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Sartre's dialectical method says that, through praxis, we work the matter around us in order to negate a need. We all have needs, perhaps something lacking in the material world around us that entices us to work to change our world through action.
An improved health care system is a national need. For too long, the clunky Frankenstein that is the American health care system has plodded along, a hybrid of private health insurance corporations and "sewn-in" government intervention that has become massive, expensive, and dangerous to our general welfare. Especially for those who are unemployed, and hence uninsured, the time to lay Frankenstein to rest has become an ever-important necessity. President Obama identified this necessity and immediately got to work.
But there's a problem. A political solution never ends as it begins. In the Sartrian sense, when we work matter, when we create a bill, we unify the matter around us into a totality, or our definition of what health care reform should be.
However, our logic fails us because we forget that we are not the only ones whose praxis endeavors to create meaning. To think that only our world and our ideas encompass the entirety of our society is a foolish idea, especially in a democracy. Other people are working matter and shaping the world, as well. Any bill that we propose will immediately get enveloped into the field of multiple praxes that will shape that bill - to the point where we may not even recognize our original proposition.
Health care reform will never be what we wish it to be, because everyone possesses a need, works matter, and shapes their own totalities as well as the totalities of others. Unless Democrats become totalitarian in the purest, militaristic, oppressive sense, we will never achieve a pure, unfettered version of our bill. Perhaps Republicans, conservative and moderate Democrats could cease acting, but they act because they too possess a need to define the bill, as do lobbyists. However to say that the current state of the health care reform is the result of the actions of any single actor, or group of actors, forgets that politics operates in a patchwork of relations that intersect. Why would anyone believe that Obama, or congressional leadership, or Republicans, or lobbyists, or any actor has "total control" over this process? Why do our expectations for health care reform, or our criticisms of those working against health care reform, assume that any group is a leviathan that has taken over the process?
We've been trapped too long in the belief system that we are all purely autonomous actors who can shape the world world based on our fantasies and aspirations. As long as we value living in a democracy, we cannot expect that the solutions we propose will reflect only our desires. They won't, and to be honest, they never have. This is something we need to come to grips with if we are going to make sense of Obama's efforts to reform the American health care system.
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