Passing Health Reform Isn't Enough
Over at The New Republic, Jacob Hacker and Rajul Rajkumar consider our future in a "World Without The Public Plan" (cue ominous music). But I'm not really convinced that the simple presence of a public plan would ensure success as they define it. So I'm taking their article as a "World In Which We Get Health Reform Wrong" (cue louder ominous music). And I think they don't go quite far enough (cue really, really loud ominous music, and maybe a siren wailing).
Hacker and Rajkumar simply consider the policy consequences of a failed attempt at health reform. I think people should consider the political consequences of a failed attempt at health reform. People talk about Colin Powell's Pottery Barn Rule: If you break it, you own it. But there's a partner to that law: Call it the Plumber's Principle. If you hired a plumber to fix your toilet and a week later the problem returned, you'd stop trusting that plumber. If you say you've fixed it, in other words, you own that fix.
If Harry Reid and Nancy Pelosi muscle health reform through Congress, if President Barack Obama signs a bill in the Rose Garden and hands the pen to an ailing Sen. Ted Kennedy, if health reform, in other words, passes with fanfare and attention, Democrats own it. This will not be a quiet accomplishment. They will have told the American people that on this historic day, under this historic administration, they have begun to bend the curve and and tame the insurers and guarantee coverage and generally fix this huge problem that so many before have promised action on but so few have succeeded in tackling.
And if, 10 years down the road, the plight of the middle class has worsened and cost growth hasn't slowed and the only real difference is that more tax dollars go towards low-income subsidies, Democrats will be blamed for that. Their arguments will have less credibility. Republicans will run ads about "the last time a Democrat told you he could reform American health care."
This happens all the time in politics. No one would trust Republicans to respond to a hurricane or invade a small country in the Middle East. Conversely, many people would trust Bill Clinton to balance the budget. Voters judge the success of major policy initiatives. And the success of health reform will be even more obvious than most, as they'll feel it in their weekly paychecks. If Democrats pass a bill that gets the policy wrong, they run a real risk of losing trust on what's arguably their core issue. This is high-stakes stuff.
Photo credit: AP Photo/Pablo Martinez Monsivais.
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