Providing Security to Expand Opportunity

As I've argued, Democrats need a clearer and more forward-looking economic vision, and that vision should combine a commitment to economic security with a faith in economic opportunity. This vision—which I call an “insurance and opportunity society” (but which Jon nicely termed a "security and opportunity society")—is starkly opposed to the ideal of an “ownership society” outlined by conservative critics of the welfare state. The premise of conservative’s ownership society is that we can only be free to pursue the opportunities in our lives if we do not share risks with others. An insurance and opportunity society, by contrast, is based on a very different premise: that we are most capable of fully participating in our economy and our society, most capable of taking risks and looking toward our future, when we have a basic foundation of financial security. In this vision, economic security is not opposed to economic opportunity. It is its cornerstone.

In The Great Risk Shift, I argue that an insurance and opportunity agenda must include the preservation and improvement of existing social insurance programs, like Social Security, but simply cannot end there. Our framework of social protection is overwhelmingly focused on the aged, even though young adults and families with children face the greatest economic strains. It emphasizes short-term exits from the workforce, even though long-term job losses and the displacement and obsolescence of skills have become more severe. It embodies, in places, the antiquated notion that family strains can be dealt with by a second earner—usually, a woman—who can easily leave the workforce when there is a need for a parent at home. Above all, it is based on the idea that job-based private insurance can easily fill the gaps left by public programs—when it is ever more clear that it cannot.

This means the emphasis should be on portable insurance to help families deal with major threats to income and big blows to household wealth. It also means that these promises should be mostly separate from work for a particular employer: a commitment that moves seamlessly from job to job. Yes, this will sometimes mean that government has to take the lead, but it will also mean a system of economic protection that’s more family friendly, more conducive to having kids, more supportive of obtaining new skills, more accommodating of employers buried under the cost of their benefit obligations—in short, more supportive of a large productive workforce that will lessen the strain on programs for the aged. It also means a system much less imperiled by the demographic shifts that have placed Medicare and Social Security in danger.

Instead of slashing existing protections, in sum, we should work to include families in the bargain—by, for instance, expanding Medicare to younger Americans, upgrading unemployment insurance to reflect the changing character of job loss, and ensuring that 401(k) retirement plans are broadly distributed and are capable of providing guaranteed benefits for the remainder of retired people’s lives.

I won’t go into the detailed agenda that I lay out in The Great Risk Shift here. I will, however, mention one novel proposal I have developed that I call “Universal Insurance”—a kind of umbrella insurance policy protecting working families against catastrophic drops in income or budget-wrecking health costs. I have outlined Universal Insurance in considerable detail for the Brooking Institution’s Hamilton Project, and I encourage those interested to find out more about the plan on the Project’s website As you will find if you visit the proposal, my estimates suggest that Universal Insurance would cost much less than what the government now spends to subsidize 401(k) plans each year. In turn, it would lift more than 3 million Americans out of poverty, and cut Americans’ chance of experiencing a 50 percent or larger income drop in half.

All these changes will not come without struggle, of course, and the struggle will be fierce. Yet we should not forget the principles at stake. If we acquiesce to the “creative destruction” of American-style capitalism, then we also have to accept that many Americans, at one point or another, will be hit with disasters they cannot cope with on their own. Providing protection against these risks is a way of ensuring that the dynamism of our economy is politically sustainable and morally defensible. It is also a way of ensuring that Americans feel secure enough to take the risks necessary for them and their families to get ahead. Corporations enjoy limited liability, after all, precisely to encourage risk-taking. But while today we still have limited liability for American corporations, increasingly we have full liability for American families.

This must change.


Comments (4)

We can certainly legislate "universal insurance" but many "progressives" I know didn't like the idea and thus didn't support Howard Dean who was pushing it.

When I did my research, I found out that Vermont was nearly in a fiscal crisis because of those ideas.

In general, I think that we should go to "single payer" since the new england states, alone, have more health care administrators than canada does for their entire country!

For democrats to deliver on any promise, wether it be "universal insurance" or "single payer," it really has to be "the economy stupid" and that means having a ready pool of highly skilled labor that can perform "required services" at "affordable prices."

This means "good schools" and, I believe, "economic incentives" which encourage all companies to help their workers become more skilled.

As an example, I think that Wal-Mart should be incented to provide the opportunity for all of their workers to reach "next level" skill sets.

That means something like apprenticeships but different because workers might actually obtain skills which let them shift industries.

My point? In my opinion, the "health care administrators" in the new england states are "dead weight" and they need to be repurposed to actually provide real medical care because "tax and spend" mostly allows politicians to buy loyality.

Thus, in general, i'm skeptical of your "insurance scheme" because, while it increases the number of consumers, it doesn't necessarily increase the number of producers especially because the producers benefit from low supply, high demand situations...

Besides my other comment, I would also like to mention the movie "Supersize Me." Maybe you've seen it?

A much better health insurance policy, for us all, would be a clamp down on the highly toxic food that millions of Americans buy every day.

The movie claims that "highly processed foods" will cause 1/3 of the children born after 2000 to have diabetes! And that's an expensive disease to manage!

Wouldn't it be interesting if Americans who were overweight and ate badly had money deducted from their paychecks to install exercise equipment and/or deliver them more healthy meals-- something like child support but for their own good?

In general, I don't see "universal insurance" curing the disease because it rewards people for getting really sick.

i prefer "single payer" care because it creates a "large risk pool" and the opportunity for preventative medicine instead of punative medicine. that is, under the private insurance system, customers often hide their health status in order to avoid premium increases and, therefore, turn a small problem into a big problem.

As do many movies, they may give up accuracy for dramatic effect. Now, pure overeating of bad food is not a good idea. There are a great many cases, however, where the effect of food is tied to genetics.

Just as one example, a software developer colleague, who recently retired from spending her weekends as an NFL cheerleader and teaching daily aerobics classes, would appear to have an activity level that would burn off almost anything. The first time we were on a business trip, I was surprised to hear her ordering her meal very carefully, to keep fat extremely low. She explained that her family had a genetic problem with inability to properly metabolize fat, and she wasn't doing this to reduce calories -- she had something low-fat but highly caloric for dessert -- but that if she didn't, she'd be suffering from atherosclerotic heart disease quite quickly.

With only partial explanations, different overweight people put the fat either on their bellies or hips. Belly fat is much more of a health risk, and is, for example, one of the criteria for what is called metabolic syndrome X, which will almost certainly progress to heart disease and diabetes.

There's a lot of oversimplification about "good cholesterol" and "bad cholesterol". There's only one form of cholesterol. There are several kinds of fat-protein complexes that carry cholesterol away from the liver or to the liver. High-density lipoproteins are what is "good", as with a sufficiently high level, you aren't at risk of heart disease. You could have a quite high total cholesterol, but if it was mostly HDL, you'd be at no cardiac risk. Genetic factors are most involved in LDL-HDL-total cholesterol ratios, not diet. In my own case, I have syndrome X, and it takes drugs to maintain a satisfactory LDL-HDL ratio.

Are there ways we could lead healthier lives? No question. There is, however, more genetic control than many people recognize. This is one of the reasons that at least one Supreme Court case said that insurers and employers can't discriminate because a genetic pattern shows a predisposition, but no actual disease.

--
Howard

*equal opportunity offense to both extremes*

avatar

It's ironic that the US is unequaled in technology development but our social policy is still stuck in the last century. I'm in complete agreement that social insurance is the only way for us to go. Tying health insurance to a persons job does a disservice to that individual and to their employer. Health insurance portability is a win-win idea. I'm amazed that more employers are not lobbying through the US Chamber and other trade organizations for this concept.

But making any major changes to our social policy is a hard sell due to cultural myths and a pervasive greed mentality. I think you're on the right track though, show that the numbers prove your case.

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