Faithfully Oblivious

Americans put far too much faith in “the free market” to make economic decisions about important public matters. We prefer the so-called democracy of many free individuals making their own choices and thereby enhancing the public good. Far better that, to most American minds, than letting some government bureaucrat fuck it all up by making “one size fits all”, hidebound decisions that are rightly the province of the individual. It’s a nice story, so very much part of our national myth. As long as Americans believe it, this nation will see no fundamental change. Looking at the current economy, long-term finances, foreign policy and a host of quality of life issues, I see the need for fundamental change all around. I do not find the resistance to change at all comforting.

Case in point: reforming health care. The US has a system of private-for-profit health care that is capable of incredible feats yet does not serve the public interest. Despite our Best in the World Health Care, we have some of the most dismal public health indicators in the developed world. Indicators in some inner city neighborhoods are more like Third World nations. Costs are exorbitant—very few Americans would have any hope of paying out of pocket for a major procedure. The system still functions for many of us but that number lessens with each lost job.

So the solution is to fine people for not purchasing health insurance and require employers to pay for their employee’s health care, all the while preserving the profits of an industry rich enough to pour millions of dollars into lobbying and advertising to keep those profits in place. And they call it preserving “choice” for health care consumers. Fucking balderdash! Choice would be a single payer system divorced from employment status. Not only could the worker choose providers and services, he or she could choose to leave an abusive workplace without fear of jeopardizing their entire economic future. If you don’t trust a public single payer system to establish practice norms and pharmaceutical formularies, how is it you are willing to trust a for-profit insurance company to do the same? Single payer makes perfect sense.

And yet, single payer is off the table in the current debate. Even Obama, who recognizes the logic single payer, isn’t willing to spend political capital fighting for it. In the current political climate, the best we can hope for is a public option and even that idea has induced howls of outrage from the free marketeers. So we will get “health care reform” that fits our comforting American myth even as it ignores the state of our public health and our economy. Profits will be preserved, just like they were in 1993.

postscript

I wrote the above a few days ago. Today I see the chatter is about taxing the rich to pay for health care reform. That seems reasonable to me. I will gladly pay additional taxes on income over $250K if it means I can live in a society that ensures access to an important public good, just like we do with essential infrastructure and utilities. Another option would be to look at the incredibly bloated national security budget and think hard about much more costly an empire is than actual national defense.