39
now face political parties and programs that are clearly distinct from one another. In a sense, at
both the state and national levels we are significantly closer to a system of “responsible party
government “ than we were twenty years ago.
124
Unions and their Democratic allies can and do
argue convincingly that their rejection of compromise measures helps them ultimately achieve
universal coverage and the end of employer-based health insurance. Indeed, the larger economic
trends support an argument for the decoupling of employment status and health insurance.
125
In the immediate term, however, eschewing incremental reform increases the chance of
stalemate resulting in no reforms at all. The polarization of parties is increasingly being
enshrined through state redistricting that preserves safe districts for strong partisans.
126
Furthermore, it is difficult to envision the possibility of enactment of a health care regime that
fits the most sweeping possibilities on either the left or the right anytime soon. The
constitutional barriers to a parliamentary-type system of responsible parties—notably federalism
and separation of powers—make it necessary for one party to achieve overwhelming electoral
success to enact its ideal agenda. Such a scenario is unlikely in the near future. For the time
being, at least, we must make do with what we have.
124
American Political Science Association, “Toward a More Responsible Two-Party System,” American Political
Science Review 44 (1950): Supplement.
125
Beamer, 293-304.
126
Coffey, “State Party Agendas: Representation in an Era of Polarized Parties.”
Convention