November 9, 2009--The Health Care Tar Baby

In the second of Joel Chandler Harris’ Uncle Remus stories there is the one about the Tar Baby. To entrap Br’er Rabbit in the briar patch, Br’er Fox makes one out of tar and turpentine. The Tar Baby’s special feature is that the more Br’er Rabbit struggles with it the more he is ensnared. And thus “tar baby” in the vernacular now refers to any sticky situation in which the more you struggle to resolve it the more entangled you become.

Sort of like trying to enact a national plan for health care.

First proposed back early in the 20th century by President Teddy Roosevelt and subsequently brought to public and congressional attention and debate by various presidents from both parties—from Harry Truman to Richard Nixon and most recently and disastrously by Bill (and Hillary) Clinton—it is now raging at the center of our political life.

Democrats in the House of Representatives struggled mightily to pass their version, but in spite of having a substantial 40 vote majority had great difficulty rounding up the 218 votes necessary to enact it (they eventually secured 219 plus one Republican)—the Hispanic Caucus, which includes 20 Latino congresspeople, resisted any language that they felt to be too restrictive on illegal imigrants, and progressives fought within the Democratic party about whether or not any federal funds might be used for anything related to abortions.

The Republicans in the House had recently hatched a plan of their own that, believe it or not, according to the non-partisan Congressional Budget Office would have wound up costing more than the Democrat plan and would still have left more than 40 million citizens uncovered and excluded anyone from securing insurance who had a preexisting condition.

Since it had no chance whatsoever of passing, which they knew, they used it to fuel tea-party-like rallies in Washington in an effort to, in their felicitous phrase, “kill” the Obama plan. Read their signs and listen carefully to their rhetoric and note that both are laced with violent language and images, including some of bodies piled up at Auschwitz which these deluded folks claim represent what would happen if Obama is able to get Congress to pass any version of reform.

In the Senate, sledding is even tougher. Though the Democrats have a 60-vote majority, the number they need to evoke cloture and cut off a Republican filibuster, they are at least four votes short of being able to get the 60 required to bring a final bill to a definitive vote. There are the Democrat Blue Dogs who are more concerned about their own reelection chances than the nation’s health care system and there is then of course Joe Lieberman, who I only half-facetiously last week suggested would be willing to trade his vote to end debate for a pledge to bomb Iran ASAP.

There is so much tumult about this extraordinarily complex issue that Senate leader Harry Reid was hinting at the end of last week that he could not promise to get to a full debate and vote until some time in early 2010. This would mean it would remain on the agenda just as the midterm election campaign reaches full boil. This is exactly what happened in 1994 when the Clintons’ plan was defeated. (See New York Times story linked below.)

In the event that this happens again—that is, nothing happens—Obama will get the full political blame. And though there will be many who contributed to the defeat of health care reform, Obama in fact will deserve the blame that will descend upon him. It is his tar baby.

Go back to the campaign for the Democratic nomination. During it Obama proposed a relatively modest plan. He was criticized severely by Hillary Clinton because it was not as “universal” as hers. And so over the course of the debates, to play to their progressive base—essential to securing the Democratic nomination—Obama’s plan became more and more inclusive and rose to the top of his domestic agenda, pushing aside education reform and environmental and energy policy. And then after being elected, realizing that to pass an ambitious plan would be daunting, he triangulated toward the political center, calculating that would help get it enacted; but he did not back off from setting it as his highest domestic priority.

With all the special interests circling, with all the profits threatened by any meaningful reform since cost containment is essential to pay for expanded coverage, and with all the cash poring into the political war chests of both parties, to demonstrate that he could do business in a new, bipartisan way and that he could do more than make great speeches but also could get things done, Obama would have been wise to make the case, and there is a legitimate case to be made, that no matter how legitimately important health care reform is, fixing our public schools, cleaning up the environment, and expanding the green economy should be our highest priorities. A version of what he tried to say during the campaign.

And of course if he had realized that it’s jobs, jobs, jobs stupid, and had structured the stimulus program accordingly to focus more exclusively on that, with a few significant legislative victories under his proverbial belt, after the midterm elections in 2010, he could have taken on health care reform and done so more effectively than at present.

Because make no mistake, if the current health care legislative mess spills over into 2010, as I suspect it now will, there will be political hell to pay at the polls next November, and Obama could easily turn out to be a one-term president. Especially if he gets further ensnared in that other tar baby called Afghanistan.