How to Get Healthcare Reform

How to Get Healthcare Reform

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The problems facing progressives in a post-Bush landscape are not problems of “what”. We know more or less what has to happen: withdrawal from Iraq, closing gitmo, universal healthcare, a cap and trade program for carbon emissions. (I could go on). And there are technical policy debates about the best policy architecture to achieve each of these, but those debates are, I think, fairly secondary at this point. Because the major intellectual and political problem to untangle, for everyone from journalists like myself charged with chronicling the capital, to activists and organizers and staff members, is how. How, in the face of tremendous entrenched interests, in the wreckage of a system that has been discredited and gutted over the last seven years, how do you get actual, positive, progressive reform actually enacted.

This is why you should read Ezra Klein’s piece in Slate about how to fix healthcare. Notice this:

On health care, the vital question for the next president isn’t merely what to do but how to do it. Reform requires much more than a willing executive, as anyone who worked in the Clinton White House between the years of 1992 and 1994 can tell you. The problem is not just policy–Washington is stuffed with wonks and idea entrepreneurs eager to explain how to fix the health care system–it’s politics. Without 60 votes in the Senate, you don’t have a policy. You have a position. And nobody is going to get good, affordable medical care from a position paper. Sadly, there’s a long history of executives coming in with a clear position paper explaining what they want to do to fix health care but no political strategy for how to achieve it. The next president need not repeat that mistake. He or she needs, first, a clear political approach–based, in part, around a solid understanding of the mistakes made by the Clintons in 1994–that’s backed up by a solid set of policy principles.

This is exactly right. There are hard policy problems out there (the current crisis in financial markets is a good example), but there are so many problems that progressives have clear solutions to if we can solve the fundamental political meta-problem.

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