At a crucial juncture in the fight for civil rights, Dr. Martin Luther King Jr. warned President John F. Kennedy not to “accommodate injustice to maintain political balance.” Today, few politicians are willing to speak out against the injustice in their own political party, and even fewer defy the partisan self-interest that has engulfed Congress.

The congressional health care battle reveals just how broken and unprincipled the American legislative process has become. Referring to changes in the latest G.O.P. proposal to repeal and replace the Affordable Care Act, a recent New York Times article stated, “Those changes and others …  were intended to bridge a vast gap between the Senate’s most conservative Republicans, who want less regulation of health insurance, and moderate Republicans concerned about people who would be left uninsured.”

Designing health care by balancing the ideological positions of the senators whose political party controls Congress is a fundamentally flawed approach to public policy. If Sen. Mitch McConnell had been able to force a vote and the bill had passed (at this point it seems headed for certain defeat), it would still be a failure because the legislative process itself is partisan and does not prioritize the needs of the country. Democrats are no doubt celebrating the defeat of the bill. However, both parties are responsible for having created a Congress that is so distant from the lives of real people. 

There is a basic principle in medicine that I and many physicians try to impart to our students, which is to give each patient the best care you possibly can. The principle is to support and enhance health. We would never dream of designing anyone’s treatment according to our political affiliation. Medical care is about human beings caring for other human beings and is done best when patients are included as active participants in the therapeutic process. But these principles of equality and inclusion are absent from our political process.

 Also in short supply in American politics today is leadership that goes beyond representing a particular constituency to reaching out across ideological, partisan and racial divides to build community. Our country has at times seen examples of such risk-taking courage. When carried out, it is deeply impactful. At such times, public officials have responded to crisis by taking a moral position, risking future political office and personal advancement.

 President John F. Kennedy did so after years of silence and compromise with southern segregationists. As Steven Levingston movingly narrates in his book, “Kennedy and King,” in June 1963—in the midst of the Southern Christian Leadership Conference-led Birmingham civil rights protests, and after intense lobbying and pressure from King—Kennedy gave a televised speech to the nation in which he found the courage he had until then only written about. He said, “This is not a sectional issue. Difficulties over segregation and discrimination exist in every city, in every state of the union, producing in many cities a rising tide of discontent that threatens the public safety. Nor is this a partisan issue. In a time of domestic crisis men of goodwill and generosity should be able to unite regardless of party or politics. … We are confronted primarily with a moral issue. It is as old as the Scriptures and as clear as the American Constitution.”

Five months later Kennedy was assassinated and the civil rights legislation he introduced to the nation was passed in the following year under President Lyndon B. Johnson.  

In 1967, exactly one year before he was assassinated, King said (after being advised by some to stay within the bounds of civil rights), “There comes a time when silence is betrayal.” In speaking out against the Vietnam War, he was speaking out against the actions of a president who had passed legislation for civil rights and voting rights. Some, including Black leaders, criticized him for doing so.  He said, “Some of us who have already begun to break the silence of the night have found that the calling to speak is often a vocation of agony, but we must speak. We must speak with all the humility that is appropriate to our limited vision, but we must speak.”

 Both King and Kennedy were killed, but we must carry on their leadership and work:

 “And when these lives come to an end

The people open their deepest rivers

And they enter those waters forever.

And so they become, distant fires, living,

Creating the heart of example”

—From the poem “Satisfaction” by Otto Rene Castillo

Dr. Lenora Fulani, the activist and grassroots educator whose entire life has been one of providing independent leadership, has taken the moral stand of fighting poverty and empowering people and communities, including the residents of public housing whose homes are now threatened by privatization. She is the ardent heart of leadership by example.

 Achieving quality health care for the American people will require revitalizing our calcified political process. The responsibilities of leadership do not skip those allied with the Democratic Party, which also uses health care as a political football. I would like to challenge health care providers and advocates to support nonpartisan reform of the election process. Without a massive dose of reforms, the long-term health of our democracy and of our people is at risk.

Dr. Jessie Fields is a Harlem-based physician and activist with the movement for political independence and nonpartisan electoral reform.