The health care debate has now raged on for nine months, and a public that demands results is showing its frustration. President Obama’s approval ratings have dropped into the low fifties.
Nine months? Too long a time? Try 97 years!
Theodore Roosevelt first proposed universal health coverage during his 1912 campaign. Notably, he was not running as a Republican. (The GOP had no more interest in serious health care reform in 1912 than it has today.)
Check this out from TR’s Bull Moose platform: “The supreme duty of the Nation is the conservation of human resources through an enlightened measure of social and industrial justice,” the platform read. “We pledge ourselves to work unceasingly in State and Nation for ... the protection of home life against the hazards of sickness…” Teddy lost the election, so nothing happened.
Some 36 years later, Harry Truman pushed hard for universal coverage. He too failed. Bill Clinton tried in 1994. He lost the Congress for his trouble.
All this recalls James Madison’s Federalist #10, which opens with the famous line: “Among the numerous advantages promised by a well constructed Union, none deserves to be more accurately developed than its tendency to break and control the violence of faction.”
Madison defines faction as “a number of citizens, whether amounting to a majority or a minority of the whole, who are united and actuated by some common impulse of passion, or of interest, adversed to the rights of other citizens, or to the permanent and aggregate interests of the community.”
He argues that “the effects” of faction can be controlled through representative government and federalism, both provided for by the Constitution. And what will representative government operating within a federal system produce? Careful deliberation followed by compromise — the Constitution will help us break and control the effects of faction by requiring that we compromise.
So to understand President Obama’s approach to health care reform, you have to understand Federalist #10. Hamiltonian conservative that he is, Obama embraces Madison’s argument when he urges bipartisanship.
So how is Madison holding up after all these years?
Not so good, actually. Health care reform is just the latest example of an important issue that Congress has permitted to be stalled or trashed by “a minority of the whole actuated by … common interest … adversed to the permanent and aggregate interests of the community.”
The country’s most egregious legislative failure was slavery and its resulting institutional racism. We fought the bloodiest war in our nation’s history to free the slaves and save the Union only to have a small number of racists from the Old Confederacy take over the Senate. (Those seniority rules, and let’s not forget the filibuster tradition — both alive and well today.)
They stopped bills from even being voted on. (Just as the minority threatens to attempt to do to health care reform.) And over in the House, the Southern members used the Rules Committee to prevent bills from even getting to the floor for debate; forget voting.
As a result, progress has not always come through the Congress — it was the Supreme Court, not the Congress, that ended school segregation. And it took 89 years following Lee’s surrender before that happened. As recently as the early 1940s, the Southerners derailed serious consideration of anti-lynching legislation. The Armed Forces were integrated not by the Congress but by President Truman through his 1948 executive order. And it wasn’t until the summer of 1964, a century after the Civil War ended, that President Johnson cajoled the Congress into passing the public accommodations act. At the time there were 97 members of the House from the old South. All but eight voted “no.” In the Senate? Of 21 Southern senators, 20 voted no. They denounced the reform as socialism. (Sound familiar?) In 1965, LBJ, emboldened by the 1964 landslide election and given support by moderate Republicans, succeeded with his Medicare and Medicaid initiatives. (Where are the moderate Republicans today? Name more than two?) This landmark legislation would be America’s last successful health care initiative of the 20th century.
In the late 18th century, the term “faction” referred to the emerging political parties. The framers opposed party politics. Were Madison alive today, however, he would be more concerned about the interest groups that now dominate parties rather than those mobs actuated by “common impulse of passion,” which he so feared. On Capitol Hill, an army of 7,000 lobbyists has massed, waves of three-pieced suits, all dedicated to the care and feeding of their health insurance company employers that expect members of Congress to give fair value back for all those campaign contributions.
That’s not compromise. That’s rule by a minority special interest.
Compounding Madison’s “political science” errors was his understandable failure to anticipate the late 19th- and early 20th-century arrival into the Union of our “empty quarter states.” And what have they meant for Madison’s theory of government? Well, six senators from states that are home to less than 3 percent of the nation’s population held health care reform hostage for more than three months. How is genuine compromise supposed to emerge from this silly political arrangement?
If over the next several weeks the president overcomes the deadening institutional inertia on Capitol Hill and actually manages to forge a genuine Madisonian compromise — which must take the form of a bill no one loves — he will have pulled off The Miracle at 1600 Pennsylvania Avenue. For any serious health care reform would be the first America has seen in 45 years — indeed, it would be the first comprehensive health care reform ever.
