Yet while polls show that health care is a top priority for voters, and while the policy differences among the slew of Democratic presidential candidates are meaningful, the moderators posing highly specific questions about the issue at past debates have ignored something important: However coherent, complete, fiscally sustainable, or popular the positions the candidates are taking on health reform—and on other issues such as immigration, education, taxes, and more—presidents do not get to wave magic wands and make their policies happen. They are thrown into a governing process in which a president’s plan is almost never enacted into law fully, if it is enacted at all. The legislative process, in recent decades, has become even more toxic. But questions that press the candidates on how they would navigate through this environment—and what they would do to reduce its toxicity—have been conspicuously absent in every debate so far.
Candidates’ résumés and policy proposals alone do not tell us how they would govern. President Donald Trump, elected in part by those who thought a businessman could run a government like a business, has given new life to the term
kakistocracy—the worst kind of government, run by the worst kind of people. Both Jimmy Carter and Bill Clinton stumbled in their first year as president because they thought their experience as governor of a small state prepared them for the White House. Neither established an effective personnel-management system at the outset, and both left sizable gaps in their teams at levels below the Cabinet that took years to remedy. Both mistakenly thought that dealing with Congress would be similar to dealing with the Georgia or Arkansas legislature; neither established a smooth process to run the White House early on.
Whoever is elected president in 2020 will face similar challenges, but also will have to deal with a tribalized and weaponized political process, regardless of whether the new chief executive enjoys majorities in both houses of Congress or control of the government is divided, as it is now (and was for six of the eight years of Barack Obama’s presidency). A president will have to contend with an obstacle course to get executive positions filled, much less judicial nominations, and will also face a court system that itself is becoming more partisan and divided along stark ideological grounds. The next president will have to deal with a political system ever more skewed by the unrepresentative nature of the House, the Senate, and the Electoral College; the role of big and dark money; and the lack of voting access for large numbers of Americans, partly as a result of voter-suppression efforts.
This is the frame in which voters need to evaluate candidates for president. Whether Elizabeth Warren’s Medicare for All plan is workable and fiscally sustainable means little if, as president, she faces either a Republican Senate or one in which Democrats have a slender majority—a majority that would include moderates and conservatives such as Kyrsten Sinema and Joe Manchin. Ditto for Joe Biden, Pete Buttigieg, Amy Klobuchar, and other candidates who have less radical plans to reform the health-care system. Warren’s road map depends on a huge expansion of the Medicare program, made free to millions and done via budget reconciliation, which requires only 50 votes in the Senate. But the reconciliation package would have to include a huge tax package to pay for the immediate and long-term costs—something that would be a very hard sell to the Manchins and Sinemas, among others. One can be certain that, if Democrats win the White House, the Republicans in Congress will fall back on the game plan they used for 2010 and 2014 with Obama as president: Vote in unison against anything the president proposes or supports, and delegitimize and try to undermine any policies that still get through and are enacted.
Debate moderators should ask the Democratic hopefuls questions like these:
How would you approach policy making if you face a Republican Senate led by Mitch McConnell?
If you have a Democratic majority in the House and a 51–49 majority in the Senate, how would you get your program enacted? How would you handle the filibuster, which effectively means that any significant legislative action requires 60 votes? How would you persuade veteran senators who are leery of eliminating the filibuster, such as Dianne Feinstein, to agree to a change? And how much can you really achieve via reconciliation—given that you would have trouble keeping all your Democrats in line on certain votes?
How, if at all, has Donald Trump changed your view of executive power? Where and how would you employ it if Congress blocked your priorities?
How would you organize your White House? What kind of person would be your chief of staff, and why?
You will have about 3,000 positions to fill in the executive branch, about 1,000 of them Senate-confirmable. How would you go about filling those jobs? Who would you pick to be personnel director, and why?
Who, in your view, are the best three Cabinet officers to serve in your lifetime, and why?
Name three people you might consider for secretary of state, secretary of defense, secretary of the Treasury, and attorney general, and why.
What steps would you take to make our democracy work better? How would you make them happen?
Ideally, an entire debate would be devoted to how each candidate would govern, if elected president, in a political environment like the one we actually live in. But moderators owe it to voters to ask at least some questions on the topic—instead of returning over and over to the same debate about Medicare, and to the pretense that presidential candidates’ elaborate plans magically become law.