Win or lose, Obama has pursued health care reform as tenaciously as any president has pursued any domestic initiative in decades. Health care has now been his presidency's central domestic focus for a full year. That's about as long as it took to pass the Civil Rights Act of 1964, originally introduced by John F. Kennedy and driven home by Lyndon Johnson. Rarely since World War II has a president devoted so much time, at so much political cost, to shouldering a single priority through Congress. It's reasonable to debate whether Obama should have invested so heavily in health care. But it's difficult to quibble with Emanuel's assessment that once the president placed that bet, "He has shown fortitude, stamina, and strength."
The fight has opened a second window into Obama.
The key here is his 2008 campaign assertion that "Ronald Reagan changed the trajectory of America" more than Richard Nixon or Bill Clinton did. The health care struggle suggests that Obama views changing that trajectory as the ultimate measure of a presidency's success. His aim is to establish a long-term political direction -- one centered on a more activist government that shapes and polices the market to strengthen the foundation for sustainable, broadly shared growth. Everything else -- the legislative tactics, even most individual policies -- is negotiable. He wants to chart the course for the supertanker, not to steer it around each wave or decide which crates are loaded into its hull.Obama's core health care goals have been to establish the principle that Americans are entitled to insurance and to build a framework for controlling costs by incentivizing providers to work more efficiently. He has been unwavering about that destination but flexible and eclectic in his route. He has cut deals with traditional adversaries, such as the drug industry, and confronted allies to demand an independent Medicare reform commission. But Obama has also waged unconditional war on the insurance industry. He has negotiated and jousted with Senate Republicans. He has deferred (excessively at times) to congressional Democratic leaders but has also muscled them at key moments. He has pursued the liberal priority of expanded coverage through a centrist plan that largely tracks the Republican alternative to Clinton's 1993 proposal.
Yale University political scientist Stephen Skowronek, a shrewd student of the presidency, sees in this complex record evidence that Obama and his team are torn between consensual and confrontational leadership styles. The first, he says, stresses "the progressive reform idea of bringing everybody to the table
rational, pragmatic decision-making." The second argues "that you transform politics only through wrenching confrontation." Skowronek believes that the most-consequential presidents, such as Abraham Lincoln and Franklin Roosevelt, usually start with the first approach and evolve toward the second as they encounter entrenched resistance.
http://www.nationaljournal.com/njmagazine/politicalconnections.php
A little gossip about Rahm in there too. While it may be that Rahm was suggesting alternative ways to get it done and not advocating for giving up/taking a smaller package, its curious because I thought the "I hate Obama/I hate HCR/I hate Rahm/I love Jane crowd were one in the same and it appears Rahm might have been more of a Firedoglake guy than Obama was. I do admit that onced they start scream, preaching I stop listening so maybe I never really understood who the "I hate Rahm" crowd is.
And, I still don't get the Reagan changed the trajectory line. All I can remember of Reagan, and I was an adult and following things closely, is that he was anti education/anti intellectual and did the whole welfare queen shit which drove me crazy. What the hell else did he do to change the trajectory or is that it? That he changed the trajectory to the current hate people in need and hate people who know anything?
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