Being into the whole history thing enough to have written a book on it, I tend to take a long view on the big policy battles we fight today. As I wrote the other day, no piece of legislation ever gets to perfection, and on plenty of them you can have a perfectly legitimate debate even over the most well-intentioned bill over whether it does more harm than good. In addition to the actual policy particulars, lawmakers have to weigh (if they care about political survival) a wide range of other factors, including the political implications both nationally and in their home districts, the symbolism of what they are doing, how the interest groups and donors that matter the most to them are impacted, and how the media nationally and back home are treating the issue. Trying to factor in all these things is intense, and it is understandable that politicians sometimes have trouble making up their minds.
For reasonably progressive-minded advocates and lawmakers on a huge issue like health care, after you factor in all of the above, at the end of the day you also have to ask yourself two very big questions. The first is whether the passage of this legislation sets the stage on other issues for better or worse things to come. The second is whether the legislation, even with all of its flaws and compromises, creates a platform to build on in the future.
I know that all of you think I'm writing about health care, and I am. But I think these two questions are equally applicable to the other big fights looming immediately in front of us- climate change, financial reform, immigration, maybe (hopefully) a jobs bill, Employee Free Choice Act. In every single case, progressives are going to have to make difficult decisions re the compromises they will be forced to make. On none of these issues will we be able to get what we want, and some of the tradeoffs will really suck. But as we are debating the policy pros and cons, we also need to keep those two big questions in mind.
Bob Creamer's post yesterday eloquently makes the argument for health care based on the first question, and my own experience in the Clinton White House, and in researching and writing my book, makes me think Bob nails it dead on. When we lost on health care in 1994, and then lost Congress in the elections because our base was so discouraged that they didn't turn out, it made Clinton and Democrats in general hyper-cautious about trying to do anything big or bold the rest of his Presidency. If we had won on health care, we would have kept Congress, and we would have emboldened Democrats to try other big things. It is one of the most basic laws in politics: victory makes you stronger, and defeat makes you weaker. You can fault Obama for some of his specific policy proposals, and for being too ready to compromise on some things, but one thing he has been willing to do is try to do big things, and if health care goes down, the attempt to do big things will probably will stop- climate change probably is given up on as too hard, financial reform gets weaker, efforts to create more jobs probably is given up on, immigration reform very likely gets shelved. If a health care bill is passed, as Bob argues, it will create the possibility of doing other big things.
The second question is more complicated, and depends on how you read the policy being developed. Paul Begala and I got into a debate this summer, because he was suggesting that progressives were being too stubborn on the public option, that we were "making the perfect the enemy of the good." I strongly disagreed with that argument, saying that I believed some reasonably strong form of a public option was an absolutely essential component of health care reform, because without it there would no check at all on the power of the private insurance industry. I still think I'm right, that the public option is part of the thing that gives us a platform we can build on for the future, but Paul's strongest argument was about Social Security: that when it was first passed, it was far weaker than today, and had many flaws progressives of today would have been rightfully upset about, but that it was a platform future progressives could build on. I think that's how we have to view this health care bill, the climate change bill, and at least some other legislation coming down the pike.
Making big changes is incredibly hard in this country. As I write about in The Progressive Revolution, chances to make truly big changes only tend to come along every 30-40 years, and those chances can be snuffed out very quickly, like they were with Clinton on health care. Where there is some early success, momentum can build into something bigger and more progressive over time: Lincoln, Teddy Roosevelt, FDR, and LBJ all achieved most of their big historic changes after more than a year in office. We need to create that platform so we can build big change one step at a time. Every one of those steps will be slow and painful and infuriating. I still have hope, though, if we can get the first step of health care done, we can take another step, and then another one, and that we will be able to look back many years from now with pride because we made big change history when our opportunity for it came.
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Point is, no matter how the reform debate turns out, bill or no bill, the only real winners are going to be the big insurance companies. Their monopolies will continue grow. Their profits and executive compensati
Love
Bette
Physicians for a National Health Program: http://www
Unless and until we find a new way to fund elections --one that gets office holders' hands out of the pockets of industry and instead depending on us, the voters, alone -- unless that happens, nothing will change.
Bob Dole understood if he could deny Clinton any major legislatio
What did it cost the nation in increased costs for heatlh care since '94? How many have died because of the disarray in health care? Studies show that 46,000 lives are lost yearly by uninsured people, who would not have died if they had had health insurance. If dial it down to an estimated 25,000 unnecessar
How costly are the follies of manipulati
http://www
Love
Bette
I don't want government run healthcare even an issue. This is another 900 billion dollar bill that will continue to saddle debt onto future generation
Liberals blame Bush for getting involved in 2 expensive wars.
Well, a year after the election, not only is the government getting involved in healthcare (900+ billion), a 3.5 trillion dollar budget, the still ongoing wars in Afghanista
How much longer can the printing presses, with the Chinese backing the funds, handle the strain?
Secondly, new money goes into the contempora
Thirdly, the idea that the debt falls on future generation
The defense contractor
We could easily eliminate 80% of our military, protect our borders, and have the benefits every other developed country provides its citizens with.
a right
a priviledge
feeding the glutton insurance companies
feeding the glutton politician
feeding the glutton insurance companies,
to me health care is about Human Dignity. that is how i was brought up.
Do members of Congress, the House of Representa
Poll: Only 43% would vote for Obama now.
http://www
Check out the poll results and comments.
Why mention the Constituti
Yes I cited WND. It seems that many on this site think the majority of the population is in favor of the HC bill, which if you open your eyes and minds will see that just isn't true.
If this HCR passes, we'll be needing a whole lot more than 'tea' to calm us.
"Rights" have nothing to do with it. Your humanity is your own concern and you might look to it. Grover Cleveland did say, the people support the government rather than the government supporting the people. The government is, just the same, a mutual support society of the people and, well managed, superior to random acts of charity.
The people who arranged this are monsters. There is no other word for it. Some testifying before Congress on C Span spoke of their shame. This is what the pursuit of profit has become as it began to deal with issues of life and death. Life and death are but commoditie
Scaremonge
Particular
After all, if a person was deserving of good care, that person would be rich.
Amen! Have the progressiv
Limbaugh failed on television because, bluntly, he is not attractive to the most Americans. He succeeds on radio because radio is fractured, a smaller proportion of the audience is sufficient
This kind of media flourished on the business profits of WWII and swayed the boomer generation
To impressibl
They have their random charities and, perhaps, their conservati
At that, the present crisis has a structural component. Bubbles and hoaxes will naturally arise, then be exposed with a general pain. The generality of the boomers are good people enough, all lapses are matters of degree. The greed and short sightednes
While your arguments make sense they are still lacking for me. First of all, we're playing politics as usual. A clear majority of Americans want a universal health care system, most of them support single payer. Secondly, as long as Pres. Obama plays the bipartisan game, he will be held hostage to the republican