Election 2009

Make no mistake (to use a favourite phrase of the President’s), we’re in for a major battle this August. The stakes with healthcare are high, almost as high as last year’s election in terms of the impact a setback could have on the Obama presidency's domestic agenda. The Republican camp is resurgent, it’s on message, and it’s united in its spoiler tactics, seemingly with the upper hand as its rank and file turn up to disrupt town halls and the Greek chorus in the House and on cable news media conjure up ridiculous fears of government bureaucrats ordering you to kill your granny. The New York Times is running sympathetic pieces about Karen Ignagni, talking about how in the face of Democratic aggression the poor, long-suffering insurance industry “risks being thrust in the same role it played 15 years ago when it helped derail reform.” The economy has moved out of ICU, and instead of praising the administration people are complaining that jobs haven’t started appearing yet. The healthcare lobbyists are piling money into the debate, making the Blue Dog Democrats some of the biggest money-raisers of all this past quarter. And, for once, Obama’s much touted press conference and speech didn’t quite hit the right notes, as he mastered the details but not the big picture.

The odds still favour a healthcare bill by the end of the year, much stronger than they ever were for Hillarycare. But they’re by no means certain, especially if the Republicans make all the running in August. It’s not clear whether the bill will emerge with any Republican votes at all, or whether it will be produced by Democrats alone, and one should never underestimate the political importance of even two or three Republicans breaking ranks. Such factors could have a major impact on critical issues like how progressive the underlying payment framework for the new spending is, and whether a public option is capable of seriously raising questions for the private insurers’ oligopoly. This, in short, is a big deal.

To win the forthcoming public battle royale, then, the Democrats need to fight as if it was the election all over again. That means getting out the activists who campaigned for Obama last year and getting them to turn up at public meetings, to write to their congressmen, to give money to reform PACs, place ads, and generally express their desire for change. And it means using the power of Obama’s popularity to keep the Democrats united. There was a tremendous wellspring of opposition to the regressive politics of the previous administration shown in the Obama election, and I don’t believe it’s gone away. However, too many reform-minded people seem to have sat back since the election and concluded that it’s Washington’s turn now, or are instead focused on griping about how backward and racist the Republican party is from the sidelines.

If you have the time, I thoroughly recommend this fairly short piece by author R. W. Johnson in the most recent London Review of Books, ‘Author Loses Leg in Lagoon.’ As well as being a fascinating read, it tangentially says something about the very real fears that people have who currently hold health insurance (albeit in South Africa in this instance, not America). Democrat message-makers must recognize that, as a critical issue relating to points in your and your family’s lives, when you’re most vulnerable, many people are quite naturally conservative when it comes to health care. Better the devil you know, right? Rather than impugning that fear of change and focusing on the politically-minded enemy, reformers should respect and seek to reassure it.

There’s encouraging signs that the Obama administration is sorting out its message now on this, and that Obama’s natural tendencies will push him in this direction. Nevertheless, the Democrats should focus on ramming home a small number of key points that are currently emerging as the major emphases in the debate:

1. As Obama has always said, this bill will do nothing to your existing coverage. If you like what you have, you keep it.
2. The consumer protections that have already been agreed with the insurance industry are intended to provide greater security for holders of health care and might offer the potential to control rising drug costs.
3. They’re also going to guarantee that insurers can’t refuse to cover you because you’ve got a pre-existing condition.
4. Unlike the Bush era prescription drug program, this bill will be paid for. What’s more, it may help to control the cost of insurance for small businesses are struggling in the current economic crisis.

In short, the bill is designed to be safe, secure and cheap. If Obama can really drive home these points then he’ll go a long way toward reassuring conservatives of good will that this bill is not going to be the end of the world, leaving the hardliners who will oppose anything that’s proposed by Obama or a Democrat isolated.

Leave a Comment