Lefties Against ReformA taxonomy of left-liberal opposition to the health care bill.

Click here for a guide to following the health care reform story online.

Dennis KucinichConservative arguments against health care reform tend to be monochrome: too many pages, too costly, too much government interference in our lives. But while the right supplies nearly all opposition to the health care bill, it does not have a monopoly. There is also an emerging opposition from liberals and the left. Thus far, it remains small, but its arguments are more diverse and more interesting—though ultimately, I think, mistaken. Among left-liberal opponents, I count three factions.

The unemployment-is-more-important faction. One short month ago, health care reform had no more ardent advocate than Robert Reich—former labor secretary, current Berkeley professor, and longtime policy entrepreneur. On Oct. 12 Reich wrote on his blog:

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Now's the time for Congress and the White House to say to the insurance industry: You want to play hardball? Okay. We'll play it, too. … We're going to make sure Americans have the freedom to choose a public insurance option that's cheaper and better, and you're going to have to work hard to keep them your customers.

Reich fought ferociously for the public option, which remains in play; in a June 24 Wall Street Journal column, he urged President Obama to "come out swinging for it." But other issues in health care reform have engaged him, too. On Oct. 18, he wrote that Obama ought to abandon a deal confining Big Pharma's contribution to health care reform to $80 billion in exchange for the pharmaceutical manufacturers' support, likening it to the hush money David Letterman refused to pay a blackmailer. A consistent theme in Reich's commentary was his worry that Congress and the White House might be insufficiently bold, but that only added to the urgency of his message: We must do this.

Then, on Nov. 1, Reich posted a blog entry under the headline, "Health Reform Is Critically Important, but Getting Americans Back to Work Is More So." Huh?

Obama, Reich wrote, "seems to have made all the right moves to enact something he can credibly label health-care reform." Reich continued: "I sincerely hope America gets genuine health reform and I hope it's stronger than what's emerging in the Senate." But Reich then went on to fault Obama for making health care reform his top domestic priority "when the economy is still so fragile and unemployment moving toward double digits." He continued:

While health care reform, if done right, can help American families stay afloat in the economy, the current bills won't offer most Americans any appreciable decline in the cost of their health insurance nor clear improvement in the efficiency or quality of the health care they receive, and those who will benefit won't see the benefits until 2014 at the earliest.

What's more, Reich argued, the Obama administration's reluctance to take on Big Pharma, the American Medical Association, and the insurance lobby, will probably

make the resulting reform far more costly than it would be otherwise. These extra costs will be borne by those Americans who will be required to buy insurance but won't qualify for federal assistance, along with Medicare beneficiaries who will be paying more and receiving less. These people may not know they're indirectly paying the costs of buying off these industries, but they'll know they're getting shafted (Republicans will be sure to make them aware, even though the GOP has a much longer record of shafting the middle class for the benefit of big business).

Reich stops short of saying Obama should immediately drop health reform and fund a jobs program instead. Indeed, Reich says the "realist" in him recognizes that even if Obama were to "pivot off a health-care victory" with legislation aimed at reducing unemployment, that would still come too late to make much difference in next year's congressional midterm elections. The inescapable conclusion is that it's already too late: Obama should have bypassed health reform months ago and assembled a jobs bill instead. Never mind that Reich himself has, for months, been urging swifter, bolder action on health care reform.

I initially dismissed this analysis because Reich is only one man—and one with a uniquely short attention span. But the unemployment-is-more-important movement has since acquired a second adherent in Bob Herbert of the New York Times. In a Nov. 9 column, "A Word, Mr. President," Herbert writes that although health care reform is important, it is not nearly as important as putting Americans back to work or ending the war in Afghanistan. Like Reich, Herbert now thinks Obama should have put off health care reform to focus more of his attention on these other problems. "We have spent the better part of a year locked in a tedious and unenlightening debate over health care," Herbert complains, "while the jobless rate has steadily surged. It's now at 10.2 percent. Families struggling with job losses, home foreclosures and personal bankruptcies are falling out of the middle class like fruit through the bottom of a rotten basket."

I believe as strongly as anyone—even the two Bobs—that the government should be working to reduce unemployment as quickly as possible, through direct public employment if necessary. (See "Wrong Harry," in which Charles Peters and I called on the Obama administration to emulate Harry Hopkins' Civil Works Administration, which in 1934 created 4 million government jobs in two months.) But the idea that health care reform represents some petty distraction from what truly ails America is just screwy. In February, when Obama first turned his attention to health care reform, sagging employment meant that 14,000 Americans were losing the health coverage every day. Today the comparable figure is probably more like 5,000, since the economy is shedding jobs about one-third as quickly as it was nine months ago. That doesn't mean lack of health insurance has become a less urgent problem. In February, unemployment stood at 7 percent; now, as Herbert noted, it's above 10 percent. And as Herbert's New York Times colleague Paul Krugman noted in January,

helping families purchase health insurance as part of a universal coverage plan would be at least as effective a way of boosting the economy as the tax breaks that make up roughly a third of the stimulus plan—and it would have the added benefit of directly helping families get through the crisis, ending one of the major sources of Americans' current anxiety.

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Timothy Noah is a senior writer at Slate.

Photograph of Dennis Kucinich by Paul J. Richards/AFP/Getty Images.

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