How hard was it to pass Medicare? Harry Truman failed to pass universal health coverage multiple times into the 1950s. John F. Kennedy failed to push Medicare through as a senator, and again as president. Even Lyndon B. Johnson couldn't pass the bill without "unseemly deal-making" and "a big pay-day to hospitals and doctors," writes David Leonhardt in the New York Times. And that was only after his 23-point landslide victory in 1964 coincided with the Democrats picking up their 68th seat in the Senate. In other words, it took a super-duper-majority in Congress and a hugely popular president. Matt Yglesias takes this history as evidence that Democrats needn't cling to the "get it right the first time" mantra.
He's right that passing one health care bill should be considered a
beginning, rather than beginning, middle and end, to healthcare reform
efforts. But the story above suggests that September represents a truly
unique opportunity for the Democrats to pass significant health care
reform. This story shouldn't placate liberal Democrats. It should give
them nightmares.
If the Democrats' only successful effort to pass health care
legislation after 20 years of failure followed
landslide presidential and Senate elections, wouldn't that suggest that
the Democrats' best chance to pass health care reform this round
would be, well, following landslide presidential and Senate elections?
You might say, "Hey, the Democrats always have 2010 to pad their
majority." That's obviously true, they do have 2010. But recent history
suggests that big majorities like this are difficult to maintain (look
at '94 for Democrats or 2000, '06 for Republicans),
and if health care reform flames out, it doesn't bode well for an even
tougher fight on climate change and financial regulation. I'm
not saying November 2010 is riding on September 2009. I'm saying I
don't see any reason for much patience. How could the road to health
reform get any easier for Democrats? How much closer to 1964
can you get?
The other issues with 2010 are that unemployment could be over 10% by then (even if the recession is over, which it probably will be), and Afghanistan could be a front burner issue, if it remains as bloody as it was last month.
America still has a populace that believes in an economically conservative ideology. Legislation goes by the prevalent ideologies of those in the Senate. Liberals have historically gotten the shaft in the legislative branch, there's no reason to believe it to be any different. This strengthens the case for a more moderate bill that would hopefully placate Senators and Representatives.
"America still has a populace that believes in an economically conservative ideology."
Um, no. Conrgress has a small state bias, whereby the 532,000 residents of Wymoming get 2 Senators, just as the 38,000,000 residents of California get two Senators. Even though CA has 76x the population, they get equal representation.
So even though America has a center-left population, they get shafted with a center-right Congress.
The co-op plan is more likely to pass, since that means less accountability for the insurance companies. They won't meet the requirements for any reform, and since there is no trigger, they won't need to. The co-ops will fail, since they'll be designed to fail.
And then Republicans will hang the failure of "reform" on the Democrats.