If the Democrats fail to pass real changes in the health care system this year—rather than a sham that mimics and mocks reform—they will have nobody to blame but themselves. Or at least nobody to blame but other Democrats, notably those in the White House who have never been committed to this most venerable and fundamental aspect of party policy.
Of course the right-wing rumormongers have done their share of damage, spreading lies about “death panels” and stirring up the boob cohort with warnings about socialism. Republican elected officials have decided to damage the president rather than address an issue they know is critical to the nation’s future. Health insurance lobbyists and corporate leaders have spent millions of dollars to kill reform, buying legislative obedience the same way they buy advertising time or legal advice.
Yet in the months that followed the momentous election of November 2008, the Democrats have possessed the power to fulfill the moral imperative—good, affordable health care for all Americans—that they have pursued since the Truman era. Both the new president and the new majorities in both houses of Congress declared their determination to create the kind of health care system that other developed nations have enjoyed for the past 50 years or so.
Now competing measures that might or might not accomplish that worthy goal are stalemated in Congress while the White House dithers over how best to placate Republicans and conservative Democrats who have opposed serious reform from the beginning.
The ultimate responsibility for this sorry state of affairs belongs with the president, who vacillates between speaking out boldly for a “public option,” and permitting his aides and appointees to undermine his message by confiding their plans to sell out. His worst tendency, to exalt bipartisan compromise above progressive policy, has left him at the mercy of senatorial frauds like Charles Grassley, the Iowa Republican who pretended to negotiate over details while denouncing the president for seeking to terminate America’s grandmothers. He assigned far too much responsibility for health care reform to aides who exacerbate that weakness—and in particular to Rahm Emanuel, the current chief of staff and former congressman from Chicago.
Every mistake made by the Obama White House in the pursuit of health care reform can be traced to the political style and ideological prejudices of Mr. Emanuel, who has sought to intimidate progressives and empower conservatives, always in the name of winning elections and “getting things done.”
A self-styled tough guy who famously likes to prove his point with abusive language and threats, he led the Democratic Congressional Campaign Committee during the years when the party regained its majority—when he spent millions to elect the “Blue Dogs,” who have done so much to thwart the president’s agenda on health, energy and economic recovery. He repeatedly intervened in primary elections around the country to promote G.O.P.-lite candidates against challengers who actually represented the party’s bedrock beliefs. Around that same time, he co-authored a lightweight volume on national policy, titled The Plan, that explained why he believed that universal health coverage could not be passed, so Democrats should settle for covering the nation’s children, which had largely been achieved by then.
All this dubious history was no secret when Mr. Obama appointed the combative Chicagoan to run his shop. Although few Democrats trusted Mr. Emanuel to hold true to principle, many hoped that he would get things done—and that those things would reflect the progressive outlook of his boss rather than the attitude of accommodation he picked up on Capitol Hill.
Instead and perhaps inevitably, his narrow pragmatism is shaping the Obama administration’s approach to reform. As long as some kind of bill passes, Mr. Emanuel won’t worry when the corporate powers override the public interest once again. He will congratulate himself on a job well done. His Blue Dogs will boast of frustrating that liberal Obama. Everyone will get a nice check from the insurance lobbyists.
But the president’s promise will be soiled, and the nation’s future will be dimmed.