Even Democratic strategist James Carville admits that the Democrats will lose seats in the 2010 election, but partisan politics won’t have a permanent impact on their agenda.
AAOS Now: Is Washington paralyzed by partisanship right now, and if so, why?
Mr. Carville: Well, I don’t know if it’s paralyzed but it is partisan. There’s not very much cross-voting. I think that the combination of the gerrymandering of the congressional districts and the segmentation of information probably has something to do with that. There’s also some intensity in the country that’s pretty deep that makes it very difficult to maneuver. But this has been going on and building up for some time. I wouldn’t be surprised to see it break. A lot of times, things get really bad, then they get better.
AAOS Now: Is this about the worst you’ve seen it?
Mr. Carville: It was pretty bad in the Clinton years. The current situation is exacerbated by the fact that we have wars and recession, which always makes people more frazzled than they’d be normally. It may be a little bit worse, but it’s certainly not unanticipated.
AAOS Now: Did President Obama made a tactical mistake in not reaching out heavily to Republicans a year ago?
Mr. Carville: I don’t know how much more he could have done. I just don’t think the Democrats were ever going to get any Republican votes, even after the Democratic leaders said, ‘Well, we’ll put in the four things you want.’ They got three Republican votes on the stimulus package in the Senate.
AAOS Now: Can Republicans gain political capital by opposing healthcare legislation?
Mr. Carville: They’ve gained a lot of political capital. But you know, we’ve still got a long way to go between now and election day. I think that some Republicans sense that they’ve got to try to do something where they don’t look too obstructionist.
AAOS Now: Are the Democrats making a mistake in not embracing tort reform more?
Mr. Carville: Well, President Obama said, ‘I’m going to put the pilot program in the bill,’ and if the Republicans would have come in and negotiated, they could have gotten a lot more. If that was what they wanted, the Democrats would have given more to get them to go along. But, really, why do you need a national law? Any state can have any tort law it wants. What physicians want is a federal statute. Okay, but understand a state legislature can have any law it wants.
AAOS Now: What are the consequences in November if the Democrats unilaterally pass healthcare reform?
Mr. Carville: First of all, if they don’t pass it, it’s almost certain that they’ll pay a huge price. There’s a 100 percent chance that they’re going to be damaged significantly and profoundly if they don’t pass it. Maybe there’s a two-thirds chance they’ll be damaged significantly and profoundly if they do pass it.
AAOS Now: What effect would not passing healthcare reform have on President Obama?
Mr. Carville: If it fails, he’s going to look weak. If it passes, he’s going to look stronger. Everybody knows that—the Republicans know that, and the Democrats have come to sort of realize that. That’s why I believe they’re going to get the votes to pass the bill.
AAOS Now: Have physicians fallen by the wayside in this healthcare reform debate?
Mr. Carville: If you look at the American Medical Association—their contributions and stuff like that—they have a pretty big presence in Washington. You could make an argument for political activism from individual physicians, but they’re pretty well represented in Washington.
AAOS Now: Are there areas that the healthcare reform legislation has covered well, or areas in which it has fallen short?
Mr. Carville: I don’t know. In our system it makes no sense to insure a 58-year-old obese diabetic. It also makes no sense for a healthy, active 22-year-old to buy health insurance. To get insurance companies to insure people with preexisting conditions who are likely to get ill, you have to bring a lot of people into the system. That’s what legislators, in some inelegant, imperfect way, are trying to do. They’ve been very inarticulate about explaining that to people.
AAOS Now: Could they have done a better job explaining the issues?
Mr. Carville: Nothing of any magnitude—particularly something of this magnitude—has ever been done that, when you look back, you could say it could’t have been done better. It’s impossible. We won World War II even though we did things that were bloodily stupid, but we did more things that were smart. No one would say that mistakes weren’t made. If the standard is perfection, we would never get anything done.
AAOS Now: Any predictions for the 2010 elections?
Mr. Carville: I think the consensus right now is that the Democrats will lose 27 House seats and 6 Senate seats. I think there’s some hope that the Democrats can cut their losses a little shorter than that, but they’re going to lose seats—no doubt about that.
AAOS Now: If power shifts in Congress, could that smooth some things out and force bipartisanship?
Mr. Carville: It might. But, remember when it shifted in the 1990s, the first thing the Republicans did was try to shut the government down, and that didn’t work too good. But I think that when things look like they can only get worse, that’s when they actually start to get better. It’s kind of counterintuitive.
AAOS Now: Coming from New Orleans, you probably have a pretty good perspective on that.
Mr. Carville: We moved down here in June 2008, and it was just awful. And now look. Who would have thought that on Saturday night we’d have a new mayor elected with 66 percent of the vote, and the next day we’d win the Super Bowl? What a weekend!
AAOS Now: Are there some areas where you and your wife find some consensus?
Mr. Carville: Neither one of us thinks that term limits are particularly effective. I’m not very much of a protectionist. We both have no problems with any kind of gay rights.
Locally, we both supported the same candidate for mayor. We share a lot of common beliefs.
Peter Pollack is a staff writer for AAOS Now. He can be reached at firstname.lastname@example.org
Editor’s note: Keynote speakers for the AAOS 2010 Annual Meeting Mary Matalin and James Carville were featured in the Friday Daily Edition of AAOS Now.
After their speech, the two pundits sat down one-on-one with AAOS Now writers Terry Stanton and Peter Pollack for exclusive interviews. The polar-opposite couple shared their thoughts on everything from life in New Orleans to politics in Washington, D.C.