Health Care Reform and the Democratic Party

The debate within the Democratic Party over health care reform generally, and the public option specifically, raises several bigger questions about the party. These questions predate the health care debate, but the controversy surrounding the extent of the Democratic Party's commitment to extend health care to as many Americans as possible brings this into sharp focus. If the Democrats do not pass a meaningful health care bill, with a public option it will be hard to answer the question of what the purpose of the Democratic Party is.

The Democratic Party has not been burdened by a unified ideology, or even vision, for quite some time. The last major legislative victories by a Democratic president occurred during the mid-1960s during the Johnson administration. Even the accomplishments of the Clinton presidency, the most successful Democratic administration in at least a generation, were products of good management and small scale legislative changes, not sweeping reform or major new programs.

During most of the last 40 years, the Democratic Party has defined itself primarily through opposition to the ascendant Republican Party. Never was this clearer, or more necessary, than during the eight years of the Bush presidency. Public anger at the Republicans by the end of the Bush administration was almost certainly the major contributing factor to major Democratic victories in 2006 and 2008. Being the party of opposition relieved the Democratic Party of having to initiate or agree upon any vision or policies. This worked fine, until the Democrats won control of both houses of Congress and the White House in 2008.

The failed policies of the Bush administration and the extraordinary desire for change during the last few years masked the reality that once again the Democratic Party was not unified around, and to some extent did not really stand for, anything. This was not a problem during the campaign or even the last two years of the Bush administration, because the Democratic Party could effectively define itself almost entirely relative to the Republican Party. However, it has become a big problem now.

Republican talking points notwithstanding, the biggest danger the 2008 Democratic election victory presents is not Nancy Pelosi, Harry Reid and other congressional Democrats steering the country to the far left, but of the Democrats failing once again to use their power to chart a new more progressive course for the country. While the Republican supported tactics including confrontational town hall meetings, rumor mongering, Nazi and red baiting, are repugnant, they are not entirely relevant to the health care debate, or any other part of Obama's program. At least until 2010, legislation will occur almost entirely within the Democratic Party. A united party will not be easily stopped, but powerful Democrats who want to weaken or stifle progressive legislation have a great deal of power in this process, far more than congressional Republicans.

The Democratic Party has always been an umbrella party representing a broad range of views. There is nothing new about this, but the overall political environment has changed. With the liberal wing of the Republican Party all but nonexistent in recent years, the Democrats need a greater degree of unity to be successful. The next few months will determine whether or not that unity exists; and health care will be the key issue where this will be tested.

It is evident by now that health care reform without a public option will represent minor change and not solve the major health care related problems facing many Americans. If health care reform with a public option is not passed it will almost certainly be due to some Democratic members of congress who oppose the public option. This will represent a failure of the Democratic leadership at an absolutely decisive moment in domestic policy making, perhaps the most decisive in a generation. Failing to pass health care reform because of Republican opposition is politics as usual and Democratic voters would have to accept that defeat and move on. Failing because of what happens within the Democratic Party is a categorically different problem, and a far more serious one.

A failure of unity at this moment will raise the question of why the Democratic Party exists. This is something of an overstatement because it is obviously important to have an alternative to the Republican Party; and even an unsuccessful Obama administration would be a great improvement over the Bush administration. However, if the Democratic Party, with sizable margins in both houses of congress and a popular president, manages to lose health care reform to internal fighting and to its own conservative wing, the question of what the Democratic Party can do, or what it is for, will be hard to avoid. The party will have demonstrated that it cannot be anything more than an alternative to the Republicans. This is not a good foundation on which to continue to build for the future or a good strategy for maintaining recent Democratic electoral gains.