Obama’s health care reform has divided Americans more deeply than any other domestic topic has in decades. The bitter fight touches upon fears that are deeply rooted in the American psyche: How deeply can the government be permitted to interfere in the lives of the individual citizen.
Every American hates broccoli. Generations of mothers in the United States have forced the stuff on their young. After all, it is so healthy. And so the question posed this week during the hearing on health care reform by Justice Antonin Scalia, one of the five conservatives among the nine justices on the Supreme Court, was not chosen without perfidy: Could the government force its citizens to buy broccoli?
On trial is that reform of President Barack Obama that is supposed to at least partially remedy a crass social grievance in the U.S. It is a matter of requiring health insurance for all Americans. About 50 million Americans are now uninsured; for about 30 million of them that would soon change. The reform has, however, divided the country more deeply than any other domestic dispute in decades.
According to Obama’s concept, in the future every American must buy private health insurance or pay a penalty. What then, asked Justice Scalia, would the government allow for itself after that? Could it just as well force its citizens to buy broccoli? In the end, isn’t the freedom of every American threatened when the court rules insurance as mandatory? The bitter fight over health care reform touches the deep layers of the American psyche, upon fears that are encoded in the national genome.
The U.S. was founded more than two centuries ago because the settlers were fed up with being bossed around by a foreign government on the other side of the ocean. Here lies the foundation, the aversion to any form of central authority. Since then it runs through history like a common thread.
The London of colonial times was replaced by Washington — the leviathan had simply moved. The Southern states had in this way justified their secession ideologically , that it was the only means of escaping from the dictatorship of an estranged central power (that wanted to prohibit the holding of slaves).
Still today it is the Feds, primarily in rural America, the representatives of federal authorities, who are perceived to be intruders. Be it in the form of the tax authorities that also collect money for the nation (although one has already had to pay taxes to the municipality and the state). Or be it by FBI agents who become involved with things that would be better regulated locally. Sarah Palin, the populist heroine of the right, masterly plays with conservative Americans’ fears of the dictates of distant bureaucrats. Obama, too, flirted with the position, when he promised four years ago to bring change to Washington.
This authority-phobic reflex operates in most Americans. Only in this manner can the indignation that Obama’s well-intentioned law has triggered be understood: The health care reform was seen precisely by conservative citizens as a boundless intrusion by the government, as patronizing, as a limitation on freedom. Up to now the indignation has hardly died down — proponents and opponents balance each other out in surveys.
Now in the U.S., the government is being allowed functions that come close to the European understanding of the social state. There is pension insurance. There is unemployment compensation and government health insurance for the old and the poor. When President [Franklin] Roosevelt established pension insurance in 1935, the conflict resembled the current debate about health care reform. Roosevelt’s reform also quickly landed before the Supreme Court.
At that time, the judges decided that a provision at a national level was absolutely needed — the injustices were too enormous. All the same, the same fight as today was dealt with: May the government do that? May it force insurance on its citizens in order to eliminate a grievance of national dimensions?
Under the impact of depression and mass unemployment, the judges of the time found: “When public evils ensue from individual misfortunes or needs, the legislature may strike at the evil at its source.” They let the pension reform happen.
The Overriding Evil
Obama argues with the same logic today: The damages from the insurance crisis are enormous for the country — the uninsured are also treated without insurance in the emergency room. But times have changed. The logic of the overriding evil would no longer be recognized by any of the five conservative justices.
In the past decades, the pendulum in the U.S. has swung far to the right. The tea party movement and their anti-government slogans are only the shrillest expression of this sociopolitical change. Solidarity is only countenanced by America’s right if it is exercised by neighborly help or on an individual basis. The social state principle implemented by Roosevelt is foreign to this generation of conservatives. It is even used as a pejorative, because it sounds like government dirigisme. And so it can’t come as a surprise if the Supreme Court, with its conservative majority, actually derails Obama’s health care reform.
What would the consequences be, however? For millions of the chronically ill without insurance — diabetics, those suffering from heart disease or cancer — the dream of finally being able to afford treatment would be destroyed. Day after day, thousands of the acutely ill would continue to beg for treatment and medicine in hospitals and pharmacies — an undeserving condition. Politically, the president would without a doubt be hit harder, only months before the election, his most important work of reform declared unconstitutional. He would have little to show. Obama could stylize himself the victim of obstinate partisan judges.
This version would not be so wrong. Because the justices will have rendered for a third time within little over a decade a decision that reveals the court to not be the arbitrator of America but rather the executor of an ideological turnaround. In 2000, the conservative majority of the court decided the extremely narrow vote count of the presidential election in favor of Republican George W. Bush. Two years ago it opened the floodgates for the influence of money in elections: Millionaires and billionaires have since then financed election campaigns without limitation, therefore virtually buying elections. Now the largest sociopolitical reform in over a half a century stands before a downfall.
A new attempt to reform the health care system would be unthinkable for decades in the face of the political polarization. And so, the failure of the reform before the Supreme Court would only be a renewed expression of the self-paralysis of the country and its political system.