Party Power

Hillary wouldn't have pushed for health care? Don't believe it

Via Kevin Drum, Bruce Bartlett has an essay at today that comes to a peculiar conclusion (emphasis added):

I think the evidence suggests that Hillary Clinton could have won the Democratic nomination with just a little bit more support, and probably would be governing significantly more conservatively than Obama. For one thing, given her disastrous experience with health care reform in 1993-1994, it’s reasonable to assume that she would have stayed away from that issue at all costs.

Accepting that point, Bartlett says, conservatives should have identified Clinton as their “second-best alternative,” and shifted their support to her once it became clear that a Democratic win in the general election was likely. Their failure to do so, he says, “gave us Obama, and much more liberal policies”

Bartlett’s claims about Clinton’s relative conservatism aren’t limited to health care. But his assertion that she wouldn’t have pushed forward on that issue in particular is off base for a number of reasons. The first, as Drum points out, is that it rests on a view of her as uniquely “principle-less [and] endlessly calculating” that is basically a conservative myth. There’s not really any reason to think that she, personally, would not have been just as committed to reform as Obama—or, for that matter, any number of other politicians.

But there’s another factor here, one that’s unrelated to assessing anyone’s moral character. During the 2008 primary, the Democratic Party was strikingly united on policy issues, and one of the issues that united the party was the need to push for health care reform. The candidates produced lengthy plans to demonstrate their commitment to the issue, and the details became the subject of some fairly substantial debate—for awhile, whether or not an “individual mandate” was necessary was actually a running topic. (Clinton’s plan had one; Obama’s—at the time—didn’t.) Having thus promised a broad coalition of supporters that health care would be a top priority—and enjoying, after the election, large congressional majorities with which to press the issue—they couldn’t very well have backed down, even if they wanted to.

This is a point that Jonathan Bernstein, a blogger and political scientist, has been making for awhile. Here’s a recent example, from March 26:

First, as I’ve argued, thinking of health care reform as a choice for Obama and the Democrats gets it wrong. Obama was able to win the nomination only by promising to make health care reform a priority. He, and virtually every Democratic candidate for Congress, campaigned on health care reform. Presidents don’t take office, and Members of Congress don’t take office, with blank slates; they take office constrained, and often severely constrained, by the promises they’ve made while running. If Obama had abandoned health care reform, he would have broken promises and lost the support of his election coalition. Presidents can do that sort of thing, but it imposes high costs.

Following up on that last line—yes, Clinton (or another Democratic president) could have abandoned her commitment to push forward with health care. But in the process she’d have ripped apart her coalition, doing far more damage to her ability to govern than Republican opposition could have inflicted. (Think of the persistent criticism Obama faced from parts of his base for not pushing harder, or in a more liberal direction, on this issue and multiply it by about a thousand.) So even if she were, as Charles Krauthammer put it in a column cited by Bartlett, inclined to follow the “self-interested, ambition-serving, politically expedient” path, that wouldn’t be it.

This is not to say that there are no meaningful differences between politicians within the respective parties, and in an environment in which the parties were not so united, those differences would loom larger. And it’s not that every policy promise is equally constraining. But there’s a good reason that, in 2008, Republican voters didn’t go looking for “second-best” alternatives among the Democratic candidates—on the big domestic issues, there wasn’t going to be much space between them.

Update: Bernstein weighs in with more thoughts in this vein: “Guesses about their true policy preferences (or lack thereof) is speculative too, but in my opinion basically irrelevant. Obama, Clinton, Edwards, Bill Richardson or Joe Biden, no candidate was going to win the 2008 nomination without making health care reform a top priority and acting accordingly in 2009.”

Greg Marx is an associate editor at CJR. Follow him on Twitter @gregamarx.