Healthcare Reform: This is No Time to Fold

December 21, 2009

David Coates is a political science professor at Wake Forest University and author of the forthcoming book, “Answering Back: Liberal Responses to Conservative Arguments.”  In the second of a two-part post, he shares his perspective on the healthcare reform efforts. To interview Coates, email Carol Cirulli Lanham at or call 972-818-0895.

If reconciliation was easy and problem free, this would be a no brainer. If the version of the public option contained in the Senate bill was a powerful one, its loss would make the bill significantly weaker.

Sadly neither of those propositions is true. Reconciliation as a process is fraught with danger for progressives. Parliamentary rules could gut the reconciled bill of even more than has already been lost, and very likely would. The public option now cut from the Senate bill would have covered at most 3 million Americans, and been no significant competitor to the private insurance industry. Indeed its premiums may have had to be higher.

The House bill is not perfect either. Remember, it (unlike the Senate bill) contains the Stupak amendment, and even so passed with a majority of just 5 votes. A majority of five votes is no great shakes! It is not only in the Senate that the progressive instincts of the modern Democratic Party are held in check by the party’s conservative wing.

So why threaten to withdraw support from the Senate bill?

If this is a ploy designed to play chicken – to see who blinks first – it won’t work. After all, to play chicken you have to face each other. You have to be going in opposite directions. Withdrawing support from the bill would put progressives on the same side as the conservatives, going in the same direction: creating a majority to do exactly what the Republicans have wanted all along. No health care reform. Losing 1-6 would be a huge Republican victory, and open the road to a mid-term disaster for progressive candidates that would close completely the possibility of real legislative progress on any major issue in Obama’s first term. Shades of 1994: there is more at stake here than health care reform alone

Letting the perfect drive out the good is never a good strategy for progressive politics. Progressive objectives in a political system as dysfunctional as ours are won inch by inch, negotiated clause by negotiated clause. Health care reform is a process, not a moment – it is a series of stages won one at a time.  On health care now, as on immigration reform later, progressives will need to win what they can when they can, then dig in and fight on.

This is no time to fold. It is time to play out the hand we have, take what winnings we can, and then re-deal the cards. There will be another day and another play.


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