Will Liberalism Survive Obamacare?

December 3rd, 2013

Two weeks ago I blogged about a piece in Politico that contended that with the botched launch of the ACA, “the future of the Democratic Party’s plausible agenda, and of liberalism itself, is on the line.”

Ezra Klein poses a similar question at WonkBlog, in a piece titled, “After Obamacare, will Americans ever trust the government again?”

HealthCare.gov is recovering from its disastrous launch. But liberals are increasingly worried that public faith in government will not.

“There’s a reputational loss that has already taken place about the capacity of government to cope with complexity and deliver services,” says Ted Marmor, a leading expert on Medicare. “Whether Obama can recover from that is one thing. But even more, can the discussion about government recover from this sad example?”

Over at Slate, Matt Yglesias is thinking along similar lines. “The public has long been skeptical of the political system’s practical ability to do the things progressives say they want to do,” he writes. “A health care website that comes in months late, over budget, and still lacking full functionality confirms all those fears when it was initially meant to debunk them. And that’s true whether or not it in some sense ‘works.'”

But the fact that the public will trust the government to do big things again doesn’t mean they should.

The deeper problem progressives (and conservatives!) need to grapple with is that the government’s track record really is terrible of late. The implementation of major initiatives, both domestic and foreign, launched under both Democrats and Republicans, has been badly botched. Few believe Congress is legislating wisely, thoughtfully, or effectively. The minority party is actively trying to sabotage laws passed by the majority. Most everyone agrees that federal procurement, particular for the information technologies that are so fundamental to 21st century services, is badly broken. The list goes on.

The New Yorker offers a differing take on whether liberalism will survive Obamacare:

Now to how liberalism is faring. If you’ve been reading some of the articles out of Washington in recent weeks, you may have received the impression that it’s an endangered creed, and that the troubled rollout of the Affordable Care Act might just about finish it off. I’m not just referring to the coverage in conservative outlets like theNational Review, the Weekly Standard, and the op-ed page of the Wall Street Journal, which have been publishing obituaries of liberalism for decades. In mainstream and even liberal publications, some of the best columnists in Washington have expressed worries that the problems afflicting healthcare.gov amount to such a political disaster that they endanger the very idea of activist government, which lies at heart of progressivism. ….

And anyway, American liberalism, like its opposite number, American conservatism, is much bigger than any individual policy or slip-up, however dire. To suggest that the problems of the A.C.A. will do irreparable damage to liberalism makes about as much sense as suggesting that the government shutdown will do irreparable damage to conservatism. It confuses politics with history and ideology. ….

What I object to is the larger suggestion—sometimes it is made explicit; often it remains implicit—that Obamacare is the embodiment of twenty-first-century liberalism, and that its failure would upend the entire liberal project (whatever that may be). Neither claim withstands examination.

In short, the ACA’s marriage of government regulation and private insurance is not liberal. Thus Obamacare’s failure is not a failure of liberalism, but a “test of technocratic centrism.”

Strictly speaking, however, Obamacare isn’t a test of liberalism; it’s a test of technocratic centrism of the sort advocated by Romney and, eventually, endorsed by Obama. If the reform has any liberal antecedents, they lie in the “Third Way” neoliberalism associated with Tony Blair and Bill Clinton. While some aspects of that doctrine remained hazy even to its proponents, one of its clear and central tenets was that, wherever possible, the private sector should be left to deliver goods and services. In both Romneycare and the A.C.A., the designers of the system went to great lengths to make sure this would happen. The system of employer-financed insurance was left intact. In the individual market, the government set out to facilitate private commerce by setting up online marketplaces populated by insurance companies and providing subsidies to those purchasers that needed them.

The great irony of Obama’s reforms is that the most “socialized” bits of them—the expansion of Medicaid and new regulations that prevent insurers from discriminating against the sick, the old, and the female—are working out pretty well. Where the Administration has gotten into trouble is in trying to promote private enterprise.

In other words, the failure of this law should give motivation to liberals to further pursue a public option:

And what about the liberals—the ones who pushed the White House to pursue something more radical than a souped-up version of Romneycare? Even if the A.C.A. were to collapse before it got going—and as I’ve said several times, I don’t expect this will happen—they wouldn’t be routed; they would be vindicated. Far from slinking away and conceding that their grand plans had failed, they would once again take up the campaign, which has been active in various forms since the nineteen-sixties, for the public option, and perhaps even a single-payer system.

This very well may be the case, but for the overwhelming majority of Americans who do not read the New Yorker (those people on the other side of the Hudson), none of this matters. The failures of Obamacare will be tied with the failures of liberalism. The same way the failures of Iraq were tied with the failures of conservative foreign policy. For the same reason the American people will be wary about entering new wars (Iran), the American people will be wary about any further government intrusions into the healthcare market (public option or single payer). The ACA was the Democrats’ chance to get something right, even if it was not their best option. It didn’t work. And now they’re stuck.

Obama made his bed. Now he needs to sleep in it.