A Portrait of a Technocrat: Jacob Hacker 

Whether "strong," "robust" or otherwise, the much discussed public option has now been mercifully dispatched to legislative oblivion. 

The event has provided the occasion for even the most fervent cheerleaders for Obama to wake up to the reality that what masqueraded as health care reform constitutes a de facto bailout to the insurance industries-one which will force millions to purchase junk insurance under penalty of law, limit access to reproductive health services to all but a few, and which will continue to relegate the world's richest nation to the status of some third world countries in most indices of public health. 

The question which has increasingly troubled liberals is what put them on the road to perpetual compromise which inevitably culminated in what is recognized by the administration's most die hard supporters to be a "debacle." 
 
Ultimately, the answer rests at the top. And for this we need to turn to the architect of the public plan, a then little known Yale Professor of Political Science albeit one with a incipient reputation for "brilliance" tempered with "pragmatism." 

That these two characteristics were crucial in Jacob Hacker's success should come as no surprise to those familiar with the political class, though with the proviso that the two adjectives are to be understood as near synonyms.   "Brilliance" in the lexicon of official Washington has to do with intellectual ability or achievement only insofar as this has been validated in the form of appropriate credentialling, generally  by Ivy League institutions.  "Pragmatism" is really a euphemism for what is in Adolph Reed's words,  a "politics based on proximity to the ruling class and a belief in the basic legitimacy of its power and prerogative." 

Were Hacker a toiler at an obscure state school, the bland technocratic soup served up in bite sized portions for public consumption in the New Republic or American Prospect or in heaping slabs in jargon laden academic tomes would have been relegated to the tenure file-at best.   Conversely, had Hacker used his Ivy League platform to offer a health reform plan which saved lives, improved well being and reduced costs- he would have been greeted been seen as "idealistic" or "doctrinaire" and thereby consigned to irrelevance.  The prima facie evidence for this is offered by the work of  Himmelstein and Woolhandler, whose single payer advocacy  while emanating from an equally august academic perch at the Harvard Medical School was removed from the table a priori while  Hacker's was enthusiastically greeted by the establishment from the outset.

According to its supporters,  the rejection of single payer was crucially related to its substance-specifically in its removal of the "secondary" insurance industry from the health care transaction, and hence the source of its enormous profits.  But while this reading is certainly correct, single payer was also highly problematic not only in substance but in style.  Its fatal flaw, perhaps paradoxically for those claiming to value clear language and clear thinking, consisted in its basic outlines being all too clearly understandable-especially when these were expressed in the three word slogan "medicare for all".  

In contrast, the vagueness of the "public option" proposed by Hacker was, from the standpoint of official Washington, not a liability but an asset, or, in current parlance, a feature not a bug. The endless series of congressional hearings, town hall meetings and backdoor maneuverings, resulting in the dilution of this or that component of an incomprehensible and uncomprehended public option could go on largely without scrutiny from a public whose outrage would have materialized then rather than now, after the fact.  Add into this the willful blindness of Obama's liberal base still intoxicated with "their" victory  and all too willing to place their faith in any process overseen by their anointed, the dominoes were all in position for the public option to collapse into a heap of rubble. 

Hacker's role in this farce lay first in drawing up the plans and implementing the construction of this Potemkin Village.  But while his constructive function should be recognized, it should not be allowed to obscure a secondary role as a saboteur of the demonstrably superior product offered by the competition.  For contemporaneous with his marketing of the "public option" Hacker was actively engaged both on the public stage and likely behind the scenes in undermining the single payer option. 

Hacker was smart enough to know that the case against single payer could not be made own merits.  Rather  his tactic was to claim that a "big government takeover" of health care was not just anathema to insurance companies safeguarding their bottom line, it was also, according to Hacker, feared and distrusted by the public at large.  We now know, from the recent work of Kip Sullivan, that Hacker's claims along these lines were based on selective and dishonest readings of polling data.  But by this point the wounds inflicted by Hacker and his rejectionist cadre have proven fatal; the single payer fatwa imposed across the board from the far right to the "pragmatic' left insured that the opportunity for meaningful health reform would pass by unfulfilled. 

****

The profile of Hacker which emerges from studying these and other efforts is a far from attractive one, and in adding in the background the blemishes appear in even sharper relief.  

In this connection, it should kept in mind that the governing class keeps a sharp eye out for those sending signals that they will serve as pragmatic stewards of the affairs of state-by which it is meant those willing to shape public policy in the interest of major business and financial institutions and at the expense of everyone else.  Those passing muster receive the most coveted possession among the bloated ranks of those striving is to whisper in the prince's ear: access.  

Hacker's undertaking this performance is well within a time honored tradition of the best and the brightest serving up policies to elites who  profit, literally and figuratively, from their implementation, maintenance and outcome.  But whereas the Rostows, McNamaras and Bundys of a previous generation would eventually be saddled with a fully deserved reputation as the mass murderers, liars and rogues,  Hacker has, so far at least, escaped from having his public image and personal reputation being been brought into alignment with the policies he signed off on.  He may still appear in public without concern that one of the many victims claimed by health care reform will attempt to, for example, throw him over the transom of the Edgarton ferry to expire in the watery depths, as occurred to one of Hacker's illustrious predecessors.

Indeed, there is little doubt that Hacker is now a permanent fixture in the anonymous constellation of technocrats comprising the Washington consensus. He will continue to make periodic appearances in this or that administration-always ready to with a "brilliant" and "pragmatic" scheme to comfort the comfortable and afflict the afflicted while masquerading as a reformer.

Those health care advocates who encountered his proposals should have carefully counted their change and checked their wallets.  That they did not bother to do so has much to do with the "debacle" which will define the health care system for at least the next generation.