Obama's healthcare victory carries a cost

Gone is the promise that he rode to victory on less than a year and a half ago — a promise of a “postpartisan” Washington.

March 23, 2010 01:37 am | Updated December 04, 2021 10:48 pm IST

With his party rallying around him on healthcare, President Barack Obama is now assured, whatever the ultimate cost, of going down in history as one of the handful of Presidents who found a way to reshape the nation's social welfare system.

After the bitterest of debates, Mr. Obama proved that he is willing to fight for something that moved him to his core. Skeptics had begun to wonder. But he showed that when he was finally willing to throw all his political capital onto the table, he could win.

Whether it was a historic achievement or political suicide for his party — perhaps both — he succeeded where President Bill Clinton failed in trying to remake American healthcare. President George W. Bush also failed to enact a landmark change in a domestic programme, his second-term effort to create private accounts in the Social Security system.

At the core of Mr. Obama's strategy stands a bet that the Republicans, in trying to portray the bill as veering toward socialism, overplayed their hand. Fuelled by the anti-government anger of the Tea Party movement, Republicans have staked much on the idea that they can protect the country by acting as what the Democrats gleefully call the “Party of No”.

Now, armed with a specific piece of legislation that offers concrete benefits to millions of people — and that promises to guarantee insurance for many who found it unaffordable or unattainable — the White House and Democrats believe they may have gained the upper hand.

But there is no doubt that in the course of this debate, Mr. Obama has lost something — and lost it for good. Gone is the promise that he rode to victory on less than a year and a half ago — a promise of a “postpartisan” Washington in which rationality and calm discourse replaced partisan bickering.

Not in modern memory has a major piece of legislation passed without a single Republican vote. Even President Lyndon B. Johnson got just shy of half of Republicans in the House to vote for Medicare in 1965, a piece of legislation that was denounced with many of the same words used to oppose this one. That may be the true measure of how much has changed in Washington in the ensuing 45 years, and how Mr. Obama's own strategy is changing with the discovery that the approach to governing he had in mind simply will not work.

“Let's face it, he's failed in the effort to be the non-polarising President, the one who can use rationality and calm debate to bridge our traditional divides,” said Peter Beinart, a liberal essayist who is publishing a history of hubris in American politics. “It turns out he's our third highly polarising President in a row. But for his liberal base, it confirms that they were right to believe in the guy — and they had their doubts.”

For that lesson in governing, Mr. Obama paid a heavy price. He nearly lost the healthcare debate, and only pulled out victory after deferring nearly every other priority and stumping with the kind of passion he had not shown since the 2008 campaign. His winning argument, in the end, was that while the political result could run against him — and other Democrats — remaking healthcare was one of the keystones of his “Change You Can Believe In” credo.

“I don't know what's going to happen with the politics on this thing,” Mr. Obama said on Friday in his last big rally for the healthcare bill at George Mason University in Virginia. “I don't know whether my poll numbers go down, they go up. I don't know what happens in terms of Democrats versus Republicans.”

Republicans entered this fight convinced, at least for public consumption, that they do know how it will play out: With an end to Mr. Obama's mandate and a bigger-than-normal loss for the incumbent party come the midterm elections.

In the soaring deficits that began in the Bush era and accelerated in the heat of the financial crisis, and in the argument that Mr. Obama was taking over wide swaths of the economy, an increasingly conservative Republican Party believes the healthcare overhaul encapsulates the argument that the President is about big government intruding into the lives of citizens.

“In the short term, Obama will get a boost, because the narrative is that he came back from the dead and got done what no president has managed to do in 70 years,” said Peter Wehner, who was a political adviser to Mr. Bush. “But once people discover that their Medicare taxes are going up, that there are deeper cuts in Medicare advantage, that there are court challenges to many provisions, and that the process of getting it passed created a portrait of corruption, it won't sit well.”

Perhaps so, but Mr. Obama's counterargument is that three-quarters of a century of American history is largely on his side. In 1966, celebrating the creation of the first Medicare rolls that covered 20 million Americans, Mr. Johnson recalled the complaints three decades before that Social Security “would destroy this country,” and noted “there is not one out of 100 who would think of repealing it.” (He may have been right at the time, but in the ensuing decades many have come to believe that system must change or go broke, the battle Mr. Bush fought and lost in 2005.)

Today many would tinker with Medicare; many of the arguments over the last three months have been how to reshape it, but no one on Capitol Hill has dared suggest eliminating it.

Mr. Obama's gamble is that what worked for Mr. Johnson and President Franklin D. Roosevelt will ultimately work for him. Once Americans discover that they can no longer be rejected for insurance for pre-existing conditions, he is betting, or that they can keep their children on their own insurance plans longer, the more they will come to appreciate the effect of the changes on their day-to-day lives. He is trying to sell the government's oversight role over doctors and insurance companies the way he is trying to sell financial regulation: as a levelling of the playing field, in favour of consumers.

But as the fight over healthcare shows, the political atmosphere of 2010 resembles neither 1965 nor 1933.

The more the country debated this change to the social contract, the more divided it became. The more Mr. Obama talked, the more his Republican opponents decided that their best strategy was to dig in and defend the status quo . If deficits soar, if the Congressional Budget Office's estimates prove fanciful, they will be able to argue that Mr. Obama expanded government at a time the country simply could not afford yet another entitlement.

But it will take years to know whether the Republicans' worst predictions, or Mr. Obama's vision of affordable near-universal care, will resemble reality.

In the meantime, Mr. Obama can lay credible claim, for the first time in his presidency, that he proved willing to risk all to turn his convictions into legislation. © 2010New York Times News Service

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