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Why Obama's Health Plan Falters

By Jeff Cohen
August 2, 2009

Editor’s Note: It has been a common misperception of the American Left that “organizing” or “mobilizing” is the magic wand for achieving major political changes in the United States, with almost no recognition of the importance of building media that can highlight problems and explain policies to the public.

Indeed, effective media has been a key part in every transformative phase of American history, from Tom Paine’s Revolutionary War pamphlets to Abolitionist newspapers to the “underground press” of the Vietnam era. But today’s Left mostly ignores this reality.

The lack of media on the Left – especially when the Right has built such a powerful media machine – narrows what is politically viable and causes nervous politicians to equivocate and finesse.

So instead of a fight for “single payer,” today’s battleground is over a “public option” and the Left’s primary media to make that case comes in spam-like e-mails. From there, the compromising begins, as Jeff Cohen notes in this guest essay:

I’ve started deleting them as spam.  

I’m not talking about the enlarge-your-penis emails or “You’ve Won the Lottery” notices.   

I’m talking about the increasingly-urgent e-mails coming for weeks from liberal Netroots groups calling for a “public option” for healthcare – a government insurance plan citizens could choose to PAY FOR instead of private insurance. 

Never has so much passion been so misdirected.  If what these liberal groups ultimately wanted out of President Obama and corporate-funded Democrats in Congress was a topnotch public plan to compete with the first-rate private plans, the wrong way to get it was to make that THE demand.

Especially of a President whose instinct is toward conciliation and splitting the difference with big business and the rightwing.

Sure, Obama was a community organizer once.  That was decades ago when Russia was still our mortal enemy, Nelson Mandela was still an official State Department terrorist threat and the White House was still funding Islamist fanatics in Afghanistan.   

For the last dozen years Obama has been a politician – and a consummate compromiser at that.  Have we failed to notice?

Activists must recognize the surest way to get a strong public option that could compete with the Cadillac of health plans. We needed to mobilize millions of Netroots people, almost every union and 150 members of Congress to endorse a maximum demand:

National health insurance . . . enhanced Medicare for All.  In other words, a cost-effective single-payer system of publicly-financed, privately-delivered healthcare that ends private health insurance (and its waste, bureaucracy, ads, sales commissions, lavish executive salaries, profiteering).

Had liberal groups sent out millions of emails building a movement that posed an existential threat to the health insurance industry, Sen. Baucus and Blue Dog Democrats and their corporate healthcare patrons might well be on their knees begging for a comprehensive public option – to avert the threat of full-blown Medicare for All.   

As things stand now, as writers like Bob Kuttner and Norman Solomon have warned, a weak public option would institutionalize a two-tiered system with healthier, wealthier citizens getting the best (private) plans, and sicker, harder-to-treat people getting an inferior (public) plan.

Newt Gingrich couldn’t dream up a better scenario to discredit an enhanced government role in healthcare.  

To win serous reforms, we need activist leaders who are tough-minded progressives making maximum demands for reforms that truly address our nation’s problems. Leave the inside-the-Beltway deal-making to the politicians, properly frightened and moved by the roar of mass movements.

We need activist leaders who have a clearer idea of who Obama is. He’s not one of us.  He’s one of them – a politician bent on placating corporate interests.

We knew all we needed to know about his current worldview from all the corporatists he put in top jobs.

And from the fact that he felt the need – six weeks into his administration, after the middle-class bailed out Wall Street – to call up the New York Times and assure the world that his policies were NOT socialist but were “entirely consistent with free market principles.”

At a time the corporate greedsters and free-market ideologues had been exposed as having threatened the economic well-being of the world, they weren’t the ones on the defensive. They weren’t doing the apologizing. Obama was on the defensive; he was apologizing to them!

When Democratic leaders start borrowing rightwing rhetoric, we know our activism has not been strong or progressive enough.
At the AARP townhall Tuesday, Obama described a public option as “controversial, I understand people are worried about that.” He went on to assure his audience that “nobody is talking about . . . government-run healthcare” or “a Canadian-style plan.”

At one point, he further assured seniors that no “bureaucratic law in Washington” would interfere in their healthcare decisions – seeming to adopt the faux-populism of anti-government rightists. Yet he seems incapable of anti-corporate populism, even with despised industries like Wall Street and health insurance.

I have huge respect for the smart young activists who built up the Netroots, unleashing all sorts of progressive possibilities for our country. But I’m bothered by their often ineffectual, Beltway-originated, halfway demands.

I became active during the Vietnam War.  We might still have troops in Vietnam if – instead of militantly demanding “All Troops Home Now” – we’d organized behind polite Beltway initiatives like: “Let’s begin negotiations” or “Let’s set a timeline for phased withdrawal.”

I fear that Netroots leaders are doing the same dance with Obama today that they did with Nancy Pelosi and Harry Reid in 2007-08.

Instead of demanding that Democrats in Congress bring our troops home from Iraq by using the power of the purse to defund the war, Netroots leaders rallied behind weak, non-binding timelines and other halfway measures cooked up with Congressional leaders.

Without a loud, clear demand for “troops home” from the large online antiwar forces, Democratic leaders started retreating and succumbing to Republican rhetoric. Reid proclaimed: “We will never abandon our troops in a time of war.” Pelosi declared: “We will have legislation to fund the troops!"  

And the corpses kept piling up.   

Great social reforms have occurred in our country not when social movements took their lead from what the White House deemed possible, but when the White House was pushed by powerful movements demanding reforms bolder than what the president was comfortable with.

Leading abolitionists pushed Lincoln toward ending slavery by demanding immediate abolition. Socialist and workers movements in the ’30s sufficiently scared elites so that FDR could pass New Deal reforms far short of socialism. Martin Luther King and civil rights activists continuously pushed and prodded JFK and later LBJ.

And these movements didn’t have the Internet.

In 1993, a National Health Insurance bill gained 100 co-sponsors in the Democrat-led House, plus endorsements from many unions, even Consumers Union.
There was unfortunately no Internet then when the Clinton White House undermined this growing movement by pushing an incredibly complex plan that left big insurers dominating the system. Clinton’s plan inspired few and confused many.

After it went down in flames, talk radio host Jim Hightower asked President Clinton why he didn’t back an easily-explained Medicare for All approach that had so much support in Congress. Clinton said he’d thought it was politically too difficult but now wondered about that judgment. 

Here we are 16 years later. Neglected by Netroots groups, John Conyers today has 85 House co-sponsors for HR 676, the Expanded Medicare for All Act, as well as the endorsement of many unions and Obama’s longtime personal physician.

If all those emails I’ve received lately had been about building the HR 676 movement and a public system instead of a “public option,” the bill would have many more co-sponsors and could be pressuring Democrats to stand tough today. 

For Obama to feel secure about reform and standing up to the right, he needs to feel that he’s in the center pushed by noisy forces to his left. He’s admitted as much. The way to help him succeed is to mobilize seriously to his left. 

The way to help Obama fail is for Netroots and liberal groups to collapse toward him from the get-go.

And if Obama does fail, we can quit laughing at a Republican Party in disarray due to Bush, religious extremism, hypocrisy and anti-intellectualism.

Because in this period of  crisis and fear, unless a progressively-prodded White House delivers reforms that actually improve lives soon, rightwing reaction could rebound more dangerous than ever in 2010 and/or 2012. 

Jeff Cohen is an associate professor of journalism at Ithaca College, founder of the media watch group FAIR, and former board member of Progressive Democrats of America.  

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