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Pragmatist Hope for Health Care

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Yesterday, David Brooks opined in the New York Times that President Obama's slide in the polls stemmed from his embrace of the left wing of his party, thus losing the support of the political center supposedly more concerned with federal budget deficits than with the plight of the uninsured. Brooks's point is that it would be "suicidal" for Obama to push through health care reform without appealing to the real American values of the political center: "You can't pass the most important domestic reform in a generation when the majority of voters think you are on the wrong path. To do so would be a sign of unmitigated arrogance."

As I held the morning paper in my hands, I realized that in the same space on the op-ed page about a week before Paul Krugman had made almost exactly the opposite argument. Krugman criticized the president for reaching out to a middle that wasn't there. In trying to achieve bi-partisan support, Krugman observed, Obama was losing the energy to achieve any substantial health care reform. On August 22 Krugman wrote:

"It's hard to avoid the sense that Mr. Obama has wasted months trying to appease people who can't be appeased, and who take every concession as a sign that he can be rolled."

The columnist urged Obama to forget about pleasing Republicans intent on preserving the status quo.

Talk about getting it from all sides! Progressives (whom Brooks identifies as readers of the Huffington Post!) apparently are disillusioned with a president who looks weak because he continues to work with elected officials who seem intent on seeing him fail. Centrists apparently are disillusioned with a president who can't create a coalition of forces able to pass legislation that will initiate some reform, even if it doesn't pretend to solve all the problems we know are there. The president is accused of being weak and arrogant.

These charges amount to saying what we already know: President Obama is a pragmatist, and he is an heir to the great tradition of the reformist progressives in the United States. This tradition, at its best, has found ways to mitigate the inequalities created by our economic system without sacrificing individual freedoms and the virtues of decentralized power. Those who approach politics with a more theoretical or absolutist bent tell you that the progressive tradition has failed to fulfill its potential, or that it is naïve in believing in incremental reform. But Obama, professorial as he may be from time to time, is no theorist. He has long known that the best is the enemy of the good, and he has been focused on getting something done now that we can build on in the future. Pragmatists don't start with a belief in the "Truth" that they then try to realize with action in the world. Instead, we begin with hope that our country can move along a path to realize its dreams of being a more just and compassionate community through collaborative effort.

Spectators of politics have no difficulty mocking the reformist, pragmatist agenda. It's easy to wave your fundamentalist principles in the air and demand that the president fulfill what you know to be the Truth. Pragmatists, after all, always fall short of the targets established by absolutists on the Left or Right, because we don't believe those targets are anything more than motivators to help get something done in the short term. And through experience and the evaluation of our efforts, we pragmatists are willing to modify our hopes as we prepare for the next round. Our motivation comes from the stories of previous battles fought, and from wanting to add hopeful chapters to those narratives of progress.

I am confident that Obama will stay focused on the moral and historical aspiration of providing health insurance for all Americans while controlling costs and maintaining the quality of care. As part of the great pragmatist tradition in American politics, he will lead efforts to pass legislation that will move us closer to realizing what has already become a shared belief among most Americans: that no one should be denied health care because of an inability to pay. In doing so, I don't expect he will satisfy those who are absolutely certain the government shouldn't get any bigger, or those who have no doubt that only the government can adequately address this basic need. But he will have made progress, and so will we.