Reform is Hard

I’ve got a new Daily Beast column whose theme I would sum up as “Monday-morning quarterbacking is easy, comprehensive health care reform is hard” pushing back on the idea that the Obama administration is running into problems because it’s making mistakes:

What Clinton tried didn’t work, in other words, so Obama’s trying it another way. Now the United States Senate looks reluctant to pass a comprehensive plan, so people think Obama is making mistakes. But looking back at American history, it’s not only Clinton who failed to accomplish comprehensive health-care reform — his effort joined reform charges by FDR, Harry Truman, Richard Nixon, and Jimmy Carter on the ash heap of history. Johnson, arguably the most accomplished legislator in American history, was too scared to try and brought us Medicare and Medicaid instead. It defies plausibility to suggest that president after president after president is blundering or inept. Rather, we should just admit the obvious — people keep trying and failing to reform the health-care system because reform is hard to do. […]

In most countries, laws are passed by a unicameral legislature elected to express, more or less, the will of a majority of the population. Under Obama, the House of Representatives — which basically fits the bill — has already passed what would, if it were to become law, be the single most important piece of environmental legislation in the history of the world. They’re also poised to pass a universal health-care bill that’s already cleared all three relevant committees and almost certainly has majority support. But the House leadership, sensibly, doesn’t want to ask potentially vulnerable members to cast another tough vote unless the Senate is prepared to act.

But of course the Senate is rarely prepared to act on anything! None of which is to say that Obama is perfect or the White House strategy has been flawless. But it’s to make the point that pinning all your hopes and dreams for substantive policy change on finding the smartest awesomest president ever doesn’t make much sense — American politics contains a lot of veto points, and systematic change requires action across all those veto points.