To Scott Lemieux for (once again) shooting down liberal fantasies that the only thing preventing Congress from passing single-payer health care insurance in 2009-2010 was a failure of will from the president.
It's an excellent job, and sadly necessary, over and over again.
One key point that Lemieux doesn't mention this time: in one sense, this really isn't about 2009 at all. It's about 2007 and 2008, when the three leading Democratic presidential candidates converged on essentially the same plan (with Obama famously omitting the individual mandate). That says a lot. It says that none of those three candidates believed that adopting single-payer would have given them a serious edge in a closely contested nomination fight -- and that no other candidate was able to leap to the top tier by embracing single-payer. In other words, it tells us that in the world of 2007-2008, at least, the ACA was mainstream within the actual Democratic Party as it was, and single-payer was a fringe position in the actual Democratic Party as it was. Maybe lots and lots of Democrats preferred single-payer in some sense, but virtually none of them, either elites or electorates, did anything about it. And that's what counts.
What this also means is that ACA vs. single-payer had virtually nothing to do with Barack Obama himself. And so Obama-centric explanations for it are clearly, 100%, wrong.
I'd further argue, although here it's not quite as clear, that there was very little about the way that Obama fought for the ACA that had much to do with Obama himself. Yes, a Hillary Clinton WH would have looked a little different from the Obama WH...but not all that very different. Yes, presidents themselves do make key decisions, and not their staff or their party. But not only are they often severely constrained by their party (and by Congress, and by lots of other things), but they're also highly influenced by the incentives of the job, and those are the same whether we're talking Obama, Clinton, or George W. Bush.
In short, there's an excellent chance that both the good and bad outcomes on health care reform would have wound up more or less the same whether the winner of the 2008 Democratic nomination was Obama, or Hillary, or a hypothetically unscandaled John Edwards, or for that matter John Kerry or Al Gore.
Meanwhile: nice catch!
Wrong link. Your link leads to an article you just posted on the Prospect, not one from Lemieux.
ReplyDeleteUgh. Thanks, fixed.
DeleteNot sure I buy the HRC would-have-done-the-same argument.
ReplyDeleteWith Obama, Congress (and the Democratic party writ large) were the drivers of the change. This was not #1 on his agenda. So, that would have been the same under HRC.
However, given how health care had previously bitten her in the proverbial butt, I have to wonder if she would have been more gun-shy on it. Some serious discussions with Congressional Dems about priorities on the agenda might have convinced them that this particular Nixon couldn't go to that particular China. The Dems could have gone with a bigger focus on financial reform, or pushed harder on cap-and-trade. Of those, I could see financial reform being the most likely.
This is not really saying that HRC didn't "want" it as much as Obama or whatever, but I can see her being cautious on this issue, and that caution translating into Congress pushing harder on other fronts. 2009 didn't lack for potential competition for the agenda.
Perhaps the largest point of Presidential decision making in the entire ACA debate came in January 2010, when Scott Brown was elected to the Senate. Rahm Emanuel pushed for Obama to all but abandon health care reform, while Nancy Pelosi pushed for Obama to forge ahead. What kind of decision would a President Clinton have made, having been defeated at this project before, and what kind of advice would she have been getting?
DeleteI think the most significant change between Clinton and Obama would have been who had better coattails where in the 2008 Senate elections. This is admittedly speculative, but I imagine having Obama on the ticket put Hagan, Franken, and Merkley over the top in a way that Clinton might not have, without any compensating victories for Clinton.
DeleteIn that Senate, Clinton would have needed six Republican votes for the stimulus to Obama's three. Perhaps Coleman or Smith would have been the fourth and fifth, having narrowly won Clinton states, but they'd still need to find one more. The compromise necessary to get six Republicans probably could have gotten a lot more, or alternatively the stimulus would have failed. Either way, the proximate cause of Specter's primary challenge and subsequent flip to the Democrats would probably have been absent. On the other hand, the motivation to deny the Dems the 60th vote to kill the ACA wouldn't have been present in the MA special election, so Coakley might have been able to pull it out.
FWIW, exit polls showed Clinton would have done better than Obama in 2008. Of course these cannot be taken at face value, because for months before the election, both Democrats and Republicans had been saying nice things about her--each party wanted her supporters. So it's not really a test of how well she would have done when faced with an actual general election campaign. Still, Obama did poorly with southern and border-state whites (in some states worse than Kerry, despite 2008 obviously having more favorable conditions for the Democrats than 2004) and it's hard not to believe that she wouldn't have done better than him with such voters. In Kentucky, it is even conceivable that Mitch McConnell would have been defeated if she headed the ticket.
DeleteClinton might also have done well enough in Georgia to help get Jim Martin elected, too.
DeleteOne of the grim ironies of the 2006 and 2008 elections is that the Republican Senators who lost were, with few exceptions, the sorts of folks who could have been gettable on the stimulus and perhaps given more cover to other Republicans who were initially in play but backed away quickly.
In Georgia, though, Obama did do considerably better than Kerry had in 2004--47 percent compared to 40.6. (and also better than Gore's 43.2% in 2000--or for that matter Bill Clinton's 45.8% in 1996!). I really doubt that Hillary could have done better--there was a strong African American turnout for Obama. and even among whites he did about as well as a Democrat could expect to.
DeleteI don't agree with you about the GOP senators who lost in 2006 and 2008. Can you see George Allen voting for the stimulus? John Sununu? Conrad Burns was pretty conservative, too. Some of the others might have, but--except for Lincoln Chafee-- only if it were watered down even more than it was (and remember that even Olympia Snowe insisted it be scaled down).
DeleteHurm. You know, you're right. I suspect Chaffee, Norm Coleman, and Gordon Smith could have been in play, but, you're right about Burns and Allen et al.
DeleteI don't think this is at all true. After the stimulus passed, health care was pretty clearly the first item on Obama's agenda, and after the Scott Brown mess, it was Obama who made sure that the whole thing didn't die.
DeleteAll true. How about Harry Reid's decision to "let Health Care go first" in the Senate, before climate, in 2009? Do you think there was any chance of a Kerry-Lieberman style bill actually passing, pre-HCR?
ReplyDeleteOnly if it were completely watered down by Senators from Louisiana, Alaska, etc. Whatever could have survived our paid-by-professional-lobbyists Congress wouldn't have amounted to much.
DeleteLiberal activists did not mourn Kerry-Lieberman: http://thehill.com/homenews/senate/110737-liberal-activists-say-good-riddance-to-kerry-lieberman-climate-bill
ReplyDelete