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Health Care May Grant Obama Legacy as ‘Reformer’

March 30, 2010 at 12:00 AM EDT
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In the wake of the passage of health care reform, Jim Lehrer talks to historians Ellen Fitzpatrick and Richard Norton Smith and columnists Michael Gerson and Clarence Page about what the victory means for the Obama presidency.
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JIM LEHRER: But, first, the big-picture impact on the Obama presidency of the health reform victory.

And we get the takes of four trained observers who are familiar to “NewsHour” viewers, historians Ellen Fitzpatrick of the University of New Hampshire, and Richard Norton Smith George Mason University, Clarence Page, a syndicated columnist for The Chicago Tribune, and Michael Gerson, former speechwriter for President George W. Bush, now a syndicated columnist for The Washington Post.

Richard, how important to the — to the Barack Obama presidency was getting this thing done?

RICHARD NORTON SMITH, scholar in residence, George Mason University: It was of defining importance. Think of the conversation we would be having if they had lost this vote by a couple votes.

Not only was it important — it — it not only changes the perceptions in this town. It overnight changed the conventional wisdom in this town, that, two months ago, not only was health care reform dead in the water, but, quite possibly, the Obama presidency itself.

And, so, by winning, and how he won — there’s been a lot of talk about how he won because he was — he — he persevered. There’s more to it than that. He actually — if he had persevered in what wasn’t working, again, we wouldn’t be having this conversation.

He took control of the bill, not just the debate, for — trying to frame the debate. On February 22, he put out — the White House put out, this is what we want to be as the bill, in effect taking it away from Congress, taking it out of process, and reestablishing his own reputation as a leader.

And, three days later, you had the bipartisan meeting at Blair House, which, whether you think it was bipartisan or not, to most people who watched at least was a — as an example of what they say they want, a president to listen to the opposition.

And so — and then finally the insider — he had a Reaganesque ability to keep attention focused on the issue, even after we wanted to change the subject. And, at the end, he had a Johnsonian ability to cut deals, apply pressure, and get across the finish line.

JIM LEHRER: How do you see it, Michael?

MICHAEL GERSON, former speechwriter for President George W. Bush: I agree. I think it puts him in a very select company, kind of the pantheon of the progressive presidents, people that made a big difference on the role of government in American life, people like Wilson and FDR and Lyndon Johnson.

Now, some of those presidents were politically successful, like FDR. Some of them were not so successful, Wilson and — and — and LBJ. But all of them did something extraordinary. They tested the limits of executive power. And they became figures that inspired both love and resentment over generations.

So, I — and I think that Barack Obama now belongs in that company, whether you like what he did or not.

JIM LEHRER: Do you agree with Richard’s kind of how much was at risk here for the presidency of Barack Obama if it had gone the other way?

MICHAEL GERSON: Well, having served some time in the White House, the main determination that the press and the public make about the president is not really liberal or conservative. It’s strong or weak.

The president had appeared weak. It’s a hard narrative to change over time. So, I think, once he embarked on this strategy, which I’m not sure was the best strategy for him — he lost a lot of support over — over time — but — and I think he would have been wiser to take on economic growth and job creation, you know, which were really much larger public priorities.

But, once he embarked on this — on this course, he couldn’t back off of this course. And I think he needed to do what he did.

JIM LEHRER: Ellen, what’s your reading here?

ELLEN FITZPATRICK, professor of history, University of New Hampshire: I agree with everyone who has spoken that this is extremely significant historically.

When Lyndon Johnson signed the Medicare legislation in 1965, he went to Independence, Missouri, to sign it in the presence of Harry Truman. And he made the comment that people didn’t vote and love Harry Truman because he promised to give the American people hell. It was because he gave them hope.

And what Obama had promised in this campaign was sweeping change in the health care system. He delivered on creating a very — helping to create a very big piece of legislation that moves the country in a direction that is probably the most significant legislative change in the system since the creation of Medicare.

JIM LEHRER: What about Michael’s point that he went from being seen as a weak president to being a strong president just because this thing passed?

ELLEN FITZPATRICK: I think it gave enormous amount of wind in his sails.

He has enormous challenges to face, however. And it is going to be — the record of his administration will be measured by more than simply this fulfilled promise. There are many other problems that will need to be addressed, obviously.

JIM LEHRER: Clarence, do you buy the idea that President Obama actually changed his style of governing, or was he always this — this way and people just finally figured it out?

CLARENCE PAGE, columnist, The Chicago Tribune: I don’t think he changed his style.

I think that steady course that Colin Powell described late in the Obama campaign was what we saw here, even while many around him, critics on the right, left and middle, were — were backseat driving over how he ought to handle health care. I agree with Michael, in retrospect, that he might have done better or had fewer problems if he had gone after jobs first.

But there were a lot of folks who were saying that. There were people who were saying, well, you know, break it up into smaller, bite-sized bits. Don’t try comprehensive health care. I was one of those people, because it looked like it was all going to collapse. And I will confess that he proved me wrong, because he got it through.

And there was internal debates at the White House, as we know, between Rahm Emanuel, apparently saying the more pragmatic view, Nancy Pelosi over on Capitol Hill, saying — it’s like, no, go for it.

He decided to go for it, so that not only did he get the bill passed, but he got the big package passed, the — the whole enchilada. So, that — that — that gives him more of a sense of really changing history, the biggest shift on health care policy since Medicare, and the kind of momentum now that enables him to do more in his second year.

JIM LEHRER: Changing history? Do you buy that phrase, Richard?

RICHARD NORTON SMITH: Yes, it’s changing in a sense. None of us know how this is going to pan out. None of us know the short-term political consequences.

But consider this. For 40 years in this country, Nixon, Reagan, Gingrich, the Republican Congress, Bill Clinton saying the era of big government is over — for 40 years in this country, there was a consensus which might be seen as a reaction against the Great Society, the notion that government was overreaching, trying to do too much, intruding in our lives, even with the best of intentions.

So, Barack Obama not only brought about a historic expansion of that government. He did it in a political climate and a cultural climate much more hostile than the one Lyndon Johnson operated in, in the mid-’60s.

JIM LEHRER: But what — Michael, the president himself said in an interview this morning on NBC that he — he rejected the idea that this is a radical change, that this health care bill in any way constitutes a radical step, that he — it’s moderate, he said — he called it a moderate bill in the middle, and that it shouldn’t be seen as some kind of big liberal thing.

MICHAEL GERSON: Oh, I agree with that. I think you look at this…

JIM LEHRER: You do agree with it?

MICHAEL GERSON: Well, no, no, I agree that that’s his argument.

JIM LEHRER: Oh.

MICHAEL GERSON: The — I think that you would find that FDR made similar arguments about Social Security and other things. These aren’t radical departures. This is not socialism — all these sort of things.

So, I think the president has an interest in making this case. But I think there’s an interesting battle of historical narratives going on. You know, I think that a lot of Democrats hope this is like FDR and Social Security. It becomes an assumption of American life, a great bipartisan commitment of — of American government.

I think Republicans view it more in the context of LBJ and the war on poverty, OK, which was eventually viewed as a very well-intentioned, but deeply flawed public policy approach that was repudiated in large part by his successors, including Republicans and Democrats like Bill Clinton.

Republicans, I think, view it more in that category. As the historians will say, we shall see.

JIM LEHRER: Yes.

But you’re a “We shall see” person on this issue, Ellen, as to what — what kind of history was made here?

ELLEN FITZPATRICK: I do think it’s very, very significant.

And, you know, the critics of the war on poverty have said that it was declared and never fought. In this case, and in the case of Social Security, these are fundamental legislative changes. They will be — these programs, this legislation, this bill, it will be changed. It will be altered, as Social Security was, but I don’t think it’s going to be undone, myself.

And, in that sense, it is a redistributive program of enormous significance. It will be tinkered with. It will be changed. It’s not going to look this way 20 years from now, even 10 years, five years from now. But I do think it is a move in a direction that progressive reformers have been seeking for well over 100 years. And this is indeed a significant moment.

JIM LEHRER: So, you would agree with Michael that this is, in fact, a radical departure in government; this was — this is not something in the middle, as President Obama characterized it today?

RICHARD NORTON SMITH: No, I don’t see it as a radical departure in government.

We don’t have a single-payer system. We don’t have the kind of reform that those on the left or liberals who see Barack Obama as too moderate would have advocated. It’s much less than what many sought. I don’t see any radical about it, in that sense.

JIM LEHRER: Clarence?

CLARENCE PAGE: Well, he — it brought a bonanza to the insurance industry, for example. I mean, this is a very pro-private-sector kind of a plan.

It’s not single-payer. It’s not public option. It — it’s exchanges, which — this is a compromise, much like Lyndon Johnson had to compromise on his initial goals with Medicare to please the AMA, the insurance companies, various interests.

It’s still — something has to be done about — about the cost savings, because the bad news is to come down the road here, insofar as paying for all this. But it’s going to — it’s going to happen.

JIM LEHRER: Finally, I want to pick up on what you said, Richard, about the climate in which this happened. The president also spoke today about this — he called it the current culture in Washington. He said it feeds the extreme sides and essentially widens, instead of narrows, differences and — and moves towards consensus.

Do you think it’s any worse now than it normally is?

RICHARD NORTON SMITH: I do think it’s worse. I think there are a number of factors contributing to it, including, on balance, the Internet and cable TV.

I mean, journalism has been has been redefined in — in many quarters as — away from the healthy adversarial relationship of yore to the Friday night fights 24/7. And — and I think that has contributed to the ferocity. You see it up on the Hill, the lack of collegiality, the lack of personal relationships, that — that contribute in part to the difficulty of passing anything, let alone something as big as this.

JIM LEHRER: Where do you come down on that, Michael? Did — did Barack Obama get this done in an unusually difficult climate, in your opinion?

MICHAEL GERSON: Well, I think it was a fairly difficult campaign.

But, you know, Barack Obama campaigned on two contradictory goals. One of them is, he was going to be the great national healer, a post-partisan president. The other one is, he was going to be an agent of change and going to solve important problems.

In this — after the Massachusetts victory, the Senate victory for Republicans, he had a choice to make: Am I going to go an incremental approach? Am I going to be the healer? Or am I going to be the agent of change?

He chose to be the agent of change. He actually chose to be both divisive and consequential. So, I don’t think these ideological divisions are just in the air. I think he chose, like many presidents, to make –to make that kind of difference for his ideological perspective that’s going to make him very, very controversial for years to come.

JIM LEHRER: In a word, do you agree with that, Ellen, that analysis? He made a conscious decision to do this, and he knew exactly what he was doing?

ELLEN FITZPATRICK: I do, but I don’t see any contradiction between a president who is healing and bringing about change. Some of our greatest presidents have attempted to do both, and earn their place in the pantheon of great presidents for pursuing precisely those tacks. And, so, I don’t see in any way that these are contradictory.

JIM LEHRER: Clarence, you seem contradictory?

CLARENCE PAGE: Let’s remember that health care was a core issue of his campaign. War and the economy were thrust upon him, but he always campaigned for getting health care solved as a leading issue. So, I think that’s why he was willing to go to the mattresses for this.

Immigration, education, other issues down the line, I think, hopefully, we will see more comity again. But we are in a very divisive time.

JIM LEHRER: As we say in journalism, we shall see.

CLARENCE PAGE: We shall see.

JIM LEHRER: We shall see.

JIM LEHRER: Ellen, gentlemen, thank you all very much.

RICHARD NORTON SMITH: Thank you.

ELLEN FITZPATRICK: Thank you.