More on Health Care Choices

Nate Silver has a very reasonable take today on the Charlie Cook thesis that health care was (1) a choice for Obama and (2) a bad choice, following up on my argument that it really wasn't a choice, after all (for why it wasn't necessary bad for him and the Democrats anyway, see Seth Masket and Jonathan Chait).  I had said that Obama had no choice about adopting a strong health care platform in order to win the nomination; Silver makes the point that health care apparently helped Obama in November, as well. 

Silver (along with a commenter on my post) says that while I might be right that Obama had to move ahead with health care, he could have delayed for a while, in light of the bad economic news.  I think that's correct, to a point.  Two problems, however.  First, as it turns out he was probably correct about the timing if his goal included passing health care reform; starting, say, in November would have been a disaster.  Second, as Chait says:

[Y]ou have to compare pursuing health care with an alternate strategy. What else could Obama have done? Cook says they should have focused more on jobs. But he offers no suggestion of what meaningful legislation could have passed after the stimulus, which exhausted Congress's willingness to spend any money on job creation. The current fiasco of a jobs bill, with the two parties bickering over symbolic legislation, suggests how little substantive progress was there for the taking.

The stimulus passed in February, and at that point Obama had presumably squeezed every penny that Congress was willing to spend on stimulus.  The main thrust of the Tea Party and other protests over the summer was against spending (stimulus plus bailouts) at least as much as it was against health care.  Is it even remotely realistic that Congress would have passed an unfunded jobs bill big enough to make any difference in March, April, May, or June?  I sure don't think so.  Perhaps, in mid-summer, Obama could have introduced  such a bill, but not much earlier.  But by then the damage was done to his approval ratings, which fell in the spring and early summer until basically going flat from mid-August on.  Of course, Obama could have pushed a jobs bill knowing that it was doomed in the Senate.  But I'm not sure how moving health care prevented him from doing that.  I think a much better case could be made against the climate/energy bill...I could definitely see an argument that had the House voted for a jobs bill just before August recess instead of climate/energy that it might have given Members of Congress a better counterattacking talking point during that recess.  But I also don't think it would have mattered very much to where Obama and the Dems sit today.  So while I'll grant that Obama did have some choice about timing, I don't really see that his actual choice was a mistake.  Especially, of course, if he wanted a bill.

I guess the truth is that I don't see health care reform, to date, as a significant loser for Obama and the Democrats.  Unemployment is at just under 10%, and most everyone thinks the economy is lousy.  Those facts, which have essentially nothing to do with Obama's strategy on health care, do all the work needed to explain Obama's current approval rating.  Improving those numbers would have meant substantive, not rhetorical, changes, and I just don't think Congress was about to throw another $300B or so at the economy, and I don't think anything much less would have made a significant difference.

At any rate, I do have to take issue with one point that Silver makes:

The bigger mistake -- and I've been saying this since at least last June -- may have been in giving the Congress so much latitude to craft its policy, which resulted in an extremely protracted process and news cycle after news cycle in which the lead story was Democrats yelling at one another.

This, again, isn't a choice that Obama had.  He certainly could have dropped a fully-formed bill on Congress...after which they would then begin an extremely protracted process with news cycle after news cycle about Democratic squabbling.  Nothing any president can do about that.  He didn't "give" Congress latitude; Congress has such latitude, whatever a president thinks.