Progressives, Lobbyists, and Health Care Reform

With the CBO numbers out on the proposed Bill, the whip counts are coming fast and furious as Democrat leaders race the clock to line up the requisite support for what will be a Sunday vote. Over at Fire Dog Lake, David Dayen is doing the yeoman’s work of putting the numbers together and providing updates of where things stand, minus a Stupak agreement, which as David notes, would make the whole exercise largely moot.

Health care reform has become a really interesting divining rod for the left , drawing out what I continue to think are some truly important distinctions between different “Democrats” if one can believably lump the entire cast of characters into one group. Nowhere is this more true than among so-called “progressives”.

On Wednesday, Ben Smith suggested that the “Rahm Emanuel” approach to health care reform — ignore the demands of progressives on the ground that they will fall into line at the end no matter — was vindicated based on recent polling (h/t: Greg Sargent).

Reaction around the progress-o-sphere has been mixed and interesting. Not surprisingly, Jane Hamsher agrees with Smith’s assessment,

Nobody will take progressives in congress seriously, nor should they. Their threats are idle and they won’t fight for anything they believe in. In the end, they’ll just take turns shaking their fists in futility and alternately sucking so no serious liberal challenge ever emerges to anything.

Glenn Greeenwald doesn’t begrudge progressives like Markos Moulitsas, Paul Krugman, and Chris Bowers, who initially opposed the Bill and have now come around to it, but thinks that Hamsher and Smith are essentially correct,

What’s not debatable is that this process highlighted — and worsened — the virtually complete powerlessness of the Left and progressives generally in Washington.  If you were in Washington negotiating a bill, would you take seriously the threats of progressive House members in the future that they will withhold support for a Party-endorsed bill if their demands for improvements are not met?  Of course not.  No rational person would.

At the Daily Kos, mcjoan lays out a smart, albeit fairly standard progressive explanation for coming around to the Bill,

I’d argue that it’s bad politically and for future policy efforts for progressives to lose sight of the fact that we had some pretty big losses in this one. Who lost? Labor, though the excise tax is better, it’s still there. Single payer or public option advocates, obviously. Women. Hyde will be law now, and the fight taken beyond public funding to private insurance. Latinos. Undocumented workers can’t spend their own money on insurance. And in the offing we went from 48 million uninsured to 31 million uninsured because we won’t count the brown people. Despite the fact that from a systemic public health perspective, getting them care will still cost money because hospitals and emergency rooms will still be legally obligated to provide that care–as they should be.

In other words, the job isn’t done with this bill. Is this a step forward? Yes, to the extent that now Congress sees it can do something about health reform. Should it be passed? Yes. Absolutely. Millions of people will now have access to coverage, and to care, that they do not have under the status quo. That’s a societal good.

There is some merit to the “something is better than nothing” arguments that various liberals have made in regards to the Bill, to be sure. I remain pretty skeptical about the “pass and patch” methodology that has become a walking stick for wounded reform advocates.

Watching how much time, effort, energy, and political capital has been expended just to get to where we currently are leaves me feeling like any patches are well beyond the political horizon in our sight line. And when I say that, I’m talking in terms of a decade plus. That’s speculation, but then, look at the length of time with which we’ve been dealing around near universal reform. And who knows what happens between now and then. I think liberals, progressive or otherwise, need to start reconciling themselves to the idea that the reform they have now is the reform with which they’re going to live for a good long while as soon as possible.

That’s a not insignificant reconciliation because I think that the shortcomings a lot of progressives are pointing to and frustrated with over the Bill are a.) real and b.) substantial (i.e. not merely cosmetic or peripheral). In terms of the reason d’etre of this blog, those shortcomings are part and parcel of the debilitating weaknesses of the party’s relationship to the lobby class and will take a Herculean amount of effort and courage to overcome in the even remote future.

This is precisely why I believe that progressives should support this version of health care reform and not based upon — or, at least, not entirely based upon — some kind of promised land projection into the future where the real battles will be fought and won.

Counter intuitive as that might sound, I think that a loss for the Bill and the Democrats pushing the Bill winds up being a real win for the lobbyists and their inner circles within the Party. Big pharma and the insurance lobby and the rest have gone along with this pared down version of reform only insofar as it hurts them in a minor, rather than a major way. Their support was bought off almost from the get go. But the status quo works even better for them, that’s an obvious point.

Also obvious is that despite the bright division lines drawn between different intra-party factions via the debate, a failure to pass some measure of health care reform is going to be a stunning loss for Democrats and will, despite all the hemming and hawing over the electoral impact of passing the reform, utterly and completely demoralize almost all corners of its base. In that situation, the folks who come out ahead and likely have an opportunity  seize even more control over the party are precisely those who are already in bed with the lobby class.

It’s an infuriating catch-22. If the Bill passes, the lobbyists and their ringwraiths win. If the Bill fails, the lobbyists and their ringwraiths win.

But in the second scenario, the vast majority of the party base also loses and has the last of its passion and enthusiasm sucked out of it, allowing a perfect storm for the movers and shakers to further game the system. If the Bill passes, well there is certainly a reasonable sum of  benefit to be realized by those same people, but there are still a modicum of players on the field, as it were.

I’m assuming here, of course, that you can separate the majority of the Democratic base and those who are in league to game the system in favour of monied interests — which I think you can.

Problems with this particular piece of legislation aside, the larger concerns and issues of progressives like Jane Hamsher and her ilk are best served to be addressed by the maintenance of an at least somewhat engaged and impassioned base. There is no way of ensuring that is the case if the Bill fails.

Ultimately, I think that mcjoan is right to bear in mind that progressives have lost here, that strikes me as a fait de complit. So they are left playing the long game. That long game may or may not involve a successful pass and patch plan, but it most definitely involves maintaining the base that Obama’s candidacy generated and, thereby, at least a minimal degree of party integrity as a means of pushing forward on important issues that fall outside the hash lines of health care reform.

And like it or not, the long game is inherently tied to the health care reform on the table.