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Who Will Be Hurt if the Democrats Pass Health Care Alone

If the Democrats pass the health care bill, and are able to do it with a public option, the Republicans will have once again put themselves on the opposing side of groundbreaking legislation.
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Eight months or so into the Obama presidency, it is pretty clear that Obama's bipartisan efforts have not been, and will almost certainly not be, fruitful. Critics of Obama might claim this is because Obama has already been captured by the far left of his party, while people more sympathetic to the president might point out that the Republican Party has been captured by an angry and out of touch right wing that has driven the party to irrelevancy. The question this raises for the Obama administration is whether or not it is now prudent to abandon efforts at bipartisanship and seek to pass major legislation, most obviously health care, alone.

Critics of this idea point out that previous legislation of such great significance was passed with bipartisan support. This is true, but a little misleading. For most of the twentieth century partisanship while strong, was often not closely tied to ideology the way it is today. Liberal Republicans and conservative Democrats were far bigger and more important political forces 50, or even 25, years ago, than they are today. So, while, for example, Lyndon Johnson passed both civil rights and Great Society legislation with support from Republicans, those Republicans were northern liberals who had political views and ideology which today would make them far closer to the Democratic than the Republican Party. Similarly, a fair amount of the Democrats who backed much of Ronald Reagan's legislative proposals were conservative Democrats who today would likely be Republicans.

Obama does not have a liberal, or even moderate wing of the Republican Party with which to work, so bipartisan policy making is substantially more difficult for him. The Democratic Party, while far from unified behind any health care plan, is far more ideologically cohesive than in the 1930s or 1960s, making the possibility of passing legislation without the Republicans possible in a way that was not the case for previous Democratic presidents.

David Brooks, among others, has argued that for Obama to pass health care legislation without any Republican support would be a big mistake and ultimately even destroy his Democratic majority. This argument raises two important questions. The first question is: so what? Clearly it is worth trading off this temporary Democratic majority for health care reform. The reason millions of Americans voted Democratic last fall was to pass progressive legislation such as health care reform. There is little point in having a Democratic majority if the party is afraid to use its majority to actually do anything. Inevitably the Democratic majority will be reduced and eventually the Republicans will come back in power. It would be a mistake to let this time go by without passing progressive legislation and get nothing out of this period of Democratic dominance, however long or brief it may be.

Second, this argument is at its core, a bluff. Republicans who argue that Democrats would be hurting themselves by passing a good health care bill without Republican support should not be taken all that seriously. These people generally are not in the business of warning the Democratic Party about making mistakes. These people are more concerned about what will happen to the Republicans if Democrats back Health Care reform without any support from any Republicans. Brooks and others are half right. Health care reform which is pushed through only by one party will hurt one of the parties, but the party it will hurt will be the Republicans.

If the Democrats pass this bill alone, and are able to do it with a public option, not only will the Republican Party have been proven beyond a doubt to be irrelevant in Washington today, but they will have once again put themselves on the opposing side of groundbreaking legislation. A good health care program which provides a way for millions of currently uninsured Americans to get health insurance will become popular, much like Social Security and Medicare have. Republican talk about death panels, socialism, Nazi policies and the like will quickly seem like the overheated rhetoric that it is as this new program will rapidly get integrated into the broader fabric of American politics and American life. It is immeasurably more likely that a few decades from now Americans will wonder why the US waited so long to pass this legislation, than that those same Americans will be living under some kind of socialist dictatorship, as the right wing suggests.

It should not be forgotten, even though the Republican Party would like you to forget, that the majority of Republicans opposed Social Security and Medicare as well. It is likely that a new health care program will be similarly popular and Republican opposition to it will be similarly downplayed by that party as the years go by. It might be better for America, and would certainly be better for the Republicans, if this program were passed with bipartisan support, but passing it alone won't hurt the Democrats. Failing to take advantage of this opportunity will, on the other hand, hurt both the Democratic Party and the country which it governs.