The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

First Take on 2010 Election Results and Health Care Reform

Posted by Alan on November 2, 2010

Election night 2010 is far from over but some general trends are clear. And there’s no question that the electorate has given the new Republican majority in the House a mandate and sent a clear message to the White House and the Democratic majority that will remain in the Senate.  Interpreting that mandate will be challenging and much is riding on how the leadership of both parties view tonight’s results.

Mandate’s are mischievous things. Mandates are like a fine whiskey, actually they’re more like too much of a fine whiskey. They feel great. After the celebrating, however, those on the receiving end too often find their judgment warped, their thinking clouded. The euphoria following a strong mandate can lead to disastrous results.

Consider what happened to President Barack Obama and his fellow Democrats. By most any objective measure, then Senator Barack Obama’s win in November 2008 was a landslide. His fellow Democrats increased their majorities in both the Senate and the House. Although it would take a number of months, once Al Franken was certified as the winner of his Senate race in Minnesota, Democrats even had a filibuster-proof majority in the upper chamber. From such results are mandates made.

That President Obama and his allies saw the 2008 election as a mandate for change is understandable and appropriate. They could also have viewed the vote as a call for a new way of doing business in Washington. One in which moderation, civility and problem solving trumped games of the ideological and political variety. When Republicans chose to oppose virtually anything the Administration put forward, Democrats could have responded by seizing the middle ground that the GOP was abandoning. Instead Speaker Nancy Pelosi and Senate Majority Leader Harry Reid, presumably with the support and certainly with the acquiescence of the Obama Administration, determined they had a mandate for their ideological interests. The result was passage of major and historical legislation, but at a substantial political cost.

That cost is being paid tonight with Republicans decisively taking control of the House and trimming the Democrat’s majority in the Senate to no more than 53. The misreading by Democrats of their 2008 mandate most likely helped Tea Party become a far more dominant force in the 2010 elections than would otherwise have been the case. And the rise of the Tea Party and the enthusiasm they generated among more conservative voters are a major reason for the GOP success in this election year. (Ironically, this passion may also be the reason Republicans failed to take a majority of the Senate – in states like Nevada, Delaware, California and perhaps others, GOP nominees were too conservative to knock off vulnerable Democrats).

The size of the GOP majority in the House of Representatives is still unknown as I write this post, but it will be substantial, a striking turnaround in just one election cycle. And truly a mandate. But a mandate for what? Were voters urging politicians to move to the center or to the extremes? Republican Congressional Leaders, and many of their newly elected troops, seem to be interpreting tonight’s results as evidence the public is taking a hard turn to the right. Speaker to be Representative John Boehner has vowed there will be no compromising with the Obama Administration. And Tea Party activists are warning Republicans that they will be ousted if they fail to adhere to the group’s principles. And given the number of upsets the Tea Party engineered against more moderate Republicans, this is more a promise than a threat. Never mind that a recent poll found that 75% of likely voters (including two-thirds of Republican) said the GOP should compromise some of its positions to get things done were they to control Congress. (Full disclosure: I don’t think politicians should follow polls blindly, but ironically, many conservatives have blasted Democrats for failing to adhere to public opinion on health care reform and the like).

What does all this mean for health care reform? There are lot of elements of the Patient Protection and Affordable Care Act that needs to be changed. Republicans could interpret their mandate as a call to modify the legislation. To preserve those provisions for which there is broad support, to add elements (think malpractice reform and meaningful cost containment) that the PPACA lacks, and to dramatically change or eliminate provisions that will drive up the cost of care without benefiting consumers). Or they could see tonight’s election results as a mandate to repeal the health care reform legislation and refuse to compromise on meaningful changes.

Refusing to compromise might earn Republicans short-term political points, but it’s bad public policy. (Interestingly, when it comes to evidence of the damage an ideological approach can have on complicated and controversial legislation, the PPACA could be put forward as Exhibit A). If the American public is lucky, the GOP House members will vote to repeal the new health care reform law (thus satisfying the more conservative members of their base), but then work for useful changes once the Senate fails to go along with repeal.

How Republicans address health care reform – whether they make changes or, by refusing to compromise fail to fix flawed legislation – will depend on how they view their mandate. GOP leaders would do well to remember: mandate’s are mischievous things. They are also fickle. Just ask President Obama.

(Note: This is obviously a post about politics. Civil comments, even those strongly disagreeing with my take on things, are welcome and encouraged. Comments featuring name calling, denigrating opponents and other forms of uncivil comments, will be deleted).


3 Responses to “First Take on 2010 Election Results and Health Care Reform”

  1. Alan,

    Wow. What a lot to cover.

    Tonight (unlike most other nights) I’ll attempt to be brief:

    1. I do not consider last night’s voting results to be a mandate to the GOP. Representative John Boehner, about to be, Speaker of the House, put it correctly and “moderately” today when he said, “This was not a mandate to the GOP, it was a rejection of the way in which the Democrats have been behaving since Feb. 2009, or words to that effect. I think that those are wise words, and if the GOP doesn’t pay close attention, all of this can be reversed in 2012.

    2. Repealing HCR, while “sounding good” to many, would be very ill-advised. Amending where necessary to arrive at the results desired by the majority of Americans would be a solution far more desirable.

    3. It should have been clear to the Obama Administration, and should now be clear to the GOP, that Jobs and the Economy (stupid…Clinton’s words, remember?) are priority #1, before all else. Tackling this extremely difficult task will be like trying to roll a boulder up a steep hill, but must take place before anything else, or the GOP will risk losing any trust that the electorate may be placing in the GOP, though I don’t think “trust” applies to either party…this was simply the electorate saying, “Okay, The Dems blew it, see what you can do, Repubs.” Assuming anything else would simply be that, “ASS-U-Ming”. And we will all lose.

    The next couple of years should prove to be…interesting.

  2. Chris Conover said

    “That President Obama and his allies saw the 2008 election as a mandate for change is understandable and appropriate.”

    Most observers interpreted the 2008 vote as a signal of dissatisfaction with the Bush administration, as opposed to a positive affirmation of the new President’s agenda. This is especially true in health care.

    The reality is that Democrats nominated the candidate with the LEAST ambitious health reform plan. Obama CAMPAIGNED in the primaries very strongly against the individual mandate, for example. It was one of the chief factors distinguishing him from Hillary Clinton and the subject of repeated contentious debate–at the end of which Obama held his ground rather than concede the need for a mandate.

    Thus, even Democrats–given a choice between numerous other candidates advocating universal coverage–selected the individual with the most modest version of health reform. In the general campaign, the traditional Democrat over Republican advantage on “health care” as an issue was far narrower than it had been in 2000 or 2004. Thus, however one chooses to interpret the victory of Obama over McCain (e.g., weak candidate vs. voters actually endorsing the Obama position on issues), it was a huge stretch to interpret this as a mandate to anything remotely as radical as the plan ultimately enacted.

    Both candidates had sharply differing versions of health reform. So the election surely was not about doing something vs. doing nothing (notwithstanding President Obama’s misleading efforts to frame the debate in that fashion both before and after the election).

    In short, on the issue of health reform, I disagree that viewing the results as a “mandate” was appropriate. In my view, the Democrats overreached badly and we’re all paying the price. Ideally, we would press the “Restart” button and craft a plan that would achieve the sort of bipartisan consensus attained by other major pieces of social legislation (Social Security, Medicare, Voting Rights Act etc.). That would be a far cleaner and productive process than trying to salvage and restore a car that was driven over a cliff.

  3. mct88 said

    and here comes the rest of the standstill…

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