With the political prognosis for health care reform turning from poor to likely terminal, many of my fellow Democrats are grieving through grievance. They're lashing out at friends and foes alike, blaming everyone from Sarah Palin to the nutty Nazi lady from Barney Frank's town hall to President Obama for sabotaging the best opportunity in a generation to realize the liberal dream of universal health care. Everyone, that is, except themselves, the people who controlled Congress, set the agenda, wrote the legislation and developed the strategy for pushing it.
Consider it a case of admittance avoidance. Our party and the liberal activists who drive it can't stomach the fact that we are blowing this debate. So they have manufactured a convenient, simplistic narrative of villains and victims, where right-wing extremists and special interests are conspiring to stop progress through a cynical fear-mongering misinformation campaign. To hear them tell it, the Democrats' main mistake has been not fighting back hard and soon enough against the exaggerations and fabrications (which, no doubt, have been manifold and damaging).
But much as the Republicans have gamed the issue, the reality is that the first and worst deception was the Democrats' own. Step back for a second, listen to what the non-screaming skeptics are saying, and it's clear the party severely overestimated its mandate and underestimated the public's growing unease with the government's massive growth over the last year. What would have been a hard sell in any environment has turned into an epic challenge. Yet the Democrats have been charging ahead as if it's still November 2008, oblivious to the dramatic change in the electorate's mood.
Of course, you could argue that Democrats misread the public's appetite for a big-government solution on health care last fall as well. The left assumed that change on health care meant a public insurance plan. But most other Obama voters had (and likely still have) no idea what the term "public option" meant. If they were voting for him on health care at all, it was simply for lower costs and better care. They may have been open to that component of Obama's plan, as polls earlier this year showed. But to say that a vote for Obama was a vote for a public option is as much a canard as Palin's phony claims about death panels.
The fact is, last fall's election was largely a referendum and a rejection of the way Washington was being governed--mostly by President Bush, but by Congress as well. Independents and moderates swung away from the Republicans because they lost faith in their leadership. Last fall, a Gallup Poll found that only 26% of the American people said they were satisfied with the way the nation was being governed, tying a 1973 reading as the lowest in the poll's history.
Even more significant were the government confidence findings. Just 42% of Americans said they have a great deal or fair amount of trust in the executive branch, the lowest since a 40% reading in April 1974. Trust in the legislative branch was only slightly better, with 47% of respondents saying they have a great deal or fair amount of trust in Congress. This marked a new low--the first time trust in the legislative branch has dropped below 50% in the 15 measurements Gallup has taken since 1972.
Obama managed to convince the middle that he would govern differently--with more competence and less partisanship. He also won support for a more activist agenda, particularly on the economy--after the market meltdown and confidence crisis last fall--and on health care too. But there is no question that the last eight years had dramatically eroded the public's confidence in government itself (call it Bush's revenge). Whatever Obama's personal popularity, he could not count on his charisma to overcome the public's built-in skepticism of big government programs and intervention.
That was the political context when Obama became president-elect--long before he chose to make health care reform the linchpin of his first term. Then came (not necessarily in this order): two rounds of TARP, the bailouts of
In the best-case scenario, the cumulative toll of all this spending and intervening would test most voters' tolerance for another major government expansion on health care. But for many already anxious Americans, it has rapidly resuscitated their skepticism about government and its competence in managing one-sixth of the economy. The fact that so much of what has come out of Congress is every bit as partisan and one-sided as the last eight years is only compounding those doubts--particularly for swing voters.
Indeed, the number of independents who say they trust Obama to make the right decisions for the country has dropped 20 percentage points since the early days of the president's tenure, according to a ABC News/Washington Post poll released last week. They still like him personally but see little difference in the way Washington is being governed in terms of competence and civility. To many independents, including many Obama voters, the main change has been to go from one extreme to the other.
In this charged climate, the president and congressional Democrats should have known that there was a real risk of government overload if they pushed a big sweeping health care bill with a public option as a centerpiece and a $1 trillion price tag. The safest move would have been to lose the public option from the beginning. But if the Democrats were going to make their case for it, their only hope was to rally behind one plan, show in concrete and credible terms that it was fully paid for and then spend months educating the public about the benefits of a public option and why it is essential to achieving the president's top goal of reducing costs.
Instead, the Democrats did the exact opposite. The president chose not to lead with his own plan, and Congress filled the vacuum with a multitude of partisan bills. This only heightened the public's confusion and wariness. The Democrats went back and forth for weeks on how to pay for their bills and then settled on Medicare cuts as the prime cost-saver, fueling doubts about whether it would be deficit neutral as the president promised. Worst of all, the House bills, which have been the locus of public attention, were found by CBO to actually raise costs instead of lowering them. That undermined the president's credibility and the public's confidence in Congress' competence.
The result? The public has become so skeptical that, according to Pew Research Center Director Andrew Kohut, it's questionable whether Medicare could pass in this environment. Back in 1965, a Gallup poll showed 63% supported the idea of compulsory health insurance for the elderly paid for by higher Social Security taxes. But Kohut noted that public's confidence in government to run a major new health program is much lower today. A CBS News/New York Times poll showed that 69% of Americans are concerned that the quality of their health care will worsen if the government provides health care for everyone.
If Democrats are going get out of this hole and pass a meaningful health care bill, Kohut argues, they are going to have to address this broad distrust of government, which is becoming more acute among independents and even some Democrats.
A good place to start, I would argue, is to stop attacking the public you are trying to woo. Yes, some town hall protesters have been disruptive and disrespectful. But throwing around loaded terms like "un-American," as House Speaker Nancy Pelosi recently did in a USA Today op-ed, only serves to exacerbate partisan divisions and widen the trust gap.
And please stop pointing fingers at the Republicans. Yes, they are being opportunists and obstructionists. But they will continue to get away with it as long as they make arguments that resonate with mid-section of the electorate. Want to put them in their place? Put out a bill--one bill--that the majority of the American people can get behind. Remember, they voted last fall for change--not blame.
Dan Gerstein, a political communications consultant and commentator based in New York, is the founder and president of Gotham Ghostwriters. He formerly served as communications director to Sen. Joe Lieberman, I-Conn., and as a senior adviser on his vice presidential and presidential campaigns. He writes a weekly column for Forbes.