When I was growing up in the United States in a small town in the Pacific Northwest, courses in topics like U.S. History and U.S. Government were taught from the 7^th grade through the 12^th grade.  Then once entering college, courses in English Literature and History of Civilization were still required to obtain a Bachelors Degree even if one happened to be specializing in a scientific curriculum.   Even before the 7^th grade one learned how Congress enacted legislation and how it became law.    Through this process it became apparent that the branch of government with the most power was the legislative branch, that is, the Congress.  One of the main responsibilities of the Executive Branch and President was to execute the laws of the United States. 

As an example, after the Supreme Court ruled in Brown v. Board of Education that “separate but equal” which perpetuated segregation really wasn’t equal and therefore through the “due process clause” of the Fourteenth Amendment was unconstitutional and therefore invalid.  Anyone interested can go through the references I’ve cited to obtain the details. 

To summarize what happened, after the Supreme Court decision the first test of its status became critical when the Governor of Arkansas ordered the Arkansas National Guard to prevent nine African American students from enrolling in high school in Little Rock, Arkansas. When  U.S. Federal Court Judge Ronald Davies said “no you can’t do that” to the Governor of Arkansas and ruled that the nine African American students must be enrolled, it fell upon the President to enforce this.  The President can “Federalize” the National Guard troops of any state whenever he decides it is necessary to do so, and this was one of the steps taken by President Eisenhower.  He also ordered the 101^st Airborne Division of the United States Army to deploy in Little Rock and enforce the ruling that was rendered in U.S. Federal Court.  

Now that’s how government works in a Constitutional Republic like the United States.  FYI:   Some misunderstand what a democracy is, at best the United States could be called a Representative Democracy although at times it seems that it is only special interests are being represented.  

Regardless of what it is called, the fact is that in the United States the President can order Federal Troops to enforce the laws of the nation if it becomes necessary.  Anyone interested in history will find that this issue was the primary basis for the American Civil War.  In brief, the Federal Constitution and the laws enacted under it are the supreme authority in the United States.  This occurs even if a significant number of people may not agree with what takes place when they are enforced.  

Now that I’m retired and observe what is going on in the country, it appears that no one understands this today.   The current Governor of Texas for example has speculated in public that his state might enjoy its composite reality more if it were not part of the USA.  Any action along these lines would set up another one of the interesting scenarios where the President would have to counter.  It wouldn't be too difficult.  He could simply tell the Secretary of Defense to order the 1st Cavalry Division at Fort Hood Texas to deploy sufficient assets in Austin to put the Governor of Texas under arrest and restore order.  Indications are that the present Governor of Texas may not be serving beyond his current term.   That said, people in states like Texas and Alaska really need to think seriously about the potential consequences of their seditionist fantasies.   It is unfortunate that I find it necessary to digress into this topic but obviously some simply don't understand it.   Do they still teach history in the public schools?

In any event, how does this exploration of the extent of Consitutional authority in a country like the United States impact events happening in August 2009?   The answer is that there are a lot of people (tens of millions) in the United States that are really scared and really crazy.  And what can be seen happening in the debate over health insurance right now (August 2009) is an example.

The BBC (they certainly didn’t understand what was going on) … quoted liberal Illinois Sen. Dick Durbin's explanation: "They want to get a little clip on YouTube of an effort to disrupt a town meeting and to send the congressman running for his car. This is an organized effort . . . you can trace it back to the health insurance industry."  So the birthers, the anti-tax tea-partiers, the town hall hecklers -- these are "either" the genuine grass roots or evil conspirators staging scenes for YouTube? The quiver on the lips of the man pushing the wheelchair, the crazed risk of carrying a pistol around a president -- too heartfelt to be an act. The lockstep strangeness of the mad lies on the protesters' signs -- too uniform to be spontaneous. They are both. If you don't understand that any moment of genuine political change always produces both, you can't understand America, where the crazy tree blooms in every moment of liberal ascendancy, and where elites exploit the crazy for their own narrow interests.

And what is critical to understand is that it isn’t just the little people carrying signs and yelling in front of the cameras that are caught up in this process.  There are vested and powerful interests that are also involved.

The orchestration of incivility happens, too, and it is evil. Liberal power of all sorts induces an organic and crazy-making panic in a considerable number of Americans, while people with no particular susceptibility to existential terror -- powerful elites -- find reason to stoke and exploit that fear. And even the most ideologically fair-minded national media will always be agents of cosmopolitanism: something provincials fear as an outside elite intent on forcing different values down their throats.

These interest groups are primarily those who supported the presidency of George W. Bush and who happened to have lost the last two national elections; the outcome in 2008 resulted in Barack Obama becoming president.  What happened after that event is something that I discuss in greater detail in Did the Republican Party lose an Election or a Civil War and The Inward Circle. 

Further as Mike Lupica correctly points out in President Obama is the real target of health care protesters, not policy:

So much of this comes from people who get all their information from right-wing media, or their cheerleading from political has-beens like Betsy McCaughey, people who don't see this as a fight for better and more inclusive health care, but who now see it as something grander and more noble, a fight to reclaim America from Obama.  They couldn't win the fight last November, when he laid out John McCain and Palin and a whole party with one election, so they try to do it now, with lies and rather amazing distortions. They want everybody to believe that if Obama gets his way, he'll eventually be in charge of insurance and doctors and whether you use CVS or Duane Reade. He's a Socialist selling socialized medicine. He'll kill Grandma. Come on. The notion that this is all honest dissent is just one more lie. … They don't just want to hijack this debate, they want to hijack his presidency. The rest of it, about your coverage and everything else, is just the cover story.

It is a subversion of the Constitutional authority of the Federal Government that is at play.  A lot of Americans just can’t accept Barack Obama as the legitimately elected President of the United States.  This fear that engenders mob scenes in front of video cameras is really that simple to comprehend:   “He’s leading us to socialism; he’s going to take away our guns.”   And the lowest common denominator in electronic entertainment is pounding this message out to everyone who needs it 7x24.

What we are seeing now then is nothing new.  Every other nation in the world with an advanced technological economy has guaranteed health care for all of its population.  In the United States things are different.  One issue is there are at least 40 million Americans with no form of health insurance at all.   And how does one fall into the orbit of the uninsured?  

The easiest ways are these:

1. Becoming unemployed and losing the insurance provided by one’s employer.
2. Being unable to afford individual insurance from a corporate insurance corporation for one’s self and family.
3. Being denied coverage by a corporate insurance entity because of a pre-existing medical condition.

It has been this way for dozens of decades and many progressive segments of the country and progressive presidents as well have attempted to change this situation.  The critical issue is that no insurance corporation will provide insurance to those who can’t pay for it and these same corporations have sufficient influence in controlling the media treatment of the subject as well as manipulating congress to block enactment of any national health care system like what one finds in the other advanced technical countries.  You see, something special has to be done for those who simply can’t afford insurance on their own.  The Health Insurance corporations enjoy the position of an economic monopoly in the United States and will never provide coverage to those uninsured on their own volition.  One must study the history and role of corporations in the United States if this is not readily understood.

This condition applied to retired persons over age 65 before the enactment of Medicare in 1965. Medicare like Social Security is a Federal program, in case anyone is unaware.  There must be something like Medicare to cover the uninsured today.  This could be accomplished in one of several ways.  It could be a Federal program like Medicare but there are other possibilities that may be more easily implemented in a political economy like one finds in the United States.  What has surfaced now is a plan that would be administered as a not-for-profit private entity.

Many progressives would oppose this and feel that a private not-for-profit entity would not have sufficient scalability to effectively compete with the private insurance monopoly.  In addition to finding a method to bring insurance to the 40 million or more that have no insurance; this must occur to bring down the overall costs of medical care.  This implies regulation of the Health Care industry as it now exists and the question is whether the private not-for-profit entity would have sufficient influence in the economy to achieve this. 

However this is how any legislation is going to be judged: whether medical care will be reformed and costs controlled in a way that does not remind one of the methods used by the Obama Administration has dealt with the economic disaster that appeared as a hugh image on the radar during the final months of the presidency of G.W. Bush.   Actually is was discernable long before this but it simply wasn’t the habit of the Bush Administration to look for such things as disasters.   I discuss this and the obvious consequences in Developing a Safety Culture in High Risk Environments.

Many Democrats want to see what they consider the legacy of their party’s greatest presidents, really the great presidents of the 20^th Century, restored.  And the essential function that must be restored in their view is the role of corporate regulation in the U.S. economy by the Federal Government.

If progressives had real trust in Obama’s commitment to doing the right thing, the administration would have broad leeway to do deals. But the president doesn’t command that kind of trust. Partly it’s a matter of style — as many people have noted, he has been weirdly reluctant to make the moral case for universal care, weirdly unable to show passion on the issue, weirdly diffident even about the blatant lies from the right. Partly it’s a spillover from his other policies: by appointing an economic team that’s Rubin redux, by taking such a kindly attitude to the banks, he has squandered a lot of progressive enthusiasm.Add in the dealmaking as part of the health care process itself, and progressives can be forgiven for having the impression that Obama (a) takes them for granted (b) is way too easily rolled by the other side. 

To sum up, there are two things at work against true reform in the Health Care system in the United States.  One is the corporate monopoly of Health Insurance corporations who don’t want to concede anything that they now have.  They want to continue deciding who they insure, what they will cover and how high premiums for their insurance will be.  They are opposed to anything resembling government regulation of their corporate conduct. 

Without control and regulation of the Health Insurance monopoly, the costs of health care will in all likelihood continue to increase; I see no reason to think that it won’t.  This affects other sectors of the economy such as Medicare and Social Security, the two signature programs that protect working, relatively healthy but less than wealthy, people in the United States from financial debacle.  It also keeps the cost of Health Care, a different subject than Health Insurance, in an ascending course.  Thus if one reforms Health Insurance, bringing economic competition to a monopolized sector of the economy, the cost and quality of health care should improve.  This really is the most important issue that can possibly be affected in the political landscape that now exists in the Legislative and Executive branches of government. 

If one seriously wants to reduce the profile of the Federal government in society, giving productive livelihoods to those who are now uninsured and living at the margins of society, now is the time to take the steps necessary to achieve it.  The necessary requirement though is to reform and regulate the corporate health insurance monopoly.  People at the margins of society will also need to overcome their fears and understand why their existence is where it objectively resides.

The other factor working against Health Care reform in the United States is the xenophobic reaction of a substantial part of the U.S. population to the presidency of Barack Obama which does not seem to have limits.  People openly carry hand guns to events where the President appears.  Nothing like this has ever happened before; it is insulting to supporters of his party and raises concerns about the ability of the Secret Service to protect the president (link to video interview). 

Health Care reform is an issue but really only one of many critical issues facing the United States today. 

One could say that the public behavior one sees seemingly engendered by an attempt to deal with the reoccurring problem of providing health care for everyone must end or at least understood for what it really is: a lingering fear obscenely exploited by individuals who still define the world in simplistic terms for self serving motives that subvert the chance to bring rationality to a system of problems that will take far more than one election cycle to remedy.   

So regardless of what may happen in the election in 2010, Democrats should forget about Republican obstructionist fear tactics and enact the best Health Care system they can provide the American people.  This almost certainly means having the functional equivalent of a so-called "public plan" that has premiums that are affordable for the working class/middle class and doesn’t discriminate against people with typical health conditions for their age.

Members of Congress as well as President Obama need to understand that this is a chance for them to accomplish something really important and good for the country, an event that has been needed for a very long time.  It is highly likely that history will judge those who got it done as heroes and the special interest obstructionists attempting to derail it as villains.   So why be concerned about them?

On the other hand, the scope of the problem considerably exceeds the issue of health care reform alone.  If the effort breaks apart once again, the consequences are likely to be much more unfavorable to the United States than past failures engendered. 

Just do the math.    Because if you do, you will see there is a genuine reason to be apprehensive about the future unless major reform in Health Care is forthcoming.