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Recently, Howard Dean wrote a recommended diary with the following observation:

The realities are Congress rarely passes reform that is not incremental and it is important that the increments they pass are headed in a direction we ultimately want to go. Expanding Medicare would do that.

 
Sounds reasonable, right?  Incremental progress as a path to eventual reform.  But before you buy this line of argument, ask yourself the following:  how many times in the next century will the Democratic party get the legislative opportunity to pass each of these incremental improvements leading to a public option?
 
I probably won't live to see the answer, but if there was a betting pool I'd think a fair guess would be six or seven.  Six or seven chances at an incremental improvement by 2110, when children born today will already be dead and their children mostly over 65.  

Why six?  Because on average we seem to get a shot at this about every 15 years.

Whether you're talking about a full-blown public option or just a step towards one, this sort of reform seems to require a major legislative advantage, at least in today's climate.  The last major attempt at reform was in 1993-4, when Hillary Rodham Clinton chaired the Task Force on National Health Care Reform.

That was the previous time that we had democratic control in the house, senate and White House, and it lasted two years.  15ish years back.  The time before that was 1977-1980.  Four years, about 30ish years back.
 
Here's a handy chart of the last century of total Democratic majorities:

2009-presentAt least two years
1993-1994Two years
1977-1980Four years
1961-1968Eight years
1949-1952Four years
1933-1946Fourteen years!!
1913-1918Six years

Of course, the fourteen year stretch was in response to the Great Depression, and it was possible in part because we had no presidential term limits.  Looking at more recent history, we see roughly a 15-year span between periods of governmental dominance, and 2-4 years seems like a good bet for the span of these periods in the near future.

The basic message here is that "incrementalism" is a sham.  Incrementalism only makes sense if you have many opportunities to make small steps.  When it comes to health care in particular, the opportunities are few and far between.  If the bus comes by once a day, you don't take it one stop at a time.

So yes, Dr. Dean is right when he says that "Congress rarely passes reform that is not incremental."  Of course it is rare:  most of the time you can't do it.  But right now, they can.  Surely this is an argument for acting when the opportunity arises, not a justification for wasting our first shot of the 21st century.

Originally posted to Caj on Fri Dec 11, 2009 at 10:25 AM PST.

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Comment Preferences

  •  Tip Jar (3+ / 0-)

    Linking to a news article is journalism in the same sense that putting a Big Mac on a paper plate is cooking.

    by Caj on Fri Dec 11, 2009 at 10:25:01 AM PST

  •  Ok, but a public option won't and can't pass (1+ / 0-)
    Recommended by:
    Angela Quattrano

    So - we take the best possible bill and we pass it. And we tinker with it.

    Howard Dean is a smart fellow. He's using his clout to rally progressives behind a pretty good bill, because he fears that they're obsession with the public option (which they barely understand) is clouding their judgment.

    LOOK IT! I WROTE A COMMENT ON BIG ORANGE SEXY TIME!!!!

    by Mark Warner is God on Fri Dec 11, 2009 at 10:30:37 AM PST

    •  Reconciliation. nt (0+ / 0-)

      Those who labour in the earth are the chosen people of God. - Thomas Jefferson

      by Ezekial 23 20 on Fri Dec 11, 2009 at 10:51:27 AM PST

      [ Parent ]

    •  "We tinker with it" (0+ / 0-)

      The point of this diary is that "tinkering" is anything but a given, while there are a huge number of diaries that assume that before we all die "tinkering" will have brought about real health care reform.

      Between now and the next time health care reform comes up, there will be little or no "tinkering" that will happen.

      If wanting the country to succeed is wrong, I don't want to be right.

      by Angela Quattrano on Fri Dec 11, 2009 at 01:27:15 PM PST

      [ Parent ]

  •  Please (0+ / 0-)

    document how many chances a century we get for non-incremental change and the circumstances in which it occurs so that we may accurately compare and weigh the options.

  •  Beyond That, Any Overall Course Acceptable (1+ / 0-)
    Recommended by:
    PaulVA

    to mainstream politics today will destroy the country as a first world, reasonably democratic society for the mainstream. As it's been doing for 40 years.

    So we're going to need not just a Democratic majority, but a hard turn toward the progressive side on economics and environment to stop the decline of prospects for most people.

    This in a time when half the people and very little of leadership has ever known an America that wasn't declining.

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Fri Dec 11, 2009 at 10:43:11 AM PST

  •  Read the history of Social Security (1+ / 0-)
    Recommended by:
    Caj

    as it relates to incrementalism...

    "Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity." --M. L. King "You can't fix stupid" --Ron White

    by zenbassoon on Fri Dec 11, 2009 at 10:59:38 AM PST

    •  Good point. (0+ / 0-)

      This is another takedown of the "incrementalism" argument:  the government does occasionally hand down huge reforms.  Social Security is one of them.  The entire WPA, rural electrification, the complete invention of our current culture of home ownership with the creation of FNMA and introduction of 30-year fixed-rate mortgages.  
       
      We do sometimes make big, dramatic changes when they become necessary.  We are still a union because of the big changes, not the small ones!

  •  Not the whole story.. (0+ / 0-)

    Here is why incrementalism could work:

    From latest DKOS/R200 poll

    18-29 demographic
            fav/unfav
    Obama 80/16
    Democratic Party 58/34
    Republican Party 7/86

    This is a demographic nightmare for the Republicans. They now have a single digit percent favorable among this generation, the largest in American history.

    In the last election Obama won this demographic by 33 points while winning those over 30 by just 1 point. This represents the largest gap between one generational demographic and the rest of the electorate in the several decades of polling which is available.

    If the Democrats keep the support of this generation, while the older demographics are split close to 50/50 they will be in power for quite a while!

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