If there is one clear lesson from the painful mess that was the 2016 election cycle, it is that Americans hate the American government. They hate a lot of things about it, too: its size, its perceived incompetence, its never-ending rules and regulations, and its invasion into the details of their lives and livelihoods. Everyone hates the IRS. The biggest reason that Donald Trump is president is that he successfully branded himself as the most anti-government, anti-establishment candidate.
And many American voters (those who vote, that is), feeling they don’t have any entirely satisfying options, have taken to voting against what they hate the most. And it appears that what they hate the most is the American government. But in voting this way, they have to accept other things they dislike, or even hate. But they don’t feel they have any better options, so they do it. Or they don’t vote. More people, by far, didn’t vote (41.9%) than voted for either Donald Trump (27.4%) or Hillary Clinton (27.8%).
This anti-government sentiment carries profound political implications. Republicans have successfully branded themselves as the anti-government/anti-regulation party and the Democrats as the Big Government/Regulation-crazed party. This is good marketing, and is winning elections, even though it is not entirely accurate. In governing, the Republican majority’s tool of choice, reflective of their anti-government/anti-regulation stance, is cutting government down to size.
Remaining Democratic politicians don’t really seem to have an answer for any of this. They blandly point to the need for regulation to protect Americans’ safety and values. This may be true, but it also plays right into the Republican branding strategy, and is out of touch with the extent to which Americans are sick of the regulatory mess that is the American government.
But all of this is un-satisfying (one of the reasons that so few people vote). While billing themselves as anti-government has been a good campaign strategy for the Republicans, cutting government does not necessarily create better government. It may create smaller government, but smaller government isn’t necessarily more effective government. And the Republicans don’t cut so much with an eye towards improvement so much as they seek to get rid of things that conflict with their values, or that get in the way of their big business campaign donors’ ability to make money. And the truth is that Democrats are likely to enact legislation, even if it is legislation addressing important matters, but that legislation too often results in a nightmare tangle of regulations that undermine the legislation’s intent, gums up business (especially small business), and breeds further discontent. Neither the Republican nor the Democratic approach leads to effective government.
But we need effective government. When a Republican administration removes regulations that protect drinking water, or when a Democratic administration creates regulations to protect drinking water that are too complicated or expensive to comply with or enforce, drinking water is unprotected. But we need safe drinking water. So we need balanced regulation that both protects water, and is simple to comply with and enforce. This is not a simple matter.
But it is absolutely necessary. The current Republican and Democratic status quo may result in undrinkable water, and that is unacceptable. And that status quo is also one of the major reasons we don’t have good health-care, our educational system is in disarray, and we have crumbling infrastructure.
In the health care sector, which as a physician I naturally have the most experience with, I have learned that better regulation begins with two steps: ask what those at the heart of the situation need most (in health care, that is patients and doctors), and then to examine the deep details of the situation. So, in health care, I have found that when we prioritize the needs of patients and their health care providers to form the goals and values of the health-care system, and then look to the devil in the details of the current system, that simple, workable solutions become obvious.
Medical billing provides a simple example of this. The current system is a jumbled, complicated mess that makes it difficult for patients to receive care and health care professionals to provide care and do business. It is so complicated that it spawned an entire industry just to administer it. If it has a true focus, it is data- and control-obsessed government bureaucrats and money-obsessed health insurance administrators. But it would be extraordinarily easy to fix—simplify its voluminous and complicated rules and regulations, and leverage modern technologies to eliminate most of the steps required by the current system. Eliminating the barriers and distractions of the current system would enable us to provide more and better health-care, and promote business.
We need government that works. It is harmful to have Americans hate their own government. We need to restore faith, and even pride, in the American government. We need a political system and government, and politicians, that we take pride in voting for rather than one we merely vote against.