THE BLOG
04/26/2010 05:12 am ET Updated May 25, 2011

How Obama's Strategy on Health Care Reform Makes Perfect Sense

I'm not sure I agree with Glenn Greenwald that the absence of the public option in the White House's new health-care reform compromise is proof of Obama's opposition to the public option:

It now seems obvious that White House's claim of support for the public option was a pretense used to placate the progressive base (in fact, it seems committed to excluding the public option very likely because it would provide real competition to the health insurance industry and is thus vehemently opposed by the industry and its lobbyists).

Let me stress that I'm not sure what Obama supports and what he doesn't -- who is sure, outside of Obama and his inner circle? -- though I tend to take him at his word that he would prefer reform with a public option. But I simply do not accept that his various public utterances in support of the public option have all been part of some grandiose "pretense," a Machiavellian plot to delude progressives.

What we know about Obama is that he is a ruthless realist. Whatever his ideals, whatever his principles, he is fully aware of what is possible, or of what seems to be possible, and he generally operates/governs within the parameters of that realism. That's how he was as a candidate and it's how he is as president.

Now, where I am deeply critical of Obama is in the area of leadership. As Ezra Klein writes:

This has been a complete and utter failure of White House leadership. They need to give this effort their support, or they need to kill it by publicly stating their opposition. But they can't simply wait for someone else to make the decision for them, which has been their strategy until now.

That failure continues. Press Secretary Robert Gibbs may very well be right that the votes just aren't there for the public option, but the problem is that the White House -- President Obama himself -- never pushed for it in any meaningful way. What was said behind closed doors I don't know, and he may well have pushed for it privately, but he never came out publicly and demanded a public option or else, using his bully pulpit to move public opinion, providing the sort of determined leadership Democrats needed.

That alone wouldn't have guaranteed success, of course, but at least the public option would have had a good shot. Now? Not.

Ezra explains:

For supporters of the strategy [to use reconciliation for the public option], that's not going to be very satisfying: Maybe there would be more supporters if the president took up the cause! It will also intensify the efforts of activists who want to prove that there is sufficient support, which means individual senators will be under even more pressure to sign the letter, which means this isn't likely to go away quietly. The White House is using the Senate as a sort of human shield here.

For opponents of the strategy, Gibbs's comments will be taken as evidence that the White House opposes the effort. I think that's actually the right interpretation, particularly given that Gibbs later emphasized Obama's intention to discuss "consensus ideas" Thursday, but it would be nice if the White House would just say what it means rather than leaving people to guess.

In other words, Obama opposes the "effort" to pass the public option through reconciliation but, if I may add to Ezra's analysis, not necessarily the public option itself (insofar as that matters at this point).

We may be critical of Obama's conservative approach to reform, of his stultifying realism, of his lack of leadership, but I suspect that the White House is driven primarily by the desire for immediate success, and by the view that passing the compromise (and admittedly flawed) Senate bill (with appropriate modifications to appease the House and improve the legislation) stands the best chance of success given the current political situation.

And why is that? Because the votes really might not be there. Or maybe they are, or at least could be with enough prodding, but maybe securing them, in both the House and Senate, would take too much time, and require too much prodding, too much additional compromise, too much playing off of competing Democratic interests, not least in a challenging mid-term election year.

And maybe the White House thinks that pushing through a more robust reform bill, one with a public option, by way of reconciliation would undermine the president's ability to sell reform as something other than a solo partisan effort. We all know what the public thinks of partisanship. We also know what it thinks of reform -- unpopular within the context of legislative sausage-making, much more popular when the specifics are known. And we know that the media are spinning reconciliation as a dirty word. So how would passing a reform bill, even one with a popular public option, through what is perceived to be partisan trickery benefit Obama, not least given how Republicans would undoubtedly propagandize against both the process and the substance? And how would it benefit Democrats running for re-election in November?

I certainly think that, in the long run, Democrats would benefit politically/electorally from health-care reform. Ultimately, the success and popularity of reform would win out.

But, for now, at this moment, given the current political reality, Obama's clear preference that the Senate bill be passed, with modifications addressed through reconciliation, is completely understandable. It is not what I would have preferred, and a big part of me does wish Democrats would bring back the public option, with or without Obama's support, but, at the same time, I just don't think that this reality can be denied. As Jon Chait writes:

Health care reform is still hanging on for dear life in the House. The dynamic is that the Democrats are going to lose some votes from pro-life members who insist on Bart Stupak's language. They need to make up the votes by persuading Blue Dog and other centrist Democrats who voted no for the original bill to vote yes this time. Many of those centrists said at the time of their original vote that they preferred the Senate bill and opposed the public option. Restoring the public option, aside form sucking up a lot of time by introducing another big fight, would greatly complicate this already-complicated task.

That's why Jay Rockefeller opposes adding the public option to the bill at this point. Rockefeller is the author of the public option. So it seems like the fear that reopening this debate will sink the whole bill really is the reason for the administration's reluctance. Or maybe Rockefeller's in on the pretense, too.

This seems to me to be the correct interpretation. Steve Benen adds:

I realize that Gibbs's response today seems unexpected, but it doesn't strike me as all that surprising -- if the White House thought the votes were there for a public option, the administration would have included the idea in the proposal unveiled yesterday. The fact that the president's version of reform didn't include the idea should have made it pretty clear that the White House thinks, correctly or not, that public option support remains insufficient.

I should note, though, that Gibbs's comments need not be the end of the public option. The White House is under the impression that the votes just aren't there to pass this specific measure, but if proponents on and off the Hill want to prove otherwise, there's still time to do just that. Gibbs didn't say the president opposes the public option -- Obama has said repeatedly he supports the idea, and would like to see it in the final bill -- he just said he thinks the public option lacks the support it needs in Congress.

If public option advocates want to prove Gibbs wrong, now's their chance.

To repeat, there is the distinct risk that such a move could meet with serious popular disapproval. But that's not to say Democrats shouldn't try. If the votes are really there, they should go for it -- and communicate to the public just why they're doing what they're doing. But if not, or if it would be overly costly or challenging, they should do what Obama proposes, which would at least give them a historic accomplishment to run on, major legislation to call their own, and which would benefit the American people with meaningful change to a health-care system that is unfair, unjust, and economically destructive.

Let's just be realistic about what can be done.

(Cross-posted from The Reaction.)

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