Ask former President Bill Clinton, who saw his first term crippled after meeting his health care Waterloo, a defeat that led in part to the historical 1994 Republican takeover of Congress.
Ask President Barack Obama, who finds himself fighting a defensive battle after irate citizens beat him up at town hall events this summer and stopped Democratic momentum on the issue. This fall, Congress is engaged in a fierce struggle over what kind of health care reform we will have if we are to have health care reform at all.
This newspaper firmly believes that America cannot wait for reform. Few people can credibly defend the current system. Even U.S. Rep. Jeb Hensarling, the Dallas Republican who is one of the most conservative members of the House, tells us the status quo is unsupportable.
But how much reform can the country take? And how should it be done? If it's true that politics is the art of the possible, health care reform backers must reconcile their ideals with hard realities.
Chief among them is legitimate and widespread public anxiety over a massive overhaul of the health care system, especially in a time of skyrocketing deficit spending. Americans really are uncertain and divided. It would be risky and unwise for Democrats to attempt to pass a sweeping reform bill that dramatically reshaped one-sixth of the U.S. economy with few or zero GOP votes.
Yet 15 years after the collapse of Clintoncare, it would be unacceptable for Congress to fail again to do anything serious to reform America's bloated and inefficient health care system, which costs too much and covers too few. Limited, incremental reform is better than no reform at all.
This newspaper will present in this space tomorrow a health care reform plan that takes a prudent approach one that advances progressive reform within reasonably conservative boundaries set by legitimate public concern over rising deficits and the shaky economy.
Obama and congressional Democrats deserve full marks for taking on health care reform, especially with so many other huge issues on Washington's plate. But they would be wise to take a lesson from their party's costly failure the last time they took this on.
An ambitious Clinton misread his mandate and pushed too far, too fast. He ended up with nothing.
Even though Democrats again hold both houses of Congress and the White House, there are serious divisions within their own party over how far reform should go.
Obama must not overreach as his Democratic predecessor did. Public support for a maximalist reform agenda simply doesn't exist. The American people want change, yes, but not a spendthrift health care revolution.
As for congressional Republicans, we are not impressed with their bull-headed naysaying on health care. They had plenty of opportunity to reform the system under President George W. Bush and a GOP Congress but did nothing.
To be sure, Republicans have a right and a duty to oppose health care reforms they don't believe in and to restrain the majority party's excesses. But is it really in the country's long-term interest to attempt to derail any and all attempts to reform a system that most Republicans agree is broken? We can't see it. There are areas of agreement both parties can work from. Republican engagement would make any bill better; leaving it to the Democrats alone would almost certainly make the legislation worse. The GOP should put the common good ahead of partisan politics and meet Democrats on grounds of workable compromise.
With urgent issues of economic stability and national security confronting America, we cannot afford a vicious duel-to-the-death over health care, compromising the ability of the executive and legislative branches to work together to deal effectively with other crises.
What's good for a particular political party is not the same thing as what's good for the nation.
Whatever legislation finds its way to Obama's desk should be only the first step in an ongoing process of improving the American health care system, which will always need reforming. The way the president and members of Congress Democrats and Republicans handle this attempt at fundamental reform will tell us something about Washington's health.
According to an NBC News/Wall Street Journal poll last month, 66 percent of adults disapprove of the job Congress is doing. Barely half 51 percent approve of the president's job performance. Almost half 48 percent believe the country is on the wrong track. Only 41 percent have a positive view of the Democratic Party, while the GOP is looked upon favorably by merely 28 percent.
No doubt about it, Americans are in an anti-establishment mood.
Failure to deliver meaningful but fiscally responsible health care reform will further erode the public's confidence in Washington's ability to get anything done. A sensible, middle-of-the-road compromise would not only be good for the public, but also politically intelligent for both parties.
As perilous as the politics of doing something on health care may be this year, they're not as dangerous as doing nothing at all.
The Dallas Morning News