Dems Need Muscle for Health Care Reform

Over the last 30 years, the great majority of Jewish voters have maintained their support for the Democrats. Jews are integral to the party’s current leadership in Congress and in the White House. And that party now faces its greatest opportunity in a generation to remake health care policy, and also its greatest challenge.

Can the Democratic Party fulfill its destiny and guarantee quality health care to all Americans? Can it vindicate the public sector in a year when, for example, California is cutting the heart out of its system of public services? If you think the health care debate is just about health care, you are missing the underlying drama. This is about the titanic struggle between the two parties over the role of the government in our nation’s life, whether government as provider of services or as regulator of the private sector. The debate over the “public option” in health care, in which a government-supported plan would compete with private insurance, is a symbol of that deeper contest.

This moment has been decades in the making. The last burst of federal activism came during the Lyndon Johnson administration with the passage of the great Civil Rights Acts and Medicare. After that, racial and cultural conflicts split the Democratic Party, and then the tax revolt (opening in 1978 with the passage of Proposition 13) gave the Republicans a wedge to undermine support for even popular Democratic programs. Since then, Democrats have struggled to keep their own divisions from blocking their ability to implement popular public sector programs without activating taxpayer resistance. It took many years to learn how to keep these issues from being so potent. Bill Clinton helped by taking the explosive welfare issue off the table with his draconian welfare law of 1996, and by his dexterity in bridging racial barriers between African Americans and working-class whites. George W. Bush’s catastrophic presidency then opened the door to a Democratic tidal wave.

But Clinton also led the last Democratic failure on health care reform, when his plan went down in flames and Republicans used that failure to win control of Congress in 1994. Republicans operated on the premise that Democrats had to be prevented at all costs from implementing a popular and effective program that would build long-term support for the public sector. Having used that strategy to kill Clinton’s health care plan, they have dusted if off again this year.

From FDR through Clinton, Democrats fought for universal health care, only to fall back in the face of opposition from conservatives and from private interests. Now more than 40 million Americans lack health insurance, and private insurance companies have turned health care into a profit center. In fact, as economist Paul Krugman recently pointed out in The New York Times (“Health Care Realities,” July 30)  the federal government already keeps the system from becoming a total catastrophe, providing health care to the elderly and veterans, helping to pay for the poor’s health care through Medicaid and providing tax breaks for employer-provided health insurance. But the government can’t really control costs, nor guarantee that Americans will not be ill-treated by the private sector without challenging and significantly altering a health care system based on profit.

Jewish Democrats are all over this health care reform. Rep. Henry Waxman has knit together most of the liberal and moderate Democrats on the Energy and Commerce Committee behind a bill that preserves the “public option.” Rahm Emanuel, White House chief of staff and former member of Congress, helped behind the scenes. These are men of the House, where muscle works and where the population is represented in districts of equal size. The House will be ready with a bill by September.

But over in the Senate, the battle is very different. The bare-knuckled politics of the House give way to the gentlemanly calm of the Senate, where good ideas go to die. In the Senate each state has two votes, regardless of population. Democrats who win statewide Senate seats tend to be more moderate than those who win House seats. The filibuster rule (not a law, just a Senate rule), allows 41 senators to prevent a bill from even being considered. The Founders intended the Senate to be a calming force against what they feared would be a popular appetite for radical change. For the Democrats, this is a serious problem because holding their 60-vote majority together requires keeping a lot of self-important prima donnas happy. They already have a draft bill prepared by Sen. Ted Kennedy’s committee ready to merge with the House version. But Democrat Max Baucus of Montana is holding up a vote in his Finance Committee so he can conduct wandering, pointless negotiations with three Republican senators for a largely toothless bill. No one seems to be able to get him moving.

Democrats have gotten this far on years of introspection and hard work to overcome their own political failings. They have a popular president with a mandate. They have put aside divisive issues to clear the way for economic recovery and health care reform. The public option is hugely popular. They can see the finish line with a vision of a new health care system for all Americans. They have a once-in-a-generation chance to show that their ideas can work. They can incorporate ideas from moderate senators and Republicans (few of whom will vote with the Democrats) into a final bill. But to get the last few steps up that mountain, they will have to reach for something that comes hard to Democrats: political muscle. At the least, all senators who caucus with the Democrats have to vote to end a filibuster no matter how they wish to vote on the final bill.

Someone once noted that members of Congress respond to two things: what you can do for them, and what you can do to them. Persuasion, inclusion and positive reinforcement are essential. But removal from committee chairmanships, threats of party primary challenges or even bypassing lethargic senators have virtues as well. (In 1964, Senate Majority Leader Mike Mansfield brought the civil rights bill directly to the floor to bypass Mississippi Democrat James Eastland, chair of the Judiciary Committee.) At the end of the day, Democrats from President Obama to Senate Majority Leader Harry Reid to average Democratic voters will have to decide if this wave that began in 2006 and took off in 2008 is going to end in a whimper at the hands of its own senators.

Raphael J. Sonenshein is chair of the Division of Politics, Administration and Justice at Cal State Fullerton.