A great deal of ink and pixels has been spent over the health care reform debacle in the Senate. And there is a real debate to be had as to whether or not passing such a denuded bill is good or bad. But regardless of the eventual outcome of the process, one thing needs to be made clear- the distinction between political cowardice and pragmatism.
Many health care policy types are of the opinion that this weak bill is better than no bill at all. They claim that it at least provides some reform that can serve as a jumping off point in future years. This argument does have some merit, if one is willing to accept that future Congresses will have any appetite for further reform. Given this year’s debacle, that may be an unfounded assumption.
Beyond that, there are very real political consequences for passing a bad bill. An individual mandate without either a public option, Medicare buy-in or some other form of competition for the private insurance companies means forcing people to purchase a product they may not be able to afford, or suffer the consequences of a fine. Not to mention the political fallout from the Democratic base and even independents who expected substantive and substantial health care reform. In some ways, it would have been better to fail spectacularly than to incrementally succeed.
With that said, there is still the chance that reform fails. There are no guarantees that Lieberman won’t have new demands prior to a vote. Or that Ben Nelson doesn’t decide rolling back Roe v. Wade is more important than providing health insurance to millions of Americans. And we can’t rule out a conference committee report that brings back some form of public option, which would die in the Senate (or that absent a public option, House progressives won’t abandon the bill).
But what is lost in the whole policy versus politics debate happening now is the underlying problem of political cowardice exhibited by Senator Reid and President Obama. I say cowardice because this is not pragmatism at work. Pragmatism implies that two (or more) sides come together, and each make compromises in order to reach an agreement. Absolutely zero concessions have been made by ConservaDems or Lieberman. In fact, all of the concessions have come from the supporters of the varieties of a public option. Senator Reid and President Obama refused to negotiate in a way that would require compromise from the other side. Instead they played a game of give-away with Lieberman.
The responsibility really lies with both the President and Senator Reid. From the beginning, the President failed to articulate a specific policy proposal, instead relying on vague parameters. He spent little to no political capital to fight for a stronger bill. And his administration has made it abundantly clear that having a bill before the end of the year was more important than having a good bill.
For his part, Senator Reid allowed the charade that was the Gang of Six to take up most of the oxygen in the Senate debate over health care reform. His unwillingness to rein in Senator Baucus’ foolhardy attempts at compromise with an intransigent GOP was only the beginning. Reid also took reconciliation off the table, even though it was his strongest chip at the bargaining table. As Ezra noted yesterday, a bill that went through the reconciliation process would be far more liberal than a compromise bill passed through the normal process. But Reid gave away that bargaining chip and went to the table with no leverage whatsoever. Bargaining with a sociopath is difficult even when you hold leverage, without any you can forget about compromise and head straight to capitulation.
So what we have witnessed is a perfect storm of political malpractice disguised as pragmatism. It’s too late to rescue a good health care reform bill now, but hopefully the Democrats will learn from this colossal failure. Otherwise, progressives can give up hope now for any major policy reform during the Obama administration and can look forward to the GOP retaking Congress sooner than later.