Start with your ideal instead of negotiating with yourself
The biggest health care mistake was starting with what supporters hoped was an acceptable final compromise instead of something ideal. That's why single-payer was never considered and some amorphous "public option" got offered instead. That's fine if you're willing to walk away with nothing if your offer is refused, but if you're not willing to take nothing, then you've allowed your opponent to force you to take something much less than what you think necessary. If you're already at your compromise position, an uncompromising opponent can make it look like you're as unwilling to compromise. The frustrating part of course is the Democratic grassroots knew the Republicans would not compromise and this was a terrible negotiating position, but DC Democrats seem unable to figure out their opponents. Either make them drag you from a strong position, or be ready to walk away when the first offer is refused.
Don't alienate and confuse your base
If you want, consider this the second part of the first lesson, because it comes from the same mistake. Even if most Democrats weren't ready for single-payer, the Democrats who make up the base, meaning the ones willing to pound pavement and make phone calls, were strongly for single-payer. By cutting it right at the start, the Democrats in the DC Beltway Bubble alienated the core of their party. They then made it worse by frequently changing their commitment to a public option. So the base not only had enthusiasm dampened by not getting even a try at what they wanted, they didn't know what they were being asked to campaign for. There was a time I said "no" to a canvass because I didn't know what I was asking other people to support, and I strongly suspect I was not alone.
It's hard to negotiate with someone opposed to change
Maybe this is the third part of the first lesson, but that's how big the mistake was. It's just basic human behavior that when negotiating with someone happy with the status quo, you're counting on them being willing to find a way to make things better for you too. If you're not dealing with someone who values your satisfaction, you better find some leverage. Unfortunately, modern conservatives believe compromise is for the weak. They'd rather suffer disaster than have a solution that gives any credit to liberals. The surest way to get some sort of public option was to have the threat of a single-payer system if they didn't work out a compromise. Just as conservatives can live with the current medical system, they can live with the lack of financial regulation and greenhouse gas regulation, so starting with a reasonable compromise on either is pointless.
Conservadems will pull things to the right
The right wing of congressional Democrats seem to think they need to take whatever liberals want to do and pull it some distance to the right. Maybe it's their own psychology or their fear of conservatives in their districts, but they seem to want to be able to claim they moderated whatever liberals tried to do. So just like they've been more hindrance than help in health care, they'll water down financial reform and greenhouse gas reduction, whatever the first bills look like.
Framing is a necessity, not a sin
One of the public option's problems was the general public didn't understand it, so it was easier for the fearmonger caucus to do its work. Even politically involved liberals, late in the game, were confused between the public option and insurance exchange. Though Republicans get framing instinctively, thus "death panels", it's hard to get Democrats beyond wonkiness. A Republican would have known at the start "public option" was a problem. Only right before the House voted did any representatives start saying "Medicare for Everyone", and even then only some, and they didn't keep it up long. People understand Medicare. Even the conservatives who want government to stay out of Medicare at least know they like it, and I even had conversations with conservatives opposed to reform who were OK with offering Medicare to everyone. Just using the phrase "Medicare for Everyone", with the same meaning as "public option", would have made a huge difference. And unlike typical Republican framing, it would have been a way to make the truth clearer instead of hiding it.
It must be explained to the general public at the beginning
In what may be another lesson growing from the same few critical mistakes, besides not framing the issue, reform was never properly explained to the public before the president gave his speech in September, when indeed support did rise, but only a bit. Opinions were mostly set. There seemed to be an assumption the public was following the policy debates and the press would explain policy, when in fact the press focused as always on the fight instead of what the fight was about. Most of the public doesn't have much time for following news closely, so the daily reports came without context. A public which knows something big is going on but not what is vulnerable to demagogues. The press takes its cue from the government, especially the executive.
Divide and conquer
I might be the only person who approves of the deal the administration struck with the pharmaceutical lobby, but so be it. It was a smart move. Instead of doing all it could to defeat reform, PhRMA ran some commercials for reform. They worked at cross-purposes with the insurance lobby. Look at how hard this fight has been just against AHIP. If PhRMA's resources were also deployed against reform, the odds would be even worse. Moreover, I have to believe that when the time comes to address pharmaceutical prices, AHIP will remember how PhRMA helped the enemy when insurance was being reformed, and will be in no mood to defend high drug prices. Considering the many special interests involved in both finance and energy, there are all sorts of opportunities to divide them against each other.
Stand up to intimidation
Conservatives achieved their goal of creating shock when they shouted down congressmen at their town halls and made forums feel like truly dangerous situations. This was also what got our side to finally rely on the Democratic grassroots and also get to the forums, and Democrats successfully made the behavior of conservatives the central issue. Combined with Obama's speech in September and the reaction to "You lie", conservative behavior might have backfired, and was at best a wash. We stood up to the bullies instead of trying to make them happy, and we were rewarded.
Use your opponents' mistakes
Democrats made hay out of Republicans' biggest mistake, their deliberate bad behavior. However, we (not just in DC, but the blogosphere too) mostly missed a chance to frame the horserace coverage when Republicans declared that victory means no bill at all passes, and the passage of any reform at all is defeat, which was incredibly arrogant given the odds something will pass. Sen. Jim DeMint boasted health care reform will be Obama's Waterloo. They know one thing many of us can't figure out: perceptions matter, and they succeeded in appearing strong and uncompromising, which was what they wanted. Why Democrats at all levels aren't mentioning these Republican pronouncements at every opportunity is beyond me. If Obama and Democrats are perceived by the press --- and thereby the public --- to be winners, they'll be perceived as effective. This can only be good in terms of public support for future initiatives, not to mention the ballot box, since voters want elected officials who they think can get things done.
Use your base
Democrats in DC seem to have planned to rely on inside baseball, deal cutting, and parliamentary maneuvers. Republicans seem to have realized the only way to make their strategy of saying no to everything was to get the base angry and active. I'll be unsurprised if the tea party movement does turn into something effective. Democrats didn't make much effort to activate the base until congressmen were getting scared at town hall meetings, and let's hope the more skittish congressmen learned something by the ability of their own base to counter the Republicans not just at town halls, but in turning out the letters and phone calls: and that was with the discouraged base I referred to above. The base needs to get involved in financial reform and global warming as soon as we can turn our energies from health care. Congress, and maybe even Obama, need to learn not just that they can be threatened from the left when they screw around, but the base wants to help. We're the "we" in "Yes We Can!" We want to be on the same side as our elected officials, not figuring out how to counter them.
We know Republicans will pick parts of bills to attack
You might have thought "death panels" and free insurance for illegal aliens were the whole of the health care bills, and that's how they've fought every fight this year. They don't offer alternatives nor even talk in depth about the Democratic bills, but pick bits to misrepresent and attack. They went after EFCA by attacking card check. They attacked ARRA (the stimulus) by picking a few projects to misrepresent, like the capitol mall landscaping and a Las Vegas to Disneyworld railroad. They have already targeted cap and trade (even though it was their idea) as the place to knock down the global warming bills. Financial lobbyists are gunning for the Consumer Financial Products Commission (CFPC). There is no excuse for being caught by surprise anymore.
On a positive note
I'm going to give an attaboy to the DFLers in the state legislature. They seem to understand the base and framing and negotiating better than their national counterparts. They've had surprising success in passing tax increases which could have happened only with getting the public behind them, and won special elections timed to reduce the DFL candidate's chances. Though Pawlenty has remained popular, his party has suffered terribly at the ballot box, illustrating the DFL has done decently at framing the issues and making use of Pawlenty's mistakes. The only real mistake was trusting Pawlenty to keep his word so he could surprise them with unallotment, but unallotment is a big topic in its own right, so I'll leave it there.
I'll just finish off by explaining what I meant when I said I see the same mistakes being made. The goal for greenhouse gas reduction is being set to 17% by 2020, which the rest of the world finds unimpressive. It was probably a realistic compromise, but again, it's being offered at the beginning. Democrats are compromising with themselves before the blue dogs even start on it. By contrast, Sen. Barbara Boxer, chair of the Environment and Public Works committee, showed the right approach when Republicans tried to block her committee's climate change bill with a parliamentary maneuver. The rules require two members of each party to mark up a bill, and the Republicans made sure only one of them was ever present. Instead of begging, she passed the bill as it was. If only Max Baucus will do the same in Finance.
In financial reform, the CFPC has already been watered down to exclude some industries and products. We should know by now that companies with multiple businesses will declare themselves to be primarily whatever isn't regulated. They'll be right back to picking their regulators again. In both cases, grassroots liberals certainly know that compromises have to made and they won't get exactly what they want, but to start the process at the minimum acceptable compromise risks the same things happening, where conservatives just obstruct, blue dogs just weaken it, the base gets discouraged because the final bills do little, and the election results in 2010 --- well, sorry to end on a sour note. |
