My wife and I are reading H. W. Brands’ biography of Benjamin Franklin, The First American. We have reached the part of the story where Franklin, Pennsylvania’s envoy to Crown and Parliament in London, pleads with politicians there for some kind of compromise that addresses colonial objections to the Stamp Act imposed in the mid-1760s.
The objections began with a simple premise: we are British subjects. British subjects have rights. Among the most important of those rights is that we have a say in the taxes laid upon us. Crown and Parliament began with an equally simple premise: you are colonials, subject to British laws. Therefore you will do as we say. The general attitude in Britain was that the colonials cooked up these objections based on rights because they didn’t want to pay. That was a big mistake in perception. Most colonists had a lot of pride in their status as British subjects. If London had treated them that way, they would have been happy to contribute their share to maintenance of the empire.
By now you have to ask, what does this history from 350 years ago have to do with Democratic prospects in the Trump era, and more particularly with the Affordable Care Act? It is relevant because passage of this act involves a similar, fundamental mistake in perception about how Congress and citizens interact with each other. The Bill of Rights does not contain a clause that says, “Congress shall make no law that forces people to buy insurance, or any other substantial stake in a private organization.” Built into the entire structure of American democracy, however, is an expectation that Congress compels payment only for taxes and fines. It can compel these payments because citizens have a say in laws that define them.
Built into the entire structure of American democracy, however, is an expectation that Congress compels payment only for taxes and fines. It can compel these payments because citizens have a say in laws that define them.
An insurance premium is neither a tax nor a fine. Citizens recognized immediately that a law to compel payment of insurance premiums lies outside Congress’s powers. No provision of the Magna Carta told Parliament, “You cannot tax colonists”; neither does our Constitution tell Congress, “You cannot compel insurance premiums.” Nevertheless, objections in both cases are correct.
Now we are ready to examine the Democratic party’s role in this fundamental conflict between Washington’s attitude of superiority, and citizens’ perception that Congress merely treats them as sources of revenue, or insurance payments as the case may be. Recommendations for redress address the party’s sense of disorientation, disbelief, and sense of emergency as it observes the post-November landscape. The party feels that a foreign power has moved into the White House, that we can no longer make any safe assumptions about how our democracy will function in the future. They do not recognize that seven years ago, as Congress passed the Affordable Care Act, many citizens felt the same way: dismay, disorientation, and disbelief.
So we come to a suggestion that seems entirely counter-intuitive to the party that strove so mightily for universal health care coverage. They might say, echoing Johnson when he gave up the south for civil rights reform, we will give up our place in the nation’s political life for better health care. The choice cannot be drawn so simply, though. Democrats have made government’s involvement in health care worse, not better. They have lost election after election for a cause that’s irredeemable. Ten years elapsed between the Stamp Act, and the first shots at Lexington and Concord. Barbara Tuchman included British stubbornness and loss of empire over the issue of colonial taxation in her book, The March of Folly. Will Democrats in this century be that foolish, to throw away so much good potential in a conflict they cannot win?
If Democrats want to adopt a twelve step road to recovery, the first step is to remove the individual mandate.
To climb out of the disreputable and unconstitutional hole the party excavated, Democrats should participate in good faith efforts to reform health care. Forget the pride Democrats take in Obama’s so-called signature health care bill. That one disastrous piece of legislation did more to undermine the party’s standing with voters than any other action the party took during Obama’s eight years in office. Obama made a lot of mistakes while he was in office, including serious mistakes in national security policy. The ACA was easily the worst mistake he made domestically.
If Democrats want to adopt a twelve step road to recovery, the first step is to remove the individual mandate. The mandate makes everyone a serf who pays tribute to large companies they did not choose and cannot change, with punishment – a tax, no less, according to enforcers at the Supreme Court – imposed for non-compliance. It forces people into consequential contracts in a critical area of life, with little or no discretion about the content or costs of the agreement. Remove this mandate, and you remove the primary cause of complaint against the ACA. Remove this degrading requirement, which strikes many as absurd, and major discontent about the legislation melts away.
Democrats say, “But the individual mandate supports the whole structure. It’s the keystone.” Sorry, but that’s Pinhead Gruber’s line from MIT. American health care managed to survive one of the worst attempts at reform imaginable in 2010. It’s another testament to American persistence and ingenuity. It can certainly survive repeal of the mandate. Federal enforcement of the mandate is already spotty. People at the bottom of the insurance food chain make do and muddle through. Everyone understands uncertainty, and we have had plenty of it. Chicken Little cannot convince people at this point that the sky will fall if ACA’s most humiliating and questionable provision quietly goes away in, say, 2020.
If Congress passed that small but significant measure, you can imagine the beginning of bipartisan cooling, and even maneuvering, to reform a marketplace that needs reform badly. I’ll tell you something: you will not see effective reform of this sector – especially its public components – without contributions from groups of political leaders who act independently of party interests. Democrats have already demonstrated what happens when you try to impose changes this significant with no support from anyone outside your own narrow claque. No endorsement from the Supreme Court, or any other authority, will relieve citizens’ resentment about the way their own government treats them. The tiniest bit of cooperation among leaders who care about the public interest – even on relatively insignificant, obscure changes to start – will give citizens hope of better to come.
Chicken Little cannot convince people at this point that the sky will fall if ACA’s most humiliating and questionable provision quietly goes away in, say, 2020.
Democrats cannot recover from their historic error in a short time, but if they do not disown the Affordable Care Act’s central concept – that government may force people to buy something they do not want to buy – they may never recover their standing as a rational party capable of leading a free people. Jonathan Gruber said the American people are too stupid to know what’s in the Affordable Care Act. Rather, the Democratic party appears too stupid to recognize why voters have retired Democratic politicians in astonishing numbers since Congress passed the ACA in 2010. As Obama acknowledged one loss after another, the party stood by its apparently unshakable principle: we know what’s good for you.
If you know what’s good for us, would you search for reasons you lost the White House to a flimflam man in 2016? Would you cast about for reasons to explain why the party’s influence in American politics is the lowest it has seen since the decades after the Civil War? At that time, it clawed its way back to parity with the Republican party only after voters observed several decades of Republican corruption and self dealing. Now, in the twenty-first century, Democrats lost power to a party so weak it nominated a candidate whose only selling points were his own ego, and a crude nationalism that attracted people partly because actions emanating from Washington, especially since 9/11, had humiliated them so.
Even though Republicans nominated someone manifestly incapable of leading a free country, Democrats still lost. It happened partly because Democrats had already shown – for different reasons – that they also had no capacity to lead a free country. With a choice like that, voters in state after state opted for a candidate, and a party, who represented less of a sure thing. It doesn’t matter if you are correct when you think you have nothing to lose. What matters is that you think it. When that attitude takes root you have conflict without hope, one of politics’ more destructive phenomena.
Democrats in 2010 enacted a disgrace based on Gruber’s pinheaded Massachusetts plan. Voters rightly punished the party, as fools ought to be punished.
I am not going to argue that if Democrats had enacted health reform consistent with American traditions of freedom, they would necessarily have kept the White House last year. John Adams, Martin Van Buren, and George H. W. Bush succeeded popular presidents from their own party, but examples of such succession are few. A Democrat would have had a difficult time winning in 2016, no matter how strong their nominee.
More persuasive is the contention that Democrats would be in better shape, from dog catcher on up, if they had not broken faith with the country in 2010, when they appeared so proud of their Gruberific accomplishment in drafting the ACA. If they had tried their best to enact health care reform that would work, voters would have forgiven them small faults and shortcomings. Instead they enacted a disgrace based on Gruber’s pinheaded Massachusetts plan. Voters rightly punished them, as fools ought to be punished.
Nearly eight years later, Democrats have an opportunity to remedy the damage they did to the country in 2010. Their self-confident, smoothly cool and smoothly arrogant leader is out of office. Nancy Pelosi is minority leader, and Harry Reid is retired. The party’s most recognizable tribune is a white-haired senator from Vermont named Bernie, God bless him. Except for Trump’s core supporters and assorted hangers on, few regard the president as an effective leader. Even Paul Ryan, Speaker of the House, cannot seem to figure out what he ought to do now his party is in front of the footlights. If the Republican party wants to project an image of chaos in place of coherence, it is succeeding.
Nearly eight years later, Democrats have an opportunity to remedy the damage they did to the country in 2010. Their self-confident, smoothly cool and smoothly arrogant leader is out of office. Nancy Pelosi is minority leader, and Harry Reid is retired. The party’s most recognizable tribune is a white-haired senator from Vermont named Bernie, God bless him.
In these circumstances, Democrats find a strange and unexpected opportunity to take initiative and modify their own handiwork, in ways apparently beyond the capabilities of their earnest opponents currently in power. Following the collapse of Republican efforts to repeal ACA and replace it, Democrats can assess where health care stands in 2017, then introduce changes that would improve the current agglomeration of contradictory rules and poorly planned innovations. They can actually lead, if they grasp the reasons for their weakness.
As a coda, consider qualities of reform necessary for effective leadership this area. New efforts to improve delivery and funding of health care should be: 1) incremental, 2) neutral regarding people who currently receive benefits from the state, and 3) gradually restore market practices to American health care. I can elaborate on these three qualities in another post. Meantime, you will see Democrats struggle to win electoral support for at least another ten years, if they do not engage in reasonable efforts to correct the bizarre series of mistakes they made when they adopted an MIT professor’s recommendations to reform the whole country’s health care system according to a vision sprouted from the People’s Republic of Cambridge, Massachusetts.