Much is being made in certain circles of the failure to obtain bipartisan support for a health care bill that would dramatically affect over one-sixth of the U.S. economy (17.4 percent, according to a Center for Medicare and Medicaid Services Report released February 4, 2010). Republicans are behaving more like Texas high school football fans than statesmen, it is being said, fanatically adhering to party-line talking points in the face of a President earnestly seeking common ground. The Republican minority in Congress is being “obstructionist,” it is said.
Well, folks, Congress is supposed to be obstructionist.
Most of the citizens of the world would agree that the U.S. Founding Fathers pretty much got it right. For more than two centuries we have been the envy of the world and preferred destination of emigrants. Many of the qualities that invite such admiration and covetousness were established in our founding documents and the institutions they created. The primary job of those institutions is to not screw up what was right to begin with.
Each branch of the federal government—Executive, Judicial, Legislative—was designed to be fairly conservative and yes, when it matters, obstructionist. Flaring tempers and public passion, from Tea Party or Me Party, are not supposed to rule the day. That’s why, when the stakes are high, fifty-one percent is not enough.
I teach American history at El Centro College in Dallas County. In one of my recent classes we were discussing the framing of the United States Constitution. I thought it would be instructive for my students to debate how much support a particular bill should have in order to become law, so I set up an example in which I asked each student to imagine that he or she was one of 100 homeowners along an unpaved street, each a member of a homeowners association with the responsibility for maintaining and improving the neighborhood.
In my scenario several homeowners had proposed that the street be paved, with expenses to be borne equally by each homeowner. My question to them was: how many of the 100 homeowners must be in favor of and vote for the project before all 100 should be obligated to pay for it?
At first, a few students believed 51% majority should prevail.
Then some pointed out that meant one person, the fifty-first, might decide that 49 would have to pay for something they neither wanted nor could afford. Others pointed out that in any event all of the owners would benefit and there were many good reasons for doing it.
Ultimately the class formed a consensus that there should be a vote of somewhere between two-thirds and three-quarters in favor.
Another consensus developed that the scope and cost of the project should have a bearing on the required size of the vote in favor: the more impact or cost, the greater percentage required. Fifty-one percent could decide to trim tree branches, for example, but three-quarters would be needed to cut down the trees and haul them away.
So it is with enacting laws at the national level. The framers of the Constitution debated a number of options to prevent a tyranny of the majority, which they believed was just as bad as a tyranny of a monarchy or oligarchy. They didn’t settle on a requirement of super majority, but instead set up a system where there were a sufficient number of “veto points” that would prevent the enactment of a momentarily popular or trendy measure that would be too expensive or too disruptive. They realized that such measures required considerable reflection before implementing, and should not be done hurriedly.
The Founders created a separation of powers scheme in which a central government would have a limited role, state and local governments would be diffuse, and the legislative process itself would be cumbersome: a measure would have to pass through two legislative houses and be approved by the executive, then, possibly, tested by the judiciary.
The Senate in particular was designed to be conservative and deliberative, from the staggered six-year term of Senators to the procedural rules of debate and voting. That meant some very good reasons and reflective consideration would be necessary before enacting measures that would be as far-reaching as, say a systematic reform of a national healthcare system. The United States Senate is a hoop to jump through, a hurdle, a minefield, or whatever metaphor you wish to employ. It is supposed to be so; it was designed to be so.
There are estimates that 14% of Americans are at one time or another without medical insurance. That means that 86% have it. But lack of insurance does not mean lack of medical care, at least in the United States.
In most metropolitan areas there are public hospitals that provide care for indigent persons and those that lack the means to pay full cost. True, they often must seek that care through emergency rooms, but they nevertheless are able to obtain it. Is emergency room care in really more expensive? Maybe, maybe not. I have it on good authority that hospitals often inappropriately charge costs to emergency room accounts as a ploy to obtain funding that ordinarily would be difficult to obtain. Such adaptive accounting exaggerates the true cost of the ER.
And one can always pay cash for medical services, sometimes receiving deep discounts from physicians grateful for not having to deal with inaurance companies.
It is also true patients often spend long times waiting in public clinics that provide free or reduced-rate services. That’s part of the price of “free” medical care.
In a debate which has lasted almost a year it has become obvious that, while perhaps fifty-one percent of Congress wants the current bill, many, many Americans do not, primarily those who will pay more for it and receive less under it. The lack of a super majority in the Senate seems to be a major roadblock, and that is good.