Obamacare: What Would Ben Franklin Do?
Obamacare: What Would Ben Franklin Do?
April 5, 2017
Congress is fundamentally a deliberative institution. Deliberations take time and they’re often messy – in fact, the bigger the issue, the messier the deliberations. The designers of our Constitution wanted a great, big, ugly debate whenever a decision was being made. They wanted the subject to be held up to every conceivable light and for every voice in the country to be heard.
That is certainly true of the effort to replace the collapsing bureaucracy of Obamacare with the patient-centered marketplace we have long promised. Those deliberations must continue until they bear fruit, because there is no excuse for failure.
Obamacare is only getting worse. Last year’s average 25 percent premium increase is likely to be followed by even bigger increases this year. The flight of health care providers from the system is only going to accelerate. The rapid expansion of Medicaid – which could exceed spending on defense by next year – is not only fiscally unsustainable – it doesn’t even guarantee care.
Dwindling Medicaid providers and lengthening waiting lists means that many Medicaid patients have no recourse but to flood emergency rooms. The original Medicaid population – the elderly, blind and disabled – who are only reimbursed an average of 57 cents on the dollar, are pushed to the back of every line by able-bodied Obamacare expansion patients who are reimbursed at 90 percent.
The American Health Care Act is far from perfect. I had argued vigorously for a comprehensive bill rather than our current piece-meal approach. I lost that debate, but I haven’t lost sight of the ultimate goal: to restore our healthcare system as the best in the world. I could list a lot of other things that could be made better in the current bill – and perhaps in our extended deliberations they will.
But those who expect perfection in our legislation fundamentally misunderstand our system. Congress was never designed to make perfect law. It was designed to make the best law that is acceptable to the most people. And it’s pretty good at that, when we let it be.
When the Constitutional Convention seemed hopelessly deadlocked, Benjamin Franklin declared that he didn’t entirely approve of the Constitution, but he had learned over the years to doubt a little of his own infallibility, and to recognize the limitations of making decisions with others. He noted that when you assemble a group of people to benefit from their collective wisdom, you also had to accept their collective shortcomings, and realize that a perfect product is never possible from such a process.
In another speech, he recalled as an apprentice tradesman, trying to fit together two pieces of wood. It was often necessary, he said, to shave a little from one and a little from the other until “you had a joint that would hold together for centuries.” In this same manner, he urged them to “each join together and each part with some of our demands.”
Compromise is not an end in itself. It is a means to an end. As long as that end moves us forward toward better policy, more freedom, greater prosperity and stronger security, whatever imperfections the measure may include are often precisely what are required to bring it to fruition.
I fear we are losing sight of these simple truths. Ironically, factions within the House who are the most adamant in opposing Obamacare have become, as a practical matter, its most effective defenders. I know they don’t intend this to be, but the reality is that Obamacare survives today solely because of their actions in this House.
Benjamin Franklin was right. In deliberations of this magnitude, it is essential that we each doubt a little of our own infallibility, that we each part with a few of our own demands, in order to join together and produce the reforms our country depends on us to enact.
A political minority doesn’t need to compromise – it has the luxury of standing solely on principle. But the majority, entrusted with making the actual decisions to guide our country to better days, must compromise if it is to make law that will hold together for the centuries.
Lincoln once reminded Congress that we can succeed only by concert. He said, “It is not ‘can any of us imagine better,’ but ‘can we all do better.’” He urged us to rise with the occasion, to disenthrall ourselves – for only then could we save our country.
I hope some of our colleagues will consider this advice during the Easter recess.