It’s now up to Obama and the Democrats

If there is a golden rule when you’re faced with adversity in politics, it is this: ‘When in doubt, follow your beliefs and principles.’ Barack Obama was elected with a majority vote (53%) and the most votes ever cast for a president. His party, the Democrats, controls the Senate with a filibuster-proof majority of 60 seats and a 78-seat edge in the House of Representatives.

The promise to reform healthcare was not made on a whim or with the intent to garner a few votes in selected electoral districts. It was the product of an extensive debate that has taken various forms since the beginning of the last century when Theodore Roosevelt put universal healthcare in his electoral platform back in the 1912. Some progressive legislation, including Medicare and Medicaid, were eventually enacted. But the all-out effort at comprehensive reform failed spectacularly under the Clinton Administration in 1993. Obama was elected to that deliver comprehensive reform and expectations are high. Failure to do so would have disastrous consequences for the President and his party.

The Republicans say that they too want healthcare reform, but not a government takeover of its delivery mechanisms. From a strictly fiscal point of view, the GOP has defended some interesting ideas. However, they have yet to put forward a comprehensive alternative to the Democrats’ plan. Meanwhile, the still-dicey economic climate has amplified fears over the impact greater government involvement in healthcare could have on the government’s bottom line, as have the billions spent on stimulus and bailouts throughout last winter. The new accounting rules used by Congress, which have added the cost of the Iraq and Afghanistan wars to the operational budget, have also caused estimates of the deficit and long term debt to grow by astronomical amounts. The Congressional Budget Office estimated that various versions of the bills before the House of Representatives would add one trillion to the deficit within 10 years—and they still would not reach their goal of universal coverage.  Given all this, the Republicans now believe they have the political cover for opposing what they have begun labeling as Obamacare.

With the town hall tour in full effect, organized interventions by boisterous groups have taken to loosely interpreting and, in some cases, grossly distorting the various reform initiatives. The talk of “death panels” by Sarah Palin and Newt Gingrich portray reform as more hazardous than the status quo. Senator Charles Grassley of Iowa, a moderate Republican, was originally seen as the only hope for a bipartisan solution, but he soon countered that perception by engaging in some fear-mongering of his own. Organized lobbies and bogus think tanks like the Lewin Group, which is wholly owned by one of the country’s largest insurers, were feeding Republican spokespersons with talking points to reinforce the case against any reform proposal coming from the Obama White House. The impact of all this in the polls is reflected in a marked decrease in support for the Obama plan and this has started to erode his overall approval numbers. A president faced with declining popularity soon sees a weakening of the so-called bully pulpit.

The Democrats have had problems of their own, as the split between the liberal, progressive wing and the conservative Blue Dog coalition over a public option and controlling costs has further complicated Obama’s ability to build a coalition. Many observers initially applauded Obama’s strategy of letting Congress deliver a proposal for him to sign. But selling healthcare reform on generalities with confusion about the specifics is a recipe for conflict and polarization if the other side has no serious alternative to present for debate. The president seemed intent on letting the conversation take place while he was building support for his initiative among the American Medical Association, the pharmaceutical industry, unions, inter-faith groups, AARP among others. He seemed aloof with respect to the legislators in the early stages. And though he eventually appeared to be more engaged, the problem is that the fault lines have become more apparent.

Recent reports suggest the Democrats may have given up on a bipartisan solution since the principal Republican spokespersons have echoed, in admittedly softer terms, the anti-reform rants of Rush Limbaugh, Glen Beck, and Bill O’Reilly. No moderate Republican would dare take on this gallery of right-wing screamers. Doing so could compromise their funding from the anti-reform lobby and place them in a primary challenge come 2010. So the Democrats’ appear focused on reconciling the two wings of their party. It is not the ideal solution for a matter as personal and as far-reaching as healthcare. But it says a lot about the state of the GOP and the inability of US politicians from both parties to rise above the calculation of political advantage.

It is becoming increasingly certain that only a united Democratic party can carry the day. The richest nation in the world must make sure that all its citizens have access to healthcare and that some of the abhorrent practices of private healthcare insurers be eliminated. These should be the goals of this particular reform effort. For that to happen, compromise and leadership must now prevail on the government side. Liberals inside the Democratic party must find common ground with the Blue Dogs, and the latter must not abandon their electoral platform in the face of organized opposition. Voters may disagree with their representatives on occasion, but they will respect them if they hold to their principles and do what they promised when they were running for office. The same applies to Obama. As Harry Truman once said, “the buck stops here,” meaning the Democrats will be looking to the president for leadership. Obama must draw a line in the sand and get his party onside. Anything less will compromise his presidency.

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