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Writing in 1835 Alexis de Tocqueville described the American constitution as the ‘most perfect in the world’ – he was deeply impressed by its ability to deliver a system of majoritarian democracy whilst avoiding the tyranny of the majority. Since its inception, the USA has largely succeeded in maintaining this raison d’être. This is no small achievement when set against a backdrop of nineteenth century revolutions in Europe, and in a context where repressive government was the norm. However, in an advanced and mature society as the US now undoubtedly is, it seems reasonable to aspire to more than the most libertarian conception of liberty. If the constitution is unable to provide a framework in which fundamental problems in American society cannot be resolved then perhaps a new constitutional settlement is necessary. A distinction does need to be made though, between problems that the state is unable to solve, and those that it is unwilling to solve. The latter point is pivotal; is the political establishment incapable of tackling issues due to the confines of the constitution? Or is the prevalent political culture of the US simply unwilling to identify issues such as inequality, lack of health care provision, and