“Health Reform: The Year Of The Schlemiels”, By the CFC’s Richard Holober

by Richard Holober, Consumer Federation of California, California Progress Report

If utterances from the White House following the Massachusetts debacle are more than posturing, then the Administration’s tone deafness on health care reform may indeed be a terminal illness.

Normally level heads including Paul Krugman call for a Congressional Charge of the Light Brigade, blogging post-Massachusetts that ‘House Democrats need to be told to pass the Senate bill.’

Howard Fineman calls this a Democratic March to Folly akin to generals pursuing a military campaign in the face of incontrovertible evidence that it will lead to ruination.

Bungling Democrats should acknowledge they lost the fight for the support of the people on health care reform.  The sooner they flee this field of battle, and move on to issues that re-connect them with the mood of America, the better their chances to salvage the mid-term elections.

It turns out the “Party of No” obstruction to Obama’s health care was sound Republican political strategy.

The right understood that Obama’s electoral sweep set the stage for a Millennial Generation realignment that could usher in a collectivist Democratic majority for decades to come, much as FDR’s election did for the Greatest Generation and as Reagan’s election set up a Republican individualist majority of Gen Xers. (Millennial Makeover by Winograd and Hais outlines realignment theory and the 2008 election).

The losing party has two options:

It can fight to the death to defeat the President’s agenda and halt the realignment. Republicans attempted this without success after FDR’s election.

Or it can become a political chameleon, recalibrate its message, and find spaces to win. Eisenhower did this in the 1950s. Bill ‘the era of big government is over’ Clinton did it more recently.

Republicans chose to fight to the finish to halt the Millennial Obama realignment.

Obama handed them a gift, when he hitched his legacy to a massive health care reform – a quagmire for Democrats in the best of times.

Obama did run on health care reform as a major platform plank, but by Election Day 2008, the economic calamity was the only issue that mattered. Economic collapses, wars, and natural disasters push every other issue off the table. Obama’s handlers should have been screaming ‘Mr. President, it’s the economy stupid.’ They too were seduced by a Cinderella candidacy that blinded so many liberals into believing that an untested President could overhaul health care by transcending the bare knuckles combat that is inevitable whenever corporate interests are challenged.

While the President deserves some credit for slowing the job hemorrhage, there is no public confidence that we’ve turned the corner to recovery. With outrage against Wall Street crooks running high, the President would have been wise to evoke the rhetoric of FDR, lambasting the ‘economic royalists’ of finance capital early and often.  Instead he appeared distracted by the Congressional health care drama.

Republicans were then handed another gift. After sowing a foul public mood with its August town hall death panel offensive, the Party of No could sit back and let Congressional Democrats self-destruct.

Senate Democrats never called them on their filibuster threat. Americans were deprived of the enlightening visual of Mitch McConnell or Jim DeMint reading the phone book on the floor of the Senate day after day while the democratic process ground to a halt.  Instead we witnessed a prolonged train wreck of Democratic schlemiels negotiating against themselves, whittling the promise of real reform into a deformed stump.

Long months of wrangling within the Senate majority caucus, deal cutting that excused big pharma and insurers from cost controls while loading excise taxes onto the union base, unseemly compromises with the Ben Nelson/Lieberman wing, downplaying the more pressing business of putting Americans back to work, and a demoralizing capitulation on the public insurance option, conspired to turn public opinion against the Rube Goldberg machine that Harry Reid produced, and which the President insisted was still health reform we can believe in.

Let’s hope that this sad chapter will produce greater honesty in the conversations among progressive reformers, and between reformers and our on-again and off-again allies in elected office.

Let’s acknowledge that there is no unanimity among health reformers. Some place primacy on expanding coverage to the uninsured. They believe political reality dictates that coverage can only be expanded by brokering a deal, however reluctantly, that cedes more control over the system to for-profit insurance companies.

Other reformers favor a single payer, Medicare for all program, and believe that meaningful universal coverage and cost containment can only be achieved by replacing the business model of private health insurance with a new model of health care as a human right.

Obama tried to bind these reform forces together with the public insurance option. The Administration assumed that this sop would mollify single payer advocates without derailing the legislation. Obama loaded the public option with enough lead weight to assure that it would sink after it was put in place. He required it to run on a revenue-neutral basis, an impractical idea because of the likely adverse selection of public insurance by costlier to insure subscribers cast out by the private insurance system.

Progressives went through the agony of sticking with the Congressional legislation, as reform after reform after reform was stripped from the bill ‘ beginning with Obama’s secret deal with big pharma to eliminate drug bulk purchasing and re-importation of prescription drugs from Canada; through the death of the public option and the President’s prevarication on whether he ever really committed to it as a candidate; to the final blow ‘ the Senate’s adoption of an excise tax on ‘Cadillac’ health plans.

The excise tax raised the specter of another NAFTA. In 1993, a union-endorsed President turned aggressively against his working class base. The base responded in kind in 1994, sitting out the mid-term election, handing Congress over to the Republicans.

Fortunately, labor and House Democrats pushed back against the excise tax. Obama resisted, claiming that the excise tax would help contain health costs. Where was the President’s concern about spiraling prices when he cut his deal with the pharmaceutical industry? Where was it when he disowned the public option after arguing for months that a public option would create price competition with private insurers?  In his calculus, are workers the only ones expected to shoulder the price for cost containment?

Meanwhile, an inept Democratic National Committee (thanks to Obama removing Howard Dean as DNC Chair) allowed Massachusetts to go red. By permitting them to disengage from the Senate Democrats’ health bill swap meet, Reid helped the Republicans look clean by comparison. Post election polling shows that disenchanted progressives and Obama voters wanting a public option or even stronger health reform played a crucial role in delivering a Senate seat to Scott Brown.

Democrats can still try to push a health care bill modeled on the Senate version across the finish line. Lacking public support, and with language delaying any redeeming expansion of coverage until after the next Presidential election, that kind of win would seal the fate of an Administration we hoped would bring change we could believe in.

In the past week we’ve seen President Obama test out a new economic fairness message, visiting regions hard hit by unemployment and sounding out against Wall Street greed. It was a good start, but he has much work to do before it comes across as a heartfelt sentiment.

Now yet another about face. A new Presidential pronouncement about freezing domestic spending for three years creates the sense of a punch drunk boxer lashing out in all directions, hoping to land any blow that might connect. It looks like the schlemiels are still the boxer’s corner men, whispering bad advice into his ear.