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Popular Dissent “From the Left” On Health Reform

Nate Silver has a post up at 538.com that is sure to get a lot of attention. Looking closely at an IPSOS/McClatchey poll that asks supporters and opponents of health care reform their underlying concerns, Nate notices that about one-fourth of those opposing current proposals think they “don’t go far enough to reform health care,” and suggests there’s a little-discussed segment of the electorate that might either grow if reform is further compromised, and/or might eventually come around if and when legislation is on the president’s desk.

This is an argument that Jonathan Chait made a couple of weeks ago at TNR, based on earlier polling.

Both articles are important refutations of the common assumption of conservatives that there is monolithic majority opposition to health care reform, and also a monolithic majority of Americans happy with the status quo in health care.

Beyond that, of course, this argument will be catnip to those progressives who are searching for ways to convince the White House and the congressional Democratic leadership to abandon or greatly toughen its endless negotiations with Senate “centrists” and the odd Republican, particularly over the public option. A majority of Americans, they will argue, either likes the current bill or wants something with more and more generous coverage, and a stronger public option. This is, of course, a subset of the ancient debate among Democrats between the strategy of seeking a majority coalition by peeling off “centrist” independents, or by solidifying and energizing the presumably liberal party “base” (along with “populist” independents).

There are, however, two problems with excessive reliance on the “progressive majority” analysis on health care reform. The first is that the polling numbers are based on some pretty vague ideas about what would constitute “doing more” on the health care front; it’s not entirely clear “more” means “more” of what progressive opinion-leaders want. And the second problem, more to the immediate point, is that in a Senate with a sixty-vote threshold for enactment of major legislation, a handful of Democratic and Republican senators, who represent not the nation as a whole but their own states, have the whip hand on the details of health care reform. I don’t think many progressives would want to abandon health care reform if a durable majority did, in fact, favor the status quo; this is a complex issue that’s not exactly good material for a plebiscite.

The more useful observation about the existence of a “dissent from the left” on health reform involves the wrath that Republicans (and obstructionist Democrats) may well inherit if nothing happens this year, and health care premiums, along with insurance industry abuses, continue to get steadily worse. We will then be talking not about a constantly shifting and poorly understood thing called “Obamacare,” but about one party that sees a major national challenge and wants to do something about it, and another that’s fine with an increasingly untenable status quo.

The diversity of opinion among those unhappy with the present legislation is, to be clear, an excellent argument for increasing the frequency and volume of claims that said legislation really will accomplish a great deal, if not everything it should or could achieve. All the news that’s been made about compromises on health reform over the last few months, along with reform advocates’ efforts to reassure seniors and others that they won’t lose anything worth caring about, have undoubtedly “undersold” the extent of change that even a “weakened” bill would make happen. A reform effort that’s marketed as a tepid bowl of porridge won’t satisfy much of anybody.


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