In the last few days, several bloggers – among them Jon Cohn and Ezra Klein — have written faulty defenses of the health care bill. They used theoretical, counterfactual alternatives in defense of the health care legislation they’ve supported, calling to mind Voltaire’s classic, Candide. In it, Voltaire heavily mocks the extreme optimism of Pangloss, who concludes all is good no matter how terrible things are because we live in “the best of all possible worlds.”
Democrats made dozens of serious mistakes with health care
It’s important to remember health care reform hurts Democrats not only because it was health care reform, or that they’ve faced lock-step Republican opposition, or because the economy is really bad. Health care reform hurts them because it was executed in a painfully slow, corrupt and incompetent manner. At almost every turn, they made horrible choices. Deciding to focus on the long-term cost curve and Congressional Budget Office score instead delivering immediate benefits was an unforgivable error in this economic climate. Wasting months trying to get ultra-conservative Mike Enzi (R-WY) on board was an act of nearly unparalleled collective stupidity. Allowing the fight to drag on as the bill became progressively less popular instead of quickly passing it with reconciliation was a very bad idea. Empowering Ben Nelson and Joe Lieberman by taking reconciliation “off the table” made jackasses of the whole party as the two Senators’ ridiculous demands clearly undercut popular support. The backroom corporate deals which netted no GOP votes were devastating. Lying to the base for months about the public option after having promised insurance companies it would be killed ensured the health care fight would end with incredibly bad blood between Congressional Democrats and their base. A mandate forcing people to buy a product from the highly unpopular insurance companies was an awful idea that Democrats foolishly refused to drop or modify. The mistakes are almost too many to list.
This election is going to be a bloodbath. A clear argument can be made that the way in which Democrats supported health care reform significantly hurt them. In spite of these same writers’ insistence the law would become popular after passage, it clearly has not. In terms of the policy, the law is at best weak and poorly designed. Given how many huge mistakes Democrats made, defending their actions requires some extreme creativity and mighty weak straw men.
Stupid choices are limited in Klein’s and Cohn’s fantasy worlds
Both Ezra Klein and Jon Cohn maintain in their strange defense of health care reform that this election would have been bad for Democrats not because of health care reform, but because of even worse political ideas.
Said Ezra Klein:
But since I’m interested in the counterfactual, let me offer it: How many seats do the Democrats lose in a world where everything is the same — that is to say, health-care reform passed, and it was an ugly process — but unemployment is 5.5 percent? How about in a world where unemployment is the same, but health-care reform was never attempted, and the Obama administration instead sought a price on carbon?
My best guess is that Democrats lose 25 fewer seats in the first world and five more seats in the second world (as cap-and-trade would provoke the same outrage on the right, and also harm some traditionally Democratic districts where they mine coal). But that’s just my best guess. What’s yours?
Given the current economic crisis, spending months focused on taxing carbon would also have been a horrible political move. If the only two choices were ignoring the economy to focus on climate change or spending months incompetently pursuing corporate-friendly health care reform, I agree the latter might have been better politics. The fact that Democrats could, in theory, have made an even worse political choice doesn’t refute the fact that the Patient Protection and Affordable Care Act really hurt Democrats.
Of course since Democrats have free will, they had thousands of good choices in addition to these two bad ones. It is not like Democrats were powerless to do anything about unemployment. Democrats could have used health care reform to focus on current economic problems instead focusing on “bending the cost curve.” Democrats and the economy would likely be in much better shape if they front-loaded benefits to inject billions into the economy and provide coverage directly to millions of voters through Medicaid expansion and Medicare buy-in. They could have passed a better law. They could have jammed through a bill a full year earlier using reconciliation before the popularity of the president and his plan plummeted. They could have then spent the rest of their year focused on programs to increase employment and deal with home mortgage foreclosures.
Jon Cohn actually creates an entire fantasy world in which Obama tries and fails to pass a second stimulus, spends a year failing to improve the economy, and then tries and fails to pass an extension of the Children’s Health Insurance Program. Not surprisingly, in this alternative universe, in which Obama is an incompetent, abject failure, Democrats also get crushed in the midterms. This is somehow proof that the health care bill was not necessarily bad or didn’t necessarily hurt Democrats.
This is one serious logical fallacy. In another alternative reality, where Obama spent all year fighting to restore voting rights to convicted pedophiles, Democrats face even bigger loses. By this logic, getting caught robbing a car wasn’t a horrible decision because the alternative was getting caught in the act of murder. It is implying the country wouldn’t have been better off not invading Iraq because we might have invaded Iran instead. Both are bad decisions, but there still exists a third good choice.
The theoretical existence of even worse choices doesn’t make something a good idea
It’s true that Democrats could have done something even stupider, even more politically detrimental than health care reform that would have made them look even more corrupt and incompetent. This in no way changes the fact that the terrible way they went about reforming the health care system did them serious political harm. It is not just that Republicans tried to stir up anger, or that the economy was bad–although both hurt support–the main problem is that Democrats pursued health care reform in a horribly long, drawn-out, and self-destructive manner. They played a huge role in killing support for the bill–and for themselves–with their endless string of bad moves.
Amazing incompetence, backroom sweetheart deals to corporations at the expense of voters, almost no immediate benefits, systematically lying to your own supporters, wasting months while the fight gets uglier, and allowing self-righteous jackasses to re-write the bill out of spite, and, quite frankly, a very bad policy as the end result all combined to make a seriously unpopular bill that caused significant political damage.
It was not the act–the attempting of health care reform in face of Republican obstructionism and a bad economy–that really hurt, it was the incompetent and corrupt way in which it was done and the poor-quality product that resulted. Health care reform is an albatross around Democrats’ neck, a clear manifestation of how incompetent they are. This is the real lesson Democrats need to learn.
Just because Democrats could have made even worse decisions doesn’t change the simple truth that the awful way Democrats did health care reform is hurting their re-election hopes, and that without their self-destructive actions on this front, they would be better off.