Baseball Crank
Covering the Front and Back Pages of the Newspaper
July 23, 2009
POLITICS: Obama's Health Care Strategy: Vote First, Sell Second

One of the most elusive concepts in politics is the notion of a mandate. Presidents love to claim them to bulldoze opposition ("the American people elected me to do this!"), but they can evaporate with astonishing speed, most famously in the case of the backlash against Franklin D. Roosevelt's "Court-packing" plan after FDR had won the most sweeping electoral endorsement for any party in a presidential election year since the dawn of the modern two-party system.

If there's one essential characteristic of a mandate, it's that the public support behind the president is solid because people know what it is they're supporting. That's how conservative presidents like Reagan and George W. Bush got mandates to cut taxes: they ran on a clearly articulated plan, everyone who cared to follow the race knew what the plan involved, and public support didn't change dramatically once they got into office and their opponents started hitting back with the same arguments they'd used against the tax cuts during the campaign. A corollary is that when Members of Congress voted for the tax cuts, they could do so knowing that the arguments on both sides had been fully ventilated to the public, and the voters wouldn't turn against them quickly for supporting the cuts.

Barack Obama is now pressing forward on health care on the theory that he was elected on a platform of doing something about "health care reform," and therefore he has a mandate. Bill Clinton thought the same thing; so did George W. Bush after winning not one but two elections while promising Social Security reform. One can argue about their assumptions (that both Obama and Clinton won because of the economy, and Bush in 2004 because of war, social issues and the economy), and of course it remains too early to predict whether Obama will succeed in getting a health care bill to his desk. But of this much we can be certain: even if he does, his legislative strategy is designed to ensure that the bill is passed without the controversial details being sold to the voters. And if Congressional Democrats follow Obama's lead, they may find next fall that they can't hide behind any sort of mandate to justify their votes.

From watching him approach the votes on the stimulus and cap-and-trade proposals and now health care, we have a pretty clear picture of Obama's modus operandi:

Step One: Lay out very general principles and trumpet the absolute urgency of immediate action on those principles. Obama is in favor of "health care reform." He wants to lower costs and insure more people. A high level of generality. There was more flesh on the bones of his campaign proposals, but not nearly at the level of covering all the bases, and in any event Obama has not even tried to insist that legislation be crafted around his campaign proposal. Yet he has insisted that even if he can't say what exactly is to be done, it has to be done quickly and without a lot of debate.

Step Two: Deflect all specific attacks by not having a single bill with transparent provisions. On the House side, we've had a bill coming together that's fairly detailed, and as recently as this morning, Speaker Pelosi was simultaneously insisting that she (1) has the votes to pass it and (2) was going to cancel the August recess to hold Members in town long enough to get the votes to pass it. At a minimum, there seem to be a fair number of nominally conservative "Blue Dog" Democrats who might vote for the House bill if forced to but would really prefer to have a bipartisan compromise emerge from the Senate instead. The Senate side has been much murkier, with support as well for a liberal bill like the House version but also a number of Democrats who are balking at the House's rigid demands and a number of Republicans who won't sign on to the House version but have left the door open to something different. In any event, it's impossible to debate exactly what an "Obamacare" bill is at present, because there's no one bill the White House is willing to publicly stand behind. Much of the Administration's communications strategy has been based on deflecting criticisms by denying that this or that controversial provision has been set in stone, using (1) the shifting nature of the various bills and (2) those bills' ultimate vagueness in passing on key decisions to an amorphous, yet-to-be-established bureaucracy as cover to stay unclear on how the pieces of the puzzle will fit together.

Let's consider, just as an example, one of the most radical changes in national policy that may end up in the final bill - public funding of abortions. For three decades, the Hyde Amendment has codified the policy under which the federal government does not provide taxpayer money to subsidize abortions. This is the ultimate middle-of-the-road compromise (for pro-lifers, just refusing to subsidize isn't nearly enough), but it maintains the pretense that the federal government is pro-choice rather than actively pro-abortion (if you subsidize something, you're actively encouraging more of it). Repealing the Hyde Amendment as a stand-alone piece of legislation would require a major pitched battle and be an enormous flashpoint for putative moderate Democrats from districts with a lot of pro-lifers; instead, it may get done as part of a huge, sweeping overhaul that brings in scores of other dramatic changes (tax hikes, huge funding increases, changes in the way insurance, medical care and malpractice are handled) all at once.

So, how does President Obama respond to criticism that repeal of the Hyde Amendment is a step too far? Here's what he told Katie Couric:

Katie Couric: Do you favor a government option that would cover abortions?

President Obama: What I think is important, at this stage, is not trying to micromanage what benefits are covered. Because I think we're still trying to get a framework. And my main focus is making sure that people have the options of high quality care at the lowest possible price.

As you know, I'm pro choice. But I think we also have a tradition of, in this town, historically, of not financing abortions as part of government funded health care. Rather than wade into that issue at this point, I think that it's appropriate for us to figure out how to just deliver on the cost savings, and not get distracted by the abortion debate at this station.

If Obama is serious about getting a public mandate for his bill, this isn't at all an honest approach; either the final bill will continue to bar the use of public funds for abortions, or it won't. But so long as he's not defending any particular piece of legislation, he can keep doing this two-step.

The list of controversial issues goes on, almost endlessly. Much of the controversy focuses on the effects of various plans on existing private health benefits. And Obama can claim a strong mandate....against tampering with anybody's existing health care. When John McCain proposed eliminating the favored tax treatment of employer-provided plans, Obama flooded the airwaves with ads hammering McCain for putting any sort of tax on anyone's current health care. Obama may argue now that the various proposals are different - the main liberal plans don't tax health benefits, they just use a variety of squeezes to try to drive them out of existence, but Obama's (laughable) pledge to make his hugely expensive proposals "deficit-neutral" leaves the door open to the possibility that a final deal may incorporate any number of as-yet unspecified tax hikes (also in violation of other of his campaign promises). But then, McCain's proposal also offset the taxes on employers with individual tax credits, and Obama pounced on him anyway, and ended up drawing substantial public support from people who - whether they knew that or not, having heard his barrage of ads - concluded that McCain would tax their health benefits and Obama would leave them in place. If proposals that tax or otherwise pressure existing benefits out of existence end up in the final bill, it will be quite a surprise to a lot of people who took Obama's campaign ads and rhetoric seriously.

Step Three: Keep as many things on the hopper as possible. For much of the year, Obama has sought to simply overwhelm the Republican opposition by pursuing so many different things at once - the above-mentioned legislative agenda, the continuing parade of bailouts, the Sotomayor nomination, the overhaul of intelligence and detention policy - that undermanned, underfinanced and disorganized Republicans simply couldn't get a hearing on all of them at once, and things could get done in Congress and the Executive Branch without a lot of scrutiny of the details. The apex of this strategy was the cap-and-trade vote that was buried in the news by the death of Michael Jackson.

This part of the strategy has broken down somewhat at the moment, as the President himself has now taken to talking almost entirely about healthcare. And that, in turn, has raised the political stakes, with Republicans openly declaring that health care is Obama's Waterloo. From here out, it will be increasingly difficult for Obama to ram through a vote under cover of other events.

Step Four: Rush to get the bill into concrete form and passed with as little time as possible elapsed from Step Two. We saw this dramatically with the stimulus bill, which got passed without anybody in DC having read the whole thing and with hardly anyone having a firm grip on exactly what was in the bill that might later prove embarrassing to have supported. And predictably, the stimulus package is much less popular now than it was when it passed.

The rush to passage is effective for muting opposition. Pelosi's desire to hold the House over August to vote would not only allow a rush to a vote, but would insulate her Members from spending a month in their districts hearing from voters while there's a proposal on the table they have some chance of understanding. But it also means the Members vote before they have sold the public on the bill and everything in it. Even if you think that's an appropriate way to make law in a democracy, as a matter of pure politics, it can be toxic later on. Even if the whole thing passed by the end of August, Republicans would have a year and a half to hammer on particular provisions of the bill ahead of the 2010 elections, and Democrats who voted for it could be caught offguard if they never spent a day guaging how individual parts of the bill would play in their states or districts.

Obama's not worried about that - he can run for re-election on his personal popularity and the historic nature of his historic presidency. But Congressional Democrats won't have that luxury - if you're a white male supposedly moderate Congressman running for re-election in a district in Indiana or North Carolina where a majority of the voters are still old enough to remember when and why they voted for Bush in 2004, you need to be able to defend the actual policies you voted for.

Which may be why Obama's hurry-up offense is at risk of a serious slowdown, with Harry Reid announcing today that unlike Pelosi, he's not going to cancel the August recess or have a vote before then. Congressmen and Senators are nothing if not self-interested, and with Obama having burned a lot of political capital to get them signed on to the stimulus, the bailouts, and the cap-and-trade bill, and with polls showing sinking support for health care reform, many of them may be ready to decide that a full and open debate on the particulars of a particular bill, and some serious time discussing those particulars with the voters, may be necessary to get their votes on a final package. And that's an outcome that can't warm the heart of the White House.

Posted by Baseball Crank at 1:16 PM | Politics 2009 | Comments (17) | TrackBack (0)
Comments

I love it Crank.

Clinton and Obama: no mandate.
Reagan and George (compassionate conservative) W: mandate to cut taxes, but apparently no mandate to be remotely compassionate.

Clinton and Obama won just because of the economy, but W in 2004 won because of war, social issues and the economy.

Keep it coming.

Posted by: Jim at July 23, 2009 4:56 PM

I'm guessing you don't think much of the guy who described Clinton's 1992 strategy as "it's the economy, stupid"?

As for Bush 2004 vs Obama 2008, I refer you to the chart in this post by Jay Cost showing that the top voter concern in 2004 was closely split between terrorism, the economy and social issues, while the economy was overwhelmingly the top concern in 2008.

Posted by: Crank at July 23, 2009 5:04 PM

Err, Crank, I agree with your post in terms of its overall point. I'm not sure the contention that GWB was elected on terrorism, social issues, and the economy is supported by that link. To me, it reads that voters for whom the top concern was the economy went for Kerry, 80-18. Sure, it was an important issue, I just don't think it could be said that "Bush [won] in 2004 because of...the economy" (third paragraph).

Jim: Thanks for harping on some minor point that hardly matters to the overall point that Obama's method of pursuing his legislative agenda are suspect if the goal is to claim they had a mandate to pass the law. Do you have anything to say on that subject?

Posted by: DKH at July 23, 2009 6:24 PM

DKH, that's a fair point, my minor point is just that the good economy helped Bush along in 2004, my major point is that he had a mandate for tax cuts in 2000, a mandate on the war & social issues in 2004, but he never really had a mandate on Social Security, which is one reason he didn't get it. (OTOH, he also had something of a mandate in 2000 on his horrible Medicare prescription drug plan, all the more because he and Gore had both campaigned on similar plans, although some of the fine print in that bill was also just rammed through with minimal debate).

Posted by: Crank at July 23, 2009 7:13 PM

In 2000, fewer people voted for Bush than voted for Gore and yet Bush had a "mandate" for his tax cuts?

Posted by: Magrooder at July 23, 2009 9:58 PM

Fascinating.... while attacking you, no one will address your main thesis of Obumbler trying to pass a massive spending/power grab before it is examined, weighed, debated etc. The reason? well no one could possibly give a logical coherent reason not to take our time before taking such an action. But you not what Crank, you, unlike the people that attack you, are just a partisan hack.

Based on election blowouts Reagan in both his terms did have mandates. Clinton, who btw, never got 50% of the vote and single handidly elected a Republican Congress, never had a mandate. Bush did not have a mandate in 2000, but in 2004 the election was about him and the Republicans did win both houses-so maybe he did have a mandate and Obama I would put in the same boat as Bush in 2004.

Posted by: dch at July 23, 2009 10:20 PM

Magrooder - Bush's "mandate" in 2000 is debatable, since whether he actually won is debatable. But he did campaign heavily and specifically on his tax cut proposals, and they were arguably more popular than he was - the opposite of Obama's situation.

Posted by: Jerry at July 23, 2009 10:29 PM

DKH: I think the argument about a mandate on any particular issue is absurd for anyone to make. What's more absurd is Crank's attempt to claim that W and Reagan had a mandate While Clinton and Obama did not. He failed to mention GHWB presumably because he was not conservative enough and because his only arguable "mandate" was the no new taxes pledge he later broke.

Crank used to be reliable for reasonable analysis (even if I rarely agreed with his premises), but he has become so consumed with hating Obama that reasonable analysis has long been absent from the political portions of this site. It does make for fun reading though.

Posted by: Jim at July 23, 2009 11:32 PM

Jim:

You're focusing on the "mandate" arguments, which contain the most subjective aspects of a very long post. The rest of the post has very reasonable analysis that neither you nor your fellow trolls have even attempted to rebut. Is that because you can't? He laid out the President's current M.O. pretty reasonably, succinctly and accurately.

Posted by: Joel in Seattle at July 24, 2009 1:30 PM

Bait and switches, strawmen, ad hominems...

Are we sure Obama himself isn't writing these comments?

Posted by: per14 at July 24, 2009 4:31 PM

What utter sophistry.

First, all politicians want to claim a "mandate," believing that it will help them achieve their policy objectives. Whether any of them is able to turn his or her "mandate" into legislation depends on a number of factors, only one of which involves campaign promises and platforms.

Second, Crank's notion of campaigning in specifics is quaint, but is totally divorced from the real world. Any candidate who does so is quickly dismissed as a "policy wonk," "egghead," etc. and faces insurmountable obstacles to getting attention in the 15 or 30 second sound bite world of political campaigns. I think we would all be better off if we had Lincoln/Douglas-type debates and serious policy discussions at that level, but most of the country would soon turn to "America's Next Top Model" or similar fare.

Third, and this really the most absurd premise of Crank's post, there are fundamental limitations on how speific any candidate could be depending on the issue. Reagan, to use Crank's example, campaigned in support of the Kemp-Roth tax cut plan, which involved 10% tax cuts each year for 3 years. No more specificity than that is needed. To reform an entire industry, arguably several industries in the case of health care, requires multiple actions and levels of detail that will, inevitably, be left up to regulatory agencies. To assert, as Crank does, that the President was insufficiently specific would be fine if the world were a seminar. It is not.

In the end, largely as the result of GOP presidential campaigns over the last several decades the country has been taught that we can have it all AND it will cost less -- e.g., tax cuts will increase revneues!!! In the real world, there are trade-offs, there are sacrifices and, in some cases, believe it or not, it can cost more to get more or even to keep what you have.

Debate the substance if you want, there are plenty of points to argue, but get out of the delusional world that you appear to inhabit in which Obama=bad and GOP talking points=good.

Posted by: Magrooder at July 25, 2009 9:53 AM

Magrooder, you are still talking past me because you are focusing on what Obama might have done differently, rather than on the inevitable consequences of what he did do, which is the core of my post. Obama did not sell the public on the specifics of his plan, and still hasn't. Either he and the Democrats will do that before they pass the bill, or they will face the serious risk of a public backlash later. And deferring the big decisions to be made by unelected bureaucrats could be the worst result of all.

Posted by: Crank at July 25, 2009 9:36 PM

I guess it depends on what you mean by the "specifics."

The public, even Congress, does not have the attention span or the desire to be told the "specifics" of a health care reform program if oyu mean the more precise details of what will happen. What the public wants to know is whether they will be able to choose their doctor(s), what will be covered, abd how much it will cost them. They don't care about "specifics" beyond that.

There is a considerable space between "let's reform health care" and the "specifics of a reform program." Whether there is a backlash or not, how severe it is, and at whom it will be directed will depend on how people feel about results, not how many details they knew beforehand.

I agree that leaving decisions to the bureacrats is not good; I was merely commenting on a likely result concerning more controversial details.

Posted by: Magrooder at July 26, 2009 7:08 PM

Crank,

"Obama did not sell the public on the specifics of his plan, and still hasn't. Either he and the Democrats will do that before they pass the bill, or they will face the serious risk of a public backlash later."

I don't see how anyone can argue with that.

Magrooder,

You say that "there is a considerable space between 'let's reform health care' and the 'specifics of a reform program.'" Well, the problem is that Obama specifically does want a health care bill that includes a public insurance option, and that's essentially what is going through Congress. It's pretty much impossible to disassociate himself from the bill if he signs it.

Frankly, I'd like to see a health care bill that does substantially less than what he is proposing, but would he sign a bill that doesn't have a public insurance option?

Posted by: MVH at July 26, 2009 7:51 PM
What the public wants to know is whether they will be able to choose their doctor(s), what will be covered, abd how much it will cost them. They don't care about "specifics" beyond that.

I disagree. I think people care if their taxes will go up, and if the added tax burden strangles economic growth. I think people care if their insurance will be portable. I think people care if their tax money goes to fund abortions. I think people care if the government is getting into the business of encouraging assisted suicides to save money. I think people care if cost-cutting leads to fewer doctors, longer waits, less investment in life-saving drugs. I think people care if the cost of the program explodes the budget deficit and the national debt. These may seem like petty details if you are rushing to sign a bill, any bill, but each of them will make some people very upset when they find out what their government did without asking them.

Posted by: Crank at July 26, 2009 8:19 PM

In a republican form of government, the elected don't have to ask. If you want "participatory democracy" and ballot initiatives, go to CA and see how well that works.

The people who care about the issues you pose (except for the one about taxes) are a small enough and splintered minority, most of whom wouldn't vote for Obama anyway.

For our healh care system to be sustainable, there needs to be significant cost-cutting in the number and scope of high-cost procedures ordered and people without access to insurance need have that access with an emphasis on wellness care.

Posted by: Magrooder at July 26, 2009 11:03 PM

"The people who care about the issues you pose (except for the one about taxes) are a small enough and splintered minority, most of whom wouldn't vote for Obama anyway."

I think you underestimate the size of that group, and you'll find plenty of Obama supporters in there too.

Posted by: MVH at July 27, 2009 11:35 AM
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