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Counterfactual histories

By Dylan Matthews
Hillary Clinton
Secretary of State Hillary Rodham Clinton (Evan Vucci/AP)

Dana Milbank considers how Hillary Clinton would have dealt with health-care reform:

Clinton campaign advisers I spoke with say she almost certainly would have pulled the plug on comprehensive health-care reform rather than allow it to monopolize the agenda for 15 months. She would have settled for a few popular items such as children's coverage and a ban on exclusions for pre-existing conditions. That would have left millions uninsured, but it also would have left Democrats in a stronger political position and given them more strength to focus on job creation and other matters, such as immigration and energy.

This seems correct, but for the wrong reasons. Just about anything that Obama or Clinton chose as their major legislative priority would have taken a protracted effort to get passed. The last immigration reform effort took up roughly as much time in the 109th Congress as health-care reform did in the 111st; the House immigration bill was passed in December 2005, and the effort was abandoned by the GOP leadership in September 2006. It's hard to see an effort to pass cap and trade taking any less time. The choice, then, wasn't between passing health-care reform or passing a compromise quickly and then passing other legislation. The choice was between a long, hard effort to pass health-care reform and a long, hard effort to pass something else.

But I still doubt Clinton would have chosen to focus on health-care reform, mostly because of her relationship with the news cycle. The most striking difference between her campaign and Obama's during the run-up to the primaries was just how focused she was on having positive cycles on TV and being on the better end of media narratives. The Obama campaign, by contrast, didn't care that, for months, every story on the race mentioned his bad national poll numbers and treated Clinton's nomination as inevitable. They trusted that the media narrative wouldn't matter for voters in Iowa, and that an Obama win there would reverse months of bad press. And they were right.

They kept this approach during the health-care debate, even after Scott Brown's win led to increased calls for a smaller, compromise bill. If the Obama administration cared half as much about winning media cycles as the Clinton campaign did, it would have abandoned health-care reform as soon as opponents started showing up at town hall meetings during the August recess in 2009, if not sooner. Maybe Clinton would have shown more perseverance once in office than she did as a candidate, but if her campaign was any indication, she likely would not have had the stomach for any major legislative push, be it health-care reform, cap and trade, or anything else.

Dylan Matthews is a student at Harvard and a researcher at The Washington Post.

By Dylan Matthews  | November 8, 2010; 12:00 PM ET
 
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Comments

Let's all remember that the midterms were voters recoiling from the policies of this administration.

'nuff said

Posted by: WrongfulDeath | November 8, 2010 12:23 PM | Report abuse

Given how central healthcare reform was to Hillary's political identity, I can't imagine she wouldn't have tried to push for it early on. And if events worked out as they did in real life, what with the Scott Brown victory, etc., I imagine she would still have pushed on.

Now, maybe she wouldn't have had 60 votes to begin with (would Franken have won?), so maybe they'd have to settle for something more incremental to be pushed through reconciliation.

Some of her advisers may say differently, but just because aides think one thing doesn't mean the president doesn't think another. After all, Rahm, Biden and others in the WH all urged Obama to drop health care, yet he persevered.

Posted by: Isa8686 | November 8, 2010 12:25 PM | Report abuse

These sorts of discussions usually strike me as a waste of time. Maybe Clinton would have been a stronger presidential candidate and gotten to office with 62 Dems in the Senate and no recount for Al Franken, and Arlen Spector would have switched in January of '09. And maybe her relationships with GOP lawmakers would have persuaded a couple moderates to commit to voting for her healthcare bill even if it had a couple things they didn't like. Or maybe she would have ended up with 57 Dems in the Senate and no Spector switch and wouldn't have gotten any major pieces of legislation passed.

We simply have to look at President Obama's legislative and policy achievements and say, "Are these better than nothing? Are there any completely clear mistakes that were made, not as compared with a fictional alternate history, but based on what was on the table at the time?"

Posted by: MosBen | November 8, 2010 12:27 PM | Report abuse

These sorts of discussions usually strike me as a waste of time. Maybe Clinton would have been a stronger presidential candidate and gotten to office with 62 Dems in the Senate and no recount for Al Franken, and Arlen Spector would have switched in January of '09. And maybe her relationships with GOP lawmakers would have persuaded a couple moderates to commit to voting for her healthcare bill even if it had a couple things they didn't like. Or maybe she would have ended up with 57 Dems in the Senate and no Spector switch and wouldn't have gotten any major pieces of legislation passed.

We simply have to look at President Obama's legislative and policy achievements and say, "Are these better than nothing? Are there any completely clear mistakes that were made, not as compared with a fictional alternate history, but based on what was on the table at the time?"

Posted by: MosBen | November 8, 2010 12:27 PM | Report abuse

Hillary would not have put the nail in the coffin by pursuing the foolish cap and tax vote.

The libs might not have lost the house without that; and even if they did, they might have held onto all those deep south long term districts.

Oh well. Time to pull out the Redistricting card. The Democrats drew something ugly in North Carolina in 2001, that's about to get reversed.

Posted by: krazen1211 | November 8, 2010 12:36 PM | Report abuse

I find these arguments not very enlightening.

The reality was that this bill was going to be slow because the Senate has nonexistent parliamentary rules that allow any individual to be an obstructionist and tie the place into knots, and the Republican party had decided to support its members if they chose to be obstructionists. Democrats didn't seem to have a particular interest on breaking the spines of obstructionists, or any grasp of how truly dysfunctional the Senate has become.

Ergo, this thing was foreordained to be a huge, drawn-out mess. The suggestion that Clinton would have had magic powers that Obama lacked is just stupid. The rules were the rules, and nobody was interested in changing them.

Posted by: theorajones1 | November 8, 2010 12:50 PM | Report abuse

"The reality was that this bill was going to be slow because the Senate has nonexistent parliamentary rules that allow any individual to be an obstructionist and tie the place into knots, and the Republican party had decided to support its members if they chose to be obstructionists. Democrats didn't seem to have a particular interest on breaking the spines of obstructionists, or any grasp of how truly dysfunctional the Senate has become."


Well, then the answer is quite simple. Simply don't do a health care bill and do more of your stimulus (read: cash giveaways to teachers unions and such ilk) instead.

Posted by: krazen1211 | November 8, 2010 1:05 PM | Report abuse

"The reality was that this bill was going to be slow because the Senate has nonexistent parliamentary rules that allow any individual to be an obstructionist and tie the place into knots, and the Republican party had decided to support its members if they chose to be obstructionists. Democrats didn't seem to have a particular interest on breaking the spines of obstructionists, or any grasp of how truly dysfunctional the Senate has become."


Well, then the answer is quite simple. Simply don't do a health care bill and do more of your stimulus (read: cash giveaways to teachers unions and such ilk) instead.

Posted by: krazen1211 | November 8, 2010 1:05 PM | Report abuse

there's an echo in here.....here.....here...

Posted by: WrongfulDeath | November 8, 2010 1:49 PM | Report abuse

Have to agree with @WrongfulDeath. And the biggest policy mistake, which cost Obama and the Dems the most? Favoring the banks with the bailouts, who he picked for his economic team, dealing with the foreclosure mess... Now the middle class thinks that Dems stand for Wall Street. Economist Jamie Galbraith has an excellent piece on this topic, it's a must-read in post-election analysis: http://www.newdeal20.org/2010/11/05/obamas-problem-simply-defined-it-was-the-banks-26159/

Posted by: BryceCovert | November 8, 2010 4:03 PM | Report abuse

Interesting analysis, if true we're far better off that Obama won. It shows how hard it can be to guess what a candidate will REALLY do in office just from the information you have during the primaries. I'm wondering if Obama now has just been really patient and strategic, and is waiting until he's reelected and the economy is in an expansion cycle again to really go for big positive change once more starting with ending the filibuster.

Posted by: RichardHSerlin | November 8, 2010 4:31 PM | Report abuse

Utter bollocks. Hillary Clinton's top priority has been healthcare, no way she would have pulled the plug. And Bill Clinton went to Congress multiple times to get people to vote for this bill in 2009 and 2010. Plus, if you have a ban on preexisting conditions exclusions as part of any compromise, that necessitates an individual mandate and so by then you might as well just do the whole comprehensive reform.

Posted by: jfung79 | November 9, 2010 2:55 AM | Report abuse

Here's a clue for the clueless:

If Hillary had become president, she would not have abandoned health care, because she would be under no pressure to do so.

Why?

Because she did not spend the entire 2008 presidential primary campaign making the individual mandate politically radioactive like Obama did!

Hillary (like Romney) forthrightly acknowledged the necessity of an individual mandate to a Bismark-type plan, and bravely championed it. Obama -- for naked political tactics completely detached from good policy -- punished her for it at every turn during the primary, even resurrecting Harry-and-Louise-type advertisements against her. If Hillary had won the presidency, it would have been viewed, reasonably, as a tenable public endorsement of the individual mandate.

But once Obama became president and was forced to acknowledge the glaring, ever-obvious truth that an individual mandate was unavoidable to a health-care reform bill, he was doomed to drink from the very chalice he had poisoned for Hillary's lips.

This back-story was quite plain and public throughout the 2008 primary season. Why is your analysis so willfully blind to it, Dylan?

Posted by: locaas | November 9, 2010 1:46 PM | Report abuse

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