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The Generational Health Care Debate
Note: a version of this essay ran in today's Roll Call. You can see it here.
Millennials, young Americans under 28, provided President Barack Obama most of his popular vote margin over John Mc Cain in 2008. Now their belief in the need to involve the federal government in comprehensive health care reform may become the President's most powerful argument in persuading Congress to deliver on that campaign promise this year. But to do so the President will have to overcome some serious differences between members of older generations in both parties, and in both houses of Congress, on just how accomplish that task.
The Senate is almost equally divided between members of the Silent Generation, born between 1925 and 1945 and Baby Boomers born between 1946 and 1964. Recent elections have raised the percentage of Boomers in the lower house to almost three fourths of all members.Of course, partisan allegiance and local politics play an important role in determining a legislator's voting decisions. But the differing perspectives of these two "leadership generations" have already influenced each house's approach to the policy debates on a number of issues so far this year and are likely to do so again on health care this summer.
Democrats in the House of Representatives, for all of their ideological posturing, are actually led by members of the Silent generation, including Speaker Nancy Pelosi (1940), Majority Leader Steny Hoyer (1939), Democratic Whip James Clyburn (1940), Dean of the House John Dingell (1926), and committee chairmen such as John Conyers (1929), Pete Stark (1931), Ike Skelton (1931), Charles Rangel (1932), John Murtha (1932), James Oberstar (1934), Dave Obey (1938), Henry Waxman (1939) and Norm Dicks (1940). The parents of the "adaptive" Silent Generation protected, some would say smothered, members of this generation during the traumatic childhood events of their youth-the Great Depression and World War II. As a result members of the Silent generation are often risk averse as adults and tend to prefer the of bi-partisan compromises that John McCain, a Silent born in 1936, talked about so often during his campaign.
By contrast, almost all of the House Republican leadership is from the Baby Boomer Generation. Boomers are the latest incarnation of what William Strauss and Neil Howe, the originators of generational theory, call an "idealist" generation. Members of this generational archetype tend to believe deeply in their own personal values and seek to use the political process to implement their personal ideological convictions for the whole nation to follow. Because the Boomer generation has been divided about equally between the two ideological poles and parties(half of them voted for Obama, half for McCain in 2008), America has experienced political gridlock for the past four decades.
Boomers have spent a lifetime rebelling against the Silent Generation's belief in institutional allegiance and compromise and will find themselves once again having to accommodate the older generation's sensibilities if they actually want to pass legislation such as health care reform. Democratic Boomers will need to find common cause with the Silents in their party, while Republican Boomers are likely to emphasize their ideological differences from their Democratic counterparts. Republican Boomers will want to demonstrate their ideological commitment to lower taxes and a less active federal government. Moderate Democrats from the Blue Dog and New Democratic caucuses, who share some of these concerns with Republicans, are likely to be more willing to compromise on these issues with their Silent Generation leaders than liberal Boomers might want or be willing to.
In the Federalist Papers, James Madison said that the Senate would be a "necessary fence" against the "fickleness and passion" of members of the House of Representatives. Either George Washington or Thomas Jefferson was reputed to have called the Senate a "saucer" designed to "cool" House legislation. Whether the Senate was meant to be a fence or a saucer, in this Congress it often operates as a generational bulwark against the increasingly hot passions and partisan bulldogs who serve in the U.S. House of Representatives.
The Senate has already played this role during this session of Congress. In the debate on the President's Recovery Act, Silent Generation Senate leaders forced the House to accommodate some of the demands of the Senate's most moderate members. During the course of that debate, House Democrats were able to prevail in the name of party unity on their Senate counterparts to accept a "recission rule" in the budget resolution that would allow Democrats, if they so chose, to ignore the Republican minority and pass health care reform with only 51 votes. But even after that agreement, Silent generation Montana Senator Max Baucus (1941) has been determined to find a bi-partisan bill that his Republican counterpart and Silent, Charles Grassley (1933), can support. Meanwhile, Senator Chris Dodd (1944), thrust into the health care debate due to the illness of Senator Edward Kennedy, has played the very typical role of those born on the cusp between both generations--seeking to find a solution that leans more to his ideological beliefs, but one which still contains an element of compromise for the other side.
But how this inter-generational interplay between the two houses and the two parties will actually play out in the health care debate will depend on how much President Obama uses his instinctive knowledge of what Millennials want to convince the Congress to get something done. Born in 1961, on the cusp between the Baby Boomers and Generation X, the President's generational style is hard to pin down. Liberal Boomers appreciate his idealism and commitment to economic equality.On the other hand, like many Gen Xers, Obama has sought to distance himself from the divisive, ideological debates of the recent Boomer past. At the same time, Obama's political behavior does not square with the harsh and cynical approach of clear-cut Gen Xers like Sarah Palin. Whether it's because of his unique upbringing in Indonesia and Hawaii, removed from the debilitating debates of the 1960s; or whether it's because his chief speechwriter is a precocious Millennial; or because of his intellectual tendency to search for consensus, President Obama's political style consistently seems to capture the very traits that his loyal Millennial supporters most admire.
Millennials are not interested in letting ideological posturing stand in the way of "getting stuff done," as Obama likes to say, especially in an area as crucial as health care. Like the members of other generations, virtually all Millennials (90%) believe that it is time that health care is made more accessible and affordable for all Americans. However, only a third of Millennials, in contrast to about half of those in older generations, are concerned about the impact of greater governmental involvement in the health care system (36% vs. 47%). And, Millennials are far less likely than older generations to prefer once again deferring health care reform to avoid higher taxes or larger deficits.
The fundamental question that members of Congress from each generation, and each party, will need to answer during this summer's health care debate is just how much they want to accomplish as opposed to scoring political points or pursuing ideological agendas. It's a classic question to which members of the Silent Generation are likely to respond with offers of compromise, even while Boomers on both sides of the aisle insist on what they consider to be non-negotiable principles. For Millennials, however, the answer is clear--reform the nation's health care system now as the next step in delivering on the kind of "change we can believe in" that their leader, Barack Obama, promised and now asks Congress to deliver.