Network News

X My Profile
View More Activity

The Liberal Revolt

PH2009081501007.jpgMonday was the day of the liberal revolt on health-care reform. If you want a nice round-up of the commentary, see Mike Allen. What's been striking, however, is the implicit argument that this is somehow a simple failure of liberal will. Rachel Maddow called it "a collapse of political ambition." The problem, she said, is that "Democrats are too scared of their own shadow to use the majority the American people elected them to in November to actually pass something they said they favored.” The question, writes Chris Bowers, is whether Obama is "more willing and able to pressure the Progressive Block in the House or the Conservadem Block in the Senate." Ed Schultz said the president needs to "start doing some arm-twisting with some folks that aren’t listening to him.”

The unifying idea here is that someone can just go into a back room and torture Max Baucus and Kent Conrad. But how? Rahm Emanuel isn't a shrinking violet. Neither was Clinton or Carter or Nixon or Truman or FDR. But none of them managed to get health-care reform past the Congress. There's not really a record of presidents being able to bend committee chairmen and wavering centrists to their will. Even LBJ, the master of this stuff, decided to go for Medicare rather than full reform. He thought the latter too ambitious. The history of health-care reform is the history of health-care reform failing. If there was some workable presidential strategy, or foolproof negotiating lever, presumably someone would have used it by now, or at least mentioned it in public.

The problem, I think, is that there is a tendency to understand heath-care reform as an equal negotiation in which all sides want a deal, and you can game out various bargaining stratagems. But health-care reform is not a negotiation. It's a campaign. Reformers wants a deal, even as some differ on its precise shape. The opposition wants to kill the deal entirely. And that gives the opponents a lot more power to say "no." "No" isn't their fallback position. It's their position. The supporters -- if they're not sociopaths of some sort -- actually do want to extend health-care coverage to 40 million people and regulate the insurance industry and create out-of-pocket caps and make life better for millions and millions of people. That makes it hard to say "no." Being a decent person turns out to be a terrible weakness. And the pressure is even greater because the history of this stuff is that you don't get a deal at the end of the day. Failure isn't an unlikely outcome. It's the default.

The reason, crudely speaking, is that time runs out. With every week, and every month, that drags by, health-care reform becomes a bit less popular. At this point, disapproval of the president's plan -- if not of his plan's ideas -- outpolls approval. That's a function of the legislative process. Of stories about congressional infighting and of anti-change campaigns mounted by the opposition and of the risk aversion of members of Congress. Almost all major domestic legislation follows the same path of public approval giving way to public disapproval.

That makes it even easier for conservative Democrats and the mythical moderate Republicans to abandon the effort. And thus the effort gets abandoned. What usually happens next is that the opposition wins the following election and reformers spend the next 15 years lamenting all the deals they didn't take, and the country ends up with 10 million more uninsured, and 100,000 more needlessly dead, and so on.

That's not to say people shouldn't push on the public option. They should! But the strategy needs to be appropriate to the context. This is a campaign for the public option, not a negotiation. Winning it will require persuading the key votes to change their mind, either by offering them other inducements in the bill or applying direct and aggressive political pressure (identifying a lot of viable primary challengers and creating a credible promise of funds, for instance). Trying to say "no" for longer than they can will simply result in reformers losing everything they want, and opponents getting exactly what they demanded.

Photo credit: Mike Albans -- Associated Press

By Ezra Klein  |  August 18, 2009; 10:18 AM ET
Categories:  Health Reform  
Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   Del.icio.us   StumbleUpon   Technorati   Google Buzz   Previous: How Much Is Security Worth?
Next: When Health Care Does Become a Negotiation

Comments

What's your point?

Posted by: NealB1 | August 18, 2009 10:23 AM | Report abuse

The problem is that democrats are currently trying to pass a gargantuan bill that affects only a small number of people (by design). That means that any voter that doesn't like even a small part of it but also doesn't gain anything from it is not going to get angry at a legislator who does not pass this.

Democrats have a massive dilemma where they both want to say that our system is the worst in the world while also not promising to change the system for the large majority of people. The far left doesn't understand this for some reason and they are getting more and more angry that other people don't see it he same way. But politicians think that ramming through a bill that does not have widespread political support is a terrible idea which I think is probably true.

To me Democrats either need to propose widespread changes and be willing to make the case that this makes all of us better off or to do incremental changes that they think improve the system. Focus just on the health care exchange and make the case for that. Then make the case for the public plan. But trying to pass a massive bill of small changes gives too many people too much not to like.

Posted by: spotatl | August 18, 2009 10:28 AM | Report abuse

> The unifying idea here is that someone can
> just go into a back room and torture Max
> Baucus and Kent Conrad. But how? Rahm
> Emanuel isn't a shrinking violet. Neither
> was Clinton or Carter or Nixon or Truman
> or FDR. But none of them managed to get
> health-care reform past the Congress.
> There's not really a record of presidents
> being able to bend committee chairmen and
> wavering centrists to their will.

Genuinely curious here: how did Dick Cheney do it? IIRC Arlen Spector (just to take one example) changed his stance and vote on at least half-a-dozen critical bills at the last minute with no apparent logrolling or other quid pro quo. As did several other less-conservative Republicans. Someone put some sort of pressure on them to change their vote. What was that pressure?

sPh

Posted by: sphealey | August 18, 2009 10:32 AM | Report abuse

Ezra, you're getting close. I'll keep responding "Polo" for a while longer.

"Winning it will require persuading the key votes to change their mind, either by offering them other inducements in the bill or applying direct and aggressive political pressure (identifying a lot of viable primary challengers and creating a credible promise of funds, for instance). "

I'm not sure there are positive inducements for the lame and weak. But I'm quite sure that 'aggressive political pressure' has, in most cases, the desired result of fear among the Dems that they'll be the subject of WWII Strategic Bombing (even though we now know that wasn't THAT effective). Primary threats, massive ad campaigns, invading attackers in their states/districts. Each has its place. But more may be needed: elected committee chairs (not seniority); no campaign support funds, moved to basement offices, etc.

This is war. Can one imagine Eisenhower, Bradley or Patton saying 'this is too hard'? Or Stalin saying 'well, Stalingrad is just a city'. Or Halsey saying 'the Japanese fleet is just overwhelmingly awesome, so lets retreat to San Diego? Or Sherman saying, 'I'm happy to rest our army here in the west, and Atlanta is so far away'?

Posted by: JimPortlandOR | August 18, 2009 10:35 AM | Report abuse

Ezra, I see your point, but the negotiation here is not with the Republicans. It is (or was) with the conservative Democrats and various industry players (drug companies, insurance companies, AARP). And the administration failed by opening with its concessions, rather than starting with something bolder and giving pieces of it away to end up where the admin really wanted to be. You just don't negotiate with yourself. Furthermore, you can't underestimate your opposition -- I think the key players in the administration truly believed they could get a substantial number of Republican votes. And that was shockingly naive.

Posted by: Janine1 | August 18, 2009 10:36 AM | Report abuse

Somebody will find this 'quaint' or naive:

"We shall go on to the end, we shall fight in France,
we shall fight on the seas and oceans,
we shall fight with growing confidence and growing strength in the air, we shall defend our Island, whatever the cost may be,
we shall fight on the beaches,
we shall fight on the landing grounds,
we shall fight in the fields and in the streets,
we shall fight in the hills;
we shall never surrender,..."

Winston Churchill

Is Obama less than Churchill or FDR in our hour of need?

Posted by: JimPortlandOR | August 18, 2009 10:43 AM | Report abuse

i would argue that they elected the "anyone other than Bush" and the thought of an African American President. That combination did not give them the mandate to drastically change something that affects every single American. The polls of 75% of Americans liking their healthplans are real and if that gets disturbed, hurt in any way the Democrats will pay a stiff price.

Posted by: visionbrkr | August 18, 2009 10:45 AM | Report abuse

I just don't understand the insistence on a public option. Shouldn't the goal be to eliminate the worst part about the US health care system, the employer-based system, which is at the center of the problems with access, cost, portability, and income inequality? Why not focus on Wyden-Bennett if you're so upset about the status quo health care system?

Posted by: Dellis2 | August 18, 2009 10:48 AM | Report abuse

No, you don't "torture" Baucus and Conrad, you make it clear that there are advantages involved in being members of the Democratic Party, and those advantages can be taken away.

The way you push our Blue Dogs is to insist that a Dem who doesn't at least vote to break a filibuster is going to face a primary challenge, and that he shouldn't expect DNC/DSCC/Obama for America/blogger money, volunteers, or public advocacy to help him fight it. And start to make rumblings about a more democratic way to select chairmen.

The LBJ analogy is off-base. Look, this isn't 1964. We don't have Dixiecrats. Our Blue Dogs, frustrating as they can be, aren't just voting with the caucus because they're still mad at Lincoln. Every one of these Blue Dogs has run on at least some modified argument for progressive principles -- including expanded access to healthcare. So it's really not fair to say their default negotiating position is "no". They absolutely do have something to lose in opposing this thing -- what exactly is the affirmative argument for voting Democrat when your Senator can't accomplish the party's biggest domestic promise?

Posted by: NS12345 | August 18, 2009 10:58 AM | Report abuse

i see some people's blood pressure starting to spike.

increase your banana intake,
or
this debate is going to end up benefiting the insurance companies!

Posted by: jkaren | August 18, 2009 10:59 AM | Report abuse

(2 bananas a day can help to lower blood pressure.)

Posted by: jkaren | August 18, 2009 11:03 AM | Report abuse

I would also argue a lot of the problem here is that Baucus' slow motion stands in stark contrast with the behavior of Chuck Grassley. Our "top negotiator" in this mess seems to be bending over backwards to appease a man who has clearly stopped arguing in good faith -- as seen in his embrace of Palin's "death panels" and his shilling for Glenn Beck.

It seems like Obama could easily be using his "presidential megaphone" to prod Baucus to drop his mini-committee and just pass something to get the process going. This is where progressives' "lack of will" argument comes in.

Posted by: NS12345 | August 18, 2009 11:05 AM | Report abuse

Ezra, yesterday you said there was nothing new about the Administration's position. Today you say there's a liberal revolt. What's the revolt about if there's been no change?

Posted by: tomtildrum | August 18, 2009 11:08 AM | Report abuse

@visionbrkr: "i would argue that they elected the "anyone other than Bush" and the thought of an African American President. That combination did not give them the mandate to drastically change something that affects every single American."

I would argue that you're ignoring reams of poll data and going with your gut feeling because it fits nicely with your predetermined outcome. Democrats (not just Obama) were elected in a landslide last year. Even a cursory examination of the previous presidency and its "50.5% mandate" renders your rhetoric ineffective and hypocritical.

Posted by: BigTunaTim | August 18, 2009 11:35 AM | Report abuse

"Winning it will require persuading the key votes to change their mind"

The first agenda item should be to identify those Democrats against the public option.

Which Democrats would vote no on the entire health reform proposal simply because people have a choice?

I want to hear these Democratic Senators say how they will kill health care reform in unambiguous language.

Its easy to say "the pubic option is not what I support" or "the public option is a bad idea" ... Its something else to say ... I will stand on the Senate floor and kill any bill that includes a public option.

Posted by: cautious | August 18, 2009 11:50 AM | Report abuse

The range of what a public plan could be are so large I have no idea how anyone could come out 100% in favor or against it at this point. I am as free market a guy as you will get and there are versions of the public plan I have no problem with. I'd also think there are versions of the public plan that left wingers would absolutely hate. I just think its amazing that people have such strong opinions on something that isn't even concretely proposed.

Posted by: spotatl | August 18, 2009 12:05 PM | Report abuse

spotatl, the public plan was proposed, written into a bill, and approved by the House.

Posted by: constans | August 18, 2009 12:18 PM | Report abuse

tomtildrum: I think Ezra would respond that either 1) liberals didn't know/ were in denial of the Administration's position, which had been stated several times in the past, or 2) this was just the straw that broke the camel's back on liberal patience. After hearing the Administration talk for months about how everything was negotiable and seeing Max Baucus give away liberal positions as concessions to Republicans that clearly aren't going to vote for the bill, hearing a million news stories about the Administration changing their mind on the public option was just enough.

Posted by: MosBen | August 18, 2009 12:18 PM | Report abuse

This is major Concern Trolling and not an analysis of policy.

You know the insurance companies do not want to fix this broken system. (Are they that desperate? Do they have critical hidden liabilities? I don't know)

They have purchased and captured the legislature (republicans, blue dogs, and senate finance committee at the very least) and possibly the white house.

There has been no widespread and significant analysis or advocacy (from opinion leaders and politicians) of or for policy that we know works (has any committee asked CBO to score single-payer?) and there has been significant noise for proposals like co-ops that require tremendous concessions to even begin to work properly (http://www.examiner.com/x-4380-Healthcare-Reform-Examiner~y2009m7d30-Health-insurance-coops-have-poor-record).

There is a particular mindset in policy-making observable in good people like Ezra and Begala dictating that the transformative stuff requires a level of cooperation from the executive suites which is beyond logic and reason. There is a real, organic, not astroturfed, movement out there which elected this administration. Some of the disapproval of 'the president's plan' can be attributed to those good folks who helped get him elected. That is a job approval rating, Not an index of desire for reform. In May or June about 70% of Americans wanted Healthcare reform that included a public option. Those numbers may have diminished but a majority of Americans still want reform with at least a public option. And a majority of the electorate voted to put the Democrats in power.

The interests of the corporations in this fight are at odds with the well-being of the people of this country.

Posted by: perhapsnot1 | August 18, 2009 12:28 PM | Report abuse

"Being a decent person turns out to be a terrible weakness."

It also turns out to not get you elected.

Posted by: itch | August 18, 2009 12:31 PM | Report abuse

"The unifying idea here is that someone can just go into a back room and torture Max Baucus and Kent Conrad. But how?"

Give them crappy committee assignments in the next Congress, perhaps?

"But health-care reform is not a negotiation. It's a campaign."

Agreed. And so is climate change legislation.

But in both cases, Obama's started off as if this could all be done inside Washington. So when the other side started pushing back, there was no reserve of public support for ObamaCare, or for climate change legislation. There was no attempt on his part, in either case, to go over the heads of Congress and the press, directly to the people, and get them leaning on Congress up front.

And the results: we got a very weak climate change bill through the House, but nothing's gonna happen in the Senate. The odds look better on health care, but we could be in a much better position right now than we are.

Posted by: rt42 | August 18, 2009 12:51 PM | Report abuse

@visionbrkr: "i would argue that they elected the "anyone other than Bush" and the thought of an African American President. That combination did not give them the mandate to drastically change something that affects every single American."

I would argue that you're ignoring reams of poll data and going with your gut feeling because it fits nicely with your predetermined outcome. Democrats (not just Obama) were elected in a landslide last year. Even a cursory examination of the previous presidency and its "50.5% mandate" renders your rhetoric ineffective and hypocritical.

Posted by: BigTunaTim | August 18, 2009 11:35 AM | Report abuse


have you seen the poll data over the last several months? Obama's dropping and I would expect he's concerned about it. That's to me why the flip flop again on a public option.

Also seen the polls in NJ and VA. Both republicans are winning those if they were held today. The tide is turning and people are sick and tired of the defecits.

yes the war is wrong before you bash me there. I was against the wars in Iraq and Afghanistan. But two wrongs don't make a right.

Look at the state of the economy. Its not getting better very fast at all. Then we've got the cap and trade to deal with, state's about to get shortfalls where there is no stimulus to save them again and the potential of a second stimulus that no one wants to talk about. All while unemployment is still high and tax revenues are still low.

Whatever happened to that report due out that was delayed by the administration on the re-look at the economic outloook for the first half of the year? I didnt' ever see that. The one where they said it was always delayed in a "new administration". I'm betting they over-estimated tax revenues and underestimated expenses.

Its 1994 all over again people and i hope that they do the reforms in healthcare that are necessary before the Democrats leave power again for another 12+ years.

Posted by: visionbrkr | August 18, 2009 1:15 PM | Report abuse

visionbrkr....75% may like their medical coverage but what question was really asked? I like my current coverage, but do not like the thought that when it runs out (I am on COBRA), I am uninsurable. What about the person who likes their coverage but feels job lock because of it? My dad liked his retiree medical coverage until his employer terminated it. I think you make some excellent points in your posts (given your inside the industry knowledge) but I have been in the industry for thirty years as well and you are apologizing for it too much.

Ezra....I think the President needs to quit telling Congress to work it out and go on TV, go on a barnstorming tour, and say "here's the deal, here is what I want"....we now know enough to know what will pass or not politically. Time to fish or cut bait.

Posted by: scott1959 | August 18, 2009 1:24 PM | Report abuse

"Rachel Maddow called it 'a collapse of political ambition." The problem, she said, is that "Democrats are too scared of their own shadow to use the majority the American people elected them to in November to actually pass something they said they favored.'”

First, the man only garnered 53% of the popular vote - only a "landslide" by comparison to the previous two knife's edge presidential elections. IMO, this fact undercuts a claim for a mandate.

Second, people voted for Obama for a lot of reasons, not simply his health reform plank. Some people may well have voted for him in spite of his reform ideas. So it is wrongheaded to claim some sort of election mandate for health reform specifically.

Third, Mr. Obama's has said he is prepared to violate some of the bedrock health reform principles he campaigned on to get a deal.

Finally - amd most importantly - polls now show that a majority of Americans would prefer no bill to any of those currently under consideration.

Posted by: tbass1 | August 18, 2009 1:34 PM | Report abuse

Ezra: "The supporters -- if they're not sociopaths of some sort -- actually do want to extend health-care coverage to 40 million people and regulate the insurance industry and create out-of-pocket caps and make life better for millions and millions of people. That makes it hard to say "no." Being a decent person turns out to be a terrible weakness."

So, by implication, opponents of the specific Dem reform bills do not want to make life better for their fellow man and are, accordingly, not decent people? That's not much nicer than calling them amoral or outright evil and other Dem leaders have.

I'd have thought such sentiments beneath you, Ezra. Your decent from punditry to partisan hackery is complete.

As you well know, there are plenty of principled reasons to oppose these bills.

Posted by: tbass1 | August 18, 2009 1:40 PM | Report abuse

scott1959,

you can't get individual coverage? I agree that there needs to be reform. I think we should have national rules and each state having different rules is absolutely impossible to figure out for anyone. I agree that there should be an end to pre-ex as long as everyone's in the system and that recision is wrong and should never have happened and should never happen again but i'm also not going to be naive enough to think that people don't adversely select against the insurance industry. And in many respects its completely legal.

Posted by: visionbrkr | August 18, 2009 2:26 PM | Report abuse

TBass1, no one's forcing you to comment on this page. If you think Ezra's a hack, go hang out somewhere else.

Posted by: PeterH1 | August 18, 2009 3:04 PM | Report abuse

Ezra, your post is confused beyond comprehension.

First you cite liberal talkers bemoaning a lack of liberal political ambition, not using the perquisites of majority to advantage, and the President not doing enough arm twisting.

Then, you take the same liberal commentators to task for not realizing that health-care reform is a campaign, that will require arm twisting.

Huh?

it's not Maddow and liberal talkers that have failed to understand health-care reform as a campaign, it's the Obama administration and Democrats on the Hill. The point of the revolt is to stiffen the spine of said administration and Democrats, who liberals do not trust. (For good reason, look at how they've run the reform campaign messaging thus far!) It's not occurring because liberal rubes simply can't comprehend the wonders of Congressional lawmaking. It's occurring because liberals want to put recalcitrant Dems on notice that their political futures are at stake. They aren't saying "no" to Republicans. They are saying "no" to conservative Democrats that think they can weasel out on this. You know, precisely what you prescribe.

Posted by: mike_silva | August 18, 2009 3:19 PM | Report abuse

PeterH1:

"If you think Ezra's a hack, go hang out somewhere else."

I'd hope, rather, to shame him into following his better lights.

Ezra's an intelligent, connected and, hence, influential guy. I come here to read for insight into the minds and motivations of supporters of health care reform and I write for my own entertainment and to contribute, in my own (very) small way, to the public debate.

Would you his comment board were an echo chamber for true believers?

Posted by: tbass1 | August 18, 2009 3:57 PM | Report abuse

mike_silva,

the point though is that those conservative democrats are in office because they are in conservative districts. Pelosi couldn't survive in Tallahassee Florida for example where there's a blue dog Rep. Unless you change the philosophies of a clear majority of the voters in those districts you'll never get your way.

Posted by: visionbrkr | August 18, 2009 4:43 PM | Report abuse

Do you think Nelson or Conrad would filibuster the bill if Obama was going to cut tv ads for their next primary challenger?

Specifically if it called out their filibuster of a bill to provide healthcare for 47 million Americans?

How would that impact a Democratic primary?

Posted by: PorkBelly | August 18, 2009 5:00 PM | Report abuse

visionbrkr,

I understand the point you make. However, Blue Dog Democrats that don't try to educate/lead their constituents to see the greater good, aren't really that much use to the party in the larger sense of trying to change things then. If they don't want to get on board, fine, the party should use all available inducements to pressure them for their vote against a filibuster on this issue, and use them as a one time resource to accomplish something big, not let them stay hanging on the party like a boat anchor. Recall Lyndon Johnson hammering the Civil Rights Act through the Senate, fully aware that it would mean losing the South for a generation.

Sometimes doing the right thing to move the country forward is more important than appeasing marginal party members in the long term.

What's more, I would suspect the benefits of health-care reform to your average voter...particularly your average conservative voter conditioned to think mostly in terms of self-interest...would be apparent enough to them that we wouldn't necessarily lose the districts for a generation. This isn't about a long term struggle to change the attitude of racists, it's a pocket book and quality of life issue. They'll see grandma doesn't get offed by "death panels", insurance premiums go down, and some family member won't lose their home because of a medical issue.

Posted by: mike_silva | August 18, 2009 9:25 PM | Report abuse

Here here! Liberals need to quit whining and organize! We live in something close to a democratic system and we need to start acting like it. Like physics (and economics maybe) there are 'laws' to a democracy. Our representatives (I mean the 60 votes needed in the Senate) need to see it in their self interest to support what we promote as the national interest. This is harder because we have a system that rewards the status quo and requires majority plus support to win. In other words we cannot win by assertion and play the victim when we lose - 'Damn those people.. If they only knew what we know!' We have to continually demonstrate to the public and the elites they look to that we need significant reform and we have to define that reform. We also have to do it in an environment where powerful interests are shooting (so to speak) at us. ie we have to go after the interests opposing reform - Whole Foods is a good example.

As I see it progressives need to unite on one of two short term objectives and their accompanying strategies. A) Advocate for reform that solve the problem (single payer, NHS, public option, switzerland etc) but accept the SHORT term legislation that gets closest but can still pass the finish line (maybe the 85% of the plan that has the most support) AND then launch the campaign for the public option/employer mandate etc as soon as the bill is signed. Revolutionary and reform movements often follow this approach - take what you get, convert it to your uses, and use to advocate/agitate for more reform/revolution. Or give up on legislation being the goal and use the current fight to promote the idea the will solve the problem. Abolitionists tended this way and their fight spanned generations.

The worst thing, strategically, we can do is be victims and blame the politicians/leaders for our shortcomings in creating the campaign that can win. note: there may be very good tactical reasons to blame our politicians - Max Baucus in particular and the media - but these are tactics for limited advantage. Cry Havoc!

Posted by: mbaker64 | August 19, 2009 6:51 PM | Report abuse

The comments to this entry are closed.

 
 
RSS Feed
Subscribe to The Post

© 2010 The Washington Post Company