Clift: Obama Will Need LBJ's Skills to Pass Health Care

Barack Obama won the presidency by appealing to the better angels of our nature, a theme that he summoned in making the case for health-care reform on Wednesday night. In a speech that closed with a letter written by the late Senator Ted Kennedy to be read after his death, Obama reminded the feuding lawmakers before him that there is something much bigger than the next election at stake-and that is the character of America, and whether health care is a right that everyone should receive, or a privilege reserved for those who can afford it.

Obama's high-toned rhetoric, along with a welcome scrappiness, breathed new life into demoralized Democrats, who had begun to wonder if the president has what it takes to survive Washington. He reminded everybody why he got elected by displaying his gifts of intellect and temperament as he defused much of the furor over the public option and returned to his core belief that members of Congress could bridge their political differences and resolve an issue that has eluded presidents for a hundred years.

Viewers at home seeing row after row of stony-faced Republicans sitting with arms folded defiantly across their chests got a sense of what Obama confronts. Some waved a paper they claim is the Republican plan to reform health care. Their behavior looked juvenile, and Obama benefited from the contrast. The speech was great, but it's not enough to move legislation. The boost that Obama is getting in the polls from ordinary Americans who tuned in and liked what they heard will help his standing on Capitol Hill. But if he is to succeed, he must persuade individual members of Congress, working them over like a modern-day LBJ, cajoling, begging, bullying, doing whatever it takes.

Lyndon Johnson was a master of the legislative arts, having served as Senate majority leader before moving to the White House. Washington lawyer Harry McPherson, who served as counselor to President Johnson, recalls how LBJ used flattery to gain support for a civil-rights bill from Republican leader Everett Dirksen. Johnson reminded Dirksen of the statue of Abraham Lincoln that stood in the town square in his hometown of Pekin, Illinois. Then he'd lean in close and suggest Dirksen's leadership on this historic bill would make it possible for him to be memorialized alongside Lincoln.

Obama took a page from LBJ when he lavished praise on Republicans for working in a bipartisan way on health-care-reform issues with Kennedy. And like LBJ, Obama understands the fierce urgency of now when dealing with Congress. That's why he's pushing for a bill before Congress adjourns this year. Delaying legislation is a backdoor way to kill it. "Don't let it lay around," Johnson instructed Wilbur Mills, chairman of the House Ways & Means Committee, who shepherded Medicare through a political minefield similar to what Obama faces. Legislation that sits around "stinks like a dead cat," Johnson told him.

The greatest weakness for Obama is how to pay for the proposals that he outlined. His assertion that much of the cost could be covered by squeezing money out of Medicare and Medicaid will be challenged by reputable economists. He succeeded in soothing the anxieties of the 80 percent of Americans who have insurance that they will lose ground in any grand reform. And he showed admirable conviction when he declared his health-reform legislation wouldn't add a dime to the deficit. But with concern about the deficit emerging with Perot-like urgency, these assurances fall short. The taxes written into the various House bills by leaders far more liberal than what the Senate can accommodate will probably fall by the wayside, leaving the last word to the Senate Finance Committee, chaired by Max Baucus, on how to pay for what finally emerges.

When LBJ was handed a cost projection that he feared could derail Medicare, he swept aside the estimates, telling his advisers, "I'll spend the goddamn money." Former President Bush did much the same thing when he passed prescription drug coverage for seniors without paying for it in the budget, and by having aides conceal its true cost. Obama can't get away with that kind of obfuscation. For one thing, when LBJ plunged ahead with Medicare, the nonpartisan Congressional Budget Office that is giving Obama such headaches didn't yet exist. President Nixon created the CBO along with the Office of Management and Budget at the White House.

The Senate Finance Committee is the biggest player in the poker game of paying for big social programs. Chairman Baucus has worked patiently with Republicans, making his committee the only venue for bipartisanship and the only realistic path to fiscal probity. But it's not clear whose interests he's serving, the U.S. Chamber of Commerce that gives him a 74 percent pro-business rating, or the president whose political fortunes are riding on what he cobbles together, and which oxen he chooses to gore. The White House has been careful to treat Baucus with deference, a lesson learned the hard way 16 years ago by Rahm Emanuel, then a Clinton aide, who gratuitously ticked off then-chairman Pat Moynihan by declaring, "We'll roll right over him if we have to." Obama delivered a masterful speech, but he better cut a deal fast before the weight of history rolls over him.

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