Democrats must find their voice on healthcare reform


What do the Democrats do now? After chasing healthcare reform since 1935, they finally had it in their grasp until Massachusetts elected Republican Scott Brown to fill Sen. Edward M. Kennedy’s seat. Jittery Democrats promptly ran for cover; gleeful Republicans saw a shot at getting their congressional majorities back. Jettisoning healthcare after a full year -- make that after 75 years -- raises a killer question for the campaign trail: Do the Democrats stand for anything? A week after Massachusetts, they’re still pouring over strategies -- how and whether to push healthcare reform through. What Democrats need more than a strategy is a history lesson and a story line.

For the history, turn to two healthcare losers -- presidents Harry Truman and Bill Clinton. After their plans went down, the two men chose very different directions -- at precisely the fork in today’s political road.

Truman submitted his healthcare plan in 1946 to mighty cries of “socialism!” So many groups lined up to blast the proposal that Congress extended its hearings and then buried the plan. The Democrats lost their congressional majorities, and Truman went into the 1948 reelection campaign polling below 30%.


If ever there was a time to retreat on healthcare, this was it. Instead, Truman (who had been, as he put it, “a dub of a speaker”) found his voice. He passionately embraced the policies he cared about, especially national health insurance. Fifteen times a day on his long, famous whistle-stop tour he would rise and scorch the medical lobbies and their congressional pals. Truman, of course, won that election. He never came close on healthcare reform, but he kept on fighting. As a result, he left his party a legacy, an ideal to fight for.

When Medicare passed, 15 years later, President Lyndon B. Johnson announced he would fly to Missouri and sign the bill in front of Harry. Nervous aides fretted about echoes of “socialism,” but LBJ brushed them aside. There would be no Medicare without Truman, he insisted. As Johnson put his pen to the paper at the Truman Library in Independence, he looked at his predecessor and said: “Many men can make proposals, [and] many men can draft laws. . . . But few have the courage to stake reputation . . . and the effort of a lifetime upon a cause.”

Contrast the Clinton effort in 1994. That legislation got a lot further than Harry’s. And Clinton was no “dub” of a speaker -- most people have forgotten how eloquent he could be about healthcare reform. “Forty years from now, our grandchildren will find it unthinkable,” he said before a joint session of Congress, “that there was a time in this country when hardworking families lost everything . . . because their children got sick.”

Republicans privately expressed alarm that the program might reconnect the Democrats with the middle class. After considerable debate between the old guard and the young rebels, Republicans united and killed the reform (Clinton had 56 votes in the Senate and couldn’t, in the end, woo any Republicans to break the filibuster). Sen. Bob Packwood (R-Ore.) famously quipped: “We’ve killed healthcare reform. Now we’ve got to make sure our fingerprints are not on it.”

Packwood did not need to worry. The Democrats dropped the issue and walked away. In his autobiography, “My Life,” Clinton wrote only that he “felt bad for Hillary” and that he should have tried welfare reform first. What about the families that lost everything because a child got sick? Forgotten.

When Democrats abandoned the cause, the opponents controlled the historical spin. Today, everyone “knows” that the Republicans saved America from Clinton’s maladroit mess. Three months later, in the midterm elections of 1994, Republicans won their widest political victory in the 20th century, and the prospect of healthcare reform vanished along with Democratic majorities.


And here we are again. Democrats contemplate scaling back or walking away. Instead, they ought to channel their inner Trumans. Find a voice. Explain why they believe in reform. After all, why would people vote for a party without a cause?

Which brings us to the story line. The Democratic leaders have not gotten credit for running this difficult reform through the daunting congressional gantlet. It hasn’t been pretty -- Democratic leaders are talking ruefully about sausage-making -- but they played the inside game brilliantly.

But they forgot to tell their story to the people. Every big piece of legislation is a contest of ideas about what the nation needs. The Republicans told their story with exquisite skill. “Death panels,” socialism and “government takeover” were all colorful ways to opt for private markets over government policy.

What is remarkable -- given the eloquent man in the White House -- is that Democrats were too busy dealing to come up with a counter story. They forgot the fundamental rule about public opinion: It is unformed. The public has hopes and fears. But who understands healthcare? The politicians’ job is to explain how this program speaks to those hopes and fears. Not just once, in a complicated speech, but every day and in ways that connect.

Programs do not make great presidents -- just ask Johnson, who passed a ton of them. Stories make great presidents. The Franklin Roosevelts and Ronald Reagans reshape public perceptions -- about policies, about government, about America’s purpose in the world.

Barack Obama has the gift. Yet, for the past year, the front pages scarcely touched his vision for the nation. Instead, the news was about the wheeling and dealing, the arm-twisting and compromising.


There’s an unsavory image that threatens to go down as the ultimate symbol of this Democratic moment in power: Sens. Joe Lieberman and Ben Nelson brazenly negotiating healthcare -- not in the backrooms but in the limelight. And negotiating over what? Pique and pork.

Parties prosper when they connect their passions and their principles to their policies. Remembering that could save healthcare reform -- and the Democratic majorities in the House and Senate. Forgetting it makes the majorities irrelevant, even if they manage to hang on to them.

James A. Morone is chair of political science at Brown University and the author, with David Blumenthal, of “The Heart of Power: Health and Politics in the Oval Office.”