What the Hell is the Presidency For?

By Richard Kirsch

Reading Caro's biographies of LBJ has become a multi-generational experience in our family. At 15, my son, who had never read anything more than Harry Potter, became enthralled with them, devouring the first three. This year, he bought the newest volume as my birthday present, I got my dad the book for Father's Day, and my dad gave the book to my son for his birthday.

Much of our great fascination with Lyndon Johnson is the duality of his character: willing to lie and cheat, devoid of any principles on his path to power, and then as president, using that power to achieve lofty, principled goals that transformed our nation forever.

As Caro describes in the latest volume, The Passage of Power, as LBJ was preparing to address Congress just after assuming the presidency, "a fierce debate" between his advisors "erupted -- over the emphasis to be given in the speech to civil rights." As the discussion went on until 2:30 in the morning, one advisor concluded with the argument, "The presidency has only a certain amount of coinage to expend, and you oughtn't to expend it on this."

LBJ replied, "Well, what the hell's the presidency for?"

As I read the words of the good Johnson -- and all it has meant for America -- it reminded me of theongoing controversy over whether Barak Obama made a colossal blunder by pressing ahead for health care reform in 2009 in the face of the growing economic crisis. I'm not interested here in weighing in on whether this was a political mistake or whether it had any impact on the economy. What matters to me is that, like LBJ, Obama overruled his advisors multiple times and made a courageous moral decision, without regard to short-term politics.

Barack Obama is not a great incarnation of good and evil like Lyndon Johnson, but he too is torn between two sides of his nature. As I recount in Fighting for Our Health, there is the Obama that is looking to conciliate, to avoid appearing partisan or strident, to be so committed to finding common ground that he'll give up half the farm with little or nothing in return. When it came to health care, this Obama surrendered without much of a fight on numerous important provisions that would have made health care more affordable and most famously refused to push for, let alone fight for, the public option.

And then there's the Obama who not once but four times went against the advice of his staff and insisted on pushing for health reform that would aim to cover everyone. The Obama who, when his back was to the wall, took off the kid gloves and won.

In the summer of 2008, Obama's campaign staff advised him not to make health care a big issue in the election. He overruled them, and in the month before the election, 86 percent of his campaign ads included health care.

In February of 2009, as the depth of the great recession became apparent, most of Obama's top team told him to give up on health care and focus just on the economy. Instead, he told the nation in his first joint address to Congress, "health care reform cannot wait, it must not wait, and it will not wait another year."

In July of 2009, before the tea party eruption, White House Chief of Staff Rahm Emanuel said it was time to retreat to "kiddycare," legislation that would aim at covering all children and pregnant mothers. The president refused, and after the August tea party demonstrations he appeared before Congress and declared, "I am not the first president to take up this cause, but I am determined to be the last.... We are the only democracy -- the only advanced democracy on Earth -- the only wealthy nation -- that allows such hardship for millions of its people."

The last and biggest test was after Scott Brown took Ted Kennedy's seat in January of 2010, a refutation at the polls that led Emanuel to press for kiddycare again. Instead, the president went to a retreat for Republican members of the House and made them look foolish. He unleashed his administration to finally go after the health insurance industry, using a big California rate increase as a pretext. And he worked closely with House Speaker Nancy Pelosi and Majority Leader Harry Reid to design complex legislative maneuvers -- along lines that LBJ would have been proud of -- to get a strengthened bill to his desk.

What accounts for Obama's deep commitment to passing a health care law that would finally make affordable health care a right? As with LBJ's commitment to civil rights, there was clearly a personal side. Obama's repeated telling of the story of his mother fighting with health insurance companies while dying of cancer was not just a good political anecdote; it was seared into his memory. His own story was reinforced by the letters he read every night in the White House from Americans recounting their own health care horror stories. At his core, Obama understood, as did LBJ, that he had the opportunity to use the presidency to bend the moral arc of the universe toward justice. As Jonathan Alter recounts in The Promise, on the night of his election, before addressing the gleeful crowd in Chicago's Grant Park, he asked himself what was the one thing he could do that would most help the average American. His answer was health care.

While today we cannot imagine going back to an America before the passage of the major civil rights legislation in 1964 and 1965, both laws met with great resistance in the South after their enactment. Even today, governors and legislatures in the South are trying to undermine voting rights legislation. It is no surprise, then, that the right and its wholly owned political party are intent today on killing a government right to affordable health coverage. But if ObamaCare survives the Supreme Court and the next election -- and it is likely to do both -- history will reward President Obama for his courage when it mattered.

Dr. King said, "Of all the forms of inequality, injustice in health care is the most shocking and inhumane." Looking back, ObamaCare will be seen as a fundamental turning point in America's health care system, toward both greater equity and a focus on the quality of care more than the quantity of care. The historic law will be viewed as a significant measure to deal with a new economy in which jobs do not come with health care benefits. As it grows and evolves, the Affordable Care Act will take its place alongside Medicare and Social Security as foundational elements of the United States government providing security to its citizens. It will be a point of pride to call it ObamaCare.

Well, what the hell's the presidency for?

Richard Kirsch is a Senior Fellow at the Roosevelt Institute, a Senior Adviser to USAction, and the author of Fighting for Our Health. He was National Campaign Manager of Health Care for America Now during the legislative battle to pass reform. This post appeared first in Next New Deal, the blog of the Roosevelt Institute, and also was cross-posted in the Huffington Post.