Was Obama’s Handling Of Health Reform a Mistake? Yet Another Analysis From A Parallel Universe

I’m enjoying Jonathan Cohn’s, Greg Sargent’s, and Ezra Klein’s counterfactuals about Democrats’ mid-term election prospects had they they never taken up health care reform. All agree that Democrats would find themselves in the same spot, or be even worse off than they are today:

COHN: A Newsweek economics columnist called Obama’s failure to address health care costs, at a time when the political forces for action were finally aligned, an unforgivable act of political cowardice. It’s hard to know whether voters share that assessment, but the perception that Obama whiffed at tackling the nation’s major issues certainly isn’t helping his approval ratings. The phrase “Carterbama” comes up a lot in conversation.

SARGENT: There are a host of reasons to believe Dems might have been in a pretty bad position even if they hadn’t attempted reform at all. And if that had happened, and Dems had sustained big losses all the same, it could have postponed action on reform for a decade or more. Those who think Dems shouldn’t have tried reform this time around need to be asked when Dems would have gotten their next bite at the health care apple — particularly with such big majorities.

KLEIN: In conversations over the past few weeks, some of the party’s leading strategists told me that it all comes down to accomplishments, or — here’s that ubiquitous word again — “deliverables.” The president, who ran such a brilliant campaign, they argue, has utterly failed to live up to the promise of his election. They cited perceived missed opportunities like the president’s decision to expand S-CHIP rather than pursuing health-care reform and suggested that he hadn’t done enough to re-regulate the financial sector in the aftermath of one of the worst financial crises in the nation’s history.

I agree with the above, but also wonder where Democrats would be today (regardless of the economy) if the President had approached reform in a more hands-on manner, publicly advocated for progressive priorities like the public option and drug reimportation, and crafted a more coherent and specific vision of what he wanted the final reform bill to look like. On one hand, it’s certainly possible that this more confrontational style would have put off the self-important lawmakers who took pride in personally crafting the law and pushed away the special interests whose acquiescence the administration bought with special agreements and tradeoffs. Reform might have died a slow death and Obama would likely be no better off than he is today — again, maybe even worse.


But had these Clintonian tactics led to a different result — if reform passed, it would have either included the kind of progressive ideas that Democrats could rally around or it would have mirrored something similar or even more conservative than the Affordable Care Act. In either outcome, if Obama steered the ship, the actual reform process could have been cut in half and even in the latter instance, Obama could have been seen as someone who stood and fought for what he campaigned for. And, it’s possible that his progressive base would have been more likely to stand with him than many are today. Conservatives, moreover, would have had less time to smear the law and concoct lies; without those falsehoods, and with a shorter legislative process, the American public would have been more receptive to the policy.”

Of course, all of this is mere speculation, but one can’t help but question if Democrats would see more public support for the law and their party today had the President publicly acted like it really mattered to him 16 months ago.