For nearly 20 years, U.S. Rep. Jim McDermott has been one of Seattle's most popular politicians.
He's been seriously challenged just once — in 1988, when, in his first race for Congress, he received 38 percent of the primary vote, with the remainder split between future Seattle Mayor Norm Rice, King County Assessor Ruthe Ridder, and four others. Since then he's received an average of nearly 78 percent of the vote.
"He will be re-elected as long as he wants to run for office," state Democratic Chair Dwight Pelz told a reporter.
Progressives have praised the 7th District congressman for voting against the Iraq war, and he became a minor national celebrity after appearing in Michael Moore's antiwar film, Fahrenheit 9/11.
But does a progressive veneer make up for below-average performance? Do good intentions excuse a lack of judgment that undermines his effectiveness and make him, in some corners, a laughingstock?
McDermott's signature issue is health-care reform. The psychiatrist has long advocated for a single-payer system to the exclusion of virtually any compromise or incremental plan.
His latest proposal, the American Health Security Act of 2007 (HR 1200), would eliminate Medicare, Medicaid, and the health plans for federal workers, military dependents, and military retirees. In their stead, McDermott would pool payroll taxes, require the states to create basic health plans, and ban private insurance companies from offering their own plans that duplicate the basic health plans.
It's the kind of sweeping change that McDermott has failed to persuade others is the right change.
And with McDermott, it's all or nothing. In 1993, at the Clinton administration's request, he deferred pushing his single-payer plan, even while attacking Clinton as "going down the wrong road." The next year, as the Clinton health-care reform plan sank under the weight of its own complexity and alarmist attacks by special interests, McDermott urged Congress to abandon health-care reform. "He evidently expected a more favorable political environment after the 1994 elections and, like many, was surprised by the result," wrote Michael Barone and Grant Ujifusa, authors of the Almanac of American Politics.
But the Democrats lost control of the Senate in 1994, and McDermott's assessment turned out to be a bad judgment call.
Meanwhile, in 1993, Washington state had developed its own reform plan that would have achieved universal coverage by 2000. The state worked hard with then-U.S. Rep. Mike Kreidler, who now is insurance commissioner, and U.S. Sen. Patty Murray to persuade the federal government to grant a waiver from a federal law so large employers could be required to participate. But the state reform would have had many of the managed-competition elements of the Clinton proposal. Since that didn't reflect McDermott's single-minded approach, he was invisible, other than to offer a lukewarm endorsement, saying state officials "did the best they could."
By 1998, while McDermott continued to advocate single-payer, others had begun working for incremental change. McDermott served on a bipartisan Medicare reform commission co-chaired by U.S. Sen. John Breaux, D-La. Breaux negotiated a proposal to get a Medicare prescription drug benefit that would be tied to structural changes and competition to hold down costs. Breaux got 10 of the 11 votes he needed. McDermott (and other Democrats) dissented, saying the cost controls would bar access for some people. Reform was stopped dead again, and Breaux was bitter, directing his comments to McDermott and his allies. "More and more people in Congress have an all-or-nothing attitude," Breaux said. "All-or-nothing attitudes generally wind up getting nothing."
Is McDermott right in insisting on a single-payer model? Single-payer proponents argue that ending privately funded health insurance would eliminate an expensive middleman, redistribute money more coherently, and reduce costs. But it doesn't change the financial incentives in the system so that they encourage keeping costs down while increasing quality — a key element of the managed-competition reforms that the Clintons and state reformers worked toward.
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