Blemishes on Obama’s Image

Health Care Reform in the United States

Conservative Democrats are forcing the American president to compromise on health care reforms. Obama’s reform plans are no longer popular in the political mainstream.

This is by no means the end for Barack Obama’s health care reform, but the president did suffer a stinging setback in the central domestic policy objective of his presidency. This has consequences for the future balance of power between him, the various wings of his Democratic Party and the Republicans. His image as a glowing winner, which has served him well up to this point, now has blemishes.

Obama had urged both houses of Congress to submit health care bills before the summer recess and to iron out any differences in the conference committees. His goal was to nail down the main points of health care reform so that his opponents would not use the five weeks of recess to torpedo the entire package with ad campaigns. But the Senate did not bend to his pressure. Sorting out the details in the committees will have to wait until the fall.

The word is that Obama’s mistake was placing Congress under so much time pressure. But that is only a superficial explanation. Even less would be happening without his urging and the risk of defeat of health care reform by procrastination would be even greater. But something else is remarkable about this: Obama was not stymied by the Republicans but rather by conservative Democrats. Theoretically, Obama does not need a single Republican vote. He has an overwhelming Democratic majority in Congress, with 256 of the 435 House seats and 60 of the 100 Senate seats.

But the U.S. Congress is not known for party discipline. Members of Congress are not making decisions according to the interests of their parties, but rather with one eye on their constituents at home and the other on their re-election prospects in November 2010. This is the flip side of his impressive election victory. In view of the disappointment with George W. Bush, very large numbers of independents and conservative Americans voted for Democrats in the 2008 election. These members of Congress are looking at Obama's goals with some degree of skepticism.

With health care reform, it is no longer a question primarily of the 47 million people who do not have medical insurance, but rather the fear that insured Americans have of a further explosion in health care costs and an increase in their premiums and taxes. The president still has high personal approval ratings, but he has lost majority support for many of his proposals. Whether it be health care for everyone, the closure of the Guantanamo Bay detention facility or climate change, the general goal is popular, but how to get there and the practical consequences of doing so are unpopular.

Conservative Democrats in Congress asked Obama before the election to back away from his campaign promises or at least to scale them back. They wanted him to do this, so that if it ever came time to compromise on an issue, they would all still have something in common with the original goal. Obama does not want to be sunk on principles, and he does not want to fall into line. He would not be the first president who was forced to the political middle by Congress, but he is now being forced to spend some of his personal political capital.