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A funny thing happened in Ida Grove, Iowa, last Saturday. Funny and a bit sad. Steve King missed his son’s wedding. The weather was perfect. The traffic was light. Steve really loves his son, Mick, and has no problem with his new wife, Stephanie. He wanted to be there and could have been, but instead he was in Washington voting against a healthcare reform Bill in the House of Representatives. Despite his vote, the Bill passed.
What was Mr King thinking? Did he miss the most important day in his son’s life because he believes the Democrats are wrong to try to extend health insurance cover to the 46 million who lack it, or because he thinks they are going about it the wrong way? He did not. As a fellow Republican with more in the way of name recognition said yesterday: “This is not about healthcare. This is about power and political control.”
That Republican was Dick Armey, an icon of the anti-Clinton movement of the early 1990s and a hate figure for the Left, but also a keen student of US social history. He knows full well that America’s employer-based health insurance system exists largely by accident. It started as a 50 cents-a-month scheme for teachers, offered in the 1920s by a Dallas hospital looking for ways to keep its wards full.
It grew as a result of bureaucratic accident and business opportunism — not legislation, let alone constitutional amendment — and for decades it offered superb care at reasonable prices. It doesn’t any more. It denies cover to many and doles out too much care to many more at prices employers and taxpayers can no longer afford. Few serious politicians in either main party deny that large parts of it are failing.
The central issue for Congress is not whether healthcare needs fixing or even how. It’s by whom.
Deep down, Barack Obama believes it’s his turn. He ran for President promising change, and won. “Change” could mean anything to anyone. That was its chief merit as a slogan. But this Administration believes in its soul that the many meanings of the word should include a willingness to expand the role of the State itself if nothing else works. On economic management that meant taking controlling stakes in banks and car giants to stop them failing. On healthcare, it means proving that the Federal Government can move into running a nationwide low-cost insurance programme, and not screw it up.
My father-in-law believes a screw-up is inevitable. For his generation of Eisenhower Republicans it is axiomatic that anything the private sector can do, the public sector can do only worse. Dick Armey and the army of Tea Party activists that he informally leads go much farther. They call the slightest expansion of the State a step towards Marxism. They say so politely, seriously, despairingly, on battle buses and in town halls across the country, and it is a great mistake to doubt their sincerity.
Never mind that the most progressive healthcare reforms debated on Capitol Hill since Mr Obama entered the White House are still so private sector-dependent that in Britain no right-wing Tory could advocate them without risking his seat. Never mind that the most state-phobic conservatives are also among the most enthusiastic supporters of a gigantic and reasonably effective government-run machine at the heart of American society, foreign policy and economic life — the US military. There is a new insurgency in US politics that believes the Democrats’ pursuit of a public healthcare option is politically, constitutionally, fundamentally unAmerican.
The insurgents also smell blood. As Mr Armey said, this is about power and political control. Mr Obama has staked his presidency on showing that he can win reforms that eluded Mr Clinton in 1994 and generations before that. He has majorities in both houses. Even the legal tussle for a disputed Minnesota Senate seat went the Democrats’ way, adding a self-important comedian to their caucus in the upper house and giving them, in principle, a filibuster-proof majority. Yet the President seems unable to use it.
His first deadline for a healthcare Bill to reach the Oval Office sailed by in August. Christmas is the next, unofficial, deadline. That looks likely to be missed as well. Each day of delay on healthcare is a day of delay on everything else the White House wants Congress to do, starting with once-in-a-century financial regulatory reform and the climate change legislation that has become a test for how the rest of the world judges this Administration’s break with the last one. Even Afghanistan is waiting. One reason for Mr Obama’s interminable delay over requests for more troops is his fear of splitting the liberal base on which robust healthcare reforms depend.
In truth “robust” already sounds ambitious. The Tea Party insurgency has blunted the health crusade from the Right. Democratic infighting over tax-funded abortions may do the same from the Left. Slippage deep into next year is entirely possible. So is complete failure, and if Mr Obama fails on healthcare what remains of the bubble of hope he created in his 2008 campaign will deflate faster than a blood pressure cuff in an overpriced private hospital. He will be, at best, a Clinton facsimile; at worst another Carter, undone by his own naivety and shorn of his unused majorities in next year’s mid-terms.
It is a prospect that sets Steve King’s pulse racing. That is why he came to Washington on Saturday instead of watching Mick wed Stephanie. It is also why Mr Clinton told a Democratic power lunch on Tuesday to stop bickering over details and get healthcare done. A Bill — any Bill — would silence the President’s critics and kick-start the rest of his agenda, he said. “The worst thing is to do nothing.”
Power drains from those too afraid to use it. It is draining now from the White House to a handful of senators who could make or break Mr Obama’s healthcare reforms, and thus his presidency. One is Joseph Lieberman, widely accused of being in hock to the health insurance industry that dominates his home state of Connecticut. I don’t think so. He’s our new neighbour; a modest chap who happens to hold the fate of a nation in his hands. It’s time for the President to take it back.