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Pirate Smile Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-18-09 02:09 AM
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The Historical Argument Against "Killing the Bill"
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Edited on Fri Dec-18-09 02:12 AM by Pirate Smile
The Historical Argument Against "Killing the Bill"
December 17, 2009, 3:03PM

The debate over whether or not to kill our current attempt at HCR and "start-over" is taking place with no where near enough historical context in my opinion. What is the history of other major progressive causes in this country? Was massive reform achieved pretty much in one swoop (in this case, we'd get everyone covered, prevent people from losing coverage or being denied coverage for being sick, and dramatically lower costs) or did it take several efforts to make changes this big?

I'm going to start with the ending of slavery, which of course we all know was begun by the Emancipation proclamation, not a vote of congress. Of course, given that we don't live in a dictatorship it was followed up by the 13th amendment two years later (only possible to pass because the South was excluded from participating). During parts of those two years, you know who was still in slavery? Blacks in Kentucky, Missouri, Maryland, and Delaware (Missouri and Maryland didn't require the 13th amendment to end slavery, they abolished slavery on their own prior in the two intervening years). Do you know that any slave state ending it's rebellion before January 1, 1863 would have been able to (temporarily) keep slavery? Talk about doing something half-heartedly, Lincoln didn't have to worry about the South at all since they had left the country and still didn't just free all of the slaves (not to mention that he waited until 1863, two years into his term to do so).

We can of course continue to follow the story of the Civil Rights movement. After years and years of institutionalized racism and segregation, Congress finally passed its first piece of Civil Rights legislation since Reconstruction in 1957. Unfortunately, LBJ knowingly (as everyone knows at that time the hammer in the Senate) sent the bill to a hostile committee where it was torn apart and it ultimately didn't really prove effective in its goal of securing the right to vote for African-Americans (but it did pass...does this sound familiar?) It was a start, and did establish the Commission on Civil Rights and lead to the creation of the Civil Rights Division in the Department of Justice. So we had to go back three years later and the Civil Rights Act of 1960 surely fixed everything. Except of course that it didn't, although it did expand the authority of federal judges to protect voting rights and required local authorities to maintain accurate records. And of course segregation itself was still legal (can you imagine that the first and second Civil Rights Acts didn't outlaw segregation? That's akin to extending coverage to everyone in America without really forcing down costs), so we had to pass the Civil Rights Act of 1964 to outlaw that, and since voting rights still weren't properly secured, we needed the Voting Rights Act of 1965. And of course we still experience sporadic problems to this day, even with the appropriate systems in make this stuff illegal. Now we all know about the Northern-Southern split on this issue, so it perhaps isn't helpful to count up Ds vs. Rs, but we'll do this for all of these things so for consistency: 1957 Senate: 49D, 47R, House: 234D 201R; 1960 Senate: 64D, 34R, House: 283D, 151R; 1964 Senate: 67D, 33R, House: 258D, 176R. (source for seat breakdowns: ).

How about women's rights, was this achieved in one fell swoop once the Federal government stepped in? Again we all know that the national women's suffrage amendment was passed in 1919, did you know it was first introduced in 1878 and that 16 states had given this right in the interim? Of course women waited until 1963 to get Equal Pay protection and 1964 for protection against discrimination on the basis of sex (part of the Civil Rights Act). This hasn't been perfect either, as we recently had to pass the Lilly Ledbetter act to improve the statue of limitations part of Equal Pay. And women still earn less than men for the same work.

Now let's go to everyone's current favorite two examples of real, great, Progressive (with a capital P!) change: FDR and the New Deal and LBJ and the Great Soceity. Starting with the New Deal, in terms of what we're interested in, which is creating the social safety net, the big one is Social Security (as everyone knows, FDR looked at, and rejected pursuing, universal health care). Social Security was passed in 1935, at the height of the New Deal, and as everyone knows, is a mechanism for providing funds for the retired elderly by taxing current workers, as well as unemployment insurance. Of course that isn't the whole story, as the act was incredibly discriminatory. Exclusions exempted nearly half the working population, mostly women and minorities. The NAACP called it "a sieve with holes just big enough for the majority of Negroes to fall through." Also, the wonderful act wasn't instituted right away, 1937 was the first year taxes were collected and benefits paid out. Guess how many times Social Security was amended since it's inception (excluding Medicare, which is technically part of Social Security)? Ten times (1939, 1950, 1954 (at this point most job categories are covered), 1956, 1961, 1962, 1972, 1977, and 1983). There's a great website for looking at the vote totals for Social Security and Medicare: . For 1935, we have a makeup of: Senate: 69D, 25R 1other; House: 319D, 102R, 11other. The final tally among Democrats was 284 Yes, 15 No, 20 no vote (can you imagine this happening today, someone just not voting?), in the Senate: 60 Yes, 1 No, 8 no vote. Republicans voted 81 Yes, 15 No, 4 no vote, 2 present in the House and 16 Yes, 5 No, and 4 no vote in the Senate. So in 1935 we had a discriminatory government program that supposedly provided a social safety net but in reality excluded around half of the population that was so flawed it needed 10 amendments and still requires more tinkering in the future due to fiscal issues.

So the Great Society and Medicare: health insurance for the elderly retired, and Medicaid: health insurance for the poor. First of all, state participation in medicaid (which, by the way, is a part-state, part-federal program...ooops numbers one) is voluntary (oops number two). Arizona didn't join until 1982, the last state to do so. Children who did not have coverage were not a part of this (oops number three), remedied in 1997 with the creation of SCHIP. As an aside, did you know that SCHIP was killed the first time it came up in 1995, per the AP at the behest of the Clinton administration because of the balanced budget agreement the White House had with Congress? This is another area that was recently expanded by President Obama, so perhaps not the ideal level of coverage upon implementation. So not too bad on Medicare and Medicaid, they for the most part achieved their stated goals and add-ons later were not as much about fixing the underlying program as expanding it. Here we finally have an example of something that tackled the problem it was supposed to solve in a reasonably complete way. Of course what this was not was universal health care, it was merely a step in that direction. What did Congress look like? Senate: 68D, 32R; House: 293D, 140D. Democrats in the House voted 237 Yes, 48 No, 8 no vote, and in the Senate 57 Yes, 7 No, 4 no vote. Republicans didn't vote with the majority like they did with Social Security: 70 Yes, 68 No, 2 no vote in the House and 13 Yes, 17 No, 2 no vote in the Senate.

How do I think all of this applies to today? First, the only place you might be able to argue that "incrementalism" wasn't the rule was Medicare and Medicaid, but those were both part of Social Security, passed thirty years previously and neither provided universal coverage (they also annoyingly leave a lot up to the states). The other uncomfortable truth to face is that though the current majorities for the Democrats are very nice, they do not measure up to the strangeholds held in Congress in 1935 and 1965--and that in both cases significant numbers of Democrats in both houses voted no. The final important difference is the attitude of the Republican party, which amazingly largely played along in 1935 and 1965: neither bill was filibustered at a time when the filibuster was harder to overcome and many voted for the final bill. All of this means that while LBJ could lose 11 votes in the Senate and 56 in the House and still pass Medicaire and Medicaid (our "best" case) comfortably, in our current case losing 39 Democrats in the House meant passage by 5 votes with the help of 1 Republican, and in the cluster-*** that is the Senate, basically losing any Democrats (and no, I'm not counting Joe Lieberman as a Democrat) means losing the bill.

Maybe the solution then is found in killing this thing now and waiting until we get to a more FDR/LBJ era-esque majority? With a nod to Kevin Drum at Mother Jones, let's take a look at the timeline of major HCR iniatives since FDR in 1935: 1948 (Truman), 1974 (Nixon), 1994 (Clinton), 2009 (Obama). Notice something about the enourmous gaps of time?

So "killing the bill" is not a recipe to getting to a better place, not in the history of this country. This bill is the beginning (or rather, a continuation of what was begun in 1935). Killing it now only means that you have to start at the beginning again at some point in the future (and as history also shows, you don't get to "redo" major reform efforts anytime soon after failure--anyone who thinks that we can simply kill this bill and start over immediately back in committee with thoughts of reconcilliation (ahem, Howard Dean) in an election year is living in a fantasy land). We've waited 15 years since the last attempt was killed in the cradle, how does 2024 sound to everyone?

Will this bill substainally lower my health care costs? I don't think so, I'm in the fortunate position of not meeting any subsidy levels. In fact, I wouldn't be surprised if this bill slightly raised my personal costs. But I thought only worrying about ourselves was the specialty of the Republicans. I believe this bill will help the poor with their health care costs and I believe it will help those who get sick keep their coverage or those who are sick get coverage (all of you healthy kill the billers out there better hope you don't get sick if you get your way...). I believe this bill is the foundation we can start to build on: now we've covered nearly everyone, let's work on opening up the exchanges and offering real, non-profit (probably government) options in conjunction with real efforts to rein in provider costs. The history of the progressive movement in this country is constant struggle. If this bill passes no one should take the attitude that we've checked health care off the list (this would have been true if the incredibly weak public option of the House's bill or the small medicare expansion of the Lieberman-killed Senate compromise had won the day). Political realities being what they are, the next good window is going to probably be in 2013--we've got three and a half years of work to do.

edit to add a little more history:

The political cost of failure

Failure does not bring with it a better chance for future success. It brings a trimming of future ambitions.

Truman sought single payer. His failure led to Kennedy and Johnson, who confined their ambitions to poor families and the elderly. Then came Nixon, whose reform plan was entirely based around private insurers and government regulation. He was followed by Carter, who favored an incremental, and private, approach, and Clinton, who again sought to reform the system by putting private insurers into a market that would be structured and regulated by the government. His failure birthed Obama's much less ambitious proposal,
which attempts to reform not the health-care system, but the small group and nongroup portions of the health-care system by putting a small minority of private insurance plans into a market that's structured and regulated by the government, and closed off to most Americans.

Failure does not breed success. Obama's defeat will not mean that more ambitious reforms have "a better chance of trying again." It will mean that less ambitious reformers have a better chance of trying next time.
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