General Interest Review 00015

Reality (political)


Political reality is the collection of outside forces that exist around a specific policy proposal, pushing toward demise, or, in a few unlikely examples, acceptance. In American politics, the environment is normally characterized by factors like public sentiment (and, by extension, re-election prospects), the opinions of interest groups, and seemingly unrelated issues that appear sporadically to either bolster or defeat the larger issue. This reality is normally observed by people involved in pushing or defeating the policy proposal. Crucial to this conception is the idea that there is only one way of acting within the political system, even though that same system is often characterized as dynamic, and even complex.

White House Chief of Staff Rahm Emanuel crystallized the sentiment in today's New York Times surrounding the health care debate:
“I’m sure there are a lot of people sitting in the shade at the Aspen Institute — my brother being one of them — who will tell you what the ideal plan is. Great, fascinating. You have the art of the possible measured against the ideal.”

Within the debate surrounding health care, this political reality has been observed repeatedly both by opponents and realists like Emmanuel. The main guts of the proposal, which would mandate health care for everyone and institute checks on the current system overrun completely by private insurance companies, have been called too radical a reform for the public. This hinges on the public option, which has already been Reviewed, but also on the general sentiment that the public at large will not tolerate a system with increased government involvement.

But it turns out there are other realities to contend with, they simply don't get mentioned. There is the reality of polling. In almost every poll conducted about health care reform, there is an overwhelming consensus that the current system must be changed. The facts are pretty basic -- the system leaves millions without health care, and costs far too much. The change could take the form of one of two options in a general sense. One is the eradication of the current private insurance companies, and speedy replacement by a more fragmented market. This is unthinkable given the power of the current insurance companies and health providers, their control vested in one fifth of the entire economy. So the other choice is to attempt to offset the private companies with another kind of health care provider in another sector, namely the public one. Given the reality of the entrenched industry that is supposed to be reformed, a public-based change is the only remotely feasible choice for reform, which, given the reality of public sentiment, should be overwhelmingly popular.

Yet even a policy that has been watered down from what most people who truly want change desire (and falls far short of the guarantees on health care delivered by the rest of the so-called industrialized world) is considered unfeasible due to outside circumstances beyond anyone's control. There is a breakdown of government to respond to the will of the people. This breakdown is the political reality, though it is rarely characterized that way.

Instead, we are told fringe issues like abortion threaten to topple the bill. A proposal that might allow public health plans to pay for abortion occupies a minuscule fraction of the bill. Additionally, this proposal is scarcely change. Health care plans already available in the private market allow for abortion coverage. The health care bill is a tome of data and proposals, with entire sections that would be thought capable of arousing more venom than a solitary proposal about an issue having little to do with the stated focus -- health care costs and access to coverage.

But this is political reality, accepted without question, acknowledged only with resignation, pedaled in service of only those who benefit directly from inaction. The health care bill is likely to pass only after a legislative group is assembled to move around the political reality and make a deal. The last resort of an antidemocratic group. Undoubtedly, they'll be sitting in the shade.