Last night, at dinner, Dave Weigel and I were talking about the momentum of the first 48 hours. Impressive stuff, we agreed. The conversations, as it often does when I'm in it, turned to health reform. "That's harder," I said. "Why?" asked Weigel. "How can Democrats not succeed at health reform? They've got 59 seats. There are no Dixiecrats. Obama is wildly popular. Republicans are confused and scared." I probably mumbled something about health reform being tricky. And it is. But maybe Weigel is right. It's often said that the history of health reform is a history of legislative failure. But it's not all the same type of legislative failure. FDR never tried. Truman proposed health reform after he became deeply unpopular and voters had given him a Republican Congress. An unpopular Nixon proposed a health reform plan that Democrats ignored because they figured they could get something better after they retook the White House. So too with Carter, whose effort was scotched by Kennedy on the left. But we have short memories. And so it is Clinton's failure that looms largest. Clinton, who proposed health care with a Democratic House and a Democratic Senate. But much went into Clinton's failure. Clinton was not a strong president from the outset. He won a plurality of the vote and faced a Republican Congress that rightly sensed a public drifting in their direction. Bob Dole, the Republican Senate leader, was planning a presidential run and Patrick Moynihan, the Democratic chairman of the Senate Finance Committee, was an ineffective intellectual who loathed the Administration and didn't want to do health reform at all. The Clinton health policy process was unschooled in the ways of Washington and the policy proposal it produced wove the unfamiliar and untested twins of managed competition and managed care into a bill that scared the public and irritated the Congress. Which is all to say that it's good to remember the past, but you can remember it too well. Barack Obama also has a Democratic House and Senate, but he has more seats, and a more united party. The Dixiecrats were felled in 1994. His coalition extends no further right than Ben Nelson, and 2010 looks like a rather safe year for Democratic senators. Obama won a strong majority and has considerable political momentum. Republicans are weak and disunited and the Democratic chairman of the Senate Finance Committee wants desperately to pass health reform and secure his legacy. There is something approaching rough consensus of what a reform bill should look like and Obama has assembled an impressive team to help help guide the legislative process. And that doesn't even get into the rise of the progressive media, the Obama administration's capacity for grassroots mobilization, the depth of the recession, the unity of the progressive advocacy groups, or the deterioration in the American health care system. Most people, myself included, expect the sort of uphill battle faced in 1994. But what if Dave Weigel is right? What if health reform is likely rather than unlikely? What does that imply for strategy and ambition?
