“Am I wrong?” – Walter Sobchak
“You’re not wrong, Walter. You’re just an asshole.” – The Dude
I’m a pretty liberal guy. Ideologically I am most aligned with the Green Party, but I am a Democrat for pragmatic reasons. I hear people say all the time that if people like me would go ahead and join a “third party” (there are lots of “third” parties, maybe we should call them something else) then third parties would be more politically viable and may even win some national elections.
That is naïve, wishful thinking.
Our winner-take-all elections make it, if not impossible, incredibly improbable to have viable third party. Our system of democracy is far from democratic. The election process itself silences the voices of those who do not ideologically identify with one of the two major parties.
If elections awarded seats proportionately rather than binarily smaller parties could have some political influence. It would be more difficult for one party or another to have a majority, so coalitions would have to be formed. Smaller parties could leverage this to gain political power.
The upshot to this would be that I would be able to participate in the party I ideologically identify with, rather than the party I am a member of, and that smaller party would be able to help shape policy and legislation.
Our winner-take-all system essentially forces us to have two parties, one that is center-left and one that is center-right. These parties would normally tend to be relatively close to each other to gain centrist votes, while being far enough to the left or to the right to gain votes on those ends of the spectrum, as well.
Today our political culture is far more polarized. Due to this polarization there could potentially be room in the middle for a third party to gain some traction, but those parties are generally either to the left or to the right of the two major parties. Further polarization, given the already polarized nature of the major parties, isn’t going to allow a third party to gain many more votes, and it certainly isn’t going to yield enough votes to win a winner-take-all election.
Why bring this up on a mental health blog?
I bring up my political ideology to establish that I am both very liberal for a Democrat and yet still pragmatic enough to not be registered with the party I am most ideologically aligned with. Pragmatism amongst liberals like me is becoming vilified this election cycle. But this pragmatism is a big part of why I am still alive. And no, that is not hyperbole.
Liberals have continually attacked the Affordable Care Act as being a watered-down compromise chock-full of half-measures. It did not establish a universal single payer system – it didn’t even provide a “public option” save for some expansion of Medicaid; instead it preserved a “corporatist” for-profit model of healthcare. This model is rightly decried as being both inefficient and immoral.
That assertion isn’t wrong. Ideologically I favor a universal single payer system. In a perfect world that system would be ideal. But, for the first time in my life, I have health insurance. The ACA is the reason for that.
The ACA may have been an incremental change to our healthcare system that ideologues despise as being a half-assed measure, but that incremental change has provided a mechanism for me to have health insurance, and with that insurance regular access to medical care.
Access to care is essential for those of us living with chronic illnesses like bipolar. Without the insurance I now have because of the ACA I would not be able to afford to see my doctors. I couldn’t see my general practitioner. I couldn’t see my psychiatrist. I couldn’t see my therapist. I also couldn’t afford the medications that have helped me achieve some semblance of stability.
Without the ACA the only access to care I would have would be the Emergency Room, where I would be stabilized just enough to, at least temporarily, no longer be a threat to myself or to others. My quality of life would be very low, and I would likely be suicidal.
I am stable now. I have regular care. I have maintenance care and not just emergent care. I have this because of the pragmatic, incremental change the ACA has ushered in.
Incremental change may be frustratingly slow. Incremental change may be ideologically imperfect. But incremental change beats the heck out of no change at all.