The Politics of Health Care Reform

Dueling rallies on health reform issues accurately reflect public frustration with the system, but it would be a mistake to think that people would calm down if the issue was resolved.  In fact, health questions are a symptom.

The underlying disease is a structural political problem that pits the interest of the political professionals in both parties, who have a preference for remaining in power backed by an impregnable base, with the voters, who increasingly think that neither party has all the answers and want the option of making ad hoc decisions in favor of the candidate who seems better on particular issues at a particular time.

A new ABC-Washington Post poll reports that a record 43% of respondents classify themselves as independents.  At best, 10% of the seats in the House of Representatives are competitive. That means that most Americans live in Congressional districts where their vote in Congressional elections is usually irrelevant.

People who realize that their vote doesn't count seek other devices, ranging from taking to the streets or aligning themselves with polarizing cable political operations or denying the legitimacy of those elected to the system (which explains why we so regularly hear about impeachment, to say nothing of those who have their doubts about where our President was born).

Despite such screams, the polls also tell us that the people generally want to govern from the middle (favoring some health reforms, but having doubts about single-payer or even a public plan) while politicians see the center of the road as nothing more than a collection place for dead armadillos (to use Jim Hightower's construct) and argue accordingly suggesting that reforms without a public plan would be meaningless or that any expansion by the government in an area where it already controls about half the market would somehow tip the scales into the cauldron of socialism).

In the short run, there's not a lot that can be done to defuse this tension. Ultimately, the White House will probably find a balance point and get a bill, but the basic tension between the center and the poles will fester on.

The symbiotic relationship between the press and politicians comprises an informal conspiracy in favor of drama and against centrist solutions.

It is unfortunate that so few realize we're on the cusp of one of those housekeeping rituals that get too little public attention -- redistricting.  Every decade we have a national census that apportions Congressional seats and requires the states to redraw the lines designating Congressional districts.

In recent years, this process has become increasingly sophisticated with computers quickly creating multiple options until an acceptable one is found.  The underlying problem does not involve technology.  Rather it reflects an inherent human conservatism.  Each party, represented by incumbents interested in retaining personal power, is more interested in retaining the seats it has rather than risking them by opting for a more competitive environment where it might win more, but only in an atmosphere where the odds of slipping back were somewhat greater as well.

The process becomes increasingly precise and sophisticated.  The number of competitive seats goes down and the amount of money spent on each seat goes up.  In essence, each of the few truly competitive races is high jacked by well-funded  outside group.  These contests become surrogates for a Presidential referendum.

Too often, incumbents are most vulnerable to a primary challenge, where few vote and modest amounts of money can make a big difference.  Primary challenges almost always come from true believers who allege that the incumbent has sold out his principles by participating in a political system greased by compromise. 

Whatever the flaws of incumbents, they are not stupid.  They know that compromise is a bad word and have become habituated to avoid it.  That works for them, but at a big price to the system.

I am not unsympathetic to arguments that have been made for strong political parties by David Broder and others.  In the past, parties have served as a moderating force, defining the 40-yard lines that appropriately  constrict American politics and creating something of a farm system that provides access to the tested unrich.

But parties don't always seem to do a good job of representing the people.  At the moment it appears that both parties are weakening (as independent identification grows)and becoming more strident and divisive in an effort to retain shrinking core constituencies.

Some of us want to see President Obama as an antidote to that trend, which is why we praise his rhetoric about bipartisan initiatives and are not discouraged by his tendency to make a mid-course correction when an issue as divisive as creation of a public health insurance plan is suggested.

Others see such behavior as weakness.   Ultimately, though, both sides are projecting their perspective as the reality is gradually constructed.