Victory at What Cost?
The Senate's passage of health reform is a great step forward, but reveals how difficult future legislative victories, and governing, will be for Obama.
Mark Schmitt | December 24, 2009 | web only
Victory at What Cost?
"The most troublesome task of a reform president," Henry Adams wrote in his autobiography, is "to bring the Senate back to decency." President Barack Obama did not accomplish that task this year, far from it. But what he and other Democrats did accomplish this morning is something that eluded every reform president before him, and is in a sense, all the greater an accomplishment for the fact that the institution -- not just the Senate itself but the Washington culture that surrounds it -- was at its most indecent.Every major policy victory, even though it creates momentum and potentially strengthens the president who leads it, inevitably comes with a cost. The cost may be an expenditure of political capital, a political concession due in the future, a sacrifice of a constituency, a compromise on some other policy, or a compromise within the policy itself. It's hard not to feel in one's gut that this victory came at a considerable price. But it's also hard to put one's finger on exactly where the cost is.
The cost is certainly not in the policy itself. The legislation is imperfect, compromised, and in many ways insufficient. (It can be improved slightly in conference with the House, through the addition of the House's mild employer mandate or a change in the financing, but everything will have to be cleared with the 59th and 60th most liberal senators.) But the answer to Jane Hamsher of the blog Firedoglake's "Ten Reasons to Kill the Bill" did not actually need an item-by-item response, although it's useful that Ezra Klein provided one. It would have been sufficient to say simply that everyone who will be affected by the bill will be far better off. And that the bill as it has passed provides the basic components needed to construct a workable system of near-universal health coverage, and all that is outstanding -- implementation and legislative improvement -- can be accomplished without anyone needing to beg at the feet of a gleefully sneering Joe Lieberman or Ben Nelson.
Many on the left were tempted to use the budget reconciliation process, which would limit the time for debate and thus require only 50 votes, to pass a more expansive bill. But that would have required major pieces of the legislation to be left behind, in the hope that they could be enacted later, though they would still need 60 votes, and the tactic would have alienated even many Democrats, making the next steps impossible. Instead, by passing a compromised but complete bill with 60 votes, Democrats will have plenty of room to expand its provisions, and even add ideas like the Medicare buy-in for older workers, using the budget reconciliation process in the future. (This strategy was unstated, as it should have been, but it's in effect just what I proposed in July.)
The bill is flawed, but only by comparison to some hypothetical piece of legislation that could never have passed. The same could be said of any successful legislation, from the first progressive income tax to Social Security and Medicare to the Clean Air Act. And conservatives would say the same about their own legislative achievements. This is How A Bill Becomes A Law. And while some of the compromises that helped the legislation dodge the vicious attacks that killed the Clinton plan in 1994 were cooked up by the White House, other were baked into the consensus even before Obama took office. That insurance companies would benefit from an expansion of the base of the insured is built in to any approach other than single-payer, and the price of requiring insurers to cover anyone always had to be that we require everyone, in turn, to be covered.
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http://www.prospect.org/cs/articles?article=victory_at_what_costMark Schmitt is the executive editor of The American Prospect. Previously he was a senior fellow at the New America Foundation, director of the Governance and Public Policy program at the Open Society Institute, and policy director to Senator Bill Bradley.
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