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Frankly Wrong About Health Care Reform


I greatly enjoyed Jason Zengerle’s interview with Barney Frank, but I’m puzzled that Frank continues to take the Rahm Emanuel line on health care reform:

When Obama made the same mistake Clinton made. When you try to extend health care to people who don’t have it, people who have it and are on the whole satisfied with it get nervous.

You think Obama overinterpreted his mandate with health care?
The problem with health care is this: Health care is enormously important to people. When you tell them that you’re going to extend health care to people who don’t now have it, they don’t see how you can do that without hurting them. So I think he underestimated, as did Clinton, the sensitivity of people to what they see as an effort to make them share the health care with poor people.

I think we paid a terrible price for health care. I would not have pushed it as hard. As a matter of fact, after Scott Brown won, I suggested going back. I would have started with financial reform but certainly not health care.

And if you’d done it with that sequencing, you could have still gotten health care before 2012?
I’m not sure, but I think you could have gotten some pieces of it. And yeah, if we’d held the House, we could have gotten it.

1)The assumption that the Democrats may have held the House had they not pursued the ACA is extremely implausible. It may explain why they did even worse than could have been expected, but there was essentially no chance of holding the House in that context.  Moreover, presumably the same political logic would apply after the imaginary successful 2010 midterms, only worse because it’s a presidential election year.

2)This is — uncharacteristically — essentially an argument against most progressive change. Anything that challenges privilege and disrupts the status quo carries risk and disrupts people’s sensitivities.

3)If not then, when? Comprehensive health care reform has failed repeatedly. Political conditions as favorable as 2009-10 are pretty rare. Essentially, Frank is arguing that the Democrats should just abandon serious health care reform, which I think is very wrong.

4)Even if the assumptions discussed in point 1 is true, at some point, so what? The point of majorities is to do things. Maybe the Democrats would have held the South longer had they not passed the CRA, but (and I stress that I’m not comparing it to the ACA in terms of impact) that’s no reason not to do it.

5)The only way this argument works is if leaving health care for the next generation would have allowed for a similarly important goal to be addressed.   But it’s hard to see how this could be true.   The most obvious candidate — climate change — got no traction at all, which puts the burden of proof on those who think that different sequencing would have led to major climate change legislation.   And it’s hard to see how it would have made sense to dump health care to focus on it.   Given the uniform Republican opposition, it’s a substantially less promising political arena than even health care — the benefits more diffuse and long-term, the powerful opposition broader and harder to buy off.    I would estimate the chances of passing major climate change legislation at roughly zero no matter how much Obama prioritized it.   I also very much doubt that a significantly stronger financial reform bill could have been passed, and even if it could it would be much easier to reform and evade than a major new entitlement.

I admire Frank, but I think he’s pushing risk-aversion too far here. Whatever other mistakes Obama made on healthc are he was right to keep pushing even after the Brown election.

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