Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he looks at Howard Dean. See Lim’s previous OUPblogs here.
The year is 1964, the high watermark of Liberalism. Lyndon Johnson takes 61.1 percent of the popular vote in his election contest against Barry Goldwater, an electoral feat that was bigger than Franklin Roosevelt’s 60.8 percent in 1936 and one that has not been surpassed in the years since. The Democratic tsunami sweeps down Pennsylvania Avenue to the Capitol, where Democrats would out-number Republicans two to one in the 89th Congress, and in the Senate they take 68 seats – the biggest supermajority held by any party to this day. The era of Liberalism had entered its Golden Age.
Unified by the inspiring memory of John Kennedy, Democrats were able to enact health-care legislation that even Franklin Roosevelt, the father of modern Liberalism did not have the stomach to attempt as part of his New Deal. It would be Lyndon Johnson, not Harry Truman, not FDR, and not his counsin, Theodore Roosevelt (running as the Progressive Party candidate in 1912) who would enact the single biggest health-care legislation in US history, offering single-payer, comprehensive health-care benefits to seniors over the age of 65 (Medicare) and an option for states to finance the health-care of the indigent (Medicaid) in the Social Security Act of 1965.
We remember the New Deal, and perhaps the Fair Deal, but it is the Great Society that is the apotheosis of 20th century Liberalism. And if 1965 is Liberalism’s high water-mark, then those who would stymie health-care reform today because of the lack of a robust (or indeed, any) public option have gravely gotten their decades mixed up.
There was a time when Liberals did not have to call themselves “Progressives.” That was four decades ago, when Lyndon Johnson attacked Barry Goldwater for wanting to roll back social security and openly campaigned for a further expansion of the welfare state. Times have changed. Today’s Progressives must cagily wrap their Liberal agenda with talk of choice, competition, and bending cost curves. And if the era of Liberalism as FDR and Johnson knew it is over, The Age of Reagan lingers on in the Tea Party Movement. Despite his aspiration to build an even Greater Society than Johnson, Barack Obama’s electoral mandate is 18 percent short of what Johnson possessed in 1965; the Democratic majority is the House is much smaller; and, despite the new cloture rules post-1975 in the Senate which has reduced the fraction of votes needed to end debate from 2/3 to 3/5, Joe Lieberman et al remind us every day that the Senate is anything but filibuster-proof.
To Governor Dean and his compatriots, it is 2009, not 1965.
Elvin Lim is Assistant Professor of Government at Wesleyan University and 
author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he looks at President Obama’s attempts to pass health care reform. See his previous OUPblogs here.
President Obama is finally attempting to take charge of the health-care reform debate with an address to a joint session of Congress on Wednesday.
It comes down to this. If he does not pass a health-care bill – whatever its provisions may look like – he will indeed face his political Waterloo, because health-care reform has become the defining issue of his 2008 campaign on which the president has staked all his remaining electoral mandate. That this is open knowledge to every member of congress does not bode well for the president, because just about the worst bargaining position one can have is the one in which everyone knows that the bargainer not only cannot have what he wants, but must make compromises to get even some of what he wants. Because everyone knows this, everyone to the left and right of Obama will make their demands, and his only hope of coming out unscathed is if one or the other side is willing to shift their bottom line (on what Democrats call the “public option” and what Republicans call “government-run insurance”.
The bargaining game ahead of the president is enormously complex, but there are few ground rules that he could follow to maximize his returns. First, he must absolutely decide in his mind if he wants a bipartisan bill or not, and there are many Democrats who don’t. I will assume that he must at least present the public facade of wanting a bipartisan bill.
Second, he must pull all sides away from the fault-line of the debate - whether or not to have a “public option” - because health-care reform is rather more than just about “government-run insurance.” The
president must find a way for us to see the bigger picture, if only so that we do not continue our microscopic attention to our differences.
Third, Obama needs to create face-saving conditions and incentives for one or more dissident factions in the health-care debate to capitulate. It seems to me his best bet is to try to change the minds of members of his own party, in part because the president seems doggedly committed to at least a semblance of bipartisanship. An electoral mandate (or whatever that is left of it) is nothing without the coat-tails effect of the president, and on this the president can try to call in a few favors in return for future ones. As I think it has become very clear during the August congressional recess, capitulation from the Republicans seems all but unlikely now. If anything, Republican members of congress have become emboldened by the president’s falling approval ratings.
Senator Olympia Snowe’s idea that a public option would only be “triggered” if certain conditions are set is one such face-saving possibility for the president to try to woo the more liberal members of his party. In privileging the status quo, the conditional triggering option concedes that median congressional position on the debate has shifted to the right of where the president initially stood. But by specifying what the triggering conditions are, liberal democratic members of congress can tell their constituents (like the AFL-CIO) that they are still achieving their initial goals but with different means. If the president can just shift the debate to what these “triggering” conditions should be - and the devil will be in the details - he would have earned a significant victory. Such a compromise will not unite the country, but it could make us less divided, ironically, because no one is getting what they want.
It is too late now for the president to tell us what he wants on Wednesday, not only because he won’t get it, but also because he has allowed the debate to fester and the battle lines are now drawn. His
job on Wednesday is to muddy the battle lines again. As he is already starting to do, Obama should try to convince all negotiating parties that there should be no bottom lines, no veto points, no categorical
demands. The erstwhile professor of constitutional law will have the unenviable task of bringing together what the constitution pulls asunder. Not the Great Communicator, but the Great Umpire he must be.
“The definition of insanity is doing the same thing over and over and expecting different results.”
Benjamin Franklin
The assault on a public option for health care is a mounting obscenity as Republicans, insurance lobbyists, and some Democrats roll out a propaganda campaign designed to scare Americans – and Congress – into turning their backs once again on the American people in favor of corporate greed.
Contrary to industry propaganda, the system we have does not work. High costs are bankrupting families and businesses and our quality of care is abominable. The United States is the richest country in the world but it provides the poorest health care among Western industrialized countries. According to the World Health Organization, The United States ranks 37th – lower than all the Western European countries. We rank lower than Saudi Arabia, Colombia, Israel, and Canada. (France is ranked #1, Italy #2, and Japan #3.) What a miserable shame we can’t – or won’t – do as well
Ranked by “Health System Attainment and Performance,” the U.S. was 72nd, between Argentina and Bhutan!
Nor is the U.S. isn’t any better than some Third World countries in average life expectancy. According to the Central Intelligence Agency’s rankings for 2009, the U.S. ranks 50th, (78.11 years), between Wallis and Futuna (You aren’t alone if you never heard of these two tiny islands in the South Pacific.) and Albania. In comparison, Japan’s average life expectancy is 82.12 years, Canada’s 81.23 years, and France’s 80.98 years.
With respect to infant mortality, the U.S. has the worst rate in the Western world, ranking 37th with 6.37 deaths per 1,000 live births, between South Korea and Croatia. In comparison, Sweden’s infant mortality rate is 2.76 deaths per 1,000 live births. Keep in mind that these are average rates. In America’s inner cities, the rates are much worse. In 2007, Washington, D.C., had the highest rate: 12.22 deaths per 1,000 live births. In New York City, the infant mortality rate for black babies was 9.8 deaths for every 1,000 live births compared with 3.9 deaths for every 1,000 live births among white babies. Minnesota had the lowest infant mortality rate in the U.S.: 4.78 per 1,000 live births.
The U.S. maternal mortality rate is scandalous, ranking 41st among 171 countries surveyed by the United Nations. Even South Korea has a lower maternal mortality rate than the U.S. Based on the United Nations’ 2005 estimates, one in 4,800 American women carry a lifetime risk of death from pregnancy, something the anti-choice crowd doesn’t bother to mention. In contrast, among the ten top-ranked industrialized countries, fewer than one woman in 16,400 carry such a risk. The most probable reason is that many European countries and Japan guarantee women high-quality health care and family planning services.
For those who tout the U.S. health system as “the best in the world,” there’s an important qualification – IF YOU’RE RICH. Anyone in the top one percent of wealthiest Americans can buy the best health care in the world no matter where they have to go to get it. But the majority of American citizens have to fight their way through a maze of bureaucratic fine print to obtain health care that, in far too may cases, is no better than that in the Third World. Families have the triple financial whammy of foreclosures, lost jobs, and mounting healthcare costs while insurance executives and pharmaceutical companies rake in huge profits. Paying for health care is the major reason for personal bankruptcies, a situation that analysts say will continue unless Congress passes meaningful health reform.
Our current healthcare system is not only a burden for citizens, it also burdens physicians. By enabling insurance companies to run our healthcare system, Congress usurps physicians’ medical expertise and burdens them with voluminous paperwork and restrictions. The nation’s doctors want to be healers not secretarial assistants to health insurance companies. Doctors – not insurance companies – are the experts in providing medical services, yet in too many cases, insurers dictate medical decisions to doctors and hospitals. Sometimes patients die because an insurer has delayed or denied needed medical care. Yet those who support corporate profits rather than public health don’t seem to give a damn.
President Obama calls for a public option. The message of the last election is that the people support a public option. Now is the best opportunity since Clinton’s failure on health care for Congress to pass a real health reform bill. If our elected officials turn their backs on we-the-people this time, such an opportunity may not come again in our lifetime.
