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Health Care Reform history lesson

First of all, major props to Harry Reid for pulling over Ben Nelson and getting the 60 votes to bring health care reform to a vote. Today is the second benchmark in an historic effort to get some real changes in our health care insurance, payment and delivery systems…we’re three cloture votes and one up or down vote away from having it be reality.

The furor from the right is expected and understood. What I’m a little surprised by is the depth of the furor on the left, at least in the netroots (and I’m sure it will carry into tomorrow’s talk shows, too). I’m not sure if it comes from expectations that weren’t realistic about how Washington works, or maybe being far closer to the goal than anyone ever expected they’d get.

Just for the record, let’s look at what happened in 1994. From Bill Clinton’s book, “My Life”, here are some select quotes from the part of the book where he faced Republican opposition on a bill far less sweeping than this one.

Clinton’s post-mortem:

“Those who profited from the way health care was financed were spending huge sums to convince the Congress and the people that fixing what was wrong with the health-care system would destroy what it did right.

I thought my argument was effective except for one thing: at the end of the health-care portion of the speech, I held up a pen and said I would use it to veto any bill that didn’t guarantee health insurance to all Americans. I did it because a couple of my advisors had said that people wouldn’t think I had the strength of my convictions unless I demonstrated that I wouldn’t compromise. It was an unnecessary red flag to my opponents in Congress. Politics is about compromise, and people expect Presidents to win, not posture for them. Health care reform was the hardest of all hills to climb. I couldn’t do it alone, without compromise. As it turned out, my error didn’t matter, because Bob Dole would decide to kill health care reform.”


So when you start hearing screams about sellouts and compromise, remember this:

  • Clinton had majorities in both houses
  • Clinton came in with a mandate.
  • Clinton had 59 Senate votes. Not 60.
  • His signal that he would not compromise killed the bills in committee. It was never about Hillary, or anyone else. It was Republicans vowing to kill the bill and having the 41 to do it.

The consequence of that failure was the biggest loss Democrats had since 1946 when Truman had attempted health care reform, because the base stayed home. Here are some of those consequences:

  • George W. Bush defeated incumbent Democrat Ann Richards as Texas Governor, despite Richards’ 60% approval rating.
  • Democrats lost 8 Senate seats and 54 House seats, turning both majorities to Republicans.
  • Bart Stupak won in Michigan running on a conservative platform, as did Kent Conrad.

Clinton closes his post-mortem with this:

“The electorate may be operationally progressive, but philosophically it is moderately conservative and deeply skeptical of government.”

Criticize away, but in so doing, be aware of the other constant battle that Clinton climbed:

“I had done a lot of good, but no one knew it.”

History is a powerful teacher.

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