Obama’s gamble on healthcare

President Barack Obama has called on Democrats in Congress to push ahead with healthcare reform through reconciliation – a procedure that evades the Senate’s filibuster rule, so that passing the combined House-Senate measure will require only a simple majority in the upper house. The move is a gamble. On the whole it is justified, but Mr Obama is at fault for letting things come to this.

Pressing on involves three great risks. The first is that, following Mr Obama’s announcement that Democrats will do the job alone, the party might fail to secure the needed simple majorities. This is entirely possible. Passage is assured in neither house. If the measure now fails, the Democrats will have only themselves to blame. They will have shown they are incapable of governing.

The second risk is that the country will regard the reconciliation manoeuvre as illegitimate. Republicans have used it in the past, so their complaints on this score reek of hypocrisy. On the other hand, this is an unusually far-reaching initiative, and voters may feel that the administration is cheating.

Greatly compounding that second danger is the third: the Democrats’ plan is still not much liked. It is one thing to pass tax cuts with reconciliation, as the previous administration did. Using the procedure to ram a radical policy down an unwilling electorate’s throat is quite another – especially with mid-term elections just months away.

Supposing that Democrats in the House and Senate can rouse themselves to pass the measure, everything will depend on the campaign Mr Obama now promises to wage in its support. To say he has left this late is putting it mildly. For more than a year he stood aside and let his party’s leaders in Congress make the running. Their protracted and wholly inward-looking machinations disgusted much of the country and confused the rest. Up to now, nobody has even tried to tell voters why this particular blueprint for reform makes sense.

What makes this even harder to forgive is that the Democrats’ proposal, though flawed, is in fact a great step forward. It would move the US much closer to universal health insurance, and take tentative but potentially important steps towards better control of costs. Each of these goals is crucial. Neither should be postponed any longer.

Mr Obama has a good case to make. If he had started making it earlier,the odds of success in this venture would be higher, and his presidency would not be in peril.