Health-Care Reform, the Morning After

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Two brief updates, on the substance and the politics. On the substance, I mentioned yesterday what I thought was the significance of the vote. A reader from Minnesota puts the point in more specific and personal terms:

When I was 15 I developed a chronic condition, and received excellent care under my mother's insurance plan. When I turned 23 and graduated from college, I lost eligibility. Tagged with a pre-existing condition, I was black balled from the private insurance market for life. Since then when my condition's gotten bad enough that I couldn't put off treatment, I've made myself unemployed to qualify for Minnesota's General Assistance Medical Care [GAMC] program, which has taken good care of me . . . because I live in a prosperous, progressive county and I know how to use the system.
 
Now Gov Pawlenty is trying to unilaterally kill GAMC. Until tonight, I have been a Democrat because of people like Gingrich and Bush, Palin and Pawlenty. After tonight, I am an Obama Democrat in the sense that my grandparents were Roosevelt Democrats. For all the problems with HCR, for all the compromises and deals and disappointments and inefficiencies, tonight the Democrats stood up and took a political risk to say that I deserve medical coverage, that it's no longer okay to treat my health as sad but acceptable collateral damage in a Social Darwinist system. That's why this moment matters to me.*

On the politics, I mentioned last month this exchange on the House floor during "negotiations" over last year's stimulus bill, sent in by someone who was there:

"GOP member: 'I'd like this in the bill.'

"Dem member response: 'If we put it in, will you vote for the bill?'

"GOP member:  'You know I can't vote for the bill.'

"Dem member:  'Then why should we put it in the bill?'

"I witnessed this myself."

As we have now seen, this was in essence how all "negotiations" over the health bill worked too. There simply was nothing that the Democrats could have put in the bill that would have made voting for it more attractive to Republicans than voting against it, with the implied promise of stopping Obama himself, his Administration's other objectives, and the general momentum of the Democratic party. In 1994, William Kristol's advice that Republicans should vote against the Clinton health care bill -- no matter what was in it, just to ensure a defeat -- was seen as shocking enough that Kristol put it in the form of a confidential memo. (More here, here, here.) This time, simply "going for the kill" was the quite open Republican strategy -- as advocated by Kristol here and by Republican legislators passim.

Fine: that's their strategy, they had every right to choose it, although as David Frum very eloquently argues, this time it didn't work.** I raise it now in response to a new wave of interpretive hogwash: namely, the idea that although Obama may have "won," he did so in a fashion that was polarizing, hyper-partisan, and extreme. Please. The quite open GOP strategy was that they were not going to vote for this bill. They had every right to that as a strategic choice. But they can't now claim that their bloc opposition to the bill is proof that the Democrats were too partisan. Rather, they can and will claim it, but they shouldn't be believed.

"You know I can't vote for the bill" -- the phrase by which this era in politics may be known. We witnessed it ourselves.
___
* A reader from Texas writes just now: "Because I have an individual policy following cobra/divorce and having breast cancer, my health insurance costs almost $30,000 a year.  They deny me dental coverage after cobra. Feel free to use this factoid."

** As Frum says, "At the beginning of this process we made a strategic decision: unlike, say, Democrats in 2001 when President Bush proposed his first tax cut, we would make no deal with the administration. No negotiations, no compromise, nothing. We were going for all the marbles. This would be Obama's Waterloo - just as healthcare was Clinton's in 1994.... This time, when we went for all the marbles, we ended with none."

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James Fallows is a national correspondent for The Atlantic and has written for the magazine since the late 1970s. He has reported extensively from outside the United States and once worked as President Carter's chief speechwriter. His latest book is China Airborne. More

James Fallows is based in Washington as a national correspondent for The Atlantic. He has worked for the magazine for nearly 30 years and in that time has also lived in Seattle, Berkeley, Austin, Tokyo, Kuala Lumpur, Shanghai, and Beijing. He was raised in Redlands, California, received his undergraduate degree in American history and literature from Harvard, and received a graduate degree in economics from Oxford as a Rhodes scholar. In addition to working for The Atlantic, he has spent two years as chief White House speechwriter for Jimmy Carter, two years as the editor of US News & World Report, and six months as a program designer at Microsoft. He is an instrument-rated private pilot. He is also now the chair in U.S. media at the U.S. Studies Centre at the University of Sydney, in Australia.

Fallows has been a finalist for the National Magazine Award five times and has won once; he has also won the American Book Award for nonfiction and a N.Y. Emmy award for the documentary series Doing Business in China. He was the founding chairman of the New America Foundation. His recent books Blind Into Baghdad (2006) and Postcards From Tomorrow Square (2009) are based on his writings for The Atlantic. His latest book is China Airborne. He is married to Deborah Fallows, author of the recent book Dreaming in Chinese. They have two married sons.

Fallows welcomes and frequently quotes from reader mail sent via the "Email" button below. Unless you specify otherwise, we consider any incoming mail available for possible quotation -- but not with the sender's real name unless you explicitly state that it may be used. If you are wondering why Fallows does not use a "Comments" field below his posts, please see previous explanations here and here.
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