Best of 2012: 3 ways court ruling on health strengthened U.S.
Editors' note: Each day during the holidays, Crosscut will revisit top stories from the last year in a specific category. Today's focus is health. This article was originally published June 30, 2012.
Three things strike me about the surprising U.S. Supreme Court decision on the Affordable Care Act. I’d call them, “minding our boundaries,” “compromise,” and “decision-making.” All three are key aspects of a functional governance system, which have been more notable in their absence than by their presence in recent years.
Like most everyone else, I was surprised to find Chief Justice John Roberts siding with and articulating the majority’s decision to sustain the ACA. His comments indicated his respect for the separation of powers and a reluctance to overturn a major act of Congress, unless it had clearly violated the Constitution.
I would call this “minding our boundaries.” Constitutionality is “our” turf and responsibility, said Roberts, legislation is yours. We’ll do our job and you do yours. And within reason, let’s stay off each other’s turf.
Working with different not-for-profit organizations one of the marks of organizational dysfunction I notice is a failure to mind boundaries. The various sub-groups and individuals making up an organization trample on the turf of others or fail to respect the role and authority of other groups. In such organizations the governing board gets into areas that belong to the staff, or the executive director disables the board by turning it into a rubber stamp. Or everyone in the organization has to have their oar in the water on most every decision.
Often this kind of thing is sanctioned and validated by appeals to “full participation,” “working together,” “inviting input,” and “everyone having a say.” Sometimes that is important. Sometimes it's a recipe for disaster.
The result of such failure to mind our boundaries is what I call “bunch-ball,” a technical term drawn from my stint as a soccer coach. Watch 6-year-olds play soccer. Everyone runs to the ball. The result? Sore shins but not much movement. As a coach, your goal is to try to get kids to play their position, so you have someone to pass to and make progress in the direction of the goal.
It’s not that different in organizations, including governments. Play your position. Mind your boundaries. Do your job, not everyone else’s. The chief justice seemed content to do that, thus striking a blow for a governance system that works.
The second thing that strikes me about the Affordable Care Act is less about the Court’s decision and more about the act itself and the public discussion of it. One hears a lot of split opinions. “I don’t,” someone may say, “like the mandate … but I do like that my daughter can stay on our plan until she’s 26.” Few, if any, seem to like everything about this legislation. Many like something. There’s a name for that, “compromise.” What a concept!
As our politics have become more ideological and polarized, compromise has joined the endangered species list. When you’re of an ideological frame of mind, every issue and every detail of every issue becomes inviolate. This makes for good, or at least, hot talk radio. But it makes for bad governance.
Compromise is, arguably, what politics is all about. Take it further — in some measure compromise is what life is about. Try approaching marriage or family without compromise and see how that works for you.
A third aspect of the health care debate is simply that the governance system took on, however fitfully, a tough and complex issue — health care — and reached a decision, one that the Supreme Court has now sustained. Functional governance systems, whether national or local, in specific institutions or organizations do this. They figure out what their challenges are, look at them as clearly as they can manage, and come to a decision.
Dysfunctional organizations either don’t look clearly at their real issues and challenges or they never manage to actually reach a resolution, that is, make a decision. The same issues fester week after week, year after year. Such indecisiveness depletes the energy and spirit of groups and organizations.
It is true that we’re certainly not done with health care or even with the Affordable Care Act. The act will be debated in Congress and it will be an election issue. And there’s still a lot to do on health care to get to a really workable system that is both more just and more affordable. But a decision was made and it has now been sustained. Working systems do that. Paralyzed ones don’t.
The court’s decision on the ACA is not only a victory for the president and for the act’s supporters, it is also a victory for our governance system. That’s worth noting and savoring because there haven’t been too many such victories in quite some time.