The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Obama Openness to Compromise Should Be No Surprise

Posted by Alan on September 6, 2009

Negotiators on the Senate Finance Committee are expected to put forward their compromise health care reform proposal on or before September 15th. President Barack Obama is not waiting to see what they produce. Instead he’s likely to provide some helpful hints during an address to a joint session of Congress on September 9th.  The speech will not lay out legislative language, but is likely to put forward the President’s prescription for change in far greater detail than has previously been the case. And liberals are nervous.

As reported by the Associated Press and elsewhere, the White House is signaling that President Obama’s intends to offer common ground for moderates, but not much red meat for liberals (to mash two unrelated metaphors). Senior advisor David Axelrod, for example, is quoted as saying that the president “believes in ‘fundamental principles’ about overhauling health care … but ‘he’s not dogmatic about how we get there.’”

This type of talk infuriates liberals who are adamant that a government-run health insurance plan – an anathema to conservatives and many moderates – be included in the final reform package. The Congressional Progressive Caucus has directly lobbied President Obama by letter and phone to include a public plan and its members are threatening to vote against any bill without one.

During the phone call the President did not reassure the liberals, but promised to continue to communicate with them. Meanwhile, the White House was signaling a willingness to accept a so-called “trigger” for a public health plan in lieu of launching a government insurance plan on Day One of reform. The trigger concept is being pushed by Senator Olympia Snowe, one of the Republican senators working on the Senate Finance legislation. She has proposed what the Associated Press describes as nonprofit agencies offering health coverage “only if private insurers could not cover 95 percent of the people in their regions with plans costing no more than about 15 percent of the person’s or household’s annual income.” (While an uninsured rate of five percent might sound like a high hurdle meet, other countries have significantly lower rates. (In Germany the uninsured rates is roughly 0.2 percent; in the Netherlands approximately 1.5 percent. Both countries have private insurers).

If on Wednesday the President fails to insist on a government-run health plan liberals will be outraged, but they should not be surprised. President Obama has been totally forthcoming concerning his pragmatic approach to politics and legislating. In a speech to Families USA in January 2007 – even before he announced his presidential campaign – then Senator Obama declared that while it was critical to achieve health insurance for all Americans, it was important to be “agnostic in terms of how to achieve those values.” Throughout the current debate he has constantly repeated his three guiding principles for reforms and, while stating his preferences, has made clear everything is on the table.

The fact is, and this will shock many, Congressional Democratic are not a monolithically liberal group – and as a whole they are certainly less liberal than their leadership. Some liberals seem to think that all members of the Democratic caucus need to think like and, more importantly, vote like, Speaker Nancy Pelosi and Senate Majority Leader Harry Reid. Such delusions are at best naive and at worst dangerous. Congress should represent a broad spectrum of opinion and their voting should reflect that diversity. In fact, one of the strengths Democrats have among the electorate is the perception they are more open to and tolerant of diverse opinions than the GOP.

Only rarely, and then usually as the result of a national calamity, do the extremes of a party pass legislation. Usually the heavy lifting is done from the center. This goes back to the importance of the final vote (in the Senate the 60th vote; in the House the 218th). As explained in a previous post, their tolerance for change has a great impact on what winds up in any particular bill. In the Democratic party, these votes are far closer to the political center than it is to the ideology of the Congressional Progressive Caucus. This doesn’t make these moderates unfaithful to the Democratic party. On the contrary, it helps define that party.

Liberals seeking health care reform need to acknowledge this reality. President Obama has long made clear he does. Like his mentor Senator Edward Kennedy, President Obama appears more interested in passing legislation than he is in maintaining the purity of his ideological positions. And like the liberal Senator Kennedy, President Obama appears willing to accept a portion of the loaf if, in doing so, he improves the lives of those he champions.

Liberals may be unhappy with this pragmatism, but in doing so they ignore the reality of the 2008 election: the Democratic Party and the independent voters they won over last November may be left of center, but like President Obama, they are more pragmatic than ideological. They seek change not purity. Unlike the true believers, they are agnostic in terms of how to achieve desired results. If that means compromising on issues like a government-run health plan, then compromise is what they, and their President, will do.


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