The widespread and vehement public opposition to the Obama administration’s health care reform proposals can be explained in two ways.
- It was a tactical defeat in which the Obama administration’s mistaken approach to politics failed to win over public support.
- It was an impossible task because most Americans were always going to oppose the plan no matter what.
We’re more accustomed to tactical explanations for political setbacks. It’s a failure of execution or persuasion, according to these explanations. The Wall Street Journal’s explanation of Obama’s “wrong turns” follows this line of thinking.
According to the tactical explanation, Clinton era attempts at health care reform stumbled because they pitted the administration against the health care industry. Obama reportedly responded to this by winning over the health care industry, and expected that Republicans and conservative groups would come along too. This turned out to have been a mistake. Republican and conservative opposition grew as the debate continued.
Both the explanations for the failure of the Clinton era reform attempt and the troubles with the Obama era reforms share a similar core assumption. Both assume that Americans would have embraced health care reform if only something hadn’t gotten in the way. Last time it was lobbying and scare tactics by the industry. This time it is “astro turf” townhall protesters and death-panel fearmongering.
At its heart, this is the Machiavellian view of the world. It views people as open to political manipulation, and therefore makes the struggle one of manipulation and counter-manipulation. This doesn’t imply that manipulation is evil or destructive. But it implies that if the good guys want to win, they’d better get good at influencing people.
The alternative explanation is that Americans just don’t want healthcare reform. Most Americans are happy with their health insurance and wary of dramatic overhaul. They fear the plan would be costly, especially to the middle classes. Most of the benefits go to the uninsured, which are only a tiny fraction of the country. People may just be willing to have some people go without insurance.
This view can actually be described as Aristotelian. Aristotle doubted that rhetoric and public debate had much of an effect of political outcomes. Instead, he thought the actions of a regime were mostly the outcome of the structure of its political leadership–democracy or oligarchy, for instance–and the character of the people.
The Obama administration is planning an all-out push for the reforms in the coming weeks, hoping the popular president will be able to win over public support. It will be an interesting test of whether the tactical or Aristotelian analysis is correct.
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