The Real Price of Politics
Obamacare is not an aberration
Dec 2, 2013, Vol. 19, No. 12 • By JAY COST
In The Price of Politics, journalist Bob Woodward describes the toll that politics took on the presidency and public image of Barack Obama during the budget battle of 2011. Elected as an outsider with little experience in governing and none in executive leadership, Woodward’s Obama is ill-equipped to handle the byzantine ways of Washington. The result is a tarnished president, a nation brought needlessly to the brink of credit default, and a sharp diminution of public trust.
While valuable as a fly-on-the-wall account of a momentous battle, Woodward’s book overlooks the real price of politics in Washington. By focusing on personalities rather than enduring power relations, it obscures the fact that in America, we regularly burden our politicians by requiring a government built for limited purposes to tackle an endless array of modern demands. Our government’s chronic failure to meet our expectations is the price we pay.
A case in point is Obamacare. It is tempting to write off the disaster that is the Affordable Care Act as a product of congressional and presidential malpractice, but that would be facile. The reality is that the terrible defects of the president’s health care bill are the sorts of excesses you would expect to see under our system as it has evolved.
Despite the intense ideological and partisan divisions that characterize our politics, there is considerable agreement on the broad contours of policy. Just about everybody believes that the federal government has some responsibility for the public welfare. The differences between the two sides are primarily a matter of degree: Liberals have much more faith than conservatives in the government’s ability to secure the public good.
Too often, debate over what government should do takes place in the abstract. But the particulars of the American system are relevant. Our government was never meant to accomplish the grand, bold tasks that both sides today believe it should. There is a reason why Congress and the courts, for instance, have had to expand the meaning of the interstate commerce clause almost to the point of absurdity: This is the only way around what was intended to be, and was sold to skeptical citizens at the time as, a limited grant of power. And the institutional structure of the government—a president, the courts, two chambers of Congress, all connected via checks and balances—was designed to manage only those limited powers.
What we the people have done over and over since ratifying the Constitution is expand the power of the federal government without revising its structure. Americans started doing this all the way back in 1790, when Alexander Hamilton read the Constitution as granting Congress the power to charter a bank, even though the Constitutional Convention had voted down that very idea. As Washington’s reach has been extended, instead of overhauling the structure, we have merely tinkered at the margins, modifying the Electoral College, instituting direct election of senators, limiting presidential terms, and so on.
The result is a profound mismatch. We expect an essentially pluralistic government to behave as a national one. It cannot do this, and so public policy is characterized by inefficiency, ineffectiveness, and even at times injustice.
James Madison thought factionalism was inevitable, and he feared some groups would dominate at the expense of the public good or private rights. So he offset a vast array of competing interests via a structure that is inherently defensive. Under Madisonian pluralism, power is distributed so that all factions have a seat at the table of government, and the likelihood of abuse by an aggressive majority is curbed. But today we expect our government to be not pluralistic and defensive, but national and active; Uncle Sam is somehow supposed to cut through parochial interests and advance the interests of the country. That is unreasonable.
In reality, bold federal endeavors require costly side deals with well-positioned factions, which must be bought off, regardless of whether their positions are good for the country or their exacting ransom is bad for the country. Our system gives them a veto, leverage to exact a fee from Uncle Sam. That is the real price of politics. Sometimes these fees simply make programs cost more than they otherwise would. Sometimes they undermine the original goals of an initiative. And sometimes they harm innocent citizens who should be the beneficiaries of public policy.
From an electoral perspective, not a single member of Congress is responsible for the good of the nation, though many are happy to indulge groups that dominate their states or districts. Only the president is accountable to everyone, but even he is also answerable to his party—and his formal powers are limited by the Constitution. If the government were asked to do only what a fair reading of the Constitution authorizes it to do, this design would not be a problem. In its time, the arrangement of powers and branches was a brilliant innovation to ensure that all sides were treated fairly. A government, however, that is expected to generate economic growth, build highways and bridges, support farmers, make sure families have food on the table, provide access to health care, fund scientific research, ensure food, drug, and product safety, help kids afford college, maintain expansive and unmatched armed forces—even put a man on the moon—invites special treatment for well-positioned interest groups. In a word, it breeds corruption.
Worse, the more authority the government claims for itself, the more parts of society it affects. This rouses otherwise dormant factions to defend their interests. Thus, the price of politics rises higher and higher. More federal power means more interest groups and therefore still more side deals. If you want to know why the population of metropolitan Washington has skyrocketed, in numbers and wealth, over a generation, this is the answer. An ever-more ambitious government has drawn more and more interest groups to the capital to make sure they get their cut of the federal pie.
This helps account for the disaster of Obamacare. There are, of course, vigorous debates to be had about whether government should be responsible for everyone’s health care. But for our government to accomplish this goal, Obama and congressional Democrats had to buy off a motley crew of factions. Indeed, this was one of their principal concerns: luring on board the “stakeholders” who had stymied reforms before.
The result is a socially indefensible law. Even if we grant that the government should insure all Americans, Obamacare’s distributional effects are perverse. An unstated rule of politics is that policy should leave middle-class families better off, or at least no worse off. Obamacare tramples on this principle, sticking it to families who buy insurance on the private market. Millions of Americans are seeing their insurance rates go up while their coverage networks shrink.
Why did they lose out? Not because they are wealthy and privileged, and so can bear the cost. Rather, it is because of the bill’s political design. These people had the misfortune of being unorganized politically at the time the bill was passed; most of those receiving cancellation letters had no idea they would suffer this way. Well-organized interests, meanwhile—doctors, hospitals, drug manufacturers, insurance providers, the AARP, labor unions—all were cutting deals so they could walk away winners. Similarly, a straightforward tax on the American people to pay for expanding health coverage was avoided for fear that people would organize in opposition. So President Obama and congressional Democrats shifted the burdens of the bill onto an unorganized group in a hard-to-detect manner. Political brilliance perhaps, but social perversity.
This is not the only example of the toll of politics. Take Medicare. It is an obscenely wasteful program that has cost substantially more than anyone initially imagined and still leaves gaps in health coverage for seniors while straining the resources of doctors and hospitals. Yet it remains essentially unreformed, because altering it would offend too many entrenched groups. Besides, who notices its gross inefficiencies? We never experience what it would be like to have the money that Medicare wastes. The loudest voices clamor to protect the inefficient status quo.
It is not just liberal sacred cows that have this effect, either. Those who champion the tax code as a tool for promoting economic development or social improvement must answer for its chronic wastefulness. The noble goal of spurring the economy is hindered in our system; you have to purchase well-positioned groups by burying hard-to-find payoffs in the tax code. Again, who suffers? The government collects less revenue than it would otherwise, but nobody personally feels a loss. The tax code, however, becomes so weighed down with special deals that it must be reformed once a generation.
All of this signals a profound irony of American civic history. A careful reading of the Founders, especially Madison, suggests that they were deeply concerned about the danger of corruption, a cancer they feared could rot the body politic from within. Their system carefully balanced structures and powers to prevent that. Subsequent leaders had less regard for balance and blithely expanded government’s powers without revisiting the structure. The result? A government so riddled with corruption that its people no longer trust it—and are right to doubt it at every turn.
For generations, Americans have prided ourselves on our Constitution, though we choose neither to follow it dutifully nor to revise it thoughtfully. Obamacare is the bitter fruit of our civic recklessness. It rewards or punishes factions in society according to their political prominence. Republicans may eventually manage to repeal it, but as long as the country retains a disjointed view of what our government can do, we are bound to repeat its mistakes time and again.
Jay Cost is a staff writer at The Weekly Standard.
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