Harry Truman wanted to create a national healthcare system. He failed. Lyndon Johnson wanted to create a national health care system. He got Medicare and Medicaid passed, but not the rest. Bill Clinton wanted to create a national healthcare system. He failed.
Now Barack Obama says he wants to create a national healthcare system. However, his strategy has consisted of putting the reform process in the hands of Democratic Senator Max Baucus, and Baucus's strategy has consisted of putting the reform process in the hands of Republican Senator Chuck Grassley, who basically opposes health care reform. What's going on here?
A clue to the Democratic approach to health care reform can be found in the Republican approach to abortion. Ever since Francis Schaeffer created the anti-abortion movement in the late 1970s and early 1980s and persuaded conservative Protestants to sign up, the Republican Party has used opposition to abortion as a way to get these conservative Protestants to donate money and turn out on election day. Of course, if the GOP ever actually got around to overturning Roe v. Wade like the religious right wants, the issue would go away, and the money and votes would stop flowing. Thus, for 30 years the GOP has been milking the abortion issue, promising the religious right to put a stop to it, and then breaking that promise. For six years, from 2001 to 2007, the GOP controlled all three branches of the federal government, and yet the Roe v. Wade decision still stands today.
If you want to understand why the Democrats keep promising to deliver health care reform, but somehow keep failing in spite of massive public support and control of the presidency and Congress, look no further than the GOP's abortion policy. Success would mean no more money and votes from the policy's supporters, so success must be avoided at all costs. Once you realize that this is the engine driving Democratic policy, everything that's happened to the reform process makes perfect sense.