Should Democrats Fight for the Public Plan?
The Washington Post put a poll into the field last week with a substantial health-care portion. Here's the part that will interest all of you:
I don't think there's anything surprising in there. A solid majority support the public plan in theory. If you say it'll drive their other insurance options out of business, they turn against it. But imagine you had asked that question the opposite way. The reason private insurers would have been driven out of business, after all, is because the public plan would offer much lower premiums. If you asked poll respondents, "What if having the public plan lowered your insurance premiums by 20 to 30 percent," my hunch is you'd see a sharp shift toward support of the policy.
And that's not, it should be said, an idle thought about polling. In the long term, the fortunes of Democrats will be decided by whether people like health reform after it passes. If the program is a huge success, if costs go down and coverage shoots up, then that will do much to bind voters to Democrats. (This was the argument that Newt Gingrich and Bill Kristol made in 1994, and they were probably right about it.) If it's considered a flop, or simply an uneven success, there will be little long-term gain from passing the policy and potentially even some long-term harm.
At yesterday's press conference, Obama made a telling remark in reply to Chuck Todd's questioning on Iran. "I know everybody here is on a 24-hour news cycle," he said. "I'm not." Some policies that might be controversial now are likely to prove popular later. Some policies that are popular now are likely to be a failure later (see the Iraq war for an example of political coup turning to an electoral embarrassment). The question asked in the poll above has to do with the short-term politics of health care. In the long run, however, it's assuming a situation in which the public plan makes health coverage so much cheaper for individuals that they abandon private insurers in droves. It's hard to imagine that outcome being unpopular, as it's an outcome that Americans would have to choose.
Conversely, you could imagine an outcome more pursuant to the poll above but much more problematic for Democrats in the long run. Health reform is enacted, and it promptly drives up the deficit. But now Democrats have ownership of the health-care system. They, after all, passed a major reform in 2010 that they promised would lower costs. It didn't. People begin to blame them for problems in the system. A charismatic Republican with a working knowledge of the issues -- Bobby Jindal, say? -- runs on a conservative health reform platform and begins to recapture the issue from the Democrats.
Which is all to say that passing health reform is different from passing a successful health reform. And certain policies which may be controversial in the legislative period might be extremely important to the implementation period.
June 24, 2009; 10:21 AM ET
Categories: Health Reform , Polls
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