Monday, March 15, 2010

The Do Or/And Die Week on ObamaCare

So this is the week that healthcare reform will happen—if it happens at all. If Democratic leaders knew they had the votes, ObamaCare would already be a done deal. They’re pressing ahead anyway, risking public humiliation for a chance to realize a seventy-year-old policy ambition. We don’t normally expect seasoned politicians to display that much ideological fortitude.

It’s not just that Democrats are tying their political fortunes to a very unpopular bill. They’re also exposing themselves to charges that they’re abusing well-established legislative procedures in order to pass it. When you learned how a bill becomes a law in junior high, the teacher never stopped to tell you that you didn’t need a conference committee if the House ping-ponged the Senate’s bill, and then got the Senate to play some of its members for chumps by using reconciliation to change features of the original bill on which they'd conditioned their affirmative votes.

Clever liberals pundits have lately devoted a lot of energy to proving that the way Democrats are proposing to use reconciliation to fix the Senate bill isn’t exactly unprecedented. But c'mon.  You know that you’re pushing the procedural envelope when the fate of a major piece of social legislation rides on the findings of an obscure Senate parliamentarian. The idea that, if things come to that, the very same pundits won’t be urging Democrats to filibuster efforts to repeal ObamaCare is merely funny.

So why are normally timid politicians showing this much political spine? For Peter Beinart, it’s mostly a commitment to a political marketing strategy pioneered by Karl Rove, adapted to Democratic politics by Howard Dean and perfected by advocacy groups like

“Whether health care reform passes or not, Obama has embraced polarization over triangulation. He has chosen Karl Rove’s politics of base mobilization over Dick Morris’s politics of crossover appeal, with consequences not merely for how he campaigns for Democrats in 2010, but for he campaigns for himself in 2012. . . .  From top to bottom, Democrats have decided to bet the party’s future on the belief that Americans prefer bold liberals to cautious ones.”
That explains why today’s Democrats are less inclined than they were during the Clinton years to tack to the political center when they encounter political headwinds. Maybe it’s even a winning political strategy. But isn’t it one thing to stick with a policy that’s currently unpopular in the hope that voters will warm to it in good time, and something else to enact a policy that’s arguably illegitimate because the decision-making process lacked integrity? It sure looks like a lot of Massachusetts voters cast their ballots for Scott Brown because they could tell the difference.

That raises a question for liberals: what counts as ideological boldness under present circumstances? We liberals have always thought of ourselves as upholding the interests of “the people against the powerful” by championing the aspirations of latent democratic majorities against organized special interests.  We’ve always assumed that only the machinations of special interests kept the costs and risks associated with the delivery of healthcare from being socialized long ago.  We thought that being a scrupulous democrat is not only consistent with, but essential to, being a bold liberal. That's why liberals were always sticklers for procedural rules, like the principle of one-person-one-vote, that made public decisions legitimate.

The architects of ObamaCare devoted so much energy over the last year to getting special interests on board to clear the way for a democratic majority to get the guaranteed access to healthcare it’s always wanted. To that end they bought off the AMA by promising to raise Medicare payment rates, the health insurance industry with an individual insurance mandate, Big Pharma by promising to oppose drug re-importation, etc. But when they did they found, to liberals' immense surprise, that there’s still no democratic majority behind ObamaCare.

Obama, Reid and Pelosi have made a fateful choice for liberals and liberalism: they’ve decided to seize a fleeting opportunity to make the healthcare delivery system more just at the price of tarnishing the liberal community's credentials as a trustworthy custodian of democratic institutions. You can admire their readiness to put all of their ideological chips on the table without forgetting how much it’s already cost.

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