Jed Lewison has an important piece up at Kos arguing that it would be good politics, as well as good policy, for Obama to get out ahead of his own Health Care Bill and admit its flaws. Its a brilliant essay and should be read in its entirety. But although Obama has been smart enough, and elegant enough, to do essentially that with his own Peace Prize, he won't do it with his Health Care Bill. Lewison's argument is that the bill itself is highly compromised, as are the key players in the Senate. He suggests Obama admit this up front, at the signing, and promise to work hard to fix the errors and omissions in the Bill as well as the structural problems in the Senate that forced the progressive Democrats (and Obama) to compromise with the most reactionary and corrupt members of their own party in order to get the damaged bill through.
I agree with Lewison that this is both good politics--putting Obama back on the side of his own supporters--and good policy (since it puts Obama and the Dems on the side of continuing improvement of the Bill and of our health care system. But the very notion of "continuing improvement" cuts against being able to campaign on "getting something done" and "getting a bill passed." Rahm and Obama have acted, so far, as if the Democrats can campaign on "well, we got something signed! yay us" in 2010. They have another think coming, but apparently it will still be something of a surprise. It has been grassroots Democrats and the progressives who have been pointing out, very late in the game, that the benefits of the Bill as currently envisioned (such as they are) won't even kick in until 2011 and that meanwhile people are forced to pay massive sums to an indifferent and corrupt insurance business for junk insurance. Its very, very, very, clear to those watching the negotiations that aside from the intransigence and ill will of the reactionary Democrats and Lieberman, Snowe, and Collins that the biggest flaw in the bill from a political point of view was that the Democratic leadership was not willing to fight for big, splashy, popular changes up front. There are lots of reasons why they failed to fight for big things fast. But for whatever reason, their strategy is to pass something--anything-- and then brag about it.
More to the point, Obama isn't going to campaign against his own Bill, and against the "centrist" Senators. He will never admit that the bill that reaches his desk is fatally flawed because of the truly bad acts of some truly contemptible Senators. Its not his style. I'm sure he will be polite, and gracious, and humble about the Bill and its good effects. He's not much of a braggart, our President. But he is not going to rhetorically undercut the Bill and the work of the Senators who worked out whatever ghastly compromise they've worked out--because one of the compromises was, doubtless, that no one would be punished for their public heckling and their private backstabbing of the Bill. Its going to be Lieberman and Lamont all over again. Neither Lincoln, Landrieu, Nelson, Conrad nor Carper will be taken to task by the Democratic Party--that's not the way the Democrats do things.
There is another and even more important point: Obama will never admit publicly that there was one, or at most two, ways to bend the cost curve (god, I hate that stupid phrase), insure everyone, pay for what we need, put the system on a good footing--and that was some form of Single Payer or a wholly regulated not for profit insurance model. Atrios put his finger on it the other day in a post I can't find--none of the decisions left in the bill make any sense until you realize that the first principle was "don't scare the insurance companies and their flacks" not "insure everyone, fairly, without gaps, from cradle to nursing home." So the flaws in this current bill will remain unenunciated and unadmitted because the flaws are grounded in a reality we can't be brought to face: capitalist, free market, approaches to health care are doomed to failure--if success is measured by the number of people happily and healthily served by the system.
A delicate, jury rigged, legislative approach to ameliorating the flaws of a for profit, employer based, health insurance system is like trying to get rid of cannibalism by partially regulating the meal times of a cannibal society. You can measure the pots and pans, you can specify how long the meal should take, you can even order people to add a few more vegetable sides to the main dish--but you will never stop cannibalism through small legislative fixes. The problem is that you have a need--food, or health care--and you simply have to find a way to replace one source with another.
But to admit that up front would be, in essence, for Obama to run against capitalism and the free market (as ideas) and also against two of the biggest industries around (Insurance and Pharma) as well as against the reactionary members of his own party. How likely is that? It would be great politics, of course. He could assume the mantle of populist leader running against Washington and that would be a great platform for him in 2012. But it is very, very, dangerous for the lower level Democrats in 2010 and it goes against Obama's general tendency to underplay himself and his agenda as revolutionary agents. So don't expect Obama to ever do more than murmur, politely, that this Health Care Bill is a great start.