09/21/2009 05:12 am ET Updated May 25, 2011

Applying Historical Lessons to Health Care Reform

As of today the Health Care Debate raging across the country has been a discussion of campaign tactics. Is the outrage on the tube manufactured? Is it real? Who organized the pros and the cons? Are the Tweeters being outmanaged by the emailers? And when the debate turns to the matter of substance, it quickly degenerates into a discussion of which position would help or hurt the President politically. Or, how the left wing of the Democratic Party is at odds with the centrists or moderates. (Strange that neither of our main parties has two wings! One has a right wing with some moderates; one has a left wing with some centrists.)

Today, all the pundits want to talk about is whether or not there will be a bipartisan bill and whether or not that would be a good thing politically. Republicans want to kill any health care bill, it is presumed, to inflict political damage on the new President. Some Democrats, like James Carville, are said to want a bill with all the bells and whistles so it will lose, giving Democratic campaign strategists a club to beat on Republicans in next year's elections. Once again, we seem to have a proof of Pat Moynihan's wisdom that "we have let politics become too important."

Fifteen years ago, when the Clinton health reform was languishing, it was suggested to the good people at the White House that a compromise bill could cover up to 95% of the population by the year 2000. (Today, that is the goal of one version of health reform, but with a target date of 2012.) That common sense was dismissed back then and only accepted when they were confronted with a stone wall. Only then did the White House acquiesce. By that time, their opponents, smelling blood in the water, refused to compromise, undercutting public officials like Republican Senator Bob Dole who had tried to find common ground with Senate Democrats on the Finance Committee.

But, you say, haven't we read that the Obama White House staff learned lessons of what not to do from the Clinton health care battles? Isn't that why the President's brains trust left the details to Congress, so they wouldn't make the mistake Hilary Clinton did with a large, detailed, technical, omnibus bill? And still the Republicans stonewall. Well, I would submit that as much as they think they learned from the Clinton failure, it would have been helpful to study a positive legislative accomplishment or two. There may be some lessons in success, too.

I learned in graduate school from the great presidential historian Richard Neustadt that analogies must be used sparingly and carefully. Given changing personalities and fact patterns, it is often a mistake to compare one era's event with a different era's problem. (Case in point: stopping Communist aggression in Korea and U.S. involvement in Viet Nam. Bad analogy = bad policy choices.)

Still, history exists to offer us examples. In the health care fight, perhaps Rahm Emmanuel and Company might have benefited from looking at President Lyndon Baines Johnson's approach to the various Civil Rights bills that passed on his watch, particularly the 1964 legislation.

Recently, former LBJ aides like Tom Johnson have offered through opinion pieces similar advice. It generally recaps the famous (or infamous) "Johnson Treatment". That was the method of pleading, cajolery, horse-trading, threatening, thoughtfulness, and downright seduction that LBJ used to get what he wanted.

But there is more to President Johnson's method than the caricature that the "Treatment" implies. Read Robert Caro's third volume of his remarkable biography of LBJ, Master of the Senate, in which Caro describes the traditions of the Senate being bent to LBJ's will. Or read Hubert Humphrey's autobiography Education of a Public Man to see it described from a receiver of the "Treatment". If the Obama Team wants to see how it can be done, these should be required reading. Or, they can take a trip to the LBJ Library and listen to tapes of phone calls from Johnson to senators, publishers, columnists, just about anyone LBJ thought could weigh in on the issue of Civil Rights.

The Obama political and legislative team would learn that, back then, it was necessary to get 66 votes to invoke cloture and kill any filibuster. Today they only need 60, so there may be lessons of value in the past struggle for the 1964 legislation. Johnson, in an election year, had to evade and escape the clutches of his longtime allies, the Southern Democrats, who controlled key committees and used the filibuster the way we now use unmanned drones to disrupt our opponents on the battlefield.

Perhaps they would learn how to motivate their allies from Johnson's lecturing of then Senator Humphrey, the floor manager of the 1964 bill. LBJ constantly complained that "liberals" would lose any chance of success by focusing on the wrong thing and losing sight of making real progress. (Thirty years later, the Clintons would be the example of history repeating itself in their health care failure.)

Most importantly, Team Obama could learn how strategic thinking gave LBJ the victory he so desperately wanted. All through the fight, LBJ kept his eye on the prize but still managed to have multiple pieces of legislation moving forward, including a tax bill that included tax cuts. This allowed him to make trades with fiscal conservatives among the Democrats while he kept zeroing in on Republicans. Hubert Humphrey relates the story of LBJ telling him, more than once, that the Civil Rights bill must not be seen as a Democratic bill or a Republican bill or a partisan effort. It had to be, in President Johnson's words, "an American bill". For that to happen, Humphrey had to park himself with the Republican leader in the Senate, Everett Dirksen, of Illinois, and get Republican input and votes. If that meant giving Dirksen credit, or giving Humphrey a royal hangover, LBJ didn't care. His orders to Humphrey were clear: sit with Ev Dirksen, listen to him, talk to him, drink all night with him if necessary, but make this about what was right for the American people.

So, Tom Johnson may be right that LBJ would know what was important to various members of Congress, which Senators needed their local mayors or governors as they faced tough re-elections, who could be flattered or shamed into voting for the bill. Those are tactics. LBJ knew the key to victory would be the strategy: To make a major change in the system, whether in 1964 or 2009, the legislation has to be seen as America's bill.

So, to the Democrats who are picking apart any utterance by the President and his surrogates as a betrayal of their position, it is more important that they should seek to rise above politics. Maybe that's not the Carville way, but then again, he never passed a landmark Civil Rights bill. LBJ did, and he did it while knowing that its passage would shift poltical power away from his party for a generation in the South. That action, by a Texan brought to office by the assasination of President Kennedy, eventually paved the the way for a better society for all Americans. President Obama knows this better than any and may want his team to read a little more history.