Jan 26th 2010

Why It is in the Political Interest of Democrats to Finish Comprehensive Health Care Reform

by Robert Creamer

Robert Creamer is a long-time political organizer and strategist and author of the recent book: "Stand Up Straight: How Progressives Can Win," available on amazon.com.
The frustration and disappointment is palpable among Democratic Members of Congress and staff. After nine months of difficult political labor, they were days from passing legislation that Presidents have unsuccessfully sought for half a century.

Then came the political disaster in Massachusetts. For many Democrats, last week was like living through The Empire Strikes Back. Of course we must all remember how that trilogy ultimately turned out.

Regardless, there are those who don't want to sit through a whole new episode, who simply want the health care debate to go away, to move on to something else and forget they even tried. That would be a terrible political mistake for swing district Democrats. Here's why:

1). Millions of dollars of advertising from the insurance industry and Chamber of Commerce have convinced large numbers of voters that the general concept of health care reform is a bad idea
. But it has done nothing to turn them against the underlying elements of the bill. Americans still strongly support ending the insurance industry's ability to deny claims because of pre-existing conditions; forcing insurance companies to use most of their revenue for health care instead of profits or CEO pay; providing affordable coverage for all Americans; ending the "donut hole" in pharmaceutical coverage for seniors; and reining in the power of the insurance industry.

If Democrats stop now, swing voters will continue to believe that the Democratic health care initiative was a bad idea. The only way they will change their minds is if health insurance reform passes, and they begin to see some of the benefits for themselves - and, just as important - see that the sky doesn't fall.

History shows that every major piece of social or economic legislation has increased in popularity once it is passed.

If comprehensive health care reform is passed this spring, it will rapidly increase in popularity between passage and next fall's elections. That is particularly important for all the House and Senate Members in swing districts, since it will improve the general political environment and improve the popular perception of the votes many swing Members have already taken on health care reform.

The fact is that if Democrats don't pass a bill, swing members will be stuck with all of the negatives of voting for the bill - and none of the benefits of passing it. Republicans will advertise ad nauseum about how Congressman X voted for "Obamacare" but they won't get the credit from those who favored the bill, since it never passed into law.
When I was 16 years old, it snowed in my hometown of Shreveport, Louisiana. When it snows in Shreveport, everything stops and the schools let out. Well, this snowstorm happened right in the middle of Mardi Gras, so a friend and I set off on the train to stay with his brother in New Orleans and partake in the Mardi Gras fun.

In the course of that trip, we were naïvely - and with wide eyes - walking down Bourbon Street, when a big hawker at a strip joint said something that taught me an important lesson in life and politics. He said: "Come on in, sonny, they're going to say you did anyway."
Two hundred and nineteen House Members and Sixty Democratic Senators all voted for health care reform. No matter what happens Republicans will try to attack them for their vote. Might as well have a major political accomplishment to show for it.

3). Voters like winners - not losers. They don't want to hang out with losers, and they don't want to support them. If the Democrats - after working for months on health insurance reform - can't get it over the finish line, the voters will write them off as losers and be less prone to give them their vote.
Being a winner is an independent variable in politics. Once Massachusetts voters heard that Martha Coakley was a likely loser they began to desert her in droves. And the same thing works in reverse. Barack Obama got a huge boost when he won the Iowa caucuses. Part of that was simply because he was viewed as a winner.

Voters don't like cowards. Nobody likes the guy who blows the World Series taking a strike instead of swinging at the ball. It would be one thing if Democrats fight tooth and nail to pass a final bill, and go down swinging. It's another thing if they don't even try.

5). Americans are welling over with frustration that government can't get anything done to benefit their lives.
As far as most Americans are concerned, Democrats are in charge of Government. That means Democrats have to deliver real progress.
If Democrats don't pass comprehensive health insurance reform, we will look like more than just losers and cowards - we will look incompetent. Now that would not be a fair characterization. Reforming one-sixth of the economy is a huge undertaking. That President Obama and the Democrats have made it this far is an enormous accomplishment. But that won't count for anything among the voters. They want us to deliver.

6). Passing comprehensive health care reform would be a big accomplishment not only for Congress, but for the Obama Administration. History shows clearly that the popularity of the President is the major factor affecting the number of Members of Congress from a sitting President's party that lose in mid-term elections.

The failure of the health care reform effort in 1993 led directly to the Democratic loss of the House the following year.

If you are a Democratic Member of Congress facing a tough race, there are very few things you can do that are more important to your re-election than voting to make sure that Congress finishes health care reform.
And there is a clear route to accomplish that goal. Two days before the disaster in
Massachusetts, the House and Senate leadership had come to a virtual agreement on the final shape of health care reform.

Members of both chambers should pass that agreement. The only issue should be the procedure used. Basically, it will likely involve the House simultaneously passing the Senate bill and a "patch bill" that will incorporate the changes made during the negotiations. That "patch bill" will have to be passed in the Senate (before or after the House acts) through the "budget reconciliation" process that is not subject to filibuster.

Members do not need to worry that this will be viewed as "jamming" the bill through. Any bill that is passed by a majority of both houses is not "jammed" through. It is passed through a democratic process. What is undemocratic is the 60-vote filibuster rule that allows a minority to thwart the will of the majority.

And from a political point of view, no one ever remembers the "procedures" that were used to pass a major piece of legislation anyway
. It will ultimately be evaluated based only on the impact it has on real people's lives in the real world.
While we're at it, let's forget all the talk about a "scaled-back" bill of "market reforms." If
you ban the use of pre-existing conditions to deny care - which is the main market reform - without requiring everyone to have insurance, you encourage people to wait until they are sick to get health insurance. If that were to happen, the price of insurance would skyrocket, and even fewer people yet would buy insurance until they needed it. The effect would be a vicious cycle of rising premiums, and fewer and fewer people with coverage.

To have insurance "market reforms" everyone must be covered. To assure that, we have to provide subsidies and regulate insurance companies to make sure that insurance is affordable. That means you need comprehensive reform.

The leadership of the House and Senate - and the President - are all committed to finishing health care reform. Now, each and every Member needs to look carefully at his or her own political self-interest and figure out a way to get it done. And while they're thinking, they need to think about how their grandchildren will feel one day, if they are on the wrong side of history.

Robert Creamer's recent book: "Stand Up Straight: How Progressives Can Win," available on Amazon.com.

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