Editor's note: Health care and James Madison


4.3.12 “As long as the connection subsists between his reason and his self-love, his opinions and his passions will have a reciprocal influence on each other; and the former will be objects to which the latter will attach themselves,” so says James Madison in Federalist Paper No. 10, his essay on factions. Madison, our near neighbor, formulated the persistent problem of our government way back in 1787: Democracy, at its worst, functions as a contest of factions, and people’s political opinions are generally thinly-veiled expressions of their own self-interest.

Saul Alinsky, one of the founding fathers of community organizing, has recently worked his way back into the popular conversation, mainly because of President Obama’s brief history as a rabble rouser in Chicago. Alinsky is famous among the labor crowd for two things: embracing disruptive and confrontational methods of protest and recognizing that grassroots networks draw their power from shared self-interest. He is on the way to becoming famous on the conservative talk-radio network (Gingrich is fanning the flames) as a sort of pinko Obi-Wan Kenobi who is responsible for the socialist radicalism that has gripped our nation over the past four years (sacrebleu!).

I bring all this up because last week’s news cycle included the latest round of argumentation on our country’s efforts to reform its health care system (our takes here and here). I think it’s likely the Supreme Court will rule that the government can’t force people to buy insurance, that the Affordable Care Act will fall apart, and that the matter will come back to the people. The Court, having already decided that corporations have the same rights as individuals with respect to their voice in government, has set up the kind of donnybrook Madison could see coming a mile away.

In the red corner a faction of insurance lobbyists, hospital administrators, and high-paid specialists. In the blue corner a faction of underpaid, overworked people with high cholesterol and diabetes. Let’s get a show of hands now. How many of you pay too little for your health insurance? O.K. and how many of you don’t want it at all?–Giles Morris