Commentary: Liberals' passion for public option

Editor's note: Julian E. Zelizer is a professor of history and public affairs at Princeton University's Woodrow Wilson School. His new book, "Arsenal of Democracy: The Politics of National Security -- From World War II to the War on Terrorism," will be published this fall by Basic Books. Zelizer writes widely about current events.

PRINCETON, New Jersey (CNN) -- President Obama was caught off guard by the frustration that liberals expressed at the suggestion he might drop the public option from health care reform.

House Speaker Nancy Pelosi warned that, "There's no way I can pass a bill in the House of Representatives without a public option."

The proposal for the government to offer Americans health insurance as one of their options had excited many Democrats.

But the White House insists that the public option was not central to its original plan. One senior adviser complained to the Washington Post, "I don't understand why the left of the left has decided that this is their Waterloo." Still, the administration responded to its critics and again expressed support for the public option.

The passion among liberals for the public option is something the White House should consider when deciding how to talk about the rest of the proposals over the next two months.

Unlike so many of the health care proposals that are being discussed in Congress, the public option offers a type of clarity to average citizens that allows them to make sense of what is at stake in this legislation when they are debating the bill around the kitchen table or at the town hall. Unlike the public option, many of the other proposals being debated, such as the health insurance exchanges, are much harder to understand.

When so much is at stake with legislation, voters get anxious when they can't understand what is being proposed. This is why picking the right symbols and rhetoric has played such an enormously important role in presidential success. When Presidents Kennedy and Johnson pushed for Medicare in the early 1960s, they understood that placing the program within Social Security helped voters understand what the reform would entail.

Opponents of any kind of reform always have the upper hand. After all, it is easier to mobilize against something than it is to build and sustain support around a new proposal.

During the town hall meetings, opponents have no trouble explaining what they are against: They don't want government intervention and they don't want change. The complexity of the proposals in Congress -- and the failure of the administration to adequately explain how they would work and what they would accomplish -- has helped the cause of this opposition.

Proponents of health care have been having a difficult time with the challenge of complexity ever since President Clinton moved Democrats away from the traditional goal of single-payer system, whereby the government would become the sole source of insurance and provide every citizen with coverage, and toward some centrist hybrid of government and market-based care.

In 1993, the Clinton administration proposed a 240,000-word plan that attempted to reduce costs through regional health care exchanges. The plan was complex. Even worse, the political scientist Theda Skocpol reported that the administration was politically ambivalent about talking about the exchanges in too much detail, fearing that saying too much would only cause further political problems.

Speaking of the health care alliances, Clinton adviser James Carville told a New York Times reporter, "That's not where the debate goes. I don't understand exactly how the Social Security system works, but I'm for it." Opponents responded by portraying the plan as a Frankenstein monster.

The cartoonist Joe Sharpnack published a cartoon depicting an elephant, saying "Sheez! Can you believe this guy?" as he points to an impossible-to-follow chart labeled "Clinton Health Care." In the next frame he points to another chart, which is blank and labeled "Republican Plan," as he says, "Now here's something a little easier to understand. ..."

With voters unable to understand the nuances of much of Clinton's plan, the opposition had succeeded in portraying it as a huge government takeover that would eliminate patient choice. They have done the same this time around.

President Obama has also struggled with the complexity of the reform proposals and demonstrated the same kind of ambivalence about taking his plan to the voters. He has made things more difficult by staying out of the legislative fray, refusing to make demands on Congress, and limiting how much he talks about the specifics that he thinks must be part of the bill.

Whether the public option will remain in the mix is unclear. But the passion that exists toward the public option -- something lacking for most of the other proposals now being floated -- should nudge the White House into doing a better job explaining what Obama's most important health care proposals are and how they will work. Otherwise opponents will win the debate.

The inability of the White House to clarify its proposals has been extraordinarily damaging and has allowed August to turn into a huge political problem for the administration.

The opinions expressed in this commentary are solely those of Julian Zelizer.

All About Health Care Policy • Bill Clinton • Barack Obama