The ACP Advocate Blog

by Bob Doherty

Tuesday, October 12, 2010

"Clowns to the left of me, jokers to the right ... Here I am stuck in the middle with you."

While driving in my car the other day, I came across this chorus from a 1970s hit song by the long-forgotten British band, Stealers Wheel. It reminds me of the sad state of American politics today. Voters seeking a sensible center instead, find themselves caught between the "clowns" and the "jokers:" the talking heads from the right and left alike who take delight in the most extreme politics and rhetoric imaginable.

Senator Susan Collins (R-ME) writes in Sunday's Washington Post that, "It's a tough time to be a moderate in the U.S. Senate. Sitting down with those on the opposite side of a debate, negotiating in good faith, attempting to reach a solution -- such actions are now vilified by the hard-liners on both sides of the aisle. Too few want to achieve real solutions; too many would rather draw sharp distinctions and score political points, even if that means neglecting the problems our country faces."

She's not alone in her concern. 130 former members of Congress, from both political parties, have taken the unprecedented step of urging all current members to work across the aisle:

"The divisive and mean-spirited way debate often occurs inside Congress is encouraged and repeated outside: on cable news shows, in blogs and in rallies. Members who far exceed the bounds of normal and respectful discourse are not viewed with shame but are lionized, treated as celebrities, rewarded with cable television appearances, and enlisted as magnets for campaign fund-raisers. Meanwhile, lawmakers who try to address problems and find workable solutions across party lines find themselves denigrated by an angry fringe of partisans, people unhappy that their representatives would even deign to work with the 'enemy'."

William Galston, a policy adviser in the Clinton administration and elections expert for the Brookings Institution, tells the New York Times that "The center has disappeared."

A new poll by the Washington Post, Kaiser Family Foundation, and Harvard University finds that, "Although Democrats and Republicans have rarely seen eye to eye, the gap between the two has widened significantly over a decade of partisan polarization..." Yet the same poll also shows that the electorate's views on government aren’t easily labored as right or left. While confidence in the federal government is at an extraordinarily low level, "support for government action on such issues as national defense, health care and fighting poverty remains high, in some cases just where it was a decade ago..."

The poll finds the electorate deeply divided over health care reform. "The polarizing debate over health care has left its mark on Republicans and independents far more than on Democrats. Ten years ago, three-quarters of independents said they favored more government involvement to ensure access to health care coverage. Today, half do. Among Republicans, the falloff is more dramatic, sliding from 53 to 21 percent."

Henry J. Aaron, a senior policy analyst at the Brookings Institution, opines that the continued partisan split over health care reform doesn't bode well for the country. He notes that most Republicans have pledged to repeal the Affordable Care Act, but President Obama likely would use his veto pen to block repeal.

"Perhaps the more likely - and in some ways more troubling - possibility is that the effort to repeal the bill will not succeed, but the tactic of crippling implementation will" he observes. "The nation would then be left with zombie legislation, a program that lives on but works badly, consisting of poorly funded and understaffed state health exchanges that cannot bring needed improvements to the individual and small-group insurance markets, clumsily administered subsidies that lead to needless resentment and confusion, and mandates that are capriciously enforced.

Such an outcome would trouble ACA opponents: their goal is repeal. It would trouble ACA supporters: they want the law to work. But it should terrify everyone. The strategy of consciously undermining a law that has been enacted by Congress and signed by the president might conceivably be politically fruitful in the short term, but as a style of government it is a recipe for a dysfunctional and failed republic."

A sensible center would instead try to find a way to bridge the differences over heath care reform and make improvements. But as the former members of Congress sadly observed in their letter a politician who tries to "find workable solutions across party lines [would likely] find themselves denigrated by an angry fringe of partisans, people unhappy that their representatives would even deign to work with the enemy."

And you wonder why the refrain "Clowns to the left of me, jokers to the right ... Here I am stuck in the middle with you" keeps replaying itself in my mind?

Today's questions: Do you think the center has disappeared from American politics? And what do you think of Henry J. Aaron's view that the continued partisan polarization over health care reform could lead to "zombie legislation" and "is a recipe for a dysfunctional and failed republic?"

7 Comments :

Blogger PCP said...

The country has indeed lost the middle. The reason is the progressive rise of cultural and social liberalism ever since the 1960s.

Perhaps those like you Bob mistook that to mean that the entire country was with you. It was not and will never be. That is where it all went wrong.
When one says
"Clowns to the left of me, jokers to the right ... Here I am stuck in the middle with you"
One has to be truly certain he/she is in the middle, because the corollary is that one is either a clown or a joker.
A significant chunk of America never did sign on to this so called "progressive movement'. When we see our health system repeatedly denigrated in the press, saying that we are worse than 32 countries etc etc. We do not celebrate that, we just think back to how our republic became so successful and world leading. How it is that we contributed so much to the upliftment of mankind, and why those so called "progressives" think that we ought to want to emulate everyone else and apologize for our shortcomings rather than applaud us for our achievements.
Most of us believe that free market principles with limited simple and sensible regulations were what brought the success, and that especially in health care and especially over the past 40 yrs we have moved further and further away from those principles. In our view it is inevitable that a house built on a shaky foundation will crumble, so our system build on Centralised planning and command structure will fail. The only question is when, history teaches us so. Since we are already at the point where it is getting harder and harder to function in such a system, that might be the only way to get a renaissance.

So I think the real fallacy is amongst those who feel they know exactly where is the middle.
I guess we could say we have irreconcilable differences. I do not think that is a very harsh statement given the current gulf. I think that our politics reflects that sadly and what must come will come.

I wonder why the Democratic "middle" did not think about the ramifications of alienating the right by passing the ACA without a single republican vote? I'll tell you why, because they did not care. If they did care, they would have understood that some republican support was needed to gain overall public acceptance. When you pass such legislation, you get yourself into hot messes like this. That is no way to run a republic. FYI, inaction as bad as that is, is better than that sort of divisive action.

October 12, 2010 at 5:36 PM  
Blogger ryanjo said...

Politicians posturing about moderation...how contrived. The public is disgusted, so they change their tune. Yawn.

The reason that the Congress is polarized is that the public is disenfranchised. A large minority (or perhaps a majority) of us were not asked for any input by our elected officials (either in the national government or our professional organizations), on an issue that will affect our lifestyle and wallets for the remainder of our lives. Mr. Obama's decision to use political tricks, targeted favors and arcane Congressional regulations to push through an unpopular law left a bad taste. How many times did we hear that the law had to be done by a certain time, because of "political realities." Since the real issues couldn't be addressed (too many special favors to be handed out), we were told by the administration and the leadership of our professional groups to be happy with what we got, we'll fix it later.

The Tea Party movement, whatever its excesses, is aptly named. The original event over 200 years ago was an act of violence caused by frustration and powerlessness, as the powers of the day rammed through an unpopular law.

There is no good outcome for the ACA. It will fail as an inadequate measure, funded by voodoo economics, and an embarrassment now for even for many of its one-time supporters. Maybe inaction or legal action by the states will kill it. Don't bother repealing it, it's not worth the effort.

And next time, work for a consensus. Don't let the politicians use it for their agendas. Get everyone on board with what we can agree on, see if it works, and move forward. It may take a years, a decade, a century.

October 12, 2010 at 6:23 PM  
Blogger rcentor said...

Spot on! We are so tired of the politics of confrontation and yearn for the old politics of compromise. Our political process has become totally dysfunctional. There are no winners, and we are actually all losers if compromise does not return to Congress and the Presidency.

October 12, 2010 at 6:57 PM  
Blogger Harrison said...

I think we should rebel against all politicians who preface remarks with the words: "The American people want..."
They are almost certainly preparing to launch into a sermon about what they consider to be the right path.

It would be refreshing to have politicians tell us what they think is right. And let us decide whether we agree with them.
And while they are in office we can try to persuade them with letters and emails and phone calls.
And when their terms are up, we should decide on whether they have been honest and voted in a way that was consistent with who they said they were, and then again decide on whether we like that and trust it.

But that isn't what we do.

Alas.

Harrison

October 13, 2010 at 1:06 PM  
Blogger Harrison said...

Just another quick comment.

I follow polls a bit more than I probably should.
Last week in Washington, Sen Murray was trailing by about 3 - 5% against her Republican opponent. Today she is up on the average poll on Real Clear Politics by 2.5%. The change is a single poll result over the weekend showing Sen Murray with a 15% lead.

Around the country there is a big difference in polling of registered voters as opposed to likely voters.
In a mid term election there are fewer likely voter, meaning that voters who come out for specific interests can carry more weight.


I guess I'm not sure that polling is really very reliable as a measure of public sentiment.
And I don't think that mid term elections are a good measure of what the country is really thinking either.

I don't know what is a good measure.
I don't think it is good for us to argue about what the public wants.
It is unknowable.

It is good to argue the merits of specific points.

That is what is sad about the debate over the health care reform measure.
The Republicans clearly did not vote for it.
But in their recent Pledge to America, they vowed to repeal it, and then vowed to enact much if not most of what they planned to repeal.

There clearly was room for negotiations.
It seems likely even that individuals within the Republican party probably could have voted for the bill in its totality with only minor objections, that they would have been able to look beyond in any other year.

They voted as a block for political reasons.

Harrison

October 13, 2010 at 2:31 PM  
Blogger Jay Larson MD said...

Societies constantly struggle with the “needs of the many versus the needs of the one”. The U.S. is no different. Most understand that the balance is some place in the middle. The center has not disappeared; they are just drowned out by the extremes shouting at each other.

As Senator Susan Collins has pointed out, rather than having respectful debates, congress members prefer to act like asses to get 15 minutes of fame. This can not lead to good democracy.

As far as transforming ACA into “zombie” legislation; physicians will continue to adapt as best they can until they can no longer tolerate the hassles. Once their tolerance has been exceeded, they move onto something else, leaving more and more patients scrambling to find another doctor from a shrinking pool of choices.

October 14, 2010 at 10:01 AM  
Blogger Steve Lucas said...

I find the idea of support for health care reform and promoting the concept that we are a failed republic a disappointment. As the previous commentators have noted, it is about process, and this bill certainly did not have any bipartisan process.

In looking at the larger picture this administration has followed a policy that would exclude 52% of the population from paying taxes. In some cases people would receive checks from the government if they did not meet a certain income threshold.

The stimulus money went to government and union workers. It did nothing to promote business in the private sector.

If the Bush tax cuts are allowed to expire, corporations will find a more favorable business and tax environments in Canada or the EU. Current estimates are business is sitting on $2T.

Collectively I look at health care reform and the overall business and tax policies of this administration as an attempt to secure a voting block to remain in power. Give the people lots of services and they will come out and vote.

The problem is even among this group they understand nothing is free, and they want the opportunity to succeed. This is generating a great deal of the push back against this administration’s policies.

Additionally this group tends to have a low voter turn out. This is why you have seen attempts to “energize” the base.

The result of all this “energizing” is less than a civil debate. Personally I cannot wait until the election is over, the phone calls and mud slinging commercials are beyond anything that should be accepted.

Steve Lucas

October 14, 2010 at 1:44 PM  

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About the Author

Bob Doherty is Senior Vice President, American College of Physicians Government Affairs and Public Policy; Author of the ACP Advocate Blog

Email Bob Doherty: TheACPAdvocateblog@acponline.org.

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