Is Obama Playing This Exactly Right?

[liberalpragmatist]

The conventional wisdom - and the view of even many Democrats - is that health care reform is dead. Personally, I think that view is very premature and misinformed, but whether you agree or disagree, it's worth at least considering whether the conventional wisdom is right or wrong.

Obama's Health-Care Realism
His Flexible Tactics Match Reform to Political Reality
By Norman J. Ornstein
Tuesday, September 1, 2009

The conventional wisdom is that President Obama and Democratic congressional leaders are on the run, that we seem to be heading for a replay of 1994, when the Clinton health-care plan went down in flames. The conventional wisdom includes the refrain that the White House is too weak, too slow, too naive, and, in the words of respected health policy analyst Susan Dentzer, "they're panicked."

But having watched the lawmaking process in all its glory (and messiness) for 40 years, as well as having watched the meltdown of the Clinton health plan up close, I am seeing from the administration signs of savvy, not weakness. While health reform is far from a done deal -- and could still be derailed by the lack of a vote to replace that of Sen. Ted Kennedy, an economic double dip or an international crisis -- the issue is actually on a fairly predictable path that fits both the realities of public opinion and politics in an age of sharp partisan and ideological conflict.

The Obama strategy since his election has been based on a gimlet-eyed and pragmatic assessment of the prospects and limits afforded by public opinion and the political process. A naive president would have assumed that, after a landslide victory, huge coattails, swollen partisan majorities and a high approval rating, he could have it all -- and pushed hard and early for a far-reaching, soup-to-nuts upheaval of the health-care system. Obama and his strategists understood that would not work.

On the public front, it was clear that there was no groundswell for broad change. There is public dissatisfaction with the health-care system, but it is framed most by the universal public definition of reform -- "I pay less." Without some guarantee that reform thus defined will be enacted for the vast majority of Americans, the likelihood has always been that the closer government gets to enacting change, the more nervous voters would get about embracing the devil they don't know. And the closer one gets to broad change affecting 16 percent of the economy and a hefty slice of the workforce, the more those whose incomes depend on the current system will fight to keep their share.

<snip>

How to prevail under these difficult circumstances? The only realistic way was to avoid a bill of particulars, to stay flexible, and to rely on congressional party and committee leaders in both houses to find the sweet spots to get bills through individual House and Senate obstacle courses. Under these circumstances, the best intervention from the White House is to help break impasses when they arise and, toward the end, the presidential bully pulpit and the president's political capital can help to seal the deal.

Link.

Ornstein - who, despite his association with the noxious AEI, is actually a really good analyst of Congress (probably the best) with insights that are often well-informed correctives to the conventional wisdom - concludes that, despite the handwringing, health care reform is on track and likely to pass with a fairly robust bill.

I have some disagreements with the piece. I do think that Obama should have been firmer over what he wants to see in the bill. And I think that he should have had Max Baucus shut down his Gang of Six circus much earlier so that both the House and Senate could have passed bills by the recess.

Still, I think Ornstein makes several good points, to which I'd add a few. Number one, this was never going to be easy. One year ago, not a single person on this forum or elsewhere would have disagreed if you said that health care reform would be a massive battle in which Republicans and industry turned to opposition, center-right Democrats in Congress got cold feet, public approval slid, and the potential for failure was high. Yet now all those things are happening just as predicted and people are acting as if this is some major surprise. Whether Obama is ultimately correct or not in his strategy, there is a theory behind his actions that is fairly well-founded. And regardless of process, health care reform in this country is extremely difficult: every prior attempt at getting universal health care failed. Moreover, this effort has already gotten farther than any other comprehensive health care reform proposal in U.S. history. Never before has even a single congressional committee passed a comprehensive health care bill. Never before has it ever had the votes to pass even a single House of Congress.

Let's fight our hardest for the best bill and also be a little patient.

[Beetwasher]

1. Exactly Right? Only In Hindsight Will We Know How Well It Was Played

But it's being played, and I suspect it's being played well.

[liberalpragmatist]

3. Agreed.

Both handwringing about Obama has failed AND gloats that he's a genius are premature. I just think this article is a useful corrective that illustrates why Obama has done what he has done and why it may be a good strategy.

But you're right that we won't know for sure until this battle is over.

[Better Today]

12. +1 and by then it will be too late, but to date I still think

He knows what he's doing and has control of the situation, just in a way we don't see yet.

[NYC_SKP]

2. Anyone who thinks Obama didn't learn anything from 1994 really doesn't get it.

Great article.

The president has managed to let all manner of dynamics play themselves out this summer and is thus armed with information and the advantage of having let some of the noisiest opponents play all their cards.

It's almost the polar opposite of the Hillary Clinton approach, as I recall it.

Recommended.

[Liberal_Stalwart71]

7. I hope ya'll are right...for this country's sake. I cannot deal with another Repuke dynasty! n/t

[NYC_SKP]

13. Try to take solace by remembering that he whipped Clinton in the primaries.

Hillary came into this as arguably the strongest and most well organized candidate seen in the primaries in 40 years.

And Obama was fresh and black, how unlikely was it that he would win?

And yet he did, largely because of the use of effective strategies, many of which are in play now.

I'm pretty sure. :P

[Liberal_Stalwart71]

19. Right, but like "Dumbya" Bush who was great at winning elections and not so good

at governing, there's a heck of a difference. We all know that Democrats are better stewards of the economy and much better statesmen and women. I desperately want Obama to do well; he cannot afford not to. This country can nary afford Republican rule.

[JuniperLea]

8. Yet again, he's given the opposition enough rope...

And they've said some pretty ridiculous things lately.

[NYC_SKP]

14. I LOL at how they've played out all their Kookie Kards. Now we can have an adult conversation...

And I think it's brilliant and deliberate.

:patriot:

[JuniperLea]

20. Me too...

I love seeing Obama all serious looking, and saying things like, "I keep hearing..." then turning around and blowing it out of the water. It almost appears he's trying to keep from rolling his eyes... but then, maybe I'm projecting.

:)

:patriot:

[RaleighNCDUer]

16. I think he's not only looking at 1994, but also at 1936 -

when Roosevelt got Social Security started it was ripped, torn, and shredded from what he originally advocated, but it DID get passed - and over the next 20 years everything that had been excised by congress was re-introduced and approved, expanding coverage, creating SSI, etc.

I want single payer. I'd be satisfied with a strong public option. It looks like it will be a fight to get a weak public option. But if the framework is passed, those items can be added back in over time. I hate to have to take a long view when there is such immediate short-term need, but I'm not going to give up on this if it is less than what I want.

[NYC_SKP]

21. IIRC, Social Security started out as a very small and limited program...

...in contrast to the comprehensive and massive (maybe too massive) program it is today.

Perhaps getting a weak public option is the best anyone in the whitehouse could ever have accomplished given all the circumstances.

And that it can grow into what we need it to be over time.

:shrug:

[babylonsister]

4. Has Obama Played Health Care Exactly Right? Does It Even Matter?

http://voices.washingtonpost.com/ezra-klein/2009/09/has_obama_played_health_care_e.html

Has Obama Played Health Care Exactly Right? Does It Even Matter?
Ezra Klein




The White House's legislative strategy is coming under a lot of fire lately. Some observers think it's been too focused on bipartisanship. Others believe it overly solicitous of Congress. But congressional expert Norm Ornstein thinks that it will eventually come to be seen as quite wise:

The Obama strategy since his election has been based on a gimlet-eyed and pragmatic assessment of the prospects and limits afforded by public opinion and the political process. A naive president would have assumed that, after a landslide victory, huge coattails, swollen partisan majorities and a high approval rating, he could have it all -- and pushed hard and early for a far-reaching, soup-to-nuts upheaval of the health-care system. Obama and his strategists understood that would not work. ...

Enacting reform the way it should be done -- with broad bipartisan leadership support and broad bipartisan majorities -- was simply not in the cards in today's political universe. Bipartisan support was clearly a non-starter in the House, if less so in the Senate, but past experience also showed that finding partisan majorities, even with healthy margins in both houses, would not be easy. Bill Clinton had almost identical Democratic support in the House and Senate, but he could not find a formula to keep his partisans together. Trouble with Blue Dog Democrats in 1994 nearly derailed health reform in the House and slowed it enough to prove disastrous in the Senate. Ideological, regional and urban/rural splits always make uniting Democrats a challenge. In 2009, unlike in 1994, every issue has a filibuster line drawn in the sand, making the hurdle 60 votes more often than 50.

How to prevail under these difficult circumstances? The only realistic way was to avoid a bill of particulars, to stay flexible, and to rely on congressional party and committee leaders in both houses to find the sweet spots to get bills through individual House and Senate obstacle courses. Under these circumstances, the best intervention from the White House is to help break impasses when they arise and, toward the end, the presidential bully pulpit and the president's political capital can help to seal the deal.

No health reform bill can be enacted unless the House and Senate each pass a version, and that has been the single-minded goal of the White House. If the Senate has to resort to reconciliation, it can only work if more than 50 Democrats are convinced that it is the last resort -- that every effort was made to compromise to include significant Republican support. Thus, the White House signal on the public option. Once both houses pass versions, no matter how disparate, a conference committee can find a way to meld the bills -- no doubt with heavy White House input -- into one plan that goes back to each house for up or down votes. There, the pressure on lawmakers to support health reform will be much greater, as will the ability to break filibusters by urging all Democrats, even if they can't support a bill, to vote for cloture as a procedural issue.

The odds remain reasonable that a solid, if not dramatic, health reform bill can make it through this process and become law. Any bill, under these conditions, will be a major accomplishment. The odds have been improved, not damaged, by the president's approach.

Broadly speaking, I agree with this analysis. And whenever you hear someone complaining that Obama has given too much power to Congress, remember that the great complaint about Clinton's reform effort was that he took too much power away from Congress. We have a tendency to work backward when trying to understand why something is going wrong, and that necessarily leads us to think a lot about tactics. But it doesn't answer the question of whether the outcome would be different if the opposite strategy had been tried. Under Clinton, it was tried. And it failed. Obama's strategy has brought him a lot closer than Clinton ever got, although it's also been yoked to a much more modest piece of legislation.

It's also worth pointing out another problem with this sort of thinking: The passage of needed reforms shouldn't be predicated on perfect legislative tactics from the executive branch. Congress is supposed to want to solve problems, after all. Asking them to legislate in the national interest is not some sort of imposition, or break in the routine. They're the branch of government that actually passes laws and makes changes. The president, after all, cannot pass legislation over the objections of Congress. But Congress can pass legislation atop the objections of the president. If legislative progress is dependent on the perfection of the executive branch, this country won't see much progress, because presidential administrations are seldom perfect, and they don't have that much power over Congress, anyway. Our political system has to be more robust than that.

[RaleighNCDUer]

17. The fact that Dole was on TV saying that Obama needed to put his name

on the reform bill indicates to me that Obama is doing it right.

With his name on the bill, it becomes about HIM, not the reforms. Making it about HIM is the easiest way to whip up opposition to it. They've been trying to call the reforms "Obama's healthcare plan" for weeks, even though it isn't his healthcare plan - it is still several plans being debated by congress in congress. If they come up with something that is totally unacceptable to him he can ask them to revise it. If they don't, he can veto it. And when it passes, THEN it becomes HIS healthcare plan.

[Gman]

5. It's not conventional wisdom...

it's just somebody's opinion, which, like a butt, everyone has.

[HereSince1628]

6. I really have my doubts, People fall in love with hope and promise, but

they buy homes based on price, location, square footage and the quality of the existing structure.

I really don't want to fall out of love with Obama, but...

It's as if the dems, under Obama's oversight, went out to sell Americans a home that doesn't yet even have a blueprint.

If this is clever Chess, it is incomprehensible compared to the practical way Wisconsinites approach their personal finances.

[rudy23]

9. Oh I don't deny he's playing it just right. For which side, though?

Us, or the insurance companies that donated so much to his campaign?

Rahm has already indicated he's not on our side. Unless these guys are the best reverse psychologists of all time (and I'm holding out 5% hope that Obama could be), what we are seeing is what we get.

Now it seems like they really think Obama is so popular they can pass a weak public option, and we'll get on board once they call progressives enough hurtful names.

[Phx_Dem]

10. Ornstein makes some good points that are based in reality.

The reality is, getting health care reform through Congress is very difficult, even with a Democratic majority. As we've come to discover, Republicans aren't the only ones standing in the way of health care reform.

Obama, unlike Democratic commentators and talking heads, understands this. In the end, I beleive we will get a solid reform bill with a public option.

[SpartanDem]

11. Exactly right? No but pretty close

The throwing in the towel by some is mind boggling considering Obama has shepherded this further than anyone else Truman and Clinton didn't get this far. Yet, you have people abandoning ship and calling the effort a failure at what are the normal bumps in road when taking on a legislative task of this size. It's not say that everything has been done perfectly, I agree with OP that the Gang of Six should've been shut down earlier. I would add that Obama should've started selling the plan to public, particularly to those that already have insurance, sooner. First, the insurance reforms are the one constant thought all the different bills and people want concrete ideas not just broad principles. Secondly, most people have insurance and much of the early focus was on the uninsured, Obama didn't address the "what's in it for me" thoughts. As a consequence we lost control of the message battle during much of the recess, but they've regained control in last couple weeks and I think we're well poised to push ahead when Congress returns.

[Proud Liberal Dem]

18. What better time to start regaining control of the message?

now that I'm sure the wingnuts have been worn down by their antics and many of them have been exposed as "plants" for the astroturf organizations fighting against HCR.
I think that Obama and the Democrats backed off a bit befoer Congress left for recess knowing that nothing would be enacted prior to recess and Pubs were already gloating at how opposition to HCR would crystalize over the recess and more Congresscritters would come back to Congress convinced of the need to "slow down" or refuse to pass HCR.
If THAT was their objective, then I don't think that the Pubs have succeeded. Now that the wingnuts have had a nearly month long orgy of screaming, yelling, distorting, lying, and disrupting over HCR, Congress will FINALLY be back in session and will actually be getting back to work on the legislation and Democrats now have PLENTY of excuses, couched in the soundbites of their Republican colleagues, to unilaterally pass legislation that we know for sure the Pubs won't support no matter how much is compromised.
Plus, we have all that wonderful footage of wingnuts and even some Pubs making fools of themselves disrupting town hall meetings and wearing their guns around. Conrad also fell flat on his face sloppily pitching his stupid Co-op idea, which was apparently becoming the favorite of him and Baucus in the Senate Finance Committee. If anything, this past recess has really been a godsend for HCR advocates, not its opponents and Obama, either by accident or design, was wise to just let them "shoot their wad" and not interfere. What are the wingnuts and opponents of HCR left with now?

[SpartanDem]

26. I agree it has been better for our side than many realize

the media fascination is more or less over so they won't distract as much during the real action. Also it's hard to keep that level of fervor for very long and they galvanized us to push back even harder. Look at reaction the when some in admin signaled that PO may be drop whether that by design to fire up the base or it was simply testing the waters it let the party know we were serious about the po

[Proud Liberal Dem]

27. The media has the attention span of a gnat

(no offense to gnats ;-)). Probably best to let the corporate mediawhores scratch that "itch" to cover the town hall disruptors, "deathers," and "teabaggers", et. al non-stop while Congress has been on recess so that they can move on to other things- as they seem to be doing now.

[blm]

25. I'm pretty much with you on this - I think he just might be counting on the drama

associated with fear of defeat, and then be seen as the 'only one' who could save some form of public option in the health bill.

Just not sure that he's on board with a public option that's as strong as the one preferred by us.

[bvar22]

15. Exactly Right ??? ....LOL

If the plan is to pass something that channels $Billions into the pockets of their patrons in Health Insurance Industry (a wholly owned subsidiary of Wall Street), THEN Obama and the "Centrist" Democrats in union with the Republicans have indeed played it "Exactly Right".

If the plan was to provided "quality Health Care to Americans" and "open the door to Single Payer", then the most politically practical, easiest to sell, and most economical way to do that was to simply expand Medicare incrementally. Let the Republicans attack Medicare.

But Obama and the "Centrists" already know that.

[Oregone]

22. If he was a super-duper, 3D chessmaster, you will all have single-payer in a year

He isn't. Sometimes a cigar is just a cigar.

[SIMPLYB1980]

23. Single-payer was DOA before the Democratic primaries even started.

Maybe it's time you started to support the public option if you want to get anything meaningful passed.

[Oregone]

24. Then fuck the Democrats

If they wont support my agenda, why should I support them


(of coarse, exceptions to the rule exist and there are actually liberal Democrats)

[TankLV]

30. Exactly!

I'm fucking TIRED of voting AGAINST the WORST choice!!!

[notesdev]

28. No

Obama is conducting "Amateur Hour at the White House". Reading savviness into the serial blunders that have quickly come to characterize this administration is pure desperation.

He has already gotten to the point where his inaugural political capital is gone, and he has nothing to show for it.

If the Democrats retain 180 seats in the House this next election, I'll be surprised. It certainly won't be because of this President.

[TankLV]

29. No - it's doesn't look good at all...

we can always HOPE, but HOPE is all we have so far, BECAUSE SO FAR NOT A GODDAMN THING HAS BEEN DONE BY THE DEMOCRATS AND OBAMA, NOT ONE GODDAMN THING!!!

It's a few minutes to midnite, and NOW he's PLANNING to fight - not ACTUALLY FIGHTING - just PLANNING - no I mean STARTING TO PLAN!!!

"great" - just fucking "great"...

[democracy1st]

31. No fight whatsoever in this WH just a bunch of passive bs