August 2, 2009 10:56 pm

Obama’s challenge to sell healthcare reform

One quip doing the rounds in Washington is that last year’s elections and their aftermath show that “Republicans can’t get elected and Democrats can’t govern”. In fact, this is too fair to Republicans. One of the reasons Republicans lost so badly in 2008 was because of their appalling record in the previous eight years.

But the quip is not necessarily unfair to Democrats. In contrast to Republicans, who become more homogenous and therefore more disciplined with each electoral cycle, Democrats remain a diverse coalition of often clashing interests. Nowhere is this better illustrated than in the painful battle to push through healthcare reform.

Barack Obama may have believed that a thumping presidential victory, which also strengthened his party’s grip on both houses of Congress, would make sweeping healthcare reform achievable in his first year. He may yet pull it off. But one of the reasons his party now controls both chambers is because it has been so willing to forgo ideological litmus tests to recruit candidates who can actually win in conservative districts.

Many of these newcomers – from 2006, when the Democrats regained control of the House for the first time since 1994, and from 2008, when Democrats extended their majority – are now chafing at the kinds of changes the White House wants to include in healthcare reform.

Rahm Emanuel, Mr Obama’s pugilistic chief of staff, knows this better than anyone. As head of the House Democratic election campaign in 2006, Mr Emanuel oversaw the recruitment of many of the “Democrats” who are now giving him such trouble. Put bluntly, this group included conservatives with a small c.

Many of the centrist new Democratic intake are looking at the poll numbers, which show steadily eroding public support for healthcare reform during the past few weeks, and wondering whether it is worth risking their jobs over it in next year’s mid-term congressional elections.

Shifting those numbers is the single most important thing Mr Obama can do in the next few weeks before Congress returns for what promises to be a fetid session after Labor Day.

It will not be easy to do. Indeed, Mr Obama has already been doing his best for weeks. The last time he tried in late July he gave almost an hour of prime time television to healthcare, which at the last minute was drowned out by his throwaway remark about the police acting “stupidly” in its arrest of his friend Henry Louis Gates.

Mr Obama has since drawn a line under that episode by having Prof Gates and the sergeant in question, James Crowley, over for beer and pretzels on the White House lawn. But the poll numbers on healthcare continue to get worse. So do the forces arrayed against it.

According to the Centre for Responsive Politics, a watchdog, the health industry, led by the pharmaceutical companies, which stand to lose most from reform, outspent every other sector in Washington with $133m in lobbying spending in the second quarter. These include campaign donations to many of the 50 most vulnerable Democrats (in the House Democrats have a majority of 77).

Opponents of “socialised medicine” – a misnomer, but one that is starting to stick – have a big war chest to step up that pressure with publicity events in vulnerable Democratic districts during the next few weeks.

They also have simplicity in their favour. At more than 1,000 pages, the detailed compromise hammered out by conservative and liberal Democrats before the House went into recess last Friday is hard to boil down into a simple bumper sticker. In contrast, detractors can simply label it a big tax hike, or a license to expand government bureaucracy, or socialised medicine and leave it at that.

Polls show Americans are confused about healthcare reform. As an illustration of this, an implausible number of politicians are claiming to have heard an elderly woman at a town hall meeting attack government medicine and conclude: “Keep your hands off my Medicare!” Medicare is the existing government programme for retirees.

Whether apocryphal or not, the story is believable. Before Congress returns, Mr Obama will need to have created a simple and compelling story in favour of healthcare reform. It is a hard thing to do. But essential.

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