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CAPITAL POWER STRUGGLE : Don't Bemoan Gridlock--the Constitution Likes It

November 20, 1994|James Q. Wilson | James Q. Wilson is the Collins Professor of Management and Public Policy at UCLA and the author of "Bureaucracy" (Basic) and "The Moral Sense" (The Free Press)

As we prepare for the convening of a new Congress, we ought to be clear about what we can expect. The defeat of health-care reform and the passage of the crime bill in the last Congress are widely misunderstood, in part because Democrats and Republicans are making partisan claims but in larger part because Americans do not understand what they can and cannot expect from their national government.

To liberal Democrats, Bill Clinton's health-care plan was defeated because of political-action committee spending, Republican obstructionism, special-interest pressure and misleading television advertising. To conservative Republicans, the crime bill was passed because it was laden with "pork."

The fate of high-profile political issues cannot solely be explained by personal failings, narrow partisanship or devious maneuvering. These forces are always at work, of course, and sometimes make a big difference, but whenever this country comes to grips with a major controversy, the way it is resolved usually depends more on the central features of the U.S. constitutional system than on the tactics of the participants. These features are:

* The system of checks and balances requires the creation of a majority coalition out of disparate, often antagonistic elements if any significant policy is to be adopted.

* In assembling such a coalition, the benefits of a program must appear to be real and the costs either small, deferred or displaced onto the "other guy."

* If there is strong public demand for some specific federal action, coalitions can be formed out of the sheer pressure of electoral necessity; but if there is no such clear demand, members must receive side payments in exchange for joining the coalition.

* Despite the aggrandizement of federal power during the last half century, the Constitution and the political culture require that many policies be implemented by state and local authorities.

Applied to health care, these principles have the following implications:

A new policy initiative of the magnitude of Clinton's health plan requires either a crisis or strong popular support if it is to pass. The plan must convince people that its benefits exceed its costs or that its costs will be paid by somebody else. The support of groups already delivering the service must be assured by making them part of the process and plan, or their opposition must be made ineffectual by isolating and demonizing them.

The Clinton health plan did not address some of these requirements and tried but failed to meet others. There was no popularly sensed "health-care crisis." There was popular concern over rising health-care costs, but little demand for changing the ways in which the health-care needs of uninsured people are being met. The public thought the President gave an effective health-care speech to Congress, but few believed they were the people he was talking about. Groups now delivering health care--doctors, hospitals, insurance and pharmaceutical companies--were largely frozen out of policy development. Many large corporations like the idea of the government taking over some of their post-retirement health costs, but they were outnumbered by the small firms that resisted taking on new costs. The public wouldn't mind seeing uninsured people receive care and their own coverage guaranteed, but they will only support these things if someone else pays. Clinton tried to persuade them that the "someone else" were greedy insurance and pharmaceutical companies and wasteful paper-shufflers, but his effort to demonize these groups failed.

Had the United States a parliamentary system, everything would have been different. In all likelihood, we would have long since had a single-payer system like Canada's or some version of the German plan. But the U.S. Constitution does not permit us to move decisively in such directions without a crisis; it permits us, at best, to modify the existing system, correct the worst and most widely recognized problems and devise new ways of having public-private partnerships that take into account diverse local realities. So stop complaining about Harry and Louise ads, PAC spending and congressional gridlock.

Crime is a different story. There was, and is, in the public mind a genuine crisis, so some action is politically imperative. The problem is that neither the Constitution nor public opinion permits the federal government to do much except make symbolic gestures (the federal death penalty) and ship money to the states (to pay part of the costs of a few police officers, build some prisons and try some untested programs). And even to do these things, Washington must promise to help every congressional district and not just those with a severe crime problem. The recently announced allocation of federally subsidized police officers to the cities illustrates what this means--such crime hot spots as Stanislaus, Calif., St. Albans, Vt., and Rock Springs, Wyo., will get some "tree" cops.

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