Health Care and the Democratic Soul

What is at stake in the debate over health care is more than the mere crafting of policy. The issue is now the identity of the Democratic Party.

By now we know that Democrats can bail out traditional Republican constituencies like Wall Street, but it remains to be seen whether they can enact a convincing version of their own signature issue: health-care reform.

At this point, it's fair to ask whether Democrats remember why health care is their issue in the first place. As health-care debates always have done, this one has pushed to the fore all the big questions about the rightful role of government, and too many Democrats have sought to avoid them with mushy appeals to consensus and bipartisanship. The war is on and if Democrats want to win they need to start fighting.

In the early years of the campaign for national health insurance, the battle lines were more clearly drawn. Back in the '40s, the issue was part of an "economic bill of rights," a grand Rooseveltian idea pushed by President Harry S. Truman.

Truman had a knack for populist phrasing. "In 1932 we were attacking the citadel of special privilege and greed," he declared in accepting the Democratic presidential nomination in 1948. "We were fighting to drive the money changers from the temple. Today, in 1948, we are now the defenders of the stronghold of democracy and of equal opportunity, the haven of the ordinary people of this land and not of the favored classes or the powerful few."

The Democrats won that particular battle with "the powerful few" but, fighting among themselves as usual, failed to enact national health insurance. Health-care reform nonetheless remained their great cause, their high-voltage appeal to average voters, even those who otherwise saw them as a Harvard-and-Hollywood elite. And even during feeble reform campaigns like President Bill Clinton's 1993 attempt, the opposite half of the populist melodrama--in that case, the insurance industry--duly acted out its corporate bad-guy role.

This year things were supposed to be different. Democrats hold good-sized majorities in both houses of Congress and are led by an eloquent president who won an undeniable mandate last November. This time, the Democrats got the traditional opponents of health-care reform on board: "Ex-Foes of Health-Care Reform Emerge as Supporters" declared a headline in the Washington Post in March, over a story describing a friendly summit meeting between Mr. Obama and various health-care industry representatives.

This time the health-care fight was to be what official Washington loves: An act of cold consensus, not of hot idealism or Trumanesque populism. All the "stakeholders" would be taken care of. No one would need to get his suit ruffled.

And all it took to send the whole thing crashing to the ground, it now appears, were a few groundless rumors and a handful of angry right wingers who figured out how to game town-hall meetings and get themselves on TV. "Today there is another populist revolt afoot," wrote Gary Bauer in Human Events last week, hailing the righteous grassroots outrage he sees in the town-hall protests.

So we have come full circle: The reformers shake hands with the special interests, while conservatives denounce the whole thing in the name of the common man and the Founding Fathers.

After I listened to a few angry town-hall meetings on the radio, the situation was clear to me. Democrats had to meet this pseudo-populist challenge by rolling out the real thing, the New Deal vision that is their party's raison d'être.

So far, however, many in the party's leadership haven't been able to awaken from their bipartisan reverie. When Mr. Obama found his plans under attack, for example, he promptly began to downplay the "public option," an obvious predicate to cutting a deal and placating the insurance industry. In other words, the prospect of a populist outburst from the right apparently moved him toward abandoning the most populist element of his party's plans and toward an even more Beltwayist position--to move that much closer to the caricature of Democrats traditionally drawn by the right.

Mr. Obama still has time to reverse course. A great deal depends on it. To fail on health care yet again might well be the "Waterloo" Republicans dream of. And yet, as the party's leaders click through their PowerPoint presentations and review the complicated details, they seem unable to confront the biggest questions that the right is asking, the ones about the eternal perfidy of government.

Maybe Democrats are afraid it will hurt their standing with those generous fellows on K Street if they channel Harry Truman and say what needs to be said: That government can be made to work for average people. But it will hurt even worse if they refuse to say it.

Read other Opinion Journal articles:
Bernanke's Second Chance
Four Ways to Help Africa

Comments

[Emerald1943]

I have not felt the need to "take it to the streets" since Vietnam, but this may be the singularly most important issue in my life....no­t for myself as I am now 66 years old, but for my children and grandchildren and all that come after me.

JOIN US IN WASHINGTON, D. C. ON SUNDAY, SEPTEMBER 13TH TO MARCH IN SUPPORT OF THE PUBLIC OPTION!

If you cannot make it to Washington, check in your area for local events. There are marches and rallies planned in major cities all over the country! Here's a link to give a little informatio­n....

www.marchforhealthcare.com

C'mon, folks! Get up off the couch and show your support! We are going to have to fight for this!

[Iambeat]

Mr. Frank hit the nail on the head. To say as he does that special interests were'nt supposed to "get their suits ruffled' points out a very important strategic effort of the Obama administration to define the parameters of the reform. They had hoped to do this in a lower profile manner. Lets face it, they did'nt get too badly burned. The point is that it was a deliberate strategic move. This may have angered the public, but it was just another violation of our integrity; these violations are commonplace. Noteworthy in the way of strategy, is how the administration then strategically responded to an extremely well organized GOP pr campaign. In the marshall arts one uses the momentun of an attacker to create it's own fall; so to say that rationality will not work in this instance, only allowing irrationality to expose itself will work This is what the Obama administration is hoping for.
This strategy will create an arena in which a deliberately uninformed and misinformed public can foment in a hyped up argument about periphery issues that have more to do with supposed violations of liberty than health insurance reform! This is all just a primer intended to tire the public of the issue so that by mid September we're all weary of it. Would it be a stretch to say that it is then more likely that they can come around to their original parameters? From which they ever had any intention of moving away from?

[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.

[WorkingClass]

DLC Democrats and Blue Dogs have no soul. They sold it to the "health care industry". Dennis Kucinich and his tiny band of followers and the progressive caucus in the house are the only Democrats worth saving. The rest, and especially Obama, are Republicans.

[kempis]

I decided during the primaries that I no longer knew what the soul of the Democratic party was. So I became an independent. The party was split pretty much down the middle, but the party leadership had apparently decided to give the nod to the fellow who preached unity and bipartisanship. I assume that all the progressive and New Deal-type Dems who are dismayed now simply didn't pay attention to anything other than Will.I.Am'­s wonderful "Yes, We Can" video, because the candidate with the truly progressive health care plan and the fighting spirit to get it done was trashed as a psychotic harpy.

[hmldjr]

Because that was what she was. Her husband was a republican in sheep's clothing and so is she. One of the weaknesses of this adminstration is that he relied too heavily on the Clintonites instead of bringing in true progressives.

[ctom]

I wish, they frame it in black and white:

1. Universal healthcare really means everyone will need to give up existing private coverage as it exists now for a gov't one for which there are no details available yet. In time, those who could afford it will get extra insurance to cover what gov't won't cover and wealthier people will have better medical care, just like now but at least, all will be insured.

2. Public option which really isn't "universal" means tax-payer funded corporation(s) will compete with private ones and will run at losses (paid by tax payers) which will bankrupt most private plans. Hence as competition between private and public heats up, private companies will close down or will specialize to cater to those people who want better coverage and have the money to pay. Again, those with money will get better care but again, at least people have coverage and tax dollars are needed.

Hence, the simplicity of the argument is that will you pay extra taxes (deficit = taxes) to cover someone who can't afford it, which is the public plan, and if you want to keep your private plan, just pay extra so you get the extra care that you want? Healthcare costs can't go down and it's a moral choice whether you want to help out those who can't pay or not?

Politicians always say "it's complicated" which really means "if I tell you the truth, I may not get re-elected­."

[Romeover]

ctom, I agree. It needs to be framed in black-and-white.

Insurance companies' prime raison d'etre is to take health-care money and spend it on denying health-care, and paying political bribes to keep their CEOs in luxury.

It's that simple.

[clevelandchick]

The Public Option is a road to Universal Healthcare. It is going to cover what most plans cover now, except the government won't refuse valid claims, practice recission aka deny cancer treatment to someone who once had acne in the 10th grade but neglected to mention it on their patient history, or refuse to cover pre-existing conditions. Those items alone are what put most Americans WITH health insurance into bankruptcy.

Think of the positive impact that would have on our economy. Americans are paying too much of their income towards healthcare and that number is going to double in a few years....t­hat's money that could go into savings, go back into the economy in other sectors, be used to start a small business.

The amount of money Americans are putting towards healthcare right now far outweighs the extra money in taxes we'd pay with a universal plan. Our current system is killing our economy more than an increase in taxes ever could.

[Emerald1943]

Fanned! Exactly!

[FogBelter]

Mr Frank, simply stated, there is no place in the Democratic Party for Republicans. Currently the Democratic Party is contaminated with Blue Dogs. It doesn't matter if it hurts any feelings ... I say to Conservative Democrats, be honest with yourselves, join the GOP, that is where you belong.

[TheIndependenceParty]

Thank you, Mr. Frank. You have framed the challenge to the Democrats, even the Mad Dogs in that party, to follow a call for universal health care which they themselves issued so long ago, but have never found the courage to heed.

How concerned they seem with the "cost" of health care, ... when they should be concerned with the cost of "unresolved illnesses" among our homeless, our jobless, and our under-employed. 50 MM Americans without health coverage!!! Pathetic. How much could they do, accomplish, ... produce, if they felt well? If their diabetes were in check, and their teeth were healthy, ... and their hearts, and their lungs? How much?

The real question is what our nation could achieve if health were the norm! What would be our GDP if the engine of commerce could focus on work and not the cost of benefits, ... with a 36% wastage for insurance company administrative costs? What then???!!! What if?

That is the challenge to the party that will seize the initiative of healthcare reform! Show what a healthy nation can achieve, and you will see the costs dissolve in the very economy that supports it. The Democrats have the opportunity to claim that gain for our nation, and lead for decades. Or, ... they can drop the ball, and leave it for the Republicans to claim for their own.

Which will it be?

[davidallan]

It doesn't matter what benefits we reap-re a healthier more productive nation. There is only one question, how the richest nation the world has ever known and according to the cons, the most Christian of all nations, can morally justify 50 million of its citizens without the FUNDEMENTAL RIGHT to healthcare. Whether preventative or curative is irrelevant and a distraction. The only answer is that every American can see their family doctor and get their prescribed treatment regardless of their ability to pay.

[steve-in-abq]

Wow. A FUNDEMENTAL RIGHT to healthcare. And it's not mentioned in the constitution. Funny, it seems the Founding Father would have caught that.

[thnk4selfagain]

Agree that the values and therefore the future of the Dem Party are on the line. After so many leaders selling out our values, from Clinton to Daschle to Reid, raging consternation is all I can feel about their -- let's face it-- unwillingness to enact progressive, good-for-A­merica's-f­uture legislation. They would rather follow Repubs lead and not take any initiative. Thank heavens for the Progressive Caucus in regard to healthcare reform, otherwise I would count the Dems extinct.

What's up with Obama not acting like the Party's leader? Reid is no one we should be proud of (like Daschle). Is Rahm Emanuel the defacto leader of the Party? (I'm with Maxine Waters and Howard Dean on Emanuel responsibility for Blue Dogs.) Dems need to realize that this historical moment will seal their fate.

[StPeteDave]

I'm sorry I won't be around in a hundred years to see how this plays out. I wonder how history will look at all of this.

[steve-in-abq]

"Democrats hold good-sized majorities in both houses of Congress and are led by an eloquent president who won an undeniable mandate last November."

Does this mean the Democrats can ignore or bypass the Constitution? Does this mean that the tyranny of the majority will become the standard in government policy making? (If it isn't already.)

I can hear the dems already. "We won't make the same mistakes as the Republicans, we will make different ones." "We won't trample the Constitution like the Bush/Cheney gang, we'll trample it our way."

[treetracker]

Hey, we all make mistakes - just look at all those made by Bush & co. We have, after all, lived under the "tyranny of the majority" for quite some time - now it's your turn. Get used to it and get over it.

We certainly can't make any bigger mistakes than were made in the last 8 years. And don't give me the crap about the Dems being in control of the last two of those. It's called a filibuster and it has been overused to block again and again.

So you had your chance. Give us ours. We certainly can do no worse.

[Newbie71]

Agreed, Bush and Co sucked the big one. But yes, we could have made bigger mistakes: Gore and Kerry. Or, are you ready for this? Obama - the guy is basically Bush III - only he raised a record amount of money. Do you really think he raised it from the luttle guy? No, he raised it from the people who stand to make money on a) the $787 B stimulus, b) Cap and trade, c) Health "Insurance" reform and whatever else we see come up in the next six months.

The argument that health care reform is necessary to helping the economy rebound is a non-sequiter. The argument that it is a moral imperitive makes people stop and consider, but it is equally inane, when you consider it fully.

Health care is an economic "good" and health insurance is essentially a financing mechanism. To fundamentally alter that would be the same as legislating that everyone should be able to buy a house. Oh, wait, that's what got us into the current mess.

[steve-in-abq]

...now it's your turn.

No, now it is everyones turn. We all suffer when the R's or the D's trample the constitution and the "tyranny of the majority" is in play. You're assuming I love the R's. Fact is, I find them are only slightly less objectionable than the D's. You said "for quite some time", I thinking the 60's is when the feds got out of hand. You suggested "last 8 years". Please try to free yourself from that refrain.

[jeanrenoir]

Obama came to town with plenty of Class-A "Democratic soul." He came as a post-Boomer pragmatist. But what he encountered was not just a Republican stone wall, but plenty of Democrats almost as yuppie and soulless as the Republicans, the only difference being that at least the Republicans are not hypocritical about their own values. The Congressional Dems, like their yuppie Boomer supporters, like to pretend that their "heart is in the right place," as they drive to Whole Foods, or visit their financial advisor or yoga instructor in their SUVs, but they're just a bunch of "fiscal conservatives," not willing to sacrifice anything at all for social justice. They just wanted to elect Obama and beat their chests over their "progressivism," the last refuge of a Boomer narcissist. But when it came time for the "progressive" rubber to hit the road, and be paid for, they scattered as fast as possible, trying to find any excuse they could to kill social justice if it threatened to ever cost them anything in higher taxes. Obama's the last gasp of the Democratic soul. It's sadly appropriate that Teddy Kennedy, a pre-Boomer like his brothers, has died in the midst of this Democratic fiasco. HE was a true progressive, not the pretense of a progressive that most yuppie Boomers who vote Democratic the way they drive Volvos are, because progressive values make them feel superior to the white lower orders they despise.

[ditsylilg]

Well said.

[steve-in-abq]

."...not willing to sacrifice anything at all for social justice...­But when it came time for the "progressive" rubber to hit the road, and be paid for, they scattered as fast as possible, trying to find any excuse they could to kill social justice if it threatened to ever cost them anything in higher taxes."

So,social justice is what, the redistribution of wealth. I always thought social justice was equal treatment under the law, equal opportunity, and the assurance that no one's human rights would be violated by others. Your definition requires one group to give STUFF to another group. You want to give some people STUFF. My definition requires that everyone be equally FREE to succeed or fail on their own. I want to give everyone FREEDOM. You may want to re-consider your stance. Is your "heart in the right place"?

[yakmeat]

Those bankrupted by medical expenses due to accidents or illness will never have the "freedom" to succeed. They're already on the road to failure. We're not talking about "giving stuff" to anyone. We're talking about a more level playing field.

[clevelandchick]

Tell me, would you characterize the Wall Street/Bank Bailouts with taxpayer money "the redistribution of wealth"?

[MarkGau]

The United States of America is really going to reform health care. Wowzers!
I hope it works well. I'm all for it.
The Democrats (well, most of them), will have accomplished this without any Republican support what so ever.
The Republicans have just played politics . This is what the Grand Old Party has become.
They'll win back all three houses by 2012 for sure. (wink, wink)
posted by

[Newbie71]

If I were a Republican right now, I would trademark "The Party of No". And I would definitely not look for any bi-partisanship at all. There are lots of options out there for health care reform that don't include "public option" or "single payer". Does anyone even remember the basic goal - to cover people that have fallen through the cracks?

What's happened to date is a recipe for disaster and at this point it's all on the democrats (small d because I have this romantic notion that they somehow remember the concept of Democracy.­) If there is all this money to be saved with Medicare, why not just go ahead and legislate that - why tie it to all this other stuff? It's a sham - that's why.

[yakmeat]

"If there is all this money to be saved with Medicare, why not just go ahead and legislate that - why tie it to all this other stuff?"

That's why we should support HR 676, which would expand Medicare to cover all citizens.

[noneIn2008]

Part of the problem is there are several Democratic Parties. The Progressives have gained more control than the Liberals. Many progressive policies will be repugnant to real liberals. The liberal objective is to have health care for everyone. It would be nice to focus on this single objective. The progressives want a government controlled data base to make medical "decisions points" based on "factoring health states into models of illness pathways" to "manage our medical resources for society as a whole". Liberals want to take care of the people. Progressives want an optimized government technical system.

[noaxe397]

As always Mr. Frank is right on the mark.

Besides the problems the dems have with the president caving in, the bluedogs, etc., the question I have is Where is the Dem bench? The governors, mayors, celebrities, etc speaking in support of health care reform.

Name one, just one other Dem politician (besides Teddy) who is fighting for HC reform with the pres.

Quick, just one.