Death by Bipartisanship

Health care reform is wildly popular. Three separate polls show over 70% of Americans favor a public insurance plan. Remarkably, the majority of us are even willing to pay higher taxes to provide health insurance for our uninsured compatriots. (see here, here, and here).

But elder statesmen and the Washington commentariat warn that it would be a grave political mistake to include a public option in health care reform. Why? Because it doesn't have bipartisan support.

When the ever elusive bipartisanship becomes a more important goal than, say, the well-being of nearly 50 million uninsured Americans, it's time to examine our priorities.

The supposed superiority of "bipartisanship" to "partisanship" is premised on three myths about the relationship between the people and the political parties. We have become hopelessly confused about ends and means, about why and when bipartisanship should matter. Here then, is a guide to the myths and realities of bipartisanship.

Myth 1: Bipartisanship is good because it proves that a national consensus has been reached.

Once upon a time, the two political parties were more or less equally matched, and bipartisan support for a measure indicated that the views of all Americans had been taken into consideration. But today, the Grand Old Party is viewed favorably by only 28% of the American people, an all time low. At the same time, 57% of Americans view Democrats favorably.

In short, nearly three out of five Americans look to the Democratic party to take care of their interests and consider their views. The basic principle of democratic government -- as the situation in Iran reminds us -- is majority rule. "Consensus," or broad-based popular support, is generally a good thing for any major undertaking. But bipartisanship is the wrong yardstick of the people's will. We've confused a once accurate proxy for popular opinion with the real thing.

Myth 2: Bipartisanship ensures that the proper compromises will be made.

Once upon a time, necessary political compromises were reached by negotiations between the elected officials of the two political parties. Compromise isn't pretty, but it's how we work out our differences peacefully so that the imperfect results will be accepted by all Americans. Bipartisanship was good, in other words, because it made compromise happen.

Since the Clinton administration, however, the GOP has cast itself as the Party of No. This leaves the Democrats with two choices: capitulation to the Right, or legislation on strict party line votes.

The good news is that the spirit of bipartisanship is alive and well -- inside the Democratic party. As the GOP has been dragged to the outer reaches of the Right, Democrats have welcomed the ex-GOP independents and moderates into the party's big tent. The spectrum of mainstream public opinion on health care reform is currently reflected within the Democratic party.

The problem, however, is that the debate on health care reform is being skewed to the Right by holding up bipartisanship, rather than compromise, as the supreme goal. The confusion of ends and means, substance and image, is apparent in the case of the public plan. The public plan option is in fact an exemplary case of compromise. Most public plan advocates recognize that a single-payer health care system would provide better medical care at a lower cost, but understand that single payer is not on the table.

Although an overwhelming majority supports the public plan, a handful of "Centrist" Congressional Democrats have promised to save health care reform by killing the public option. They portray themselves as the voices of compromise, warning us that only they can win Republican votes for their plan. (They can't, of course -- the history of the last 16 years suggests powerfully that those votes will never materialize.) Treating these claims as credible gives these "Centrists" undue leverage in the negotiations. Real compromise -- negotiated among Democrats -- would require these outliers to accept the public plan to satisfy the public consensus. Bipartisanship requires the reverse: repudiating the national consensus to satisfy a few Senators.

Myth 3: Without a bipartisan vote for health care reform, the public will eventually turn against it.

Once upon a time, all the big and great things in American politics were achieved with bipartisan support. Faulty logic and flawed history come together in this most incantatory myth about bipartisanship.

Lyndon B. Johnson did not win Medicare, Medicaid, the Civil Rights Act, and the Voting Rights Act because he respected bipartisanship. Indeed, after his 1964 election when he had a filibuster-proof majority in the Senate, Johnson told his staff:

Hurry boys hurry. Get that legislation up to the Hill and out. Eighteen months from now ol' Landslide Lyndon will be Lame-Duck Lyndon.

As Robert Reich pointed out the other day, Johnson won "because he knocked heads on the Hill."

We should also be careful what we wish for. Franklin D. Roosevelt hardly needed Republican votes, but he did have to win over his own party leaders. As a concession to Southern Democrats, the Social Security act "exempted" agricultural and domestic workers. That is, many African-Americans were denied a "universal" government benefit in order to gain votes from segregationists. Whether you consider Roosevelt's action necessary statesmanship or repugnant appeasement, we can still agree that Social Security is good in spite of -- not because of -- how it was accomplished.

But really, when it comes down to it, does any living American know or care which dead Republican did or did not vote for all those popular programs?

Why, finally, are we hearing so much about "bipartisanship"?

Americans haven't fallen for the GOP's slippery-slope-to socialism theory, or their Panglossian America's health care system is the best of all possible worlds. The myth of bipartisanship is all the opponents of substantive health care reform have left in their arsenal.

Like the boys and girls in my daughter's 4th grade class, the GOP sheds tears about being "excluded." Of course, they're crocodile tears. The GOP, bereft of ideas and abandoned by the public, just hopes to gum up the legislative works. Slow death by inaction is still death. Every savvy political activist knows that, regardless of how little public support you might have, you can usually get traction by complaining about the unfair process.

The motives of the "Centrist" Democrats in the bipartisan chorus are mixed. Some, as Paul Krugman observes, want to be kingmakers. For others, pious commitment to bipartisanship helps deflect public attention from the corporate interests financing their campaigns and writing our legislation. Too harsh? Don't take my word. According to the Chamber of Commerce, "The Senate Finance Committee," dominated by these "Centrist" Democrats, "now represents the last, best hope," to kill the public option. Strip away the mantle of "bipartisanship" and the naked truth is exposed.

Comments

[neckozihp]

The healthcare reform debate has many sides. Reading other articles can be helpful in understanding the issue.
For example: http://townhall.com/columnists/LarryKudlow/2009/06/23/we_dont_need_big_bang_health_care_reform?page=full&comments=true

[Estreet1964]

The Democrats remind me of the Three-headed Knight from Monty Python and the Holy Grail. When confronted by a band of King Arthur's knights they confer about how to defeat them. One of the heads says in a silly voice, "Let's be nice to them."

That's what the Democrats always want to do with the Republicans. They are going to bend over backwards to compromise with the Republicans which will only serve to water down the final bill so it will succeed in protecting the profits of health care related corporations while providing no real relief for WE THE PEOPLE.

And in the end, the Republicans will vote against it anyways.

[capitaldysfunction]

Here Here! to Estreet1964. The Democrats have more cause to worry about a final bill that doesn't get the job done than being nice to their fellow good old boys in both parties. A flaky health care bill, like the credit card bill that didn't address interest rates, is a prescription for electoral doom. If it doesn't matter what sort of results are accomplished, then why vote Democratic?
I am a disabled veteran with private health insurance. I know the government provides better care than the private sector because I have access to both. And if all my Democrat vote accomplishes is the right to be screwed over by a private insurer with a 9.6 million dollar a year CEO who apparently sees denying me as the road to profits that justify his salary, then take your health care reform and cram it in your Republican right wing Democrats-­take-the-b­lame oral cavity.

[bighat]

Do you really believe the republicans are holding up the health care bill?

[capitaldysfunction]

Republicans are right about tort reform but wrong about everything else concerning health care. Republican US Senator Grassley of Iowa has over seventy percent of health insurance companies alive and well and headquartered in his neck of the woods, Iowa, and he receives significant assistance from his cash cow. He is also the principal Republican attempting to negotiate with Democrats in the Senate. His private health insurer-centered proposal may be the only one that will draw enough votes to pass the money test (corruption test?) of the United States Senate, but it is a prescription for systemic failure without sufficient cost control. A health care proposal centered on private health insurance is nothing but a Republican attempt to bring about government intervention in the health system and guarantee its failure so they can continue their right wing anti-government dialogue.

[jill2468]

continued

A majority of Americans supports government involvement in health
care, and many think the government would do a better job than the private sector providing coverage and controlling costs. Most also favor a government option that competes with private insurers. But there are concerns to overcome. Many Americans are concerned that their own health care may be compromised if the government is involved, and while they are generally willing to pay more in taxes for universal coverage, that support drops when dollar amounts are mentioned. Few support -- and many are unsure about -- some of the specific policy options that have been proposed, including creating a government insurance pool for purchasing health coverage. By two to one, Americans disapprove of taxing employer health benefits, and many are uncertain.

So you see, I could have taken the same poll and written an article and titled it “Americans are unsure about Healthcare Reform” and just sited the facts I highlited.

[jill2468]

Here is the poll as printed on the CBS site.. This is the kind of thing that makes most people disregard information on polls given in any article but the poll itself. I also think that the legislators are being Bipartisan. There are far to many questions to ram this thing through Congress without many, many questions being answered. Look what happened when they rammed through the Stimulus Bill.
(CBS) A clear majority of Americans -- 72 percent -- support a government­-sponsored health care plan to compete with private insurers, a new CBS News/New York Times poll finds. Most also think the government would do a better job than private industry at keeping down costs and believe that the government should guarantee health care for all Americans.

The new poll shows the idea of a government­-sponsored plan, or "public option," to be fair non-controversial, though Democrats in the Senate have considered nixing the proposal in order to win Republican support for the bill. House leaders on Friday unveiled a health care reform plan that includes a public option.

The poll reveals, however, the obstacles that remain in the way of the public option and broader reform efforts. Many Americans are concerned that their own health care may be compromised if the government is involved, and while they are generally willing to pay more in taxes for universal coverage, that support drops when dollar amounts are mentioned.

[doug108]

The corporations can't be allowed to win this fight. Enough is enough about profits. Profits and capitalism are not the be all and end all to living a good life. Hopefully the scales are finally falling from people's eyes.

The Republicans know that if people start seeing how other ways of organizing society can work, and that their lives are better for it, things could never be the same.

It IS a slippery slope, for the Republicans and their corporate masters.

[zell]

Thank you, Ms. Cohen, for this posting. It is an excellent article. You have hit the nail on the head. We, the People, are not obsessed with bipartisanship. It's ok if we need the vote, but if we have enough votes why do we have to cater to the republicans? There is something wrong with that scenario--it makes one think that the republicans are in charge when they are supposed to be the minority party. The Public Option would be the greatest achievement of the Obama administration. If Mr. President gives up on the Public Option, then there is no teeth in healthcare reform. There would be just more window dressing for the HMOs to continue getting more money and giving less healthcare to We, the People. As far as the DINOs are concerned, well they are a hopeless cause, unless the constituents of their states vote against them in the next election. Yesterday, I was listening to Thom Hartmann on XM Radio and he called all of the Democrats in name only (DINO) out. I mean he named each one who is against the Public Option.

[Hemihead]

Health care for all is a nice thought, but the simple fact is that a public plan will squeeze doctors and hospital payments, as Medicare and Medicaid do; the balance of those costs will have to be made up by people in the private plans, raising their cost even further.

This will cause more and more people to switch to the public plan which will be less expensive, and eventually eliminate private health care options. In other words we will then have socialized medicine.

So, if you want to increase the deficit by over a trillion dollars, reduce the quality AND availability of health care, then you would be in favor of a public health care.

I personally would rather see tort reform to bring down the cost of private health insurance, and keep our present health care system. I believe that it is better to have superior care for 85% of the people, than inferior care for 100%. In the ideal world we wouldn't be faced with such a choice, but in the real world we are.

[zest]

What part of the healthcare insurance industry does the American public not understand. They are in the profit business not the healthcare business. Without pofit they would not exist. How does that protect your healthcare needs?

[Gingersp]

Not just for profit, but for LOTS of profit!! How many millions do the CEO's of most major health insurance make? The number one enemy is GREED and it will always be with us. That's why you can't make capitalism the be all and end all. Some people aren't satisfied just to live well-- they've got to have it all at the expense of the rest of us.

[hauty007]

WOW the incite & enlightenment of one person's opinion and people believe buy it. As a DEM, let me say 1 thing 1 TRILLION, bigger government, less freedom of choice.

[doug108]

I think we could safely spend 1 trillion dollars over the next ten years on improving our health and access to treatment to everyone.

Better than pissing a trillion dollars away in the sands of Iraq.

[Gingersp]

...or to the insurance big-wigs!!!

[superbowl3]

Universal health care sounds nice but who is going to pay for it? I know I don’t want my taxes going any higher than they already are. There is no cause in this world that would make me agree to raise my taxes any higher than they already are. If this passes, Can Obama honestly say that he will be giving 95% of the American people a tax break? That could be the biggest lie since we heard the words “Weapons of Mass Destruction.”

[Gingersp]

Do the math. If your taxes went up to pay for universal health care, you wouldn't have to pay health insurance premiums (or your employer), deductibles, co-pays, etc. We already pay for "universal" fire and police protection, paved roads, etc. through your taxes. You don't get a biil from the police if you have to have someone investigate something at your home. Why should health care be any different?
AND... if people didn't have to spend their life savings paying for health care after an accident, cancer, etc, they would have more money to spend on other things, stimulating the economy, and making taxes eventually go DOWN. You have to look further down the road.

[pup sydney]

"May be" there is not a majority of true liberals in this country. May be the GOP voters that voted for Dems were not liberals (duh!). May be the nation needs to go further down the drain before eyes open up. The problem is we elect pseudo-liberals, then true liberals get blamed for the problems remaining unsolved, and GOPs get elected and the cycle restarts.
Stop this madness: a third or more parties is/are necessary even if it means not to see progressive advancements for decades because it will keep the "big" players honest and will stop the drift to the right. We have to keep the system honest because now it is a joke and a fraud.

[Dweezle]

Greed! Eliminate Corporate GREED from the medical establishment and it will be affordable! There is nothing in the Hippocratic Oath about treating patients to be wealthy, in fact there is one phrase, "I will go for the benefit of the sick and will abstain from every voluntary act of mischief or corruption and further from the seduction of any patient." If all health care was non-profit as it is in much the rest of the world it would be much more affordable.

[jill2468]

The best and the brightest would then chose another profession. We will be left with substandard care. Think about it.

[Gingersp]

No one is saying that the medical profession shouldn't make a good living. But the costs are ridiculous. We had an emergency room situation where upon getting the bill from the doctor (separate from paying the hospital), he had charged over $300 for ordering an IV treatment. This was in addition to his over $500 charge for his "call". The nurse administered the IV. All the dr. could have possibly done was sign his name to an order. This is where it gets ridiculous. We are up a creek. we have no choice but to pay it (or our insurance pays it). We saw this person for maybe 5 minutes and he may have spent another 5 minutes looking at test results.
I disagree that the brightest and best would look for another profession. Maybe we would actually get people who want to heal.

[camanokat]

Physicians in "socialized medicine" countries make an excellent income. The best and brightest will still go into medicine. For-profit health insurance companies and HMO's will go the way of the dinosaur. Good thing IMHO.

[langej]

Myth 1: Whenever a large (57% or 70%) majority wants something, then what the 28% wants doesn't matter a hoot: Look where that would have left blacks & hispanics yesterday and where it would leave gays today.

Myth 2: The GOP is the party of NO: under Clinton they were and they are going that way under Obama, but under Bush the Dems were the party of NO - opposing government policy on just about everything whilst offering no alternative of their own. Look to the lobby money (healthcare industires have contributed more to Dems than Repubs since 2008) and force the recipients to prove they haven't been bought.

Myth 3: The public will support whatever we can cram through: actually, only if it works. Note the recent public sentiment turning against the Stimulus bill because they see it as not working.

Myth 4: Bi-Partisanship is a lost cause. Refusing to follow that kind of thinking is how Mr Obama got elected. Those who follow this myth will be wondering why they are out of power in 4 to 8 years

[padrushka]

wow,did we just figure out the bipartisan problem? seems like same old same old to me.

[ptbyb]

Nice assumption in the first paragraph. 70%! I don't think so. Write the same article after you've polled a group of "satisfied" Canadians, aka 5%.

[jmyoung666]

Public health insurance dopes not equal Canada. Canada's system is F'ed up, but not because of government insurance. Even Britain's system is not that great. However, France, Germany, and Sweden all have health care systems that are far superior to the US and cost substantially less.

[jmyoung666]

I don't understand where my previous post went, but why do you ignoramuses keep bringing up Canada? Neither Canada nor Great Britain have particularly good systems. However, France Germany, and Sweden all have health care systems that are far superior to ours.

[camanokat]

Then why are Canadians so satisfied with their health care?