Victory for public action

What worried me most during the nadir of healthcare reform was that the country had become essentially ungovernable and incapable of solving our largest and most pressing problems. Our nation, with its checks and balances and devolved federal structure, is exemplary at allowing political action and participation to flourish (as well as factionalism — see Madison). However, those same characteristics combined with evolving Senate rules have also made collective action at the federal level on something as complicated and detailed as healthcare a near impossibility. What Congress proved on Sunday was that our republic isn’t a pre-modern relic.

Congress reached an elegant solution that provides needed security for uninsured families who are exposed to the unconscionable vulgarities of the healthcare market. At the same time, it maintains market principles and resists the annexation of healthcare to the federal government. Yes, an individual mandate makes some libertarians uncomfortable, but it is a necessary step. If a smaller, less obtrusive solution were available, Congress and the president would be obliged to seek it. Healthcare is a unique policy issue in that the risk of falling ill must be spread broadly. There is also a broader principle at stake: Healthcare proponents believe our republic is not based merely on personal responsibilities, but also some basic obligations to each other.

Critics of the plan like Douthat and Will argue that Congress will not be able to enact these Medicare reforms because they will be too politically painful. If they are correct, then what's the point in even trying to fix our country's policies — presumably their own fixes are susceptible to the same fatalistic critique, or are not large enough to actually fix anything. Their solutions are plenty painful and lack none of the elegance of the new law.


The views expressed in this blog do not represent the views or opinions of Generations United.