Health Care: History Or Herculean Failure?
How will this morning's health care vote be remembered? A major victory for the forces of progress? A great moral advance in the history of America? Or the culmination of a scandalous series of secret compromises, backroom deals, and a blind ignorance to public opposition?
Depends. Depends on whether the bill turns into something greater than the sum of its parts, becomes an achievement that moves out of the sphere of legitimate political debate into the sphere that contains the collection of accomplishments that mark America's fundamental identity -- Medicare, Social Security, the Voting Rights Act. The media -- the legacy media, the new media -- will provide guidance, but the public, in the end, will make the decision. If health care is successful in retrospect -- if the immediate mechanisms prove popular, if the Obama administration can manage the implementation, if the economy improves and with it, the public mood -- then the Republican gamble will turn out to be a spectacular failure.
Does it matter if, as Ezra Klein puts it, the win was ugly? Or just that it was a win? The same forces that colluded to produce a difficult process -- the Constitution's prescription for the apportionment of Senators, the filibuster, Senate culture -- make it all the more likely that, from the standpoint of liberals, a much better edifice will rise from this foundation. More subsidies. More regulation on insurance companies. Some sort of competitive mechanism. In due time, of course. Will any Republican with a grain of sense run on a platform of repealing health care?
The liberal activist opposition is not inexplicable, and the White House hopes that it is not implacable. It has been overstated -- no offense to Adam Green and his PCCC, but the ability to generate Beltway media interest is not the same as moving votes against moderate Democratic senators -- and, oh, by the way, the history of Rahm Emanuel's involvement in the health care debate has been completely misread by the left -- but it is not insignificant. It will be present throughout Obama's presidency. Progressive activists have the technology, though not the infrastructure, to make a lot of noise and hold the White House to the broad spirit of its campaign promises. A White House hasn't dealt with this type of internal self-auditing before, and it will be interesting to see how it plays out. (This is catnip to the press, so we will probably overstate its significance.)
So what's next? The White House will pivot hard to jobs, and they will pivot, less visibly, to a placation campaign. There will be legislation, executive orders, rallies, communiques, dog whistling, blogger meetings with POTUS -- lots of stuff, stuff designed to convince the liberal activist elites that the President represents their interests in the Oval Office.