Last night you heard President Obama say that we have to pass health care reform this year. Reports today that Speaker Pelosi and Majority Leader Reid are working on a plan to move the reform legislation through Congress. I know that many of you are disappointed and angry that we have not yet succeeded. I am, too.
But I taught and studied American politics for many years before I became an activist, and I know that what we have seen in the 19 month long fight for health care reform is the usual course our politics takes on the most important questions.
Special Interests vs the people This story is so commonly accepted partly because it is, to some extent, true. But that's not the only reason. It is also accepted because it portrays our politics as a populist morality play in which the majority, the virtuous people (that's you and me), are being trampled by the interest who corrupt a system in which we are the only ones to whom our politicians should attend. It's always nice, heartwarming even, to portray oneself as part of the moral majority, you should excuse the expression, rushing into battle against the forces of evil. And this simple story of good and evil also implicitly promises that the good guys will ultimately win, when the people, provoked by the perfidy of our politicians finally rise up as one and over throw them, restoring the Republic to its rightful owners, the people.
While this story is appealing, it is not wholly true. Indeed, I'm fairly certain that it's not the primary reason that health care reform has been so hard to pass. But the other reasons are more difficult to grasp, don't make for such an easy tale of heroes and villains, and, also, is not quite as optimistic because they don't promise victory for the people in one stroke.
If we really want to move this country in a more progressive direction it just won't do to keep rehearsing the simple story because the simple story most often won't give us a strategy that leads to victory. And, as we shall see, the defeats we suffer will be even harder to bear if we understand them in the way the simple story encourages. A full account of the complicated story would take one or two books on American politics.
So what I write here is necessarily going to be compressed. But let me try to cover all the major problems beyond the special interests as quickly as I can in a short space. Health care is by far the most complicated issue any of us have ever worked on. This makes it difficult to explain to people what is in this complicated legislation and just how good it is. (See this blog post if you are not sure, yourself.)
One reasons progressive are disheartened now is that we are unlikely to get a public option. But, while this is a loss, the public option was never as important to the legislation as we often suggested. We talked about the public option so much not because it was critical but because we thought it would be the hardest provision to win. But in terms of helping the insured and the uninsured and controlling costs, the public option was helpful but not indispensible.
All the complications of the legislation also made it easy to demonize it, not just for being too large a program but for being too complicated and embodied in too long a bill. And the complications of the legislation have also made it more difficult to answer the attacks against it, attacks that often come from the ideological predisposition of Americans to oppose new federal initiatives.
Ideology
We have lived in a country for most of our lives that had a moderately conservative majority and in which distrust of government has been the predominant public mood. And looking back beyond the Reagan years, since 1776 the US has always been more anti-statist and less progressive on questions of government involvement in the economy than the European social democracies.
We remain the only liberal democratic country that has never had a strong socialist movement. Many people, who would benefit from this legislation, even in Pennsylvania, thus remain skeptical about it. That keeps their Members of Congress from becoming champions of for reform. We also live in a country that is ideologically divided. In some parts of the country most people don't approve a using government to attain greater equality.
Progressives like to point to polls that show huge support for many of the elements of health care reform. But polls can be very misleading. People are quite capable of holding contradictory views, especially on issues they do not understand well. What they say to a pollster depends to a very large extent on the question that is asked. I've seen people accept the usefulness of a pragmatic reform like the health insurance Exchanges when they are thinking about detail and then turn around say that government should stay out of health care entirely.
The only way to get a good sense of where people really are is to look at a wide variety of polls, pay careful attention to their wording, and, if possible, stress test them by asking follow up questions that raise the likely objections that will be made to any particular point of view. (That, by the way, is why the one poll in the last five years that shows that people support single payer is so meaningless. Many polls show that people want government to guarantee that everyone has health care or health insurance. But since one can do that without single payer, those polls don't show that there is support for single payer. Only one poll, by the New York Times last year, ever showed that. And that poll was not stress tested.)
There is, on my reading of the polls, a majority of people who support the kind of health care reform President Obama and HCAN support. But while this is true for the nation as a whole, it is not true in every part of the country. Some of the Democratic legislators who oppose health care reform come from parts of the country—indeed there are such parts in Pennsylvania—in which support for these reform is very weak.
Institutions
Ideology has been a problem. But the fundamental difficult is that we couldn't overcome the institutional barriers to getting progressive legislation enacted. The US has always had more of these barriers than other liberal democracies because we have a presidential rather than a parliamentary democracy and because Congress has so much power and is divided into two branches, one of which doesn't represent the population.
Our system of checks and balances was designed to slow political action. It works, far better than our founders may have wanted. And it has gotten worse since the filibuster became more widely used 20 years ago. Sixty votes are required for Senate action. But because they represent states not the population, Senators representing as little 20% of the population can block action.
Since the Age of Jackson, it has been our political parties that have made government work. But our huge country has always had regional and other divisions that make the kind of unified political parties found in Europe impossible here. And those divisions are greater that larger the majority in any party. With the exception of Maine, the Senate Republicans are reduced to their core areas of support. It is easy for them to remain unified. But Democrats hold seats in areas of the country that are strongly Democratic, weakly Democratic, and not all that Democratic.
So when people complain that "the Democrats" are betraying us by not moving fast enough, I sometimes laugh to myself and think how wonderful it would be if we could really hold a unified party called "the Democrats" responsible for the failure to act already. We can't. The leaders of the party, President Obama, Speaker Pelosi and Majority Leader Reid, have been unified in support of this legislation. They haven't done everything we have wanted because they have other concerns and a fractious party to lead.
Majority leader Reid did make a tactical error in thinking he could convince Joe Lieberman to go along with the public option. He might have embraced reconciliation if he knew how recalcitrant Lieberman would be. But, much of the time, Reid and Pelosi they have provided critical leadership when they had to do so. All these barriers are difficult to overcome. But they don't make for the easy morality play of the fight against the special interests put forward by too many progressives today.
When we acknowledge the complications in the legislation we can undermine our own message about importance of one or two provisions. When we talk about ideological division in this country, we acknowledge that our own views are not universally held. Most of us not like ideological conflict and the recognition that the people are divided between different ideological views in this country. When we talk about institutional problems, we run up against our veneration for the founders. And we also implicitly point to a difficulty in our politics that is going to be hard to overcome.
That is to say that once we present a complicated picture of the barriers to political reform we both lose our moral edge, our purity in standing for the people against the interests but we also lose the hope that we will win quickly. And, especially in a country in which many of us don't have time for sustained political engagement, that is hard take. I can't tell you how many times I've seen frustrated progressives who say, "we worked and vote for Obama; we got sixty votes in the Senate; this should be done."
And so often, underlying those complaints is the notion that the speaker would like to be done with politics and go back to his or her work and families. But that is not how change is made in America and how a progressive politics will be built. Change is always hard. And it requires the constant attention and effort of citizens.
Citizen activism is the critical ingredient that helps convince the public to side with tne point of view or another and that overcomes the barriers to action in our polity. We citizen activist have to make is critical to the process.
How we have won in the past
Democracy in America has never just been about holding elections. Every major legislative step forward we have taken in this country—from Social Security to Civil Rights to Medicare to the Clean Air and Water Acts—have required an activist movement that lead, convinced, and organized their fellow citizens to put pressure on Congress. Every one of these legislative victories divided the country. Every one took longer than their activists initially expected. And every one produced legislation that was good, but not as good as the activists initially wanted.
But in each case, progressives built on these victories, expanded the initially limited legislation, and create institutions and program that became enormously beneficial to all citizens and very popular as well.
What you have done and need to continue to do
So, unlike the simple story of the people vs the interests the true story doesn't make life easy for us. It doesn't tell us to do politics for a fe months and then go back to tending our own gardens. It tells us that we have to keep working, this year, next year, and the ear after. Pennsylvania health care activist have lead the way in creating such a long lasting movement this year.
Take a look at our blog to see over 400 of you in action over the past weekend. Look at the video of the inspiring action in Philadelphia last Saturday. And look back through the blog at the hundreds of rallies, marches, protests, press conferences and other events we have held. You are part of a huge movement for change, one that has made an enormous difference so far.
We would not be this close without you. And we can't ultimately win without you. I have every confidence that if we all stick it out, we can win a major victory on health care this year, one that not only helps tens of millions of people get health insurance and control costs for everyone but that allows us to build something even better in the next ten years. But you have to stick with it and put aside your frustrations. You have to realize that in working for health care reform, you are in it for the long haul. And that is true for energy and climate legislation, net neutrality, and the other key issues of our day.
Democracy is not for those seeking easy victories or for the faint of heart. So please stay with us. And as we announce new events and actions designed to push our leaders to make the final push toward legislative victory, please come out and help.
I know we count on one another to stay the course.