A realist's achievement
It is in the nature of our system of government that compromise is almost always required when some wish to make substantial change in the laws we live under. In the House vote, one issue group (pro-life) forced another issue group (revision of the health-care system) to yield on one of its preferences in order to achieve others. That is the way of democracy.
Leaders must always weigh and rank priorities because they can seldom get everything they want. When one surrenders a lesser goal in order to achieve a higher goal, that is generally a sign of good leadership; when one surrenders a more important goal to win on a lesser goal, that is poor leadership. The trick is in determining which goal is of the higher priority. In this case the president and the speaker concluded that passing a health care bill now was more important than either access to abortion or a more comprehensive government insurance program.
In 1965, Democratic leaders in Congress, working with President Johnson, gave up hopes for a broad national health insurance program in order to enact smaller pieces of one -- Medicare, to cover the elderly, and Medicaid, to cover the indigent. Today, those are considered by advocates of health care subsidies to be monumental achievements.
It's not a matter of weighing what you get against what you fail to get; it's a matter of weighing what you get against what you would have gotten if you had failed to reach a compromise. Some leaders are visionaries, whose legacies are inspirational, but other leaders are realists, whose legacies are often solid, if incomplete, achievements. Both kinds of leadership are valuable, and people placed in positions of formal leadership quite frequently have to decide which kinds of leaders they will choose to be.
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