There has been a bit of back and forth about whether or not it's fair to blame Obama for the state of the health care debate , with Yglesias and Klein, among others, saying that criticisms of domestic initiatives should be focused on the congress rather than the president, who has little institutional power to affect it. I think it's true that the congress, particularly the Senate, is the choke point on domestic legislation, but the fact remains that the president is the only one who runs a national campaign and he sets the agenda. And depending on the extent of his mandate, the president has a tremendous amount of power, particularly in the first year of his term, because he has a measurable support from the public. And public opinion, believe it or not, is important.
The White House knows this very well and it husbands its capital, prioritizing the things it cares enough about to spend it on. Here's a somewhat twisted example of how the president is using his power right now:
Lawrence O'Donnell: Howard, when you have shaky votes on the Democratic side. And you have Howard Dean, physician, Dr Dean coming out against this bill, there have to be some Democrats in the Senate who are saying in effect, you want me to cast this vote, which in my state is kind of difficult and I might not get thanked politically by anyone. I might not get thanked by the base represented by Howard Dean, I certainly won't get thanked by Republicans and I don't know what's going to happen with Independents. It seems to me it does make the Senate vote much more tense
Howard Fineman: Well I think it's symbolic, in a way, of the predicament that the president and the Democrats are in. At the meeting at the White House today, Lawrence, from talking to people about it from people who were there, the subtext of it was look, you think things are bad now, if we don't pass this bill the president in effect said, you're going to be damaging me. The economy's bad, the historical trends are against us in 2010, but if we don't pass this bill, I'm going to look bad and that's going to make me useless to you as a vehicle to try to help you guys this next year and the period after that.
So the president might be jawboning in a way, but he's not really threatening. He's saying don't make me jump. Because I'm the one who's going to get damage and that's not going to help you.
That's the argument that's being made and that the argument Harry Reid is making to his fellow Senators as I understand it. He's saying look, we need to pass a bill because we can't afford to damage our president any further than he's already been damaged. That's kind of a backhanded way of looking at the thing, but that's what's going on behind closed doors right now...
There are not a lot of good reasons why he wouldn't use the power of his popularity when his numbers were stratospheric to insist on something other than cost controls. One can only assume he didn't want to.
Even I knew that the Senate was full of a bunch of prima donnas who had to be deftly handled and given a tremendous amount of attention and engagement when you try to do something big. That's just how it works in that chamber, especially when Democrats are in the majority. It was never going to be easy. But the president had a tremendous amount of good will and political power when he came into office and indicated from the beginning that instead of pushing through his agenda quickly and efficiently he would have the congress to "take the lead" and only inject himself when it was necessary to consecrate some (preferably bipartisan) compromise. That's a recipe for slow action and bad legislation.
The president may not have the singular power to enact good domestic policy, but he is the only one with the power and public backing to knock heads and lead in his own party. And if the best he can do in that regard is tell the Democrats that they need to "protect him" by passing any bill, well, that's pretty weak.
Considering the recent polls, however, you can see why he's making that pitch:
A bare majority of Americans still believe government action is needed to control runaway health-care costs and expand coverage to the roughly 46 million people without insurance. But public opposition to the proposed health reforms under consideration has hit a new high, and there are signs the political fight has hurt President Obama' s general standing with the public.
One can only speculate about what might have happened if they had gamed this out a little bit differently. Maybe it wouldn't have made any difference. But the fact remains that Obama last made a speech about health care last September (in which he inexplicably put a 900 billion dollar cap on the legislation) and there's been nothing but mild admonitions to "work it out" ever since then. He simply did not show leadership on the issue. And now his own ratings are suffering because of the mess. If Greenwald is right when he says that the White House achieved the plan they always wanted, then it came at a very high price.
I actually think they originally conceived of health care reform as a necessary gesture to achieve their Grand Bargain and so the details didn't much matter to them. They would have "given" us something we could call health care reform and then it would be time put some of our own "skin in the game": "entitlement" reform. I suspect that rather than being the result of some master plan, the health care debate just got away from them. (It's a terrible irony that the technocratic "what works" administration would find themselves tied up in knots creating an image of fiscal probity.)
I'm not sure how that will all work out in the end. But I'm fairly confident that the deficit scolds are getting ready to launch a full scale offensive on government spending, so "improving the bill" in any financial way is probably not going to be on the agenda any time soon, certainly not with a looming election and tanking poll numbers. And with the president's approval rating suffering not simply due to health care reform, but because of unemployment and economic torpor, what we get in this health care reform bill had better be enough to last us for quite a while.
Update: I should add that contrary to some reports I am not arguing to "kill the bill." Even if I thought we should, I have yet to see a strategy that could make that happen. I think the bill will pass, I always have. So, what I'm writing is simply analysis of what has happened and what is.