How to spend political capital

I'm not sure it's wise to assume that a significant number of Republican senators will hop aboard a universal health care bill without actually making it a bad bill. It's not just that Republicans don't want Democrats to benefit alone from the legacy of the policy but that they actively dislike the policy. I'm also not sure advising that the next president make health reform his or her number one issue speaks to anything more than the advisers personal interest in that particular area of policy.

That said, young health wonk Ezra Klein is exactly right here.

[I]n 1994, Bill Clinton... convened a massive task force that eventually grew into 30 separate working groups that boasted 500 separate participants. The point of this task force? Er, to write a bill.

Predictably, those arms of government actually tasked with writing bills felt a bit left out. Sara Rosenbaum, now the chair of health policy at George Washington University, was eventually charged with drafting the Clinton plan. Looking back, she says, "I was the biggest mistake of the Clinton health care bill. It was a terrible error to have the president doing what Congress was supposed to do. It was a misuse of the relationship between the legislative branch and the executive branch. The executive branch is supposed to generate action, and the committees are supposed to actually take the action. By sending a 1,300-page bill, you're writing a detailed blueprint for the policy rather than using the congressional process to create a consensus."

A very important bit of history, this. Whatever issue the next president tackles first, he or she would be foolish to become wedded to the passage of a particular bill (with a particular title) before that bill has been larded up and swiss-cheesed by the very people on the Hill who will gladly exploit the president's ambition. That's a fantastic recipe for blowing a bunch of political capital by paying for the quiescence of the worst politicians in the country, and (if everything goes well) signing a bill at the end of the process that nobody likes. Much better for the president to take a position of authority and demand that Congress submit a bill with X and Y mandatory provisions (and without X and Y poison pills) for consideration by date Z. The president, in other words, should goad Congress into giving more and more, rather than allow Congress to goad him into accepting less and less.