Health Care Reform: Where Is Obama's Army?

By Harold Meyerson
Wednesday, July 8, 2009

If you measure the Obama administration's campaign for health-care reform by its ability to win crucial support from major institutions, things are going swimmingly. Wal-Mart, which insures less than half of its million American employees, has endorsed the requirement that employers either cover their workers or pay into a public fund to subsidize coverage. The hospital industry and the drug companies have agreed to scale back their Medicare and Medicaid billings to make universal coverage more affordable.

But if you measure the administration's campaign by the degree of street heat on legislators to enact a universal plan, the results look far less rosy. Though most Americans support the provision of universal coverage and a public plan, a mass movement for health-care reform doesn't exist. And the efforts of the administration and of the groups promoting universal coverage aren't likely to conjure it up.

The problem begins with the administration's inability -- or disinclination -- to use its greatest political asset, the list of 13 million supporters that the Obama presidential campaign amassed last year. In 2008, that list was the wonder of the political world, enabling Barack Obama to run the best-funded campaign in history and to activate more volunteers than any candidate ever had.

This year, however, the administration has asked far less of that list and received, not surprisingly, far less in return. Organizing for America (formerly Obama for America), which maintains that list within the confines of the Democratic National Committee, has asked those 13 million Obamaites to "create a conversation within their communities," in the words of one DNC official. Specifically, the DNC has asked them to collect health insurance horror stories and put them online, to support a set of broad health-care principles, and to go door-to-door among independent voters in their neighborhood and talk to them about those principles. On June 27, some activists participated in what the DNC termed a "day of service," working in blood banks, volunteering at health clinics, raising money for medical research.

All very commendable, and about as likely to affect the outcome of the health-care deliberations as the phases of the moon. "What made the presidential campaign so potent were clear goals and a strategy that made sense to people," says Marshall Ganz, one of liberal America's foremost organizing geniuses (who led training sessions for Obama campaign staffers and volunteers last year). Such goals and strategies are hard to discern today, and the participation of Obama volunteers has declined accordingly.

Even when the battle for health care finally comes down to a single bill, the plans to activate Obama supporters are conceptually modest. "We can't target individual members of Congress," says one DNC official. "To tell people to target certain Democrats puts the party in a weird position." Not even 13 million supporters, apparently, can instill party discipline into a political culture that scarcely knows the meaning of the term.

But what of the advocacy groups that work under none of the party's constraints -- groups the administration is counting on to play the kind of public hardball with individual lawmakers that it cannot? Already, and the Service Employees International Union have run commercials attacking some Democratic senators for pushing compromises that would undermine a universal plan. Such ploys can be helpful in the legislative back-and-forth -- no small thing. But they are no substitute for campaigns to build the one thing that would ensure enactment of such a plan -- a mass movement. They are the fruits of a legislative strategy, not a movement-building strategy.

Major progressive legislation in America is seldom enacted absent a mass movement clamoring for change. The New Deal's legislative triumphs were the product not merely of Franklin Roosevelt's political genius but of the political pressure built up by general strikes and wild-eyed campaigns for social insurance. The great civil rights legislation of the 1960s was the product not merely of Lyndon Johnson's legendary political skills but also of the blood and sweat of a generation of demonstrators in the Jim Crow South.

Obama and his lieutenants, and the leaders of progressive organizations, know this history inside and out. They might have concluded that no equivalent movement exists for universal health care. But the administration's willingness to limit the potential of its army of supporters and the progressive groups' unwillingness to try to create a movement (say, for single-payer health care) that goes beyond the administration's goals have all but ensured that legislators will feel no major pressure for systemic change as Congress crafts national policy. If Obama doesn't want to use his mega-list to pursue his mega-goal, supporters of universal coverage might ask him, as Abraham Lincoln once asked the notoriously inactive Gen. George McClellan, to borrow his army as long as he isn't using it.

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