Success on health reform holds risks for Democrats

By Matthew Dowd
Thursday, December 17, 2009; A33

President Obama needs an exit strategy. I am not referring to Afghanistan or Iraq (though there are quite a few similarities between the situation Obama is in on health-care reform and the political difficulties President George W. Bush faced on Iraq). Congressional Democrats and Obama are headed toward a "catastrophic success" politically if they pass health-care reform in its current legislative form. And catastrophic success was a term then-President Bush used on Iraq when he acknowledged the great initial victory but didn't take into account the long-term calamity and costs.

I am not seeking to argue the substance of health care and the merits or demerits of the bills, and will leave that to experts in policy and its effects. I am talking about the politics of the legislation and the effect it is likely to have on Obama and Democrats in Congress.

Unlike many other pundits and political experts in both parties, I think that passage of a bill by the Democrats at this point will be politically damaging to both the president and congressional Democrats. Conversely, defeat of the legislation is much more likely to hurt Republicans in Congress.

The latest Post-ABC News poll shows the president's overall approval rating at a new low of 50 percent -- about the rating President Bush had going into the November 2004 election, when Democrats said Bush was ripe for defeat.

There are many reasons for this drop in support for Obama. The stagnant economy is the biggest factor, but close behind is the fact that the administration is pushing health-reform efforts that have polarized the electorate, and that independent and swing voters have moved against in large measure.

As Wednesday's Post-ABC poll shows, a majority of Americans believe that if this bill passes, their health-care costs will rise, the federal deficit will increase, the costs of the overall health-care system will climb, and their own care would be better if the system stays as is. Democrats (including former president Bill Clinton) claim that they need this bill to pass for political reasons. But let's examine that. At present, a majority of Americans are against the effort, the legislation lacks bipartisan support, the costs of the reforms are upfront, and the benefits won't kick in until after the 2012 elections. When has that ever been a formula for political success?

If this legislation passes, Democrats will be held accountable for any failures or problems in the system. So if Americans' insurance premiums rise, they will blame the Democrats. If patients have to wait in line at emergency rooms, it will be seen as the Democrats' fault. If health-care costs don't drop, the Democrats will face the wrath of the electorate.

Many Democrats, including people in the administration, blame poor marketing for their difficulties in passing health reform. They say they haven't gotten the message out. But advocates of reform have spent millions on advertising and lobbying this year. And Obama, who many say is the best orator ever to occupy the White House, has pushed for this legislation constantly over the past six months. In that time, support for Obama's handling of health-care reform has dropped by more than a net of 30 points.

Yet before Republicans cheer that they may defeat this effort, they should beware what they wish for. A vast majority of Americans still believes that we need fundamental health-care reform. If the legislation fails, Democrats can blame Republicans by saying reform was in sight and the GOP blocked it without offering a real alternative to decrease costs and increase access.

The dominant issues today are the economy and jobs, and the public doesn't see either party making these a real priority. Further, polls show trust in government handling of domestic issues remains at historic lows. What most voters hear from Washington these days is squabbling over health reform involving a government role they don't trust and don't want.

My advice? Leaders in Washington ought to concentrate on what matters to Americans, not on what they think should matter to voters. Come up with a health-care bill that draws real bipartisan support. And before pushing a bigger role for government, begin to restore trust in the government's ability to do even small things. Democrats pushing so hard for success on health care could find themselves in a situation resembling President Bush's situation on Iraq. They could topple the statue and win the day, but lose politically over the coming months and years.

The writer, a political analyst for ABC News, was the chief strategist for George W. Bush's 2004 presidential campaign.

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