Obamacare Redux 

Barney Frank made a misdiagnosis on the president's health-care plan.

Representative Barney Frank gave a memorable exit interview recently to New York magazine suggesting that President Obama "underestimated, as did Clinton, the sensitivity of people to what they see as an effort to make them share the health care with poor people."        

The Democratic Party "paid a terrible price for health care," Frank said. "I would not have pushed it as hard."

Is Frank right? We know what Republicans unanimously think. What's surprising is how many Democrats, with the benefit of hindsight, agree with Frank. Although they support the substance of the law, they are appalled by its political fallout and wish they had a do-over. Their thinking was summarized this week in the National Journal by Michael Hirsh, who wrote that by embracing health care reform amid the economic crisis, Obama confused his priorities and took his eye off the ball, much as President George W. Bush did when he invaded Iraq instead of worrying more about al-Qaeda.        

This analysis has new resonance because of the recent Supreme Court oral arguments over Obamacare. Democrats are wondering if it was worth it to lose the House in 2010 and perhaps the White House in 2012 over a bill that may be declared unconstitutional anyway.        

The answer is yes. To understand why, we need to be clear about the purpose of politics. It's not to win elections — hard as that may be to believe in the middle of a campaign. Public approval as expressed in elections is the means to change the country, not the end in itself.        

Insuring 30 million Americans and ending the shameful era when an illness in the family meant selling the house or declaring personal bankruptcy? Nothing to sneeze at, whatever the cost to one's political career.        

Frank is mistaken that the White House underestimated the political price. At various points, Vice President Joe Biden, senior advisor David Axelrod and Chief of Staff Rahm Emanuel advised the president to focus entirely on the economy and leave comprehensive health care for another day.        

I asked the president in late 2009 why he overruled his team. He answered: "I remember telling Nancy Pelosi that moving forward on this could end up being so costly for me politically that it would affect my chances" in 2012. But he and Pelosi agreed that if they didn't move at the outset of the Obama presidency, "it was not going to get done."        

Obama was right that his political capital would diminish over time. Even if the Democrats had delayed health care and held the House in 2010, their numbers would almost certainly have been reduced. Can you imagine trying to bring it up now or in a second term?        

Hirsh argues that Obama should have stayed focused on the economy not for appearances' sake but because it was worse off than he and his closest advisers recognized. This wrongly assumes that he could have done substantively more to spur a rebound or keep the benefits of recovery from skewing toward the top 1 percent.        

It's important to remember that Obama began his presidency with economic recovery, not health care. In his first month in office, he pushed through a mammoth stimulus package that, contrary to the analysis of Drew Westen and others, was as big as Congress would allow. There was no political appetite for a second stimulus before the first had even kicked in — the period when health care was on the table. In other words, the opportunity costs of health care reform were zero.        

The "eye off the ball" critics have a point, but it relates to the second year of Obama's presidency, not the first. Just as Richard Nixon had his "18-minute gap" on the Watergate tapes, so Obama had his 18-month gap, from the signing of the Affordable Care Act in March 2010 until the introduction of his jobs bill in September 2011.        

If the president had pivoted more quickly from health care to a jobs agenda and signed a bill before the midterms, he would be better off politically and might even have helped the economy a bit.        

But let's not pretend health care reform was a fatal Iraq-style distraction from the main event. Instead of costing thousands of lives, it will potentially save many more with its incentives for preventive care, among other historic provisions.        

The public might not appreciate it yet, but Obamacare took leadership and guts from the president whose name it bears. n        

Joe Conason is the editor in chief of NationalMemo.com

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