So I thought I would, but I also wanted to post it here, because I have readers from many states who will be voting on February 5, only a little over a week from now. And while you are thinking politics, take a look at this story in today's New York Times in which Edwards turns free market logic, usually used to support privatization, on its head. Let private insurers compete with a government-sponsored health plan, he suggests: Americans will have the right to decide which kind of plan they think is better, and if the private insurers go out of business, then the question of the viability of a single-payer system in the United States will have been fairly decided by the people, not political and financial elites. This is a progressive version of what Harvard historian Liz Cohen, among others, has called "consumer citizenship." If the private insurers don't go out of business, it will show that they are doing a good job for the people who can afford them. And people who can't afford them will still have health insurance.
How much sense does that make?
I have also recently received mail from John opposing a bill currently on the floor of the Senate that is up for a cloture vote: the bill revises the Foreign Intelligence Surveillance Act (FISA) and "would give 'retroactive immunity' to the giant telecom companies for their role in aiding George W. Bush's illegal eavesdropping on American citizens." The filibuster is being led by Connecticut's Senator Chris Dodd. If you live in Connecticut you can call Senator Dodd at (202) 224-2823 and tell him you approve; you could also call Connecticut's other Senator, my Shoreline neighbor Joseph I. Lieberman at (202) 224-4041 and tell him to act like a Democrat.
But better yet, click this link and call your senators. Ask them to support Chris Dodd and the Constitution of the United States. It will only take a second. And if your senators are Republicans, so much the better: many conservatives feel very strongly about the right to privacy and there is a good chance to defeat this bill despite the jingoistic "war on terror" it claims to support.
In other political news of interest to academics and the students they serve, Charles Grassley (R-Iowa), ranking minority member of the Senate Finance committee, is issuing subpoenas to the 136 wealthiest colleges in an effort to push them to "use more of their wealth for financial aid and threatening to require them to spend a minimum of 5 percent of their endowments each year, as foundations must. The committee pointed out that donations to universities and their endowment earnings were both tax-exempt." The subpoena also asks them to reveal what they are paying their money managers, which is a great idea: according to a prominent Harvard alum I know, last year Crimson financial advisors earned tens of millions for their advice. Hence, the most wealthy universities are directly lining the pockets of a financial elite rather than siphoning the money to the communities they are in, supporting local public education or further subsidizing tuition and fees. I think the Senate hearings that will ensue are a good idea, but one potential problem is that we risk limiting the discussion about the rising cost of college to a conversation with only those very few colleges who can do something about it. What is left out of the equation is how hard institutions, private and public, community college to state university, have been hit by the retraction of federal and state-level spending on education. Most students don't go to those 136 schools. How are we going to help them?
And finally, just when you thought you knew everything about Al Gore, he comes out for gay marriage. Regular readers of the Radical know how she feels about marriage, not to mention the icky little bit where Gore suggests that marriage helps control promiscuity, but that does not put me above just loving him for this.
Between Al and John, I have to ask this question: is it possible that anti-racist white progressives in the South who are not affiliated with research universities are making a comeback, after all these years? Whoever becomes the Democratic presidential nominee, this could be something to watch. And, if you happen to be inclined that way, pray for.
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Unfortunately, Edwards's health-care plan/gimmick will most likely not be a fair test. Like any government run enterprise what would it mean for it to fail? What's to ensure it doesn't price well below cost and make up the difference out of tax revenues or borrowing? How can private plans compete on a fair playing field when the state-run plan has the power of the tax dollar behind it?
If you really want a fair test of markets versus government, then maybe it's time to seriously remove the various policies that alter the way private sector insurance and health care markets work and, in so doing I would argue, make matters worse for most Americans than would be the case without them. As one example, the whole reason our system is dominated by employer-provided health insurance in the first place is that it's a consequence of government policy rather than some sort of "free market" outcome. Tying health care to employment causes all sorts of problems that would not exist without the distorted incentives that government policy has created.
Edwards's little gimmick also runs the risk of the continued mis-labeling of the US health care system as "free market," which it most certainly is not. Untangling the mixed economy mess that it is in order to figure out what degree of government involvement and what underlying market processes are both responsible for the problems and desirable for solutions is going to involve a lot more thought and creativity than what Edwards is proposing.
"If the private insurers don't go out of business, it will show that they are doing a good job for the people who can afford them. And people who can't afford them will still have health insurance."
Who's going to fund government health issurance for people who can't afford private insurance?
Well, I'm guessing that would be income tax payers, unless you think this is somehow going to be funded through sales taxes or some such thing.
Since poor people don't pay income tax (you see, you have to have a certain level of income to pay taxes on it, hence the term "income" tax) you're advocating that those who want nothing to do with government insurance and can afford to avoid it be forced to fund their own private insurance as well as insurance for the poor.
No thanks. And I suspect that is what Edwards is going to find at the polls, over and over and over again.
No, actually what I am advocating is that good health care is something citizens of the United States should receive whether they can afford to pay for it or not, and whether that payment comes directly from wages or whether it comes from taxes paid by the rest of us. It's not optional. And, as in Canada, Britain, and other countries, some of us who can afford a more luxurious policy will have the option of whether to pay for it or not. If some Americans distrust the government to run a good system, they can pay for something else -- by the same logic, some people send their children to private or religious schools, or they home school. This is what we call liberty.
And let me say -- universal health care is not considered radical in Canada, Britain, France, Germany and a host of other countries that have had a strong -- and sometimes dominant -- conservative movement in the last two decades that has advocated privatization of all other public services except health care. Sick people can't work. People who lose their homes because they have been bankrupted by an illness no longer pay property taxes. Children who can't breathe from their asthma or who have painful, rotten teeth can't learn, ultimately get decent jobs, or become tax payers/productive citizens. And people who receive no preventive care turn up in emergency rooms desperately ill and cost communities millions of dollars a year.
I think the idea that a country that believes that its well-being depends on a large number of people remaining immiserated and unhealthy is not a democracy in the truest sense of the word. Perhaps the greatest harm of Clintonian neoliberalism, in my view, is the adoption of the Reagan-era "me first" suburban centrism/conservatism. This is part of why I am reading and featuring the Lassiter book this week: it tells the story of why "I've got mine, screw the neighbors" became common sense in this country.
TR
I think we have to avoid idolizing any particular system, ask what our values are, and then adequately fund a system that reflects them. My conclusion is that competition doesn't really work; or rather, the government provides end up being "honest" but unaffordable. I have lived for the last two years in a country where everyone is required to have health insurance, the health insurance is supplied by companies, some for profit (called "private"), some nonprofit (called "public," although they are not really public). It is not an option, if you are employed in a normal employment situation, not to have health insurance. There are ways to avoid the requirement, for example, by working solely freelance, but even so the requirement to prove that you and your children are insured comes up so frequently that it's difficult to do it for long. And the result for many years was that the "public" rates are so high, because they can't refuse anyone, that young or wealthy people flee to the private insurers, who can charge what they want and offer benefits as to attract business, but also exclude people at will. The consequence of this situation was that two years ago the government had to revise the system fundamentally to keep the "public" insurers from running out of money--this involved a raising of rates for the private insurers and forcing them to accept customers that they had dropped for various reasons. To keep the system going, the government ends up having to regulate the private insurers very heavily. In essence, the private insurers don't keep the public ones honest; the effect has been to force the public insurers that have to cover anyone to the verge of bankruptcy, and the government has to intervene to keep the private insurers honest so that the system doesn't collapse.
This is the question: do we think that health care is a human right that should be covered by the government? Or not? And US Americans still seem to be very divided on this question. My suspicion is that things will have to get very much worse before anything happens to change that.
Just a quick correction: Chuck Grassley is the ranking member of the Finance Committee and is a Republican.
Noted!
TR
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