Saturday, August 29, 2009



It looks as though, despite the death of Ted Kennedy, the most ardent champion of a single payer health system, or something very much like it, and despite talk of a Democratic “go it alone” strategy, we will see no significant changes to our nation’s health care system during this Congress, or for a long time afterward. This outcome was eminently predictable months ago, or even during the presidential campaign, when “health care” was such a hot topic. Why? It has nothing to do with the noisy town hall meetings. It has little to do with the growing Bush/Obama deficits. It certainly has nothing to do with the specifics of the various pieces of legislation or the Democratic leadership’s, both in the White House and on Capitol Hill, political ineptitude. No, major changes (reform, to some) of the health care system, a fervent goal of the left, is nowhere in sight for the same reason that educational vouchers, a fervent goal of the right, are nowhere in sight: the constituency that counts, the suburban, home owning, middle class voter, is happy with both its access to health care and the schools to which it sends its kids.

How can I say that the suburban, home owning, middle class is the constituency that counts? First, it votes. Second, within that broad set of people reside two vital and, paradoxically, intersecting sub-constituencies. The first of those is the swing voter, mostly moderately conservative but who would certainly entertain the notion of voting for a level headed Democrat, often because that voter’s roots, or his or her parents’ roots, are in the city and in the Democratic Party, but not the Democratic Party of Nancy Pelosi and Charlie Rangel, or the notion of voting against an incompetent, or seriously troubling, Republican, like George Bush, Sarah Palin, or Alan Keyes. The second sub-constituency is the bedrock Republican voter; indeed, the suburban, home owning, middle class voter is the very foundation of the Republican Party. These voters are not the foundation of the Republican Party because they are the ideological bedrock of the Republican Party; they are not the “true believers” (Though if my conversations with my neighbors are any indication, this is changing as more people have taken up Rush Limbaugh and Glenn Beck as pastimes.) because they don’t buy into any extreme ideology and/or they are too busy making a living to spend too much time agonizing over the finer points of domestic or foreign policy. So it is not ideology that makes these people the bedrock GOP constituency and it is not even their (admittedly fading) instincts that government is not the answer to their problems and their now completely obsolete belief that the GOP stands for smaller government. No, these people are the very foundation of the GOP because, without these voters, the GOP ceases to exist as anything more than a bothersome anachronism. The GOP’s existential need for these folks once made the Republicans receptive and attentive to the concerns of this constituency, long before they abandoned these middle class suburbanites and became the meretricious lapdogs of its Wall Street and defense contracting bankrollers. This abandonment of the suburban middle class homeowner in favor the seven and eight figure CEO and investment banker is the reason that the GOP is probably going the way of the Whigs, but that is grist for another post.

So the suburban, middle class, home owning voter is the only constituency that really counts because it votes and because it is the swing vote, and if it continues to swing away from its former home in the GOP as that party comes to be controlled by the Sarah Palins and the Bush acolytes of the world, the GOP is finished. If the GOP can keep these voters in the fold, it still has a chance. Given that both parties need this constituency, and that this most vital of constituencies is happy with its health care situation, major revisions to the health care system in this country are going nowhere. Likewise, though not as salient at the moment, since the typical suburban homeowner is happy with his or her kids’ schools, vouchers have been off the table for a long, long time and are highly unlikely to make a comeback.

The Democrats had a chance to make this constituency restive about its health care options (See my now seminal 2/15/09 piece, “SICKOS.”) back when the economy was falling apart. (But the guys in Washington and Wall Street have turned that situation around, right? Happy days are here again! Grist for yet another post...or twenty.) But, instead of exposing the typical worker’s vulnerability under our perverse system in which one’s health insurance is tied to one’s type of employment, the Democrats decided to subsidize COBRA payments. While that was probably the right thing to do from a humanitarian standpoint, from a purely Machiavellian political standpoint, they blew their brief, shining moment of a chance to achieve one of their long cherished, and now distant to the point of invisibility, goals: radically changing the system of health insurance in this country. The Democrats instead opted to keep the suburban, home-owning, middle class voter happy, probably because the Democrats are smart enough to see that they need these voters…and maybe smart enough to see that the Republicans need them far more.

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