You are using an outdated browser.
Please upgrade your browser
and improve your visit to our site.
Skip Navigation

Democrats, Health Care Reform, And The Center

Last week, my former editor Peter Beinart had an article in the Daily Beast arguing that the passage of health care reform would forever change the Democratic Party. Peter argued that the party has long been run by centrist strategists who believe that, in the fact of a presumably skeptical public, Democrats must hew close to the center and make it their highest priority to avoid provoking public ire. Their opponents, first organizing around Howard Dean's 2004 candidacy, countered that Democrats had more to risk by appearing wishy-washy, and could attract voters by displaying principle.

I think Peter oversimplifies the debate here in a lot of ways. Still, there's something to it. I think it's worth thinking through what we've learned from the health care triumph. I think it has altered Democratic thinking about political strategy, but hasn't completely overturned it.

The Clintonite political strategy was a hyper-vigilant application of what political scientists call "median voter theory." In a nutshell, the theory holds that the most powerful force in politics at any given moment is the voter in the center of the political spectrum. The party that hews closest to the center wins the allegiance of that median voter and wins the election. The Clintonite approach was to ruthlessly purge the party of any positions that alienated the center. Democrats would embrace capital punishment, welfare reform, middle-class tax cuts, and anything else they needed to do in order to avoid being stuck holding an unpopular position.

I would analogize this theory to the most simplistic, neoclassical economic theories, which envision an efficient economic system in which every individual maximizes his own utility. In the broad sense, the theory works pretty well. But there's enough friction, lack of information, and other problems that the system rarely works perfectly. And there are some rare occasions where it completely breaks down.

Mitch McConnell has frankly explained one of the ways his own strategy has exploited some of the weaknesses of the median voter strategy. Voters don't follow the details of legislation closely. They base their opinions on broad heuristics, the most important being the presence or lack thereof of bipartisan support. McConnell explained this to the New York Times:

“It was absolutely critical that everybody be together because if the proponents of the bill were able to say it was bipartisan, it tended to convey to the public that this is O.K., they must have figured it out,” Mr. McConnell said about the health legislation in an interview, suggesting that even minimal Republican support could sway the public.

He has made the same case to National Journal:

Then as the year unfolded -- whether it became the stimulus, the budget, Guantanamo, health care -- what I tried to do and what John [Boehner] did very skillfully, as well, was to unify our members in opposition to it. Had we not done that, I don't think the public would have been as appalled as they became over the fact that the government was now running banks, insurance companies, car companies, taking over the student-loan business, which they're going to try to do in this health care bill, and taking over one-sixth of the economy.
Public opinion can change, but it is affected by what elected officials do. Our reaction to what they were doing had a lot to do with how the public felt about it. Republican unity in the House and Senate has been the major contributing factor to shifting American public opinion.

McConnell's argument is persuasive. One corollary of that argument is that Democrats were also correct to believe that they can shape public opinion. Republicans tried to spook Democrats into letting health care reform die, stating over and over that Americans oppose it. That's true right now (by very slight margins), but Democrats, too, can shape public opinion through their actions. Letting reform die would create an atmosphere in which their idea was seen as a failure, and the whole party tainted by it. By passing the bill, they could unify their base behind it, and put Republicans into the position of proposing a change to the status quo, and having to explain the numerous popular reforms they would undo. David Axelrod laid out the rationale:

Axelrod said that the GOP would have to explain why insurance companies should once again be able to discriminate against customers on the basis of pre-existing conditions, for example.

"Let's have that fight," he said. "Make my day."

This is the dynamic that Clinton-era political strategists have failed to understand. The central problem of Democratic strategy has been a static and over-literal reading of public opinion. This came through in John Kerry's losing presidential bid. Kerry held the high ground on nearly every question of public opinion. But George W. Bush won by arguing that "you may not agree with me, but you know where I stand." It's not true that all the Clinton-era strategists urged Obama to abandon health care reform and try to pass some smaller alternative, but it is true that many of them, including Rahm Emanuel and Mark Penn, did.

But just as market failures don't debunk capitalism, failures of the median voter theory don't prove that politicians can always ignore public opinion. And there's little evidence that the Obama administration has taken this misguided lesson. Howard Dean ran on a platform of repealing all the Bush tax cuts, including the middle-class portion, a step Obama has pointedly refused to take. People have well-formed views on the question of whether they support middle-class taxes that you're not going to talk them out of. The same holds true for other issues.

But health care reform is a seminal political moment in that it is a repudiation of the party's extreme terror of ever finding itself south of 50% on any major issue. Republicans have done well by grasping that American politics is not an issue-by-issue referendum conducted with an informed audience. Democrats are finally catching on.

For more TNR, become a fan on Facebook and follow us on Twitter.