Obama and the Bipartisan Health Care Fantasy

Bipartisanship, as it relates to the debate over health care in the United States Congress, is dead.

Not that you’d know this from listening to President Obama or his Republican tormenters in the House and Senate, all of whom continually proclaim their resolve to “reach across the aisle” in an effort to forge a health care agreement. This is what people like to hear politicians say, so they say it.

The reality, though, is that the most consistent dividing line in politics is and almost always has been ideological, not partisan. This used to create the illusion of bipartisanship, back when a northern liberal was just as likely to be a Republican as a Democrat and when a conservative southerner was always a Democrat. The “bipartisan” alliances that resulted didn’t reflect some long-lost spirit of cooperation; they just affirmed the primacy of ideology.

Thanks to civil rights politics, the Reagan Revolution, and the 1994 Republican takeover of Congress, both parties have evolved into the ideologically homogeneous entities we know today: most of the liberal Republicans have simply become Democrats, and most of the conservative Democrats have joined the G.O.P. Thus, we don’t see the same “bipartisanship” we used to.

And so it is that virtually every Republican in the House and Senate, united by a reflexively ideological opposition to “socialized medicine,” is now preparing to vote against whatever final health care plan Mr. Obama and his Democratic congressional allies cobble together—the same kind of uniform opposition we saw earlier this year, when every single Republican on Capitol Hill voted against the stimulus bill.

There is no amount of pleading, arm-twisting, or ego-massaging on Mr. Obama’s part that will change this reality: He will never get a truly bipartisan health care plan through Congress. The closest he could come at this point would require gutting the current Democratic plans (by ripping out the public option), a gesture that might sway a handful of Republicans to sign on.

No, if he’s going to succeed on this issue, the president is going to have to rely on his own party. The good news for Mr. Obama is that—at least on paper—he has the numbers to pull this off, with a robust Democratic majority in the House and a 60-seat, filibuster-killing bloc in the Senate.

Any House health care vote will be close, with the remnants of the old Democratic south (now known as “Blue Dogs”) likely to defect, but Nancy Pelosi should be able to squeeze out a bare majority—218 votes—for the final Democratic plan. It might not be pretty, but the majority party in the House—particularly when the White House is on its side—has often shown a magical knack for winning the close ones. (Remember when House Republicans held open the Medicare prescription drug vote in 2003 for an extra three hours?)

It’s the Senate where a Democrats-only strategy will face a stiffer test. Republicans will filibuster any Democratic bill that clears the House, meaning Democrats will need absolute party loyalty (and perfect attendance) to muster the 60 votes needed to end the filibuster and force a final vote.

Four Democrats in particular threaten to block the path to 60 votes: Ben Nelson, Mary Landrieu, Ron Wyden, and Joe Lieberman (not officially a Democrat, but close enough), all of whom offered a letter to Mr. Obama last week urging that he significantly lengthen his timetable for health care passage. If just one of them sided with the G.O.P. in a filibuster, the filibuster would succeed.

With Mr. Nelson, Ms. Landrieu and Mr. Wyden, the White House’s best strategy would be to steal a page from Bill Clinton’s playbook. When fellow Democrat (and personal rival) Bob Kerrey was holding out and poised to derail Mr. Clinton’s crucial first budget in 1993, Mr. Clinton and Senate Democratic leaders delivered a blunt message to Mr. Kerrey: Vote no and the demise of this presidency will be on you. It worked. With a health care filibuster, the message could be a little easier: Vote against the final bill if you want, but you owe it to your party to kill the filibuster and allow a final vote.

Given his black-sheep status within the party, that appeal might not work with Mr. Lieberman. But he could be reminded that his committee chairmanship can be taken away, and that his already dicey re-election prospects for 2012 (Connecticut’s popular Democratic attorney general is raring to challenge him) would be severely complicated if he were to become Enemy No. 1 to the White House.

A Democrats-only strategy won’t be easy for Mr. Obama. But it may be all he’s got.

Obama and the Bipartisan Health Care Fantasy