Health care reform afterthoughts: Speculative glimpses of democratic possibilities

Several years ago, back when there was no reason to believe an obscure African-American junior senator from Illinois would be our next President and try to pass health care reform, a wise friend explained to me one reason why it was so hard to make progress on this issue. He's one of those policy wonks, a researcher of health economics.

"Did you know that, by and large, people who have health insurance now are registered to vote? And most of them vote. The uninsured? -- they are not registered and don't vote!"

No wonder our politicians have taken more than half a century to make a commitment to getting almost everyone some kind of access to insurance.

So, now that they've expanded coverage, does that mean that it's the moment to work hard on getting the previously uninsured into the voting pool? It seems realistic to think that people who have newly received health insurance through government action might think that trying to influence what that government does had some value to them. Any such movement into the political class will take awhile; expanding registration is slow, tough work. But it is just possible that, like our improbable President's campaign, this reform is a step in the direction of expanding the electorate.***One of the best results of the excruciating HCR process has been delegitimating the U.S. Senate and U.S. Senators. Okay, the Founders had to throw a bone to the tiny population states (think Rhode Island, New Hampshire, Delaware) to get them to throw down with the big ones (New York, Virginia, Pennsylvania). And so the Constitution gave us the Senate. But what do these preening peacocks with their crackpot rules do for our democracy anyway? Not much, though their unchecked individual and collective power to gum up the works makes them an attractive buy for lobbyists.

(I am writing this while Senators are holding a "voterama" while trying to polish off the amendments to the insurance legislation. I could explain, but the point is to get rid of these curlicues, not understand them.)

I doubt we'll manage in my lifetime to get rid of the Senate; the current tiny states such as Wyoming like it too much. But the political pundit class is beginning to define the Senate as a problem. Retiring Senator Evan Bayh denounced misuse of Senate rules such as the requirement for 60 votes to end debate on anything (filibuster) for breaking the institution. We may get some reforms of some rules in the next session if Democrats retain the majority. (This is likely, though they may be reduced from 59 members to more like 53 out of 100.)

More generally, popular education about what a useless, anti-democratic body the Senate has become can create strong pressures for somewhat better behavior. Let's do it.