by leoncillo sabino

Health Care Reform: Another Victim of US Presidentialism

The vote by the US House of Representatives on health care reform has been hailed by many as a victory for those many million Americans deprived of any sort of medical coverage. True, there are important, new developments, which Rose Ann DeMoro of the California Nurses Association does a very good job of explaining. Some of these measures were part of Obama’s electoral manifesto during the 2008 campaign.

Still, the conceiving of a tax-financed single-payer system, let alone a “socialized” one, is nowhere in sight. It still sounds bizzarre to people like myself, who live on the other side of the pond (where systems, it should be pointed out, differ both in terms of organization, financing and quality, but still rest on the principle of free, or almost free health care for all), that the largest economy in the world would choose not to grant what is considered as a right (generally enshrined in the Constitution) in most of the world’s advanced countries. Autocratic Germany passed the Health Insurance Bill in 1883, which was gradually extended to cover the entire population; Britain created the NHS in 1948; Italy officially created its in 1978, to make just a few examples. Too often have I listened to horror stories concerning many Americans (including personal friends) who developed serious illnesses and thanked fate for residing abroad, thus obtaining free health care in their new country of residence.

Now, the way this US bill was elaborated and passed represents, in my opinion, further corroboration of the fact that the US presidential system was devised, more than 200 years ago, to attain a specific goal: that is, preventing “radical” legislation from being passed by the political system. As I argue in my book The Roots of Contemporary Imperialism: The Founding Fathers, the U.S. Constitution, and 200 years of corporate dictatorship, the Founding Fathers were cunning enough to devise a system which would create “a path strewn with obstacles in the belief that it would encourage the kind of slow, deliberate politics that were their ideal,” as Daniel Lazare has argued; or, as Charles Beard has put it, “disintegration of positive action.” The political system they devised aimed at preserving the status quo, that is, domination by an already powerful business elite over the people. Only overwhelming popular pressure, extreme crises and the risk of implosion of the system have led to major legislative breakthroughs (or, rather, “concessions” from the elite), such as, to make just a few examples, the Sherman Antitrust Act of 1890, the National Labor Relations Act of 1935, the Minimum Wage Act of 1938 and the Civil Rights Act of 1964. Indeed, as street riots or a widespread popular rebellion directed toward obtaining a national health care system appear as a remote possibility, the vicissitudes of the health care bill show the truthfulness of such assertions.

Constitutional engineering alone does not explain the shortcomings of the presidential system.

There are three additional elements, not strictly related to the US Constitution, which nevertheless overlap and help create a situation in which:

* party nominees are not necessarily their parties’ leaders (as a result of primaries), and thus their political platforms do not necessarily tally with their parties’;
* with very few exceptions, only those “eager to ‘go along to get along,’ ” as William Domhoff has put it, that is, those willing to accept massive corporate donations will win a Congress seat or the presidency, a phenomenon which is obviously not just Republican, but regards Democrats as well, thus further alienating Democratic voters as well as potential ones;
* the electoral system, in joint action with the size of the US territory, stimulates fragmentation and therefore party weakness, thus resulting in lack of party discipline, a situation made even more serious by the influence of corporate interests on elected politicians.

These three elements overlap with constitutional ones, such as the rigid separation of powers: two separate Houses, elected in different ways and at different times; and an executive (that is, the President), elected by a state-based electoral college. Thus, the President is not guaranteed a majority in one House, let alone in both; or, the President might have a majority for a limited time, and then lose it at mid-term elections; or, he may have a majority for his entire term of office, but that does not guarantee party discipline or a common plan on specific issues (with Democrats being a perfect example, supporting, for instance, emancipation in the North and Jim Crow in the South). Also, the President is not even allowed to introduce bills into Congress, and therefore has to rely on Congressmen for that; and Congress is fragmented into countless committees and sub-committees, which in most cases do

Pages: 1 2 3 4