Where Health Care Stands

by Patrick Appel

From Andrew's column this week:

I suspect the bill will pass but I sure wouldn’t bet much money on it. If it fails, does this mean we could face such deadlock in the world’s largest democracy that we are threatened with what one British economics commentator has described as “a financial crisis so horrific that actions by the British or European governments would be swept away like beach huts in a tsunami”? Er, no.

People forget that the American political system is designed to stop anything getting done. Civil rights bills, even after Kennedy’s assassination, were filibustered for 37 days straight. Bill Clinton’s healthcare bill failed; Bush’s social security reform failed. The Senate, with its arcane procedures, is a brick wall against change just one senator can, in effect, stop everything. Rural states with barely anyone in them have two senators each, while the national capital, Washington DC, has none. The population represented by senators who favour health insurance reform dwarfs the population represented by senators who don’t. As Churchill once said: “Americans always do the right thing after they have exhausted every other alternative.” And that’s what the founders wanted. This isn’t a bug; it’s a feature.

After the appalling imperial presidency of Bush, Obama is trying to restore constitutional balance and order. While Dick Cheney, the former vice-president, had contempt for the rule of law, Obama is a stickler for it. His seeming passivity is actually what used to be called constitutionalism, which is why I still see Obama as a One Nation Tory rather than a liberal radical. If he squeezes this bill through, no one will now believe he rammed it through. He tried. Just as, if he imposes sanctions on Iran, no one will be able to say he didn’t try all he could to bring Tehran around. And this strengthens his position in the long run, when not all of us will be dead.