What is reasonable to expect from our government?  What ought we to expect from our elected representatives?  After a year of effort, of back and forth in both houses of Congress, of hearings and work in subcommittees and committees, of opinions left, right and center in the public discourse in all the various aspects of our hyper –media; after the Sturm and Drang of single payer/public opinion/Medicare buy-ins, of triggers for the public option and opt ins and opt outs, the worth of co-ops and insurance exchanges with not-for-profit companies; after raucous town hall meetings, after foolishness about death panels and pulling the plug on grandma; after misrepresentations about undocumented workers and shocking disrespect for the President of the United States speaking before a joint session of Congress; after disingenuous Republican rhetoric about a government take-over of healthcare;  after backroom bargaining, hours and hours of debate, after Republican obstructionism and votes taken in the wee-small hours of the morning; after a Christmas Eve vote in the Senate that brought a glimmer of hope that the United States, at long last, would finally join the rest of the developed world and provide universal healthcare for its citizens, our elected representatives have yet to pass a comprehensive health care bill.  There is doubt whether or not they will.

Is it too much to expect that after all of this, that a Congress dominated by one party with a president of the same party could get comprehensive health care reform accomplished?  I do not think this is too much to expect.  Not even now.  Let us be clear. The results of the special election in Massachusetts to fill the seat of the late Edward Kennedy made no difference.  Even though the Republicans won the vote they needed to sustain a filibuster, it is of little consequence.  The House and Senate would have had to produce a compromise bill in the Conference Committee.  Unless the bill was exactly the same as the Senate bill, it would have been difficult to pass it through the Senate because the Democratic consensus in the Senate is so fragile that a different bill would have landed back in the sausage making machine that was so ugly in the days before the Christmas Eve vote.  The House ought to pass the Senate bill as is and allow the Senate to include a public option through the reconciliation process.  This would require only a simple majority.  And the votes are there.

Achievement matters.  The ability to pass important legislation matters.  In doing this, congressional leadership is as important as presidential leadership, perhaps even more so.  The president can inspire and persuade the citizenry.  He can try his best to rally his party troops, but at the end of the day, he has one vote in his home state.  He has no vote in Congress.  When the framers wrote the Constitution of the United States, the Congress was the first of the three co-equal branches of government that they crafted.  This is because it is at once closer and more remote from the people than is the president.  The House of Representatives stands before the people every two years, senators every six, the president every four.  The people hold sovereignty on Election Day.  Once the votes are counted, sovereignty functions through the elected representatives.

Again, what ought we to expect?  The values of a nation tell us what we ought to reasonably expect.  Philosopher Anthony Weston, in his book A 21^st Century Ethical Toolbox, writes:  “Let us say this.  Moral values are those values that give voice to the needs and legitimate expectations of others as well as ourselves” (50).  Justice, domestic tranquility, common defense, general welfare, and liberty are values outlined in the Preamble of the Constitution.  They give voice to our needs and expectations.  We can therefore expect our elected representatives to work to establish these values in our nation.

Healthcare is a human right.  It is justice because it is what is due to every citizen and every human being.  The world has said so in its adoption of the Universal Declaration of Human Rights.  When we think about the common defense, we ought to expand that concept beyond the ideas of protection against enemies foreign and domestic, but think about a common defense against disease and ill health.  The general welfare of a nation includes the health of its citizens. And when health insurance is a given, when health care is a given, we gain more liberty.  We are not shackled to a job that we hate because we ourselves or a family member needs the health insurance.  These values lead us to a legitimate expectation that our elected officials ought to pass comprehensive healthcare legislation.

Instead, we have hyper-partisan ship, a Democratic party that so far has proved feckless in its inability to get this done, and an obdurate Republican party that seems only to want to stall and to defeat President Obama’s domestic agenda by any means necessary.  (We must give them proper respect for their unity in this goal.)  They seem to care not a whit about the good of the American people.  And now, one election has too many Democrats quaking in their boots and too many Republicans gloating, thinking, wrongly, that the American people approve of their position.

While both parties are over-reading the election in Massachusetts, they both are missing the import of this moment in American history.  This is the era of the independents.  They declare loyalty to neither of the two parties.  And they want results.  They want their government to help them to live better lives.  This is a legitimate expectation.  In Massachusetts nearly half of the registered voters are independents.  In the special election, the progressives stayed home, the conservatives voted Republican.  History does not reveal its alternatives, so we are left to only speculate about the outcome had comprehensive healthcare reform already been law.

The irony is that while Democrats are afraid of the next election and progressives want to change the subject from healthcare to jobs and a populist attack on big banks, while Republicans are overconfident, while there is much too much talk about scaling back on health care, passing only those provisions that are popular and easy, people are paying attention and are in no mood to reward either party for failure to get something done.

Healthcare is urgent.  Elected representatives talking about incrementalism or about starting over from scratch enjoy healthcare paid for by the taxes of millions of working Americans who do not have health insurance and cannot afford it.  People die unnecessary deaths every day in the United States because they do not have health insurance.  Families go bankrupt everyday in the United States because of medical bills.  Such is obsolete in most other nations in the developed world.  People who think that comprehensive healthcare is too expensive, will cause the nation’s budget deficit to rise and ultimately result in higher taxes are missing the forest for the trees.  Benjamin Franklin was wise to say: “An ounce of prevention is worth a pound of cure.”  When more Americans have access to primary care, when they begin to live healthier lifestyles under the supervision of family care doctors, when the experiment of community health centers—grassroots wellness– that is part of the Senate bill begin to bear fruit, healthcare costs in the United States will go down.  This means the money that the government spends on entitlements such as Medicare and Medicaid will also go down.  And with the baby boomers about to enter the Medicare system, this is vital.   This will decrease the deficit in the long run.  Further, healthcare reform ought to pass so that businesses, large and small, will know what their obligations are to their employees, and they can plan.  Jobs are related to the completion of the healthcare reforms.

It is a legitimate expectation to expect our elected representatives –Democrats and Republicans—to find a way to give this nation comprehensive healthcare reform.  And if they do not, we will remember in November.