It’s all just a little bit of history repeating?
The Daily Kos carries an article today showing the White House attempting to rachet down expectations of President Obama’s health care plans. Michael Tomasky at the Guardian is pointing out something pretty similar: that there is unlikely to be a public option in the final legislation, merely a series of local co-ops that would have nowhere near the bargaining power of a national health organisation. Tomasky quotes proponent of the co-ops, Senator Kent Conrad (D-ND), as claiming that there aren’t enough votes in the Senate for a public plan and that “there never have been”.
All of this strikes me of the 1993 fiasco of Bill Clinton’s attempt to establish some sort of public option for healthcare. In organising the people and millions of dollars needed to fight against Clinton, the Republicans established an electoral engine that helped turn the US House of Representatives into a Republican playpen from 1995-2007. Though Republicans seem divided now, with Newt Gingrich and others talking about a 2012 third party run, there will be absolutely nothing that could unite them as easily as stopping the Obama administration in its tracks.
Of course, that is precisely why Obama is withdrawing the public option, if indeed that’s what we’re seeing. He’s gambling that a smaller victory will not have the same galvanising effect on Republicans, or divide Democrats. However, the sacrifices are pretty huge. First Obama will score something of a public healthcare net, but with the risk of indeterminately higher costs that will face attack from many sides when the cheques have to be written. Secondly, for many activists, defeat over such a key issue as healthcare will mean disillusionment in the “Yes we can” rhetoric.
I have been sternly pessimistic about the potential for Obama’s administration – but Obama’s gamble could pay off and is potentially the right thing to do. A small defeat can be compensated for. Today Ezra Klein lays out numerous ideas that could be fitted into the bill that might take some sting out of the loss of a public option. Meantime, if Obama’s team keep their eyes on the prize – the 2010 midterms – and use their influence to get the right candidates picked, the result could be a more radical Congress than the 111th, all the better to work on health care reform.
From the beginning, credit where it is due, Barack Obama has been in favour of a public option to American health care. It is one of the key priorities for any administration seeking to alleviate the expenses and difficulties of millions of working class Americans. Even if Obama fails to get the public option his supporters wanted this time around, he has a duty to come back to it – and planning for that eventuality should be a major factor in how the Democrats approach the 2010 House and Senate races, with the whole House and a third of the Senate up for grabs.
Obama’s campaign juggernaut, especially the millions of contact details gathered during the election, was folded into the Democratic National Committee, and an Obama supporter succeeded Howard Dean as DNC chair. The Party heirarchy could use the activist base Obama established to push support towards candidates more likely to support a radical departure in health care: the single-payer public option. Whether or not that’s what actually happens, and whether or not Obama returns to the issue – even if he suffers a loss this time – should be the yardstick we use to judge the man come 2012. I suspect this will be how his supporters judge him – and that’s important.
Even if, come 2012, there’s no one else to vote for, failure to properly handle healthcare may well result in a victory for anti-politics and apathy for those outside of the radical Right – and America has already been down that road. It leads nowhere good.
So what we mean is another weak American leader all speak no balls.
It depends. I could be completely wrong about the reason for Obama’s seeming climb down. It could simply be that healthcare is a great and populist bandwagon to climb on, to run an insurgency campaign, and Obama never really cared about it that much. But I don’t think that’s fair: I think one of the major problems is that the corporations opposed to it are also heavy investors in Democratic politics.
Perhaps an Obama strategy in between letting the ball slip this time and picking it up again could be campaign finance reform?
In terms of poll testing, there’s likely to be less opposition to the local co-ops plan because they are independent of government. So the idea of “government-run” healthcare would be out of the window – and those against reform would have pause for thought.
What would be stopping the local co-ops linking together, in any case?
Nothing – but without government funding, organising national co-ops is an awfully big mountain to climb, and it hardly requires new legislation if it is really being run by and for members. Additionally, without providing for national bargaining, state laws and so forth apply – and this makes organising on a national level all the more difficult.
Moreover, how do you convince people to sign up to the plan? Initially, costs won’t be lower than already-established healthcare, because not enough people will have joined to occasion any bargaining power.
“how do you convince people to sign up to the plan?”
I was under the impression that the co-op option would be funded via the federal government, like the proposed public option.
To be honest I suspect the 46 million without health care are praying something comes along. God I know the NHS is not perfect and it run whether we like it or not on a Post code Lottery, but I’d not give it up for anything else.
I strongly suspect that whatever healthcare reform Obama manages to achieve will be around for a while. Surely he’s not going to do something now and then try to change the system again in a second term? I really doubt that Obama will be in a stronger position in a putative second term, so he needs to take the Republicans on now and force a public option through. If he can’t confront the Republicans and the conservative movement now, when will any Democrat be able to? It’s not just about making things a bit better. It’s about destroying the orthodoxies that stopped healthcare reform under Truman, Nixon and Clinton.
Seems that the White House may have cottoned on to your view as well: http://www.dailykos.com/storyonly/2009/8/18/768749/-Sebelius-walks-it-back
I expect that the co-op talk will not be diminished. It helps explain to people that the government officials in Washington will not be involved in healthcare decisions.
It’s all startlingly similar to the arguments used by sections of the capitalist class in this country to agitate against the introduction of the NHS – the government will tell doctors how to practice, etc. Bevan got round this by concessions to GPs, allowing them to go on profiting from their practice.