We all know how the health care debate is likely to end, so let’s cut the crap and save us all some trouble.
1) The public option, if not quite dead, is in critical and declining condition. It exists solely to serve three political purposes: as a sop to the progressive base, as a chew toy for the radical right, and as a bargaining chip to be backed off slowly by Democratic leaders, like a puppy facing a radioactive bone.
Sure, with few exceptions, the Democratic leadership is making the right noises about being behind the policy; this is only the kabuki until they sorrowfully announce that they don’t have the votes or the support to pass it. This is how you can tell they’re not serious about it: they let it be the radical option. If President Obama were serious about backing this policy, his strategy–now impossible–would have been to leave single-payer on the table. Let that option, which he never supported, draw the slings and arrows of the right, and the public option becomes the moderate alternative.
To miss this calculation, you have to either believe that the president is politically naïve, or that he did not mind if the public option became a sacrificial lamb. I don’t believe that Obama is naïve.
2) The most likely result is tepid compromise. The Democrats are too incoherent to pick a position and pass it. The Republicans are too weak to block the bill entirely, and have developed a heads-we-win, tails-you-lose strategy: with health care reform or without it, their demagoguery for 2010 is already well mapped. They, too, are just proceeding with their 22-month kabuki play.
3) A compromise is not going to be good policy. Anything which passes will be sniped at relentlessly by Republicans and conservative Democrats. If $N are required to fund whatever plan passes, expect $N/2 to be allocated, with further reductions intended by those who would prefer reform to fail. If mandates are placed on individuals and businesses as part of the plan, presume that numerous loopholes will be carved out by the lobbyists, driving more people into the underfunded public support network. Our political system is rigged to produce either sweeping change or incrementalism; large doses of incrementalism are the worst of both worlds.
4) The safety net will continue to fray. The negative trend lines on health care delivery and coverage have been consistent, through Republican and Democratic administrations, recoveries and recessions. This will not be stemmed with a bilgewater reform bill, offering “universal” coverage with high deductibles, high co-pays, and unaffordable premiums in the absence of sufficient federal funding. The status quo will be maintained: those who cannot afford coverage now will do their best to avoid incurring medical expenses, even if they’re under a putative universal coverage plan. Instead, they’ll be driven into the system by the same factors which do so now: when their pain and suffering becomes unendurable. Such a system will neither realize public health benefits, nor long-term cost savings, nor systemic promotion of the general welfare.
5) The entitled classes will continue to be reminded of their victimhood. Meanwhile, those who pay for private coverage, and who mistakenly believe that their economic positions are secure, will be treated to unending news reports about the welfare queens enjoying their free health care, while they continue to face the problems they have now: rising health care costs, private rationing of care, and increases in personal insecurity. Presumably, the worst abuses of today’s system will be ended, but a system designed to maximize private profit will continue to screw the middle class–or at least, that is how they will perceive it. What will change is that they’ll now have a population of newly-entitled poor upon which to vent their wrath.
This leads to several nearly unavoidable results:
1) The Democrats lose in 2010. The progressive engine which supported Obama in 2008 is feeling rather put-upon; without a change in perception, don’t expect to see quite so many people going door-to-door next time around. These losses will be stemmed solely by the continued implosion of the Republican party; with no standard-bearer aside from inchoate fear and rage–the spirit of September 12th, indeed–the Democrats remain the only game in town for the rational, no matter how disappointing they may be.
2) The systemic problems in the system go unaddressed. Americans continue to be deeply unhealthy and chronically unhappy as compared to our peers, while rejecting any evidence presented to us that this is our state of affairs. Our media are saturated with happy talk about Wall Street and celebrity piffle; in that portion of America which still remains engaged by political discussion, private interests dominate the grounds for discussion and set the terms of debate.
3) Eventually, the reckoning comes. Today, you only hear talk of armed insurrection on the right, in opposition to the perceived socialism of Obama’s centrist policies. The left, by and large, is content with their usual relegation, sticking with the best they can get out of the Democrats. This might be a viable short-term solution, provided we are actually on our way out of the Great Recession. Historically, however, systemic lack of improvement, and unequal economic distribution, serves only to radicalize politics on both the right and the left; our polity would not be well served by a leftist movement as radicalized as what is now considered normal on the other side. Yet that is the natural outcome.
Unfortunately, there are real natural and demographic forces which are coming to a head. The AARP brigade of 2019 just saw the destruction or diminution of their savings; they’re scared, they’re large, they’re organized, and they’re losing their power to earn. Every indication is that we will do the bare minimum to prevent climate change in the hope that a deus ex machina technology will someday save us. We’re embroiled in two wars, still, which show little chance of providing us long-term security in return for our expenditure, while we continue to largely ignore the hotbeds which will dominate the headlines of the next generation.
Simply put, there are numerous precarious tipping points in our immediate future, and the American people have been trained for 30 years to do nothing so much as cling desperately to the status quo, attempting to stay abreast of the incoming tide. We have faced political cataclysms in that time, but we have done little to nothing to prepare for the next one–unless we are so lucky that it should be identical to what we have already faced.
And even so, it is clear that the calcification of our political debate is such that repeating the past is just as likely to derail us. The groundwork has been laid for exactly that path to self-destruction.
As I see it, there is one clear path out of this, and one way in which the American people can be mobilized into resilience. The rest of this is addressed to Barack Obama, and those of his supporters who wish the same:
Mr. President, it’s about time you started doing your goddamn job.
You were elected to be transformational: in your person, and in your policies. You give the impression–to all but the lunatic few–of deep intelligence, erudite thought, sound judgment, and slow emotion. You command the nation’s attention. You are probably among the most skilled orators we’ve produced in 100 years. You have a photogenic family, even a cute dog.
These are the historic ingredients of American trust.
What have you done with these talents to date? You have enacted huge plans and sweeping changes–nearly all of them purely reactive to the failures of the past. Your bailout and stimulus intend to restore the financial status quo; your industrial policies seek to prop up a failing economic sector; your health care plan–well, beyond rhetoric, it’s pretty damned unclear just what you expect your health care plan to do, since no one knows what bouillabaisse will emerge from Congress. It was good, however, to see you resume your role as chef.
You seek bipartisan discussion between parties which are having none of it. You preach moderation to the immoderate. You claim to seek a new way of governance, and you are losing to the old rules.
Your goals are laudable; someday, I may even find them convincing. But these cannot work without the clarion call, the unified banner, the New Deal. Your New Deal, whatever that turns out to be, and whatever you choose to call it.
The people will forgive you your inevitable stumbles if they know in which direction you intend to march. Your opponents will snipe at you no less vociferously if you fail to provide a clear destination, and no more effectively when you do. The sole thing which can destroy you–and by extension, us, since your opposition has no vision beyond amassing the power they have lost–is incoherence.
You, Mr. President, have less excuse to be incoherent than anyone we’ve elected in a very long time.
You clearly know the rules: you began to follow them with your speech to Congress. Set the agenda. Absorb those enemies with whom you can reconcile, and crush those with whom you can’t. State your policy, articulate your plan, and then use every ounce of skill you can muster to sell it to America and her elected representatives.
In one word: lead.
This is not accomplished by turning over the details of your vision to the pack of squabbling game hens which is your party. They are looking for leadership, and manifestly unable to generate it themselves.
You can consider your job well-accomplished when it can be said–as it cannot be said today–that the average American knows your goals and your nonnegotiable principles. The progressives will return to you, and will fight for you, if you give them a vision. If you are willing to fail. If your compromises do not come in early negotiations, but in late politicking, and with clear benefits in return for what is traded.
At a time when your enemies are legion, loud, weak, and unfocused, the American center will join you when the path is clear, when their friends and neighbors in your political base are activated, and the cause is just. These are not the emotions you are invoking today; your actions are not living up to the seeds of greatness which you planted last year, and which we idealists are still waiting to sprout. Health care is only the beginning; this requires clear vision on foreign policy, our long-term economic strategy, America’s role in the world, and our dedication to human rights at home and abroad. Your job is to create of these a cohesive whole.
You have given many fine speeches, which form the nucleus; what history and the country require of you now is synthesis.
A vision so articulated may have legislative setbacks, and will be subjected to the laboratory of results. Greatness is not measured by such increments; it is instead amassed by audacity of purpose as expressed in the collective will of the people. The people whom you lead, Mr. President.
You have shown that you have no excess of timidity, and the willingness to take bold steps. What a shame it will be if you squander these talents without defining the agenda. You have two choices: be inspirational, or be a mediocrity. It is still early; there is time yet for you to choose.
We are waiting.
