While some members of the House Republican “suicide caucus” shrug their shoulders in, one hopes, feigned nonchalance, and media outlets sputter that anxieties over the shutdown of the federal government are overblown, more than 800,000 other Americans are wondering when they are going to see their next paycheck. In New York harbor, Lady Liberty, like other federal park facilities across the nation, has gone dark; and hundreds of cancer patients, including 30 children each week, have been locked out of their last-resort treatment at the National Institutes of Health’s Clinical Center. What little time—and hope—these patients have left is burning away while a gang of House Republicans fiddles with the American government.

These are just a handful of the pernicious effects of the shutdown that resulted on Oct. 1 after the G.O.P’s latest effort to obstruct the Affordable Care Act. The closing of the federal government not only shuts down so-called nonessential services, like nutrition aid to women, infants and children, it also means that a federal flow of $3 billion a day into the already twitchy American economy has been cut off.

A Republican fringe has generated a major legislative impasse, holding the national economy and majority rule hostage to an idée fixe on the Affordable Care Act, a law that has been passed by Congress, vetted by the Supreme Court and signed into effect by a now twice-elected president. This is a law intended to provide health insurance and care to previously unmoored citizens and legal residents. It deploys a free-market model once endorsed by Republicans in a manner consistent with other liberal democracies since the late 19th century, an era many in Congress seem eager to revisit. If Congress’s health care extortionists are able to achieve even a “compromise” remnant of the ransom they seek, it could mean that government by fiscal hostage-taking will become a regular and profoundly destabilizing feature of U.S. political life.

The U.S. bishops, unhappy themselves with the A.C.A.’s contraception mandate, nonetheless were aghast at the political breakdown. In a letter to Congress on Oct. 1, they reminded the nation’s legislators that the proper role of government is to “make accessible to each what is needed to lead a truly human life,” including food, clothing, heath care, education and culture. “In our country today, millions of Americans struggle to meet these basic needs, through no fault of their own, as a result of an economy that continues to fail to create sufficient economic opportunities,” the bishops wrote, adding that internationally, millions more rely on “life saving” aid from the United States. “This work must continue,” the bishops said, “and human needs must be met.”

In other words: Get back to work. A shutdown may make good political theater, but it is an unconscionable burden on those least able to bear it. A tolerance for some factionalism and legislative log-jamming is programmed into the nation’s constitutional DNA, but this month’s paralysis, joining other recent examples of ongoing dysfunction, the “sequestration” failure and the ascendance of the fake filibuster, begins to call into question the effectiveness of the two-party system itself. Many Republican representatives come from conservative districts where the only significant threat to re-election comes from Tea Party challengers in the primaries—a dynamic that tends to produce ever higher levels of ideological purity.

The Supreme Court decision in the Citizens United case has allowed a handful of plutocrats to become major players on national social policy; and the permanent election cycle means that members of Congress are forever scurrying back to their base, however indifferent that base may be to compromise, good government or even to reason. It is enough to provoke longing gazes toward European parliamentary systems. Responsible voices within the Republican Party are already trying to find a way out of this artificial standoff. But even if the nation escapes this time, it is clear that something has to change in Washington. The problem, as always, is that the people most in need of reforming are the only ones constitutionally empowered to make it happen. 

Perhaps this latest debacle will propel a popular drive to revisit congressional procedures and privileges, even to force legislation to neutralize the worst effects of the Citizens United decision. But a campaign that might result in loosening the political stranglehold of the nation’s two dominant parties will likely have to bubble up from below, as citizen initiatives lead to structural reforms at the local, then state levels. This is a reform that can only trickle up from an outraged public that deserves—and must learn how to demand—better.

This article appears in October 21 2013.