In the opening comment of the hot-off-the-pixels new issue of the New Yorker, Hendrik Hertzberg uses the current push-me-pull-you over health care to make a point that we ought to make regularly: The United States government is set up, in ways that are bizarre by the standards of the world's democratic systems, to favor inaction over action, even when the whole country agrees that action is needed.

Here's the relevant portion:

"In other free countries, legislation, social and otherwise, gets made in a fairly straightforward manner. There is an election, in which the voters, having paid attention to the issues for six weeks or so, choose a government. The governing party or coalition then enacts its program, and the voters get a chance to render a verdict on it the next time they go to the polls. Through one or another variation of this process, the people of every other wealthy democracy on earth have obtained for themselves some form of guaranteed health insurance or universal health care.

The way we do it is, shall we say, more exciting. For us, an election is only the opening broadside in a series of protracted political battles of heavy artillery and hand-to-hand fighting. A President may fancy that he has a mandate (and, morally, he may well have one), but the two separately elected, differently constituted, independent legislatures whose acquiescence he needs are under no compulsion to agree. Within those legislatures, a system of overlapping committees dominated by powerful chairmen creates a plethora of veto points where well-organized special interests can smother or distort a bill meant to benefit a large but amorphous public. In the smaller of the two legislatures—which is even more heavily weighted toward conservative rural interests than is the larger one, and where one member may represent as little as one-seventieth as many people as the member in the next seat—an arcane and patently unconstitutional rule, the filibuster, allows a minority of members to block almost any action. The process that results is less like the Roman Senate than like the Roman Games: a sanguinary legislative Colosseum where at any moment some two-bit emperor is apt to signal the thumbs-down.

These perverse (if time-honored) institutional arrangements (and the above accounting only scratches the surface of their perversity) are the principal cause of America’s sad health-care exceptionalism. Americans, polling shows, have long been as receptive as Europeans to the principle of universal health care. Six times since 1948, we have elected Presidents committed, at least on paper, to that principle. There have been gains, small (under Clinton, the State Children’s Health Insurance Program, or SCHIP) and not so small (under Johnson, Medicare, for the aged, and Medicaid, for the very poor). Yet forty-six million of us—a number roughly equal to the population of half the states of the Union—have no health insurance at all, and, as President Obama noted during his prime-time press conference last week, fourteen thousand more are losing theirs every day. Many millions of us have coverage that is inadequate, and almost all of us live with the well-founded fear that unemployment, a change of job, or striking out on one’s own to freelance or start a business could cost us our coverage and leave us open to medical and financial catastrophe.

Pretty much everybody who believes that health care should be a human right, not a commercial commodity, and who makes a serious study of the abstract substance of the matter, concludes that the best solution would be (to borrow Obama’s words at the press conference) “what’s called a single-payer system, in which everybody is automatically covered.” But, by the same token, pretty much everybody who believes the same thing, and who makes a serious study of the concrete politics of the matter, concludes that a change so sudden and so wrenching—and so threatening to so many powerful interests—is beyond the capacities of our ramshackle political mechanisms. The American health-care system is bloated, wasteful, and cruel. Under the health-insurance-reform package now being bludgeoned into misshapen shape on Capitol Hill, it will still be bloated, wasteful, and cruel—but markedly less so. The House bill, for example, would make basic coverage available to tens of millions who now have none. It would curb the practice of denying insurance to persons with “preëxisting conditions.” (We’re all born with a preëxisting condition: mortality.) It would make insurance coverage portable, which would be a boon for both individual careers and the wider economy. Even one of these things would be a colossal improvement on the status quo."