Compromise: It's Good For Our Health

When I speak to audiences of children about my books on the Constitution and Bill of Rights, I emphasize the role of debate and compromise in the creation of both of these charters of government. I say that compromise means giving up something to get something. I explain that the Founders had much that divided them – big states vs. small states; farmers vs. merchants; North vs. South; whether or not to end slavery – and argued over provisions that some of them wanted in the Constitution and some did not.

In the end, I say, most of them had a common goal: Forming a government that enabled all of the states to work together as one nation was more important than any other issue, or in getting their way on all of the issues. And because of that common belief, the Founders compromised on many matters to achieve the goal they shared: A constitution for the United States.

So with no path left to modifying the current health care laws other than compromise, I think that’s a good thing. When it comes to governance, I’m a firm believer that the soundest decisions result from vigorous, informed debate in the spirit of achieving a common goal.

But that’s where my optimism hits a wall. Because that, I’m afraid, is what’s missing from this debate: A common goal. I don’t think that as a group this Congress or this President agree on what their goal is, and until they do whatever debate occurs going forward is not likely to result in agreement.

The majority of the people in the U.S., I believe, think that Congress and the President’s goal should be to achieve an affordable health care system that provides a basic level of coverage for all Americans and protects them from financial ruin in case of accident or serious illness.

Not all politicians appear to share that goal, however. For some Republicans, their goal is simply repealing what they derisively like to call Obamacare. On the other hand, for some Democrats their goal is protecting Obamacare at all costs and collecting a win for the “resistance.” These politicians are so focused on winning that they’re willing to sacrifice policy for the sake of politics.

Compromise for politicians whose goal is political victories is virtually impossible. One side has to win the debate and one side has to lose. There’s no middle ground. But those don’t have to be the only two sides to the debate.

On the Republican side, there are some lawmakers who want a health care system that more people can afford, but doesn’t have the rules, requirements, and mandates they found to be intrusive in the ACA. Other Republicans would explore other approaches to lowering health care costs and expanding access through the private sector, as long as the government isn’t the one managing health care. For the Democrats, some are willing to make modest improvements to the ACA to help bring down costs. And others want to see a full government-run, single-payer health care system rather than the hybrid public/private approach of the ACA.

Somewhere in that wide spectrum – from legislative changes to make health care more accessible but reduce the government’s role, to partial changes to the current system, to a full government-run system – sits a sweet spot in which lawmakers who share a commitment to making health care more accessible to more people can stake out common ground, if enough of our lawmakers and the administration are willing to put political wins and losses aside and work toward the same goal.

John Adams from Massachusetts once wrote, “the essence of a free government consists in an effectual control of rivalries.” A decade later John Calhoun from South Carolina added that “free government consists in considering offices as public trusts, bestowed for the good of the country, and not for the benefit of an individual or a party.”

Let’s hope that the next time I speak to children about compromise and the Constitution, I can point to the debate over health care as a time when those entrusted to carry on the legacy of the great statesmen of the past controlled their rivalries and did what the Founders expected them to do: Identified a common goal and compromised.