Bipartisanship died at the Health Care Summit. The president can continue to reach out—that’s good politics at a time when Gallup reports that 54 percent of Americans don’t expect the GOP to make a “sincere” effort to achieve compromise on health reform. But as he reaches out, the president also has to draw clear dividing lines. He did that at the summit. After listening to the other side obfuscate, deceive, and spurn common ground, he said, “I don’t know if we can bridge” the differences. He knew that it was crystal clear where the fault lies.
Speaking of lies, Obama called them out in that unflappable way that carried him through storm and smear to the presidency in the first place.
No, it wasn’t true that Republicans had been excluded from the process; a whole range of their proposals—at least the ones that aren’t cockamamie or counterproductive—are included in the Senate and House bills and in Obama’s plan. Competition among insurance companies across state lines, small business pools to negotiate lower rates—there are literally pages of amendments that the Party of No was for before it was against the bill.
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Unctuous Tennessee Sen. Lamar Alexander threw out the canard, concocted to frighten seniors, that the president’s plan would “cut” Medicare by $500 billion. (This from a party whose sole effort at serious reform—by Rep. Paul Ryan, ranking member on the House Budget Committee—calls for replacing Medicare with vouchers.) Alexander was wrong, and plainly, intentionally so. The bill, as the president and Speaker Nancy Pelosi responded, would not cut Medicare benefits for seniors but reform wasteful and sometimes fraudulent payments to providers.
The president deftly stuffed Alexander on another deception as well —that the reform would raise premiums for families. The Tennessee senator had read his talking points, but not the Congressional Budget Office report. According to CBO, premiums would be lower for 92 percent of Americans, in some cases by as much as 20 percent.
On and on it went. The Republicans trotted out their tired hobbyhorses—Health Savings Accounts for the wealthy and healthy and, of course, tort reform, which CBO says would address one-fifth of 1 percent of total health spending. CBO adds that the Republican version of tort reform is so ingeniously crafted that it would also reduce the pressure to avoid medical errors, resulting in 4,800 additional deaths annually. All told, the GOP’s token and total contribution to the debate is a plan to cover all of 3 million uninsured Americans while leaving the insurance companies to gouge their policyholders until the system collapses in a “death spiral” to the bottom.
To paraphrase Justice Brandeis, the television lights were the best disinfectant for Republican claims. With these televised, face-to-face exchanges, Obama has invented a new form of presidential leadership; he exercises it masterfully. The GOP knew what was happening—you only had to look at their sour faces.
Because they had so little to say that was positive or truthful, the summit was a debate the Republicans were bound to lose. But the decisive moment wasn’t the summit, it’s what happens now. Having won the debate, Democrats must now win the battle—not by conciliation but in a straight-out partisan confrontation. They hold the cards if only they will play them. House Democrats can put aside their injured sense of prerogative and pass the Senate bill—and then both chambers can improve it in the filibuster-free process of reconciliation. (Democrats should pay no attention to the crocodile tears of a GOP that used reconciliation to enact the entire Reagan economic plan and the massive Bush tax cut of 2001.)
Republicans will stop at nothing to stop health reform because they know it would reduce the Obama presidency to an authority-depleted, time-serving interval of insignificant change. Obama would be Carter rather than Reagan-in-Reverse. The president plainly understands this—which is why he has rejected counsels of caution and retreat from some of his own advisors.
Victory in the health fight—and now more than ever, it’s a fight, not a courtship—has to be a beginning, not an end. The president has to be more ambitious, not less. Early in the summit, Nancy Pelosi quoted from the letter a dying Ted Kennedy left behind for Barack Obama. The outcome on health care, Kennedy wrote, was fundamentally a test of “the character of our country.”
That outcome will also define the character of the Obama presidency—and that in turn will determine not merely his and his party’s political prospects, but the possibility, perhaps for generations to come, of a progressive America.
We saw the alternative, too, at the summit, where the character of today’s Republicans was on display. If they won’t join in, then they have to be beaten—beginning with health reform. As someone in the White House told me, when the crunch comes—and it has—“I wouldn’t bet against Obama.”
I still think that’s a shrewd assessment of the odds.
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