A number of elites have recently claimed that President Obama needs Republican support in order to ensure that his proposed health care reforms are sustainable:
Senator Ron Wyden (D-OR): "The president is very much aware that to bring about enduring change — health care reform that lasts, gets implemented, wins the support of the American people and does not get repealed in a couple of years — you need bipartisan support."
Senator Max Baucus (D-MT): "Baucus remains determined to send to the floor a bill with bipartisan support; passing health care reform by reconciliation [which requires only fifty votes in the Senate], he says, would make the new law unsustainable in the long term."
Washington Post columnist David Broder: "The goal of the Obama White House is to come up with a health-care plan that can attract bipartisan support. The president has told visitors that he would rather have 70 votes in the Senate for a bill that gives him 85 percent of what he wants rather than a 100 percent satisfactory bill that passes 52 to 48.
"There is good reason for that preference. When you are changing the way one-sixth of the American economy is organized and altering life for patients, doctors, hospitals and insurers, you need that kind of a strong launch if the result is to survive the inevitable vagaries of the shakedown period."
Is this view correct? Are policies that pass with bipartisan support more sustainable?
It turns out that the political scientists Forrest Maltzman and Charles Shipan investigated the sustainability of major legislation in a recent American Journal of Political Science article (PDF). Their results contain both good news and bad news for Obama if his goal is to pass a bill that is durable over time.
The good news for Obama, who enjoys a relatively cohesive majority in both chambers of Congress, is that legislation that is enacted under unified government is less likely to be significantly amended over time. The risk of amendment is also lower as House/Senate disagreement declines. (Maltzman and Shipan argue that these factors make it possible to craft more cohesive policies and to entrench them against future changes.)
The bad news is that bills that are more complex (as proxied by their length) and bills that pass with relatively narrow majorities are more likely to be amended. The enacting legislation for Obama's plan is likely to be long and complex and to pass on a relatively close vote in the Senate.
With that said, however, the Maltzman and Shipan results are not fully definitive on this question. Their measure of "divisiveness," which is the percentage of legislators voting yes in the closer of the House and Senate final passage votes, does not distinguish between majority party size and minority party support. As a result, bipartisanship could vary substantially for a given level of divisiveness. For instance, obtaining sixty votes in the Senate means something different now (when the Democrats hold 59 seats) than it did in early 2001 (when the Republicans held 50).* It's therefore hard to say how much Republican votes should matter to Obama.
More generally, there's an important ambiguity about the causal mechanism in the claims quoted above that also comes up in Maltzman and Shipan's discussion of the "divisiveness" hypothesis. Are policies enacted with bipartisan support more durable for political reasons (i.e. it will take more votes in the future to amend the bill) or substantive ones (i.e. the compromises required to obtain bipartisan support reduce minority party efforts to pursue future amendments)? It seems like an important question but one that's hard to disentangle empirically.
As such, the implications for Obama are again somewhat unclear, especially given the extent of the Democratic majority in Congress. Obtaining more than a few GOP votes is likely to require painful concessions -- will those compromises provide enough durability benefits to justify their policy costs? As Ezra Klein asks, "how many Republican votes are worth sacrificing a policy [the so-called "public option"] that would lower the cost of health insurance by between 20 percent and 30 percent a year"?
(* Matthew Yglesias independently posted an item this afternoon making a similar point about the changing definition of bipartisanship.)
Update 6/12 12:14 PM: Yglesias argues that, in his view, "[s]peculative ideas about stability" don't justify major policy concessions. He also notes that Baucus is reportedly targeting as many as 70 votes in the Senate for the health care bill and may dump the public option to try to get there. Still, I doubt that will be enough to attract so many Senate Republicans -- 70 votes for health care is likely to prove as unattainable as Obama's alleged 80-vote goal on the stimulus bill.
Update 6/20 2:06 PM: I got in touch with Shipan, who conducted a preliminary re-analysis of his data and found that the number of minority votes against a bill was not statistically significant (unlike their divisiveness measure).
No doubt a complex restructuring of health care financing will be subject to amendment in the future, but there's a good chance these amendments wouldn't go to the heart of the program, because fundamental changes are hard to unwind.
For example, if a government-run insurance plan underprices existing plans, it will put a lot of those plans out of business. Privatizing that government plan would be akin to privatizing Social Security--basically a non-starter. (Look at how Bush's plan to privatize even a small portion of Social Security was demagogued.) Similarly, if profits on pharmaceuticals are significantly reduced, as may well happen under government-imposed cost controls, financing of new drug research would probably shift from private companies (which will have less incentive to pursue such research) to the government. Once that mechanism is in place, it's tough to reverse.
All this suggests that boldness by Obama could make his fundamental design more rather than less subject to change by future Congresses. (An interesting side question is whether what may be the boldest part of Obama's plan, the government-run insurance alternative, might be abandoned in light of the AMA's apparent resistance to it.)
Posted by: Rob | June 12, 2009 at 12:27 AM
Right winger "Rob" doesn't realize that a significant amount of "drug research" is already done with government financing, either through direct grants, government coordination of research, grants to University research departments, etc.
Many of these public government research grants are than coopted by private industry in ways that cuts out the investor, American taxpayers, from the profit or even the benefit as the taxpayers pay twice, once for the research and then a second time for overpriced meds.
Posted by: News Reference | June 12, 2009 at 11:11 AM
David Broder always finds a way of arguing that Republicans should get their way and Dems should compromise.
I pray that no one in Obama's circle is taking him seriously.
The notion that a 100 percent satisfactory bill should be rejected to fruitlessly fish for Republicans votes that are NOT going to happen is foolish.
The only problem with a 52/48 Senate vote is that it would have to be done through the reconiation process in order to avoid Republican obstructionism.
The reconciliation process (as I understand it) has a 10 year sunset window. Republicans used the reconciliation process on a number of things in order to avoid compromising with Dems in the expectation that after 10 years the Republicans could just do it again.
So if the Dems use the reconciliation process to pass a 100 percent satisfactory bill (hopefully with a single payer universal healthcare plan) it would be fine for 10 years. If it's a success it will be interesting to see the Republicans not support it. If it's a failure, well, then a 10 year automatic sunset would be perfect, it was given a try and either failed or succeeded on it's own merits.
Posted by: News Reference | June 12, 2009 at 11:21 AM