Healthcare Reform: The End Game Begins

The healthcare reform debate has been going for a long time. Months in this Congress, years in the country at large. Negotiations are ongoing in the Senate Finance Committee, among the so-called "Gang of Six." President Obama is starting to get frustrated, and may go it alone, i.e. pass a bill without Republican support. That might be difficult, but it's possible.

Some liberals, progressives, and Democrats are nervous. Some aren't. I'm in the "not that worried" camp.

What we are watching now is equal parts flash and substance. There are strong, profound philosophical difference motivating the parties, and those differences are particularly pronounced in this debate. Government vs. free market; communal concern vs. individual rights; profit motive vs. co-ops and the "public option." Some of these are simply irreconcilable differences that come down to contrary worldviews. People like Max Baucus and Charles Grassley are trying to bridge those differences, but that is hard work.

But we are also watching a great deal of the politics, and the politics is far more interesting and obvious than the policy. For some of us, it's a game, and it's fun. Who's up, who's down, who has the better strategy, who made what mistakes?

But the politics are also far less inspiring, and far more discouraging. We are seeing compromise and gamesmanship. Most importantly, we are watching a few very powerful people bluffing.

Obama holds most of the cards, and the Republicans know it. He can pass some kind of health care reform without them; he can also pass some kind of healthcare reform with them. They, of course, want to force Obama to pass a healthcare reform with them. They want to do that because it will weaken him politically, partially by pissing off his base, but also because they honestly want some things in this bill.

What the Republicans don't know, and what terrifies them, is how Obama is going to play the end game. He is still a popular president. He is still an incredible and inspiring speaker. He is still a very charismatic leader. He has a great organization out there in the country drumming up support, gathering signatures. He still has many allies in Congress with their own organizations and teams out there fighting for their versions of the bill.

What really and truly terrifies the Republicans, so much so that many of them don't even realize it, is that they don't know which of their political weapons is going to work against Obama. They've dropped their biggest bombs, they've thrown as much mud as they can. The "death panel" claim is easily their most serious charge - the government is not only not going to help you, it's going to kill you? Some people believe that. But Democrats are not giving up fighting against it, and eventually they will win on that issue. Eventually the idea that the government is sponsoring "death panels" will be ridiculed as an absurd, extremist idea, because that's what it is.

Democrats did not take the "birther" mania seriously for a long time, but now they have spent some time and energy fighting it, and Orly Taitz was exposed as a flake and a crank.

Through all of this, Obama has looked calm and cool and collected, like he always does. Some people mistake that for lack of strategy, or aloofness, or lack of fighting spirit. But that's only in contrast to the previous administration, which worked by conniving, bullying, and subterfuge. Obama is playing it somewhat straight, because that's the way he is. He is making the strongest argument he can for the best bill he thinks he can get through Congress. Obama's problem, of course, is that he doesn't know what the best bill is that he can get through Congress.

I think Obama is going to surprise - and terrify even more - the Republicans in Congress by playing hardball at the end. He will rally the troops, like only he can. He will claim that he has been patient with Republicans, that he has listened to their concerns, that he has tried very hard to work with them, but that now is the time for decisions to be made. "Now is the time!" Imagine Obama leading a crowd with that rallying cry.

One of Obama's greatest weapons is the GOP failure to solve this problem for so many years. The absolutely last thing any Republicans want is to be reminded of is the squandered opportunities of the Bush years. Republicans do not want to be held accountable for the failures of Bush, but Obama is in a position to do exactly that. All he has to do is call the Republicans obstructionists who never offer solutions, even when they have the opportunity and the power. Obama's reputation for bipartisanship will come in very handy, because he will come across as a reluctant partisan warrior. He would much rather prefer to work with Republicans, but if he has to go it alone, so be it.

Obama is very different from the Republicans in one key respect: Obama is not afraid of his base. Obama may not agree with the Kossacks on everything, but he is perfectly comfortable using their energy and their talents. When the time comes, he will rally those troops. And he will not have to worry about whether or not rallying the base will alienate middle America. The Republicans, on the other hand, have to be scared to death of rallying their base, because they cannot control their base, and the followers of Rush Limbaugh and Sarah Palin have the potential to seriously alienate independents and the few moderate Republicans left.

So the end game begins. It's not quite a rope-a-dope; Obama is not feigning weakness. But neither is he telegraphing his strategy. Nor has he started deploying all of the weapons in his arsenal. He is keeping extraordinary strengths in reserve.

He can keep those strengths and those weapons in reserve because he is not afraid to use them. He is patient because he knows that he will know when to start the fight. He will know when to move. And then he will move very, very decisively, and very quickly. And that has the Republicans very, very afraid.