The sense most people have of the health care debate is that it’s great drama in which President Obama is the central player. All the big news has centered around hints and whispers about what the White House wants. They’re abandoning the public plan! They’re standing by the public plan! They’re giving up on bipartisanship! The press has covered the story as if Obama is Moses and we’re waiting for him to come down from the mountaintop.
This is totally wrong. The Senate is what controls the process. That’s the chokepoint for any health care bill. The question isn’t how badly Obama wants a public plan, or how much he cares about bipartisanship. It’s whether moderate to conservative Democrats in the Senate will filibuster a bill that has a public plan or lacks GOP support. Everything else is details.
This great misapprehension is at the heart of the great liberal health care revolt. The base is furious at President Obama and his willingness to compromise. They’re right to be furious. But their anger is completely misdirected. The Huffington Post’s Dan Froomkin, for instance, has written that there are two possibilities in the health care debate. Either Obama “will come out with a strong bill,” he writes, or else “will come out of it having given away the store.” Froomkin thinks this question hinges upon how badly Obama wants health care reform: “Is the real Obama being serially co-opted by his aides in there? Or is the real Obama at heart a conflict-averse facilitator, rather than a leader?”
Glenn Greenwald, meanwhile, complains in The New York Times that “for whatever reasons, [Obama] has failed to take a stand for (if not actively renounced) its central planks.” Look: Obama has not renounced the public plan. He wants a public plan. To whatever degree the final health bill falls short of liberal expectations, it will be because moderate Democrats in the Senate, not Obama, wanted it that way. Obama will sign the most left-wing health care bill he can possibly get through the Senate. There is an alternative political world in which Obama would balk at provisions favored by liberal Democrats--say, a world in which Bernie Sanders was the sixtieth vote--but that scenario does not resemble the world in which we reside.
Why are liberals so confused? Well, the news coverage has been pretty poor at explaining the institutional dynamics. Yet some blame also has to rest with the poor design of our political systems. Americans have come to think of presidential elections as the be-all, end-all of political change in America. Not only is the Senate a malapportioned, counter-majoritarian institution with arcane procedures, it’s practically designed to prevent accountability. Obama supporters who want the agenda they voted for to be enacted into law need to be exerting pressure on figures like Max Baucus and Kent Conrad. Yet these characters are accountable only to tiny, unrepresentative slices of the population. So they get angry at Obama instead, which only makes him less popular and which makes the Baucuses and Conrads even less likely to support him.
I still think there’s a pretty good chance at passing significant health care reform. But if health care reform fails, liberals need to understand who to blame and how to fix it. They need to start knocking off Democrats like Conrad and Joe Lieberman, who seem to be trying to kill health care reform, even if this temporarily costs the Democrats some seats. They need to commit the party to reconstituting the rules of the Senate along majoritarian lines--yes, even if this helps Republicans pass their agenda when they’re in charge. If health care reform can’t pass now, then a filibuster-proof Democratic majority isn’t worth having. At that point you have to consider blowing up the party and waiting a decade or two to rebuild a new one that’s able to address the country’s actual needs.