Thursday, August 27, 2009

Thomas Frank: Health Care and the Democratic Soul

It's time for Obama to channel Harry Truman.

What is at stake in the debate over health care is more than the mere crafting of policy. The issue is now the identity of the Democratic Party.

By now we know that Democrats can bail out traditional Republican constituencies like Wall Street, but it remains to be seen whether they can enact a convincing version of their own signature issue, health-care reform.

At this point, it's fair to ask whether Democrats remember why health care is their issue in the first place. As health-care debates always have done, this one has pushed to the fore all the big questions about the rightful role of government, and too many Democrats have sought to avoid them with mushy appeals to consensus and bipartisanship. The war is on and if Democrats want to win they need to start fighting.

In the early years of the campaign for national health insurance, the battle lines were more clearly drawn. Back in the '40s, the issue was part of an "economic bill of rights," a grand Rooseveltian idea pushed by President Harry S. Truman.

Truman had a knack for populist phrasing. "In 1932 we were attacking the citadel of special privilege and greed," he declared in accepting the Democratic presidential nomination in 1948. "We were fighting to drive the money changers from the temple. Today, in 1948, we are now the defenders of the stronghold of democracy and of equal opportunity, the haven of the ordinary people of this land and not of the favored classes or the powerful few."

The Democrats won that particular battle with "the powerful few" but, fighting among themselves as usual, failed to enact national health insurance. Health-care reform nonetheless remained their great cause, their high-voltage appeal to average voters, even those who otherwise saw them as a Harvard-and-Hollywood elite. And even during feeble reform campaigns like President Bill Clinton's 1993 attempt, the opposite half of the populist melodrama—in that case, the insurance industry—duly acted out its corporate bad-guy role.

This year things were supposed to be different. Democrats hold good-sized majorities in both houses of Congress and are led by an eloquent president who won an undeniable mandate last November. This time, the Democrats got the traditional opponents of health-care reform on board: "Ex-Foes of Health-Care Reform Emerge as Supporters" declared a headline in the Washington Post in March, over a story describing a friendly summit meeting between Mr. Obama and various health-care industry representatives.

This time the health-care fight was to be what official Washington loves: An act of cold consensus, not of hot idealism or Trumanesque populism. All the "stakeholders" would be taken care of. No one would need to get his suit ruffled.

And all it took to send the whole thing crashing to the ground, it now appears, were a few groundless rumors and a handful of angry right wingers who figured out how to game town-hall meetings and get themselves on TV. "Today there is another populist revolt afoot," wrote Gary Bauer in Human Events last week, hailing the righteous grassroots outrage he sees in the town-hall protests.

So we have come full circle: The reformers shake hands with the special interests, while conservatives denounce the whole thing in the name of the common man and the Founding Fathers.

After I listened to a few angry town-hall meetings on the radio, the situation was clear to me. Democrats had to meet this pseudo-populist challenge by rolling out the real thing, the New Deal vision that is their party's raison d'ĂȘtre.

So far, however, many in the party's leadership haven't been able to awaken from their bipartisan reverie. When Mr. Obama found his plans under attack, for example, he promptly began to downplay the "public option," an obvious predicate to cutting a deal and placating the insurance industry. In other words, the prospect of a populist outburst from the right apparently moved him toward abandoning the most populist element of his party's plans and toward an even more Beltwayist position—to move that much closer to the caricature of Democrats traditionally drawn by the right.

Mr. Obama still has time to reverse course. A great deal depends on it. To fail on health care yet again might well be the "Waterloo" Republicans dream of. And yet, as the party's leaders click through their PowerPoint presentations and review the complicated details, they seem unable to confront the biggest questions that the right is asking, the ones about the eternal perfidy of government.

Maybe Democrats are afraid it will hurt their standing with those generous fellows on K Street if they channel Harry Truman and say what needs to be said: That government can be made to work for average people. But it will hurt even worse if they refuse to say it.


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