President Obama signs the healthcare bill in the East Room of the White House, on March 23, 2010.

Don't make healthcare the scapegoat

Republicans claim that healthcare reform is the real reason for the public's anger -- and too many Democrats agree


Alyssa Battistoni
October 8, 2010 4:30PM (UTC)

Even before Barack Obama was inaugurated, the right was accusing him of overreach.

Never mind that he hadn't done anything yet -- they could just tell from the look in his eyes that he was about to embark on an arrogant campaign of unprecedented state expansion. Conservatives have spent the past two years building a narrative to fit those predictions, and now they're taking advantage of growing popular discontent with high unemployment and apprehension about the yet-to-be-implemented Affordable Care Act, arguing that the reason the unemployment rate is still so high is that Obama cares more about socializing medicine than he does about giving hardworking Americans jobs. 

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Over at the National Review, Hoover Institution fellow Victor Davis Hanson rants that instead of rushing into "socialized medicine," Obama should have "focused on jobs" and "postponed healthcare," while Sen. John Cornyn claimed on CNN's State of the Union that Americans see "the big-government American policies of the last year and a half being an impediment to job creation in America." Though it's the wonkiest of issues, healthcare reform has even been categorized by former Bush speechwriter Michael Gerson as part of a "culture war debate on the size and role of government" -- apparently failing to recognize that the size and role of government are in fact the fundamental questions of American politics.

Putting one of their core strengths to use, conservatives have pushed this idea long and hard enough that it's made it into the mainstream discourse: "Obama overreached on healthcare instead of creating jobs" is quickly becoming the narrative to explain the Democrats' anticipated midterm losses. So on "Face the Nation" last weekend, Bob Schieffer asked Democratic strategist and commentator Jamal Simmons, "Do you think, looking back on it, the president would have been better off if he had simply concentrated first on jobs and then moved to some of these other issues like healthcare?" For his part, Simmons more or less conceded the point, noting only that "hindsight is 20/20."

And some Democrats are themselves starting to talk about misplaced priorities in anticipation of major losses next month. At the Washington Ideas Forum last weekend, Jim Webb told CNN's John King, "I believe that the administration should have brought a different set of issues to the table when it first came in," faulting Obama for moving on campaign promises like healthcare (and, oddly, climate change, which he more or less abandoned) instead of focusing solely on the economy. (On the other hand, if you're talking to those further left, you'll hear a different story about how Obama didn't act boldly enough -- though arguably the extent of the left's dissatisfaction has been overexaggerated.)

As frustratingly incomplete as this narrative is, the actual state of the economy is much more damaging to Democrats' prospects. It's a well-established fact that the health of the economy is a major factor in elections: Incumbents tend to be reelected when the economy is strong, and to be booted out of office when it's weak. The link is particularly strong in the United States -- and that's exactly why passing a healthcare bill was so important.

In countries with high levels of social spending and strong safety nets, the link between economic conditions and electoral outcomes is weaker because citizens are better protected against the vagaries of the market. Unsurprisingly, when citizens know that a base level of material well-being is assured -- that they will not go hungry, or be put out on the streets, or be denied medication -- they are less anxious about economic downturns and make voting decisions based on a wider array of factors.

On the other hand, the absence of the kind of security assured by a basic level of provision creates a level of anxiety that crowds out other issues. So, paradoxically, politicians in countries with relatively low social welfare spending (like the U.S.) tend to be more vulnerable to economic shifts and therefore prioritize jobs and the economy over all else -- even though strengthening social programs would likely reduce electoral volatility in the long run.

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It's an understandable response for voters and politicians alike, but the constant obsession with economic conditions brought about by the lack of a real safety net diminishes our ability to think about the future both as individuals and as a nation. In the political short term, then, it can be argued that Obama should have focused solely on jobs in order to boost his and other Democrats' chances of reelection, but in the long term he would have been perpetuating a culture of myopia that is ultimately more detrimental to the country.

Furthermore, this recession has been particularly painful because so much of Americans' social welfare is tied to their jobs -- and when those jobs are gone, we have little in the way of public programs to sustain us. So while jobs are essential to economic recovery and the well-being of citizens, so are policies that help us get through the tough times -- and in a market-based economy, there are guaranteed to be some tough times.

The key question going forward, therefore, is not just how can we create jobs as quickly as possible, but how can we fit the unavoidable boom-and-bust of a capitalist economy into a humane society if we're politically discouraged from mitigating the pain of recession through social programs? How can we address long-term challenges that require sustained action, from climate change to infrastructure decay, if our fortunes are too tied to short-term economic fluctuations to look into the future?

That's why the healthcare-vs.-jobs narrative is so destructive -- not just because it makes Democrats look bad, or misrepresents a flawed but important piece of legislation (though it certainly does those things), but because it threatens to discourage future leaders from taking on difficult issues in hard times -- even when those difficult issues are themselves a part of the problem, as is the case with healthcare and the economy.

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We certainly haven't been tackling the tough issues when the economy is doing well -- instead, the why-fix-what-isn't-broken mentality takes over and people resist change, or seek to cut programs that seem unnecessary in the face of prosperity. Clinton cut welfare benefits in the midst of the booming '90s; Bush sought to privatize Social Security as soon the stock market had recovered from the dot-com bust. On the other hand, of course, many of our enduring social welfare programs were famously created during the Depression, when they were desperately needed.

Republicans would have us believe that President Obama picked the wrong time to push for change out of ideological fervor. But if we're not supposed to pass a deficit-reducing, cost-cutting, service-extending bill to vastly improve health insurance for millions of Americans at a time when more Americans than ever have lost coverage, when are we?


Alyssa Battistoni

Alyssa Battistoni writes about the environment and politics from Seattle.

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