In his rallying speech to Democratic legislators on Saturday ahead of Sunday’s Congressional healthcare vote, President Obama finally abandoned the pretence of bipartisanship, as he mocked the "friendly advice offered all across town". The eventual vote itself told the story: the only "bipartisanship" was achieved by the 34 conservative Democrats who voted against health care reform. Every Republican voted "No".
In American history, such major reforms have generally won some small level of bipartisan support so the future of health care looks shaky. Republicans are vowing to repeal it, and one CNN poll put public opposition to the bill at nearly 60 per cent. Republicans are counting on the health care reform issue to bring them to power. But the adverse political fallout they’re relying on is not so certain, as the passage of a reform often transforms the political debate to a completely different landscape from that which surrounded its passage. This is what Obama was counting on when he told Democrats that their opponents "realise after health reform passes and I sign that legislation into law, that it’s going to be a little harder to mischaracterise what this effort has been all about".
Republicans have campaigned effectively against what they call "ObamaCare" by using the same tactics they would have used against a genuinely public option — that is, with claims that it is "socialist". There are however two important points to make about Obama’s healthcare reform. The first is that it is modest by international standards. It seeks to achieve reform through regulation rather than through including the "public option". The downside of this for Obama is that it alienated many progressive supporters, who thus failed to defend the plan against Republican attacks.
Meanwhile, the upside of the same compromise is that Obama has not only appeased the centrists in his party and carried the vote, but also created a more pragmatic piece of reform. The US was unlikely to be able to create an effective universal public system in its current financial situation and in the current political environment, where public opinion has already been outraged by the "bailout" of the banks. Creating a public system is difficult and risky. Obama’s compromise will instead use regulation to mould the existing private services to fit more people. In this respect its benefits will be felt sooner with a lower risk of disasters in service delivery. Obama has at every turn been cautious and incremental, claiming "this is what Change looks like".
As much as progressive Americans would have preferred universal public health care, one has to doubt the capacity of the United States to effectively and smoothly deliver something so big and new under its current financial, political and institutional strains.
This takes us to the second point about this reform: Republicans have overplayed their hand in claiming the sky will fall in now the bill is passed. Obama is staking the Democrats’ fortunes at the coming 2010 midterm elections this November on the likelihood that the heat will fade from opposition once the reforms are underway and that new beneficiaries will strengthen his constituency.
The American healthcare system is dysfunctional, and the bill will remove some of its worst injustices, such as denying coverage to sick Americans. Republicans on the other hand are counting on their ability to continue a campaign of hysteria and misinformation after the reforms take effect. They are also counting on there being mistakes in the delivery of reform that they can beat up into a political storm. Democrats are gambling that their government can actually deliver such a modest reform competently.
There is certainly a lot about healthcare reform that is unpopular among American voters, but what is overwhelmingly unpopular is not the legislation that was passed, but the scary Republican portrayal of that legislation as a "socialist" monster that will tear up individual choice and personal liberty. The fact remains that hysteria of this sort is based on wishful thinking on the part of the conservative fringe. Once death panels fail to materialise and people’s private health insurance continues, the Republicans will look foolish. The reforms also insure an estimated 32 million people, whose benefits Republicans say they will campaign to remove.
The public has been divided and confused by the debate which the White House failed to frame let alone control effectively. Obama had no choice however but to achieve something in spite of Republican opposition and Democratic division. Had he drawn back, the opposition would have been further emboldened.
Until now, this issue has divided Democrats and thus demoralised their base, whereas Republicans have remained united and thus energised theirs. The passing of the bill promises to break this situation and take the political debate to a new phase.
There is no shortage of issues. Immigration alone is a huge issue with far more chance of dividing the free-market and conservative wings of the Republican base than healthcare was, over which both wings of the GOP have been firmly united.
Now, there is a chance for a shift in political momentum as America heads towards the next election. Democrats however need to heed the lessons of the party politics that have arrived in America. As parties in Australia have discovered, united they stand, divided they fall.
The result at the November midterms will depend on whether the Democrats can re-engage and energise their base as the Republicans have done over the past year. So far Republicans are outraising and outspending Democrats. While Obama has been busy governing the country, Republicans have been busy campaigning — in this respect the parallel with Australia is clear.
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