Presidential Retreat

Abstract

After a turbulent month of stiff opposition to his health care reform plan during which tempers flared, insults were hurled, and loud voices drowned all attempts at logic and reason, on Sunday President Obama and his family flew to the summer resort of Martha’s Vineyard, Massachusetts, for a well-deserved vacation. This will be a time for reflection and tactical decisions: the President will have to decide whether to agree to a watered-down version of his original plan -which would have the vote of a few Republicans in Congress and thus allow him to claim some bipartisanship- or to go ahead with his original proposal and sign legislation on a strictly partisan line, with Democratic votes only.

The latter scenario would appease his core supporters on the Left but would result on his exclusive “ownership” of the health overhaul process, and thus expose him to open war with Republicans for the rest of his term. It would also risk the political future of those 48 Democrats who were elected in districts carried by John McCain in the 2008 presidential election. Republicans are already optimistic that 2010 will be a replay of the 1994 mid-term legislative election in which Democrats lost 52 seats in the House of Representatives and the Clinton presidency appeared weak and defeated. Therein lies the paradox that haunts the White House: while Democrats have a majority of votes in both House (259 to 177) and Senate (60 to 40), if they use their advantage to ram through their original plan as the progressive base wants, they may be dealt a resounding defeat in the next election. It is thus business as usual in Washington, where political expedience always ends up trumping good policy reforms, and where the opposition resorts to fear mongering to effectively defeat hope for change.
           

The main point of contention is the government-run public insurance plan that would be offered to consumers and employers, who could then choose between public or private health plans. Republican critics, in an inherently contradictory argument, claim that a public option would be inefficient, would interpose government bureaucrats between doctors and patients, and, because cheaper (and one would assume, just as good or even better), it would draw the private competitors out of business as the majority switches to public insurance. At present, it is corporate bureaucrats that to protect their companies’ profits, insert themselves in the process to determine who can be denied coverage due to pre-existing conditions, and for those who do get it, which services and medications are covered at any given time. But by using fear tactics which include the labeling of the public option as “socialized medicine” or misrepresenting voluntary end-of-life counseling as “death panels”, Republicans have effectively killed the government’s plan, stirring up the anxiety of even those members of the upper and middle class with stable jobs, who voted for Obama but are happy with their insurance coverage. Because they only co- pay a third of it, most of them are unaware of the unsustainable costs their employers are incurring (the cost of health care has more than tripled in the last eight years) and the downward effect this has on their wages.  In the current political climate, any measure that would seemingly add to the federal deficit or to a raise in taxes is a non-viable proposition.
 
In times of crisis, Americans recoil to their original Lockean perception of the government as an intruder into the private realm, and are easily persuaded to deride and fear any expansion of its power. This has a singular ring of truth at present, when the government has bailed out Wall Street and owns a large percentage of the automobile industry. Republicans have thus had an easy time convincing the public that after “nationalizing” the bank system and the auto industry, the government is now coming after their health plans and that the United States of America will be soon be under a centrally planned economy. Never mind that Social Security and Medicare are both extremely popular programs that the government owns and runs. Logic has no place in this debate; basic instincts and attitudes carry the day.

As the White House sees the public option become increasingly unattainable, they are starting to move away from it, calling it “only a means to an end”, not an end in itself. Its purpose is first, to guarantee universal coverage by making health insurance affordable to all, and second, to reduce the skyrocketing costs of health care, as competition would make private insurers lower their premiums. If there are other ways to meet these two goals, they are willing to listen. The White House is signaling its willingness to compromise by accepting a co-op system of patient-based mutual care as a substitute of the public plan. Intent on defeating any bill acceptable to the President, Republicans who, on the one hand agree that co-ops are acceptable to the “American way” (read: not an “evil” Socialist invention), are also warning that they could be a Trojan horse through which the government would still get into the health care business.  But by accepting the co-ops option and dropping his initial proposal, Obama could change the dynamics of the debate. As a less controversial way of controlling costs, this compromise would enable him to peel off the votes of a few moderate Republicans, such as Olympia Snowe from Maine. It would also, assuage the concerns of the Blue Dogs, a group of fiscally conservative Democrats, and thus forge a wide majority with some bipartisan cover.

The next six weeks will be a defining period for the Obama’s presidency. The President will most likely go before Congress (the format is as yet to be determined; it could also take the form of a televised national address) for the greatest moment of truth in his leadership, namely, to announce whether he has succeeded or failed in bringing the country together on health reform. It will be a decisive test of his twofold promise of change and unity.
 
Historically, most presidents have seen their own parties lose seats during their first term. Will a triumph in health care enable Obama to defy History in the 2010 election? Not necessarily. It will definitely allow him a breathing period, but the election will be determined by the state of the economic recovery in the months preceding it, and even more importantly, by the public’s perception of said recovery: if unemployment proceeds unabated, even as growth resumes, then the Democrats will probably lose their majority in the House. Obama has been quite successful in tying the health care reform to economic recovery, but as Tom Daschle, the most knowledgeable person on this issue, recognizes, 
a major health care overhaul that will have a noticeable impact on the economy will not be achieved in one piece of legislation only. It will require a long process of which this will only be the first leg.

For now, it appears the President and leading Democrats in Congress may settle on passing a modest reform which, with some Republican support, may help them claim some kind of victory. But even this may prove elusive, as most of those in opposition are not engaged in the process in good faith but just bent on delivering a political defeat. This is clear for example in Senators Grassley’s and Coburn’s reluctance to publicly distance themselves from those among their town hall constituents that threaten to bring their guns to Washington to settle the question.

As I was ready to send this article for publication, news got in from Cape Cod, Massachusetts, that Senator Ted Kennedy, a major leader of health reform and the author of a robust bill still circulating in the Senate, has passed away after a courageous fight against brain cancer. He was 77 years old. Let us all hope that his untimely passing is not an omen of the fate of health care reform legislation in the hands of this Congress.

Senior Lecturer, Department of Political Science and Geography Director, ODU Model United Nations Program Old Dominion University, Norfolk, Virginia