a vision. But rank and file Democrats need one, too. Rank and file Democrats need to understand that America is a big ship and it doesn't turn on a dime. It takes years of patient, responsible legislative effort to turn it around. For example, defining success by "does it include a public option" - no matter what other good things can be accomplished - is a bad metric. The metric should be whether or not the American people are benefitted overall by a piece of legislation.

If substantial insurance reforms and subsidies are instituted in an effort to get to universal coverage, the package includes an expected overall cost reduction mechanism, and there is a mechanism to trigger a big public insurance plan (akin to the Dem-beloved "single payer") if expected cost reductions are not realized, then that's success in my book. That won't be as likely to trigger a loss of Congress by Democrats (a bad thing, since Republicans will just try to undo whatever the Dems did) and, a few years from now, may in fact result in single payer.

The trick to all this is you have to take a longer view than a typical 24 hour news cycle. Social Security took years to develop; Medicare took years to develop; civil rights took years to develop; and now people have an expectation of instant, radical reform of the thorniest legislative issue in history?

[TheIndependenceParty]

HuffPost's Pick

"America is a big ship and it doesn't turn on a dime.", ... your words. But it has in the past.

When Reagan manipulated the Iranians holding Americans hostage, ... it made Carter a laughing stock, and sealed his fate.

When Bush went on vacation and ignored warnings that Bin Laden would attack America, ... it changed America and its course within hours.

There are tens of millions of Americans who can not count on healthcare. Tens of thousands die each year for lack of it. America is 37th in the world for quality and availability of medical care, ... and this catastrophe proceeds apace, while Democrats dither about what to do.

This is a choice. America has proven time and again that we can do almost anything, almost instantaneously, once we find the will.

Leadership, at its core, is the ability to direct the will of the majority. Quality leadership does so to the betterment of those led. FDR and Ike come first to mind. Neither party has a leader such as those men.

[DavePalen]

Seems to me that it is only in America where those from other nations flock to get the best in treatment and where the best drugs are developed. How about tort reform if you really believe in health care reform and stop pretending otherwise.

[SShaw490]

I said that universal coverage and subsidies were necessary - otherwise, we aren't doing anything at all. And you cited single incidents that were, by their very nature, discrete, go/no go decisions. This isn't go/no go. This is a process, not a single, discrete decision.

Achievement of universal coverage and subsidies IS reform, any way you slice it. Every American would be able to get health care when he/she needs it, regardless of their employer's provisions and regardless of their financial circumstances. Defining pass/fail in terms of a public option or not, is ignoring the scope of the problem and focusing on a single tactic.

It was a long road to Social Security for all Americans, it was a long road to Medicare and Medicaid and it was a long road to achievement of civil rights. If you put a pass/fail marker 3 months into any of those paths, you'd have labelled all of them as failures.

[ErikaAdams]

Why do you want to insure the uninsured? As a staunch environmentalist, I am baffled by the so-called progressive mindset that thinks by extending and saving lives, we are somehow helping our overburdened planet. This is precisely the type of self-serving thinking that typifies the conservatives. I can only assume that those of you who preach this empty rhetoric care more about yourselves than our planet. Really, how can you laud Obama for cap and trade on one hand and then support his health care for all idea? They are diametrically opposed. You cannot save the planet and increase population. One takes precedence.

[SayBlade]

Interesting you should mention Jimmy Carter's role in the release of the American hostages in 1979. With the approval of the Carter administration (at the disapproval of the rest), the Shah of Iran received American health care at the Mayo Clinic for cancer. Carter did all the work negotiating with the hostage takers and worked with Canadian Ambassador Ken Taylor to get some of the hostages in the Canadian Embassy in Tehran and eventually all of them released with the help of Prime Minister Joe Clark and Foreign Affairs Minister Flora MacDonald secretly facilitating the project. Unfortunately, history is not kind to Carter and Ronald Reagan rode Carter's coattails to victory on that.