Obama on Health Care: Pragmatism Over Principle

Obama on Health Care: Pragmatism Over Principle

Six months into the Obama Administration, a clear pattern of legislative pragmatism has emerged: focus on winning the big votes and don’t fret too much about losing some of the details.

Working at a furious pace, Obama’s team has racked up by almost any measure one of the most successful early records in modern memory, especially if you focus on big scoreboard numbers and not the detailed stats. But each of his team’s major accomplishments — from the stimulus to the House energy bill to the health-care-reform proposals now making their way through Congress — has been just as notable for what Obama has agreed to give up during the negotiation process.

In the last week of July, news leaked out of Capitol Hill that the President’s proposal for a so-called public option on health care was unlikely to make it into the Senate Finance Committee bill. As recently as June, Obama had told a gathering of doctors in Chicago that there “needs to be a public option” in the health-care-reform bill, to help control insurance costs. But White House spokesman Robert Gibbs has declined this week to say whether Obama is still fighting for a public health plan over the alternate proposal for a “co-op,” which would attempt to insert competition into the marketplace by promoting the formation of nonprofit health entities made up of individuals or small businesses. “We’re influencing the process forward,” he said on Tuesday when asked if the White House opposed the co-op alternative. “We’re hopeful that they’ll make progress.”

Obama himself, meanwhile, has expanded his own definition of public option to include the nonprofit model, which is not publicly run in the classic sense. In an interview Tuesday, July 28, with TIME, he said that what mattered was how the program would work, not how involved the government would be. “Obviously sort of the legal structure of it is less important than practically how can it operate,” the President said. Many Democratic leaders have expressed fear that the co-op idea would have only a marginal impact on controlling private-insurance-company costs.

The White House strategic approach on energy legislation has also involved significant compromises that Obama has glossed over. Last month, Obama greeted the passage of a House energy bill with great fanfare, calling it a “bold and necessary” step and a “victory of the future over the past.” He did not mention that the price of getting enough Democrats on board with the legislation was significant compromises of his previous pledges. During the campaign, Obama had proposed auctioning off carbon permits and using that money for other green programs. But the final bill in the House gave 85% of those allowances away to industry. It also dramatically reduced the requirements Obama had originally sought for how much of the nation’s electricity needed to be renewable — from 25% in 2025 to 15% by 2020, a concession to the coal industry.

The White House set this pattern of legislative compromise and public celebration early on. During the debate over the stimulus bill, which passed just weeks after Obama took office, the President and his advisers deferred significantly to Congress to both shape and size the bill. In the end, the legislation was trimmed to $787 billion, with about $70 billion going to a temporary fix of the Alternative Minimum Tax, an annual adjustment with little stimulative impact.

At the time, the President did not call for a larger bill, despite warnings from a wide range of economists that more funding would be needed, given the precipitous deterioration of the economy. Now, however, there is a growing sense in the White House that more stimulus is indeed necessary, even though the political environment for further action has soured. “Given what we know now about how sick the economy, it turns out, was getting, probably bigger might have been better,” a senior White House official admits. “It was always an issue, of course, of what could you get through Congress.”

The most striking aspect of Obama’s approach is not that the President has been forced to compromise on Capitol Hill. Such wheeling and dealing happens all the time, even when the majority in Congress shares a party affiliation with the White House. It is rather that the President has, with rare exception, declined to highlight these compromises or take hard-line stands, even as he continues to declare in speeches and statements his determination to force through sweeping change in the way Washington operates. Despite Republican suspicion of Obama’s ideological bent, he has proven to govern as a pragmatist, willing to do what it takes to get the votes he needs.

It is a strategy with both personal and political roots, say advisers. On the one hand, the President, a former community organizer, is intellectually predisposed to focusing on common ground with his adversaries, not the differences. On the other hand, he is betting that the American people will measure success by counting the big wins, not by worrying over the detailed principles and proposals that were sacrificed along the way.

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