Sunday, September 5, 2010

Sunday Question for Liberals

Real simple one, inspired by Chait and Sprung.

Suppose the following things are true: that as it was, Barack Obama and the Democrats got the best possible deal they could get on health care reform (and, for that matter, the various other things they passed in 2010); that they could have won quite a bit more stimulus spending had the never tried to get health care reform; that more stimulus spending would have improved the economy significantly in the short term; and that helping the economy would have saved about 30 House seats and around half a dozen to ten Senate seats in November.

I'm trying to phrase this to wind up with the following question: if the choice was the ACA as passed in exchange for the difference between a mild midterm election loss and a blowout, did Obama and the Democrats make the right choice?  I suppose I'm happy to hear from those who opposed the ACA from the left (although their opinion is obvious, and a clear minority according to polling), but I don't really want arguments that both were possible, or that a better health care bill was possible.  In other words, for the sake of this question, please accept the premises.  Not because they're true -- I'm not claiming that they are -- but because the question I'm interested in is the one about trade-offs.


  1. Absolutely. The purpose of a majority is to advance the party's agenda. The majority party should seek to permanently entrench policies that will benefit the American people, not itself as a majority.

    Still, if the choice is between the ACA and a bigger stimulus, it might have been better to go with the stimulus. Not because it would have been safer, but because it might have done more good in the short and medium terms. Preventing 9% unemployment from becoming "the new normal" would be worth a lot.

  2. It would help if you defined ACA for us non-wonks.

    TEH Googley doesn't help.

    Assuming ACA means health care reform, and that the Dems will lose in Nov, anyway, the question is by how much - I don't see what your getting at.

    They should have pushed hard for stimulus, helped the economy, been far more aggressive in highlighting the negativity and obstructionism of the Repugs, and kept control of both houses.

    Clearly, I'm missing something big.

  3. Assuming ACA means health care reform . . .

    Yes. ACA = Affordable Care Act, the official name of Obamacare.

  4. I don't have a problem with the way things turned out. If the price of near-universal health care is a blowout in November, so be it. It's a lasting piece of legislation that will insure tens of millions of Americans. Yes, I would like more/better stimulus and the economy is a problem, but this was a once-in-a-lifetime opportunity to pass HCR, so it needed to be done.

  5. Awesome that someone has finally asked this question. I have been thinking about it for weeks now. Also, I think your premise is exactly right. in that any chance for more stimulus was killed by the endless health care fight. I don't think enough democrats are thinking clearly about this rather than just venting about the unfairness of it all.

    All that said, I still don't really know. Ultimately I come down to supporting the ACA w/ midterm blowout but that is partially cause I don't think there was much more stimulus could do (half of the infrastructure stimulus is still unspent) and that violates the particular rules of this game.

    Fun question.

  6. David - Thanx.

    Johnathon - No. Bad choice. We would up with half-assed health care reform, a half-assed stimulus, and nothing the Dems can crow about.

    But I think you are proposing a false choice. Why would the trade-off be between the quality of ACA and the degree of mid-term losses?

    The real choice (IMO) was between ACA and stimulus. They went for both and got little of either. A robust, successful stimulus would have addressed an immediate need, and been a political win, as well as good for the country and the world. The need for health care reform will not go away, and that could have been the next campaign, with a majority in both houses.

    They blew it, badly.


  7. They made the right call on the ACA. It was a metaphysical certainty that the Democrats would lose seats in the midterms. And that meant no possibility for ACA afterwards. It took all of the Democrats' formidable numbers, including a brief window of a 60 vote majority in the Senate, to pass the ACA. Anything less than what they had would not have been enough.

  8. Without knowing what compromises were made to pass the health care bill, it's difficult to know what the right answer should have been. I doubt that Obama would have been able to get a larger stimulus bill, either in January 2009 or six months later. He might have been able to do "stealth stimulus" through passing bills like the transportation re-authorization bill, which could have been front-loaded with spending in order to help the economy in the short term.

    Also, I'm not sure that more stimulus would have helped very much, as the Fed has the bigger lever in terms of economic growth, and it would have been very easy for Bernanke to pull the Fed back if the Congress was spending more borrowed money, which would have the same end result in terms of economic growth.

    For me, the critical question is what compromises (on Afghanistan, on re-appointing Bernanke, on the transportation bill, on cap-and-trade) Obama made in order to get health care passed. If it turns out that Obama would have made the same decisions on everything else, then he's clearly better off passing a decent health care bill and losing seats. But, if he had would have made different decisions on any of these other issues, I would be open to reconsidering his decision to spend all his political capital to pass ACA.

  9. I think they made the right choice. They'd lose some seats in the next Congress anyway, and then ACA wouldn't pass.

    I do wish they'd pushed for Romer's 1.2 trillion. OTOH, I'm skeptical that an economy based on oil, financial "innovation" and building guady McMansions 200 miles from your job can be made to work again.

  10. This question is really poorly phrased.

    Anyway, with 20/20 hindsight, would I rather have ACA as passed, or a bigger stimulus [1.2 trillion, with less tax cuts and more aid to states]?

    Easy! I'd pick stimulus! It was the first big item of the Obama agenda, and if it had visibly/dramatically turned the economy around, it would've helped reduce voters pocketbook anxiety, maintained the President's popularity and helped with subsequent fights.

  11. To be clear, I just want to say that 10% unemployment is a 3 alarm disaster. It causes massive economic anxiety that can sabotage all your other agenda items (ex climate bill, immigration reform, EFCA, etc).

    I think your question presents a false choice, but if I accept its premise, I think it's insane to choose ACA over fixing 10% unemployment.

    I guess one analogy is that it's like choosing to fix up your house's old leaky roof while ignoring the fact that the kitchen's on fire.

  12. YES, it was the right decision, but NO, the question relies on an incorrect presumption.

    The reason for smaller-than-adequate stimulus is the SAME as the reason for less-liberal-than-adequate ACA: deference to the Conservative wing of the Democratic party as an ostensibly olive branch to a GOP. You can't bargain with a party that wants America to burn whenever they're not in power.

    The correct question is "Is maintaining the power of the Senate minority worth catastrophically hamstringing the economy with a too-small stimulus, under-manning the executive and judicial branches, compromising too much on SCOTUS picks, and passing a grossly insufficient (by international standards) health care bill?" To which the answer is NO NO NO NO NO NO NO! The power of the Senate minority isn't worth preserving **at all**. (I firmly believe the SENATE isn't worth preserving at all... devolve its powers to the house and burn the chamber!)

  13. It's tough. Bigger stimulus lowers deficits, gets more people insurance (vs. the baseline of right now) by getting people in jobs and would have dramatically increased the quality of life for 30-50% of the presently un- or under-employed. It also would put the lie to the claim that government can't do anything right.

    However, one thing I think that proponents of bigger stimulus miss is that while a larger headline number would have been better for the economy as a whole, it probably wouldn't have helped Democrats' electoral prospects all that much. It's doubtful that they could have spent the money much faster. And projections suggest that the stimulus has only become a net drag on the economy in Q3 2010. (I believe this is the result of raising the GDP baseline. The amount you have to spend to grow from a higher baseline becomes higher.) Calculated risk recently said the ARRA surprisingly became a drag on growth beginning in July.

    In other words, a bigger stimulus might have knocked a couple of tenths of a percent off the unemployment number right now and maybe a bit more over the next couple of months, but would the Democrats have been that much better off with 9.0% unemployment and higher labor force participation in November rather than 9.9% unemployment?

    Ultimately, I'd rather pass the ACA, I think, but it's close. High unemployment is bad, but health care is a WAY bigger deal for our economy in the medium to long term. I reserve the right to revise my opinion if we suffer a second consecutive lost decade, though.

  14. Hi all,

    Back home, and able to look at the comments, which are quite interesting as usual. Just to clarify: I'm definitely not making an empirical claim about any of this -- I'm not saying that the premises I set out are true, that there really was the trade-off I'm asking about. I'm trying to set that aside, and just asking for how people would feel if there was such a trade-off.

  15. Calculated risk recently said the ARRA surprisingly became a drag on growth beginning in July.

    Actually Calculated Risk said that the decline in spending from ARRA would become a drag on growth, not that the stimulus itself was a drag on growth. Completely opposite from @Some Guy's statement, in fact.

    As to Jonathan's question at hand. Philosophically, it was probably better to go ahead and pass ACA and risk the political blowout(if indeed there is going to be one.)

    But you can't really get away from the unknown unknowns: we didn't really know how utterly inept and incompetent the White House communications team was at the time. We didn't really know how utterly cowardly and cynical half the Congressional Dems were at the time. We didn't really know that Obama would privilege his political advisors' advice on the economy over his economic experts at the time.

    Because ACA didn't *have* to be so unpopular. It was total, complete naivete and incompetence that it wasn't sold properly. So it didn't have to result in an electoral blowout (if indeed there is going to be one). Someone needs to pay for that colossal blunder. I nominate Rahm.

  16. No, sticking with ACA would absolutely be the wrong choice. They should have chosen stimulus. What's at stake is not merely control of Congress (though that's a big deal) or even a couple percentage points difference in employment (though that's a bigger deal), but the public credibility of Keynesian economics. If the historical lesson Americans take home from this is that stimulus doesn't work, then the next time we hit a financial crisis the outcome will range somewhere from another great depression to the end of our republic.

  17. If we accept the premise that Obama could have passed a more robust stimulus at the cost of healthcare reform, the exchange might have been a good move. A $1.2 trillion stimulus that came close to filling the demand hole would have resulted in more economic growth by now, with a decrease in unemployment in time for the midterms. Obama's approval ratings would be increasing by now and attempts to paint him as an out-of-touch liberal would have no traction at all among independents. The Dems would be looking at keeping decent majorities in both houses of Congress, which would still provide a foundation to advocate for other policies like HCR. It would be a win both politically and policy-wise.

    However, I strongly dispute the premise that this tradeoff could have been made in the real world. After all, conservative Democrats killed the stimulus as much as the Republicans.

  18. If the choice was between a larger stimulus or the ACA than Obama made the right choice with going for the ACA. Liberals and progressives wanted universal healthcare in America since 1912, when TR first proposed it. Serious attempts have been made to institute universal healthcare since the Truman Administration. The ACA was the first success in passing a healthcare bill that applies to all Americans rather than a subset like senior citizens or children. Even though it is clearly inadequate in many ways, passing it and and starting on the road towards universal healthcare was worth it.

  19. I think if a bigger stimulus could have been passed then healthcare passes easier then it did and is probably a more progressive bill(public option, medicare buy-in).

    I do think they made the right choice. These were the largest congressional majorities in a generation, and with those majorities you take all you can get. The Democrats got a lot accomplished and hopefully introduced concepts, like the public option and medicare buy-in, that can become of a future agenda.

    Even in a more favorable year, Republicans would probably pick some seats. Given the obstruction at all costs agenda of the current GOP, even slightly reduced majorities make an accomplishment the size of healthcare a near impossibility. That means big legislation has to wait for the results of the 2012 election. Even if 2012 is a good year, I find it hard to see where Democrats would have a majority large enough to get through anything like what they have gotten this year.

    Seats that are marginal or that lean toward the other party are the currency that parties use to enact their agenda, and you might as well get what you can for them when you have them.

  20. 100% the right choice. This has been a staple of Democratic Party values going back 60-70 years. We will not have majorities this large in the near future. We needed to get this in place before those sociopathic Republican bastards get their turn, because Lord knows they will not lift a finger to help anyone in need. I make all the standard criticisms - we should have had a public option, Medicare buy-in, and all the rest. And I'm sorry that we're going to lose everything in November (although of course in real life that has damned little to do with passing the ACA). But goddamn it, we did the right thing. Nancy Pelosi, Barack Obama, and even Harry Reid acted like leaders and they should be proud of this achievement.

  21. I guess one analogy is that it's like choosing to fix up your house's old leaky roof while ignoring the fact that the kitchen's on fire.

    I left an anonymous post above so don't count my vote twice if anyone's keeping score, but James is exactly right.

    I know health care reform is a big deal. I know people who went without care because of preexisting conditions. That makes me furious. It's a stain on our nation's conscience, and it's good that we addressed that, public option or no public option.

    But massive persistent unemployment is worse. Ultimately, a functioning labor market is an implicit part of America's social contract. When jobs are available, workers are allies. When they're scarce, they're competitors. Voters won't just turn against Democrats, they'll turn against unions, immigrants, poor people, and democracy. If you don't have a job, you're absolutely nothing in America. You don't just lose your livelihood, you lose your dignity, your place in your community.

    Whatever the electoral consequences (and I'd be more worried about 2012 than 2010), in and of itself unemployment is a more acute problem than our health insurance system. You should think of it like a foreign invasion or a natural disaster--you shouldn't be worried about anything else until the invasion is repelled or the disaster is cleaned up.

  22. Attn Politician: OTOH, one of the criticisms of the ACA from the Left was that it wasn't Republican proof. As our host and several other bloggers noticed, some hostile to ACA and others not, the ACA can be destroyed by the Republicans in myriad of ways from de-funding it to repealing the mandate, without actually repealing it. This is actually a very good criticism of the ACA. Medicare for All, the most liberal form of HCR, would have also been the most Republican proof but not as Republican proof as we would want it to be.

  23. I vote yes. As others have said, it took an historic and elusive super-majority to get health care passed. It needed to be passed, and I don't see any other way of doing it. I have the same problems everyone else has with it, but I am optimistic in the way Republicans are fearful, that it will turn out to be an unstoppable tide towards equitable health care for everyone and the junking of our absurd current system.

    Political majorities are there to be used, and if all we ever do is guard our seats at the expense of policy, I don't see the point of being in power. It is true that keeping the conservatives out of power protects the country in lots of little ways all the time and keeping the liberals in charge helps in lots of little ways. I think this big thing is worth giving up on the little things for a while.

    I think Consumatopia has an interesting point about the perception of Keysian economics. The problem as I see it is that I don't think a larger stimulus would have addressed that point. Even if the stimulus had been twice as big and not watered down with Republican nonsense, and even if two months after it started to take effect magical unicorns came down and gave everyone jobs while updating all our crumbling infrastructure, Republicans would still deny the stimulus had anything to do with the recovery. They are immune to facts and logic, and pretending as if they can be swayed by things that happen in the real world only leads to trouble. Now, you may have a point in terms of how the larger public views the issue, but I think there is such shallow attention paid to complex issues like this by people who aren't partisans that I seriously doubt it will be a problem. The non-political junkies you are talking about aren't paying attention and won't remember.

  24. Accepting those premises (And I don't think they're TOO far off) I think the trade off was absolutely justified, and maybe even necessary. During the health care debate, Ezra Klein kept harping on the fact that Dems were going to lose their majority SOMEDAY, they might as well use it for something in the meantime. I think that makes sense; why even struggle to GET a majority if you're not going to do anything with it? Moreover, I say "necessary" because, as we've discussed before, a health care plan was absolutely essential in the Democratic Primaries. Most of the major national players were locked in to pushing a plan, and if the Dems had let yet another era where they held the trifecta go without getting that job done, then I dunno, I think a lot of the major HCR players might've just given up.

    However, if the question is was HCR worth it at the expense of more stimulus/a stronger economy...then I just don't know. The true benefits of HCR are too far off, and the lingering damage of this economy is still too unknown.

    I'm still happy that this group of Dems passed HCR, 'cause I doubt they would've had another chance. But I can understand the idea that making a stronger economy now was more important than letting this group of Dems pass HCR.

  25. Gotta be Health Care. This was something that Obama campaigned on, he promised, and democrats have wanted it for decades. As Ezra Klein repeatedly pointed out, the ACA, while not perfect has laid the ground work for future governments to build upon.

    And besides a bigger Stimulus (in the 1.2Trillion range) would not have affected the unemployment rate much anyway (not much difference between 9.6% and 9% from a congressional race standpoint.

  26. I posted this in the overplaying post but want to ask this question, well its slightly different, but this is puzzling me.

    Why are so many people, at least on the liberal-progressive blogosphere, so angry that HCR wasn't single-payer or at least had a public option? Most of these people seem intelligent. They should know about the type of compromises required by the American political system, especially for liberal legislation. This has been pointed out and explained numerous times. Yet, the pure rage at the ACA from the left is unmistakable. Any explanations or theories?

  27. @Lee Ratner - the belief is that with majorities this large to be unable to get even the teeniest, tiniest public option in is fucking embarrassing.

  28. I do not like the game but accepting the premise, the choice we have:

    A) ACA + inadequate stimulus = possible loss of Congress and therefore no more Obama seats on Supreme Court

    B) No ACA + adequate stimulus = keep Congress, Obama replaces two conservative justices with two moderate, and a chance at ACA in 2011.

    B is better. The Supreme Court is just that powerful.

  29. Rewinn:

    I have been preaching the gospel of the importance of the Supreme Court in evaluating Presidential candidates for decades, but I don't see your point here. Which two conservatives do you think Obama has a chance of replacing?

    Kennedy lives for the position he is in. He could be the second to leave if one of the block of four is peeled off, but there is absolutely no way he is leaving while he is the deciding vote on every important case. He would have to die or be incapacitated. I don't think this will happen in Obama's second term, much less his first.

    Roberts and Alito are too young to go. I expect Roberts in particular to be around a minimum of thirty years.

    That leaves Scalia and Thomas. Scalia lives for the Supreme Court. I fully expect him to die either while he is still on the court or within two years of leaving it. He is not going anywhere.

    Thomas is your best bet. He is the least predictable of the bunch in that he seems to be powered by pure spite and hatred. That is a powerful, but unpredictable, motivator. Who knows what he might do. He is still young enough to be there quite a long time, and I would not be surprised if he died on the bench. On the other hand, I would not be all that surprised if he exploded in a cloud of bile. I certainly don't think we have any indications of a desire to leave the court though. I am pretty sure he has no desire to let a Democrat replace him. I think the only way he leaves while a Democrat is in office is because he gets so upset about something that he takes his marbles and goes home, and that is almost entirely a matter of what is happening in his head that we can't know about.

    Getting all excited about two more Supreme Court replacements seems very premature. We need to win at least two more Presidential elections before that becomes something to even realistically daydream about. At that point we might catch someone who was hoping to retire but can't wait another four years and really can't wait another eight. More likely it requires three more elections.

  30. Attn Politician- A small public option would be medicare for a few million people that make too much to be on medicare. It would be cosmetic.

  31. Lee Ratner - The thought is that you start small with the public option and keep expanding it over time. As Atrios said, it was so important because it's the hope of something better eventually.

  32. Seems like almost every vote is for the ACA side of the scale. I'd have to go with stimulus, myself. Here's my argument:

    1) The best way to get people health care, even with the ACA passed, is to get them jobs. So, since your question assumed that the stimulus would have significantly improved the economy , I have to take that as a premise.

    2) Jobs are nice to have. Every single democracy on earth punishes the party in power when jobs are scarce. Furthermore, there are many people who choose not to spend their money on health care, either choosing to not insure themselves, or whatever. So, even though I'm a liberal, it seems clear to me that people value health care above a job only so much as is necessary to live decently, so while I think some outcomes are bad and we should be protected from our foolish impulses, at some point, we have to let people make bad decisions.

    3) ACA and stimulus make the news. What hasn't? The budgets that have done the little things that we (liberals) tend to like. Losing control of Congress will lead to a heck of a lot of little things that will be bad, but will go unnoticed.

    4) The larger public health problem is not health care, it is conservativism. Yes, this is tongue in cheek, but there's a point in here. These knuckle-draggers are absolutely toxic for good public policy in all areas, including public health. If there was a chance that the GOP would have become a permanent minority party like the Dems from 1860-1930, or the GOP from 1930-1968, then that's a chance we have to take. If keeping the majority in 2010 would mean that moderates would choose to run as Dems instead of Reps, that's a big deal. That's the long run, but it's also the short run. These current conservatives scare the bejebus out of me. Moderation in the defeat of fucking INSANE extremism is no vice.

    5) Yes, Dems have wanted to do something like the ACA for decades, but that's been while the parties have been relatively similar in strength (1968-2010). Hard to do, and that's the argument of many liberals. My response: what ELSE has been hard to do because of the equal balance? The ERA? The environment? Settling the question of abortion? Gay marriage? Reducing the size of the military/NOT invading countries for shits and giggles? Labor laws? Elect more liberals and moderates (vs conservatives), and making what we liberals consider to be good policy becomes easier across the board. Lose more seats, it becomes harder.


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