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The Health of a Nation
The debate over health care reform is less about what is best for people's health or the economy and more to do with fundamentally differing views on what constitutes a strong, successful, and yes, a healthy nation.
On the right you have the argument that America is a strong, rich country because it has a large number of strong, rich individuals and corporations (albeit less of both lately). On the left, you have the view that a nation's overall success is best measured not by the wealth or well being of a few but rather the quality of life of the majority.
Besides the fact that the conservative position fosters inequality, I worry that such a world view--one that echos "every man for himself"--will lead to the creation of a society composed of people largely detached from those around them; individuals who, even if successful, are lonely, isolated, and pathetically, tragically selfish. Alas, such a condition would make for no real "society" at all. Moreover, we can be sure that the world would be a darker, more depressing place; where the misery of detachment is tempered only by the momentary thrills of consumption: more TV, more beer, a nicer car, a bigger house, a newer iPhone, more stuff, more things, more, more, more...
We must not fail to recognize that the underlying debate on health care reform is not just about health. It's about the health of a nation, one in which we either see ourselves as fundamentally linked by common hopes and dreams, shared histories and values, and a sense of community, or one where we do not. Which will you pick?
Thanks for commenting and recommending.
On the right you have the argument that America is a strong, rich country because it has a large number of strong, rich individuals and corporations (albeit less of both lately). On the left, you have the view that a nation's overall success is best measured not by the wealth or well being of a few but rather the quality of life of the majority.
Besides the fact that the conservative position fosters inequality, I worry that such a world view--one that echos "every man for himself"--will lead to the creation of a society composed of people largely detached from those around them; individuals who, even if successful, are lonely, isolated, and pathetically, tragically selfish. Alas, such a condition would make for no real "society" at all. Moreover, we can be sure that the world would be a darker, more depressing place; where the misery of detachment is tempered only by the momentary thrills of consumption: more TV, more beer, a nicer car, a bigger house, a newer iPhone, more stuff, more things, more, more, more...
We must not fail to recognize that the underlying debate on health care reform is not just about health. It's about the health of a nation, one in which we either see ourselves as fundamentally linked by common hopes and dreams, shared histories and values, and a sense of community, or one where we do not. Which will you pick?
Thanks for commenting and recommending.
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Socialism never works. The Russians couldn't make it work. The Chinese couldn't make it work. Obama isn't going to make it work. You can't make it work.
The only thing that will right the wrongs we face today as a country is a society full of good, strong, every wo/man for him/erself corporate types, all striving to make just a few extra pennies of wealth beyond their taxes and wages.
ex animo
davidfarrar
August 9, 2009 8:11 AM | Reply | Permalink
I do strive, and I don't want to lose what wealth I have because of a scurrilous insurance company that rescinds their commitment to my family's health.
I've looked for insurance while between jobs and while trying to start a small business. There isn't much out there.
What you call socialism, I call teamwork. If you limit your team to self-absorbed corporate types, the rest of us should have no trouble working together to defeat you.
August 9, 2009 9:09 AM | Reply | Permalink
I disagree with the way you framed the dilemma.
You said: "On the right you have the argument that America is a strong, rich country because it has a large number of strong, rich individuals and corporations (albeit less of both lately). On the left, you have the view that a nation's overall success is best measured not by the wealth or well being of a few but rather the quality of life of the majority."
This is a not a very honest argument, in fact you are simply repeating the propaganda without bothering to think about it.
You frame the choice as between the rich few or the majority. Materialism, consumerism, individualism versus community, health, hopes, dreams, etc. In other words, you are comparing something very bad with something very good, the "correct" solution already implied in the way you framed the choice.
If the choice was that simple and clear, we wouldn't be having these debates now and so many in the country wouldn't have voted against Obama in November.
The truth is there is no successful model of the social order that you desire.
There is a pretty successful model of what a country can become if it is built on equality of all, personal opportunity, ambition, perserverance and hard work.
Every time we decry individualism and consumerism, and then turn around and give people government cash-handouts, we're just fooling ourselves.
Do you think people went out and took advantage of cash for clunkers because of "shared values", common dreams and sense of the community?
No. They did it because of the government of hope, shared dreams, blah blah, offered them free cash.
In your worldview, people who become successful and rich are incapable of being decent, human and sharing with others. You pretend these are mutually exclusive. They're not.
August 9, 2009 10:28 AM | Reply | Permalink
Well, I tend to agree with the OP that it is simpler then we're led to believe.
I think I understand what you are saying, and surely the truth lies somewhere in between. It's simple, but perhaps not quite so simple.
I think the model you are talking about is post-WWII United States, which by most accounts was a society in which so many lived so well for so long. There were certainly very wealthy people then, and many were benevolent. Of course there was a lot less transferred wealth and nepotism, which was a result of a more realistic sense of fairness and integrity. Not that there weren't inequalities, there were, and some glaring, (I'm thinking of minorities and women,) but there was a will to do something about that, or at least a will not to make things worse.
How we got here from there is complicted. The way back, simple. The will to get there?
I don't see it. Too much of: 'I got mine, you can go screw' out there.
That isn't the stuff that societies are made of. We have to accept that there is a large price to pay in order to live in a pleasant, productive society, and quit making exceptions.
August 9, 2009 10:59 AM | Reply | Permalink
Post-WWII book is an interesting example.
On the one hand, it was the time of unprecedented prosperity and expansion of the middle class. But, according to Matthew's views in the OP, one can point out that it was driven by consumerism, materialism and explosion in affordable manufactured goods, refrigerators, cars, TVs, houses, etc. The patina of time also helps, things always look better from a distance.
Consumerism became one of those volatile politically-charged memes: it's good when it helps someone (e.g. cash for clunkers) and bad when it helps someone else.
In my view, the single biggest problem this country faces today is its inability to deliver equal opportunity (as opposed to equal income) despite more than 50 years of trying.
I define equal opportunity as access to affordable world-class education, affordable world-class health care, access to the job market that is free of gender, race and age discrimination, access to good housing as opposed to Bronx and Harlem projects, etc.
Our government took it upon itself to become the provider of opportunity, as opposed to enforcer.
In my view, that's what went wrong.
We threw trillions at public education, public housing, public health-care, etc. But we are unable to reach world-class levels in most of these, despite all the money we threw at it over the years. And the only solution we keep being offered is "more" "more" and "more" of spending on the policy ideas from the 1960s.
It's now 2009 but we're stuck in the same time-warp. We say to ourselves that the problem is we don't spend enough, but we never talk about what "enough" really is. We drove the bus into a ditch and insist we need to keep driving in a straight line forward.
If the post-WWII world is a model of prosperity for the middle class, then it surely lies in creating another unprecendented economic expansion, not restricting it.
August 9, 2009 11:32 AM | Reply | Permalink
Brilliant comment. This should be a blog. It's not about spending more. It's about spending wisely.
August 9, 2009 3:17 PM | Reply | Permalink
I agree with Jason, Lalo. You should expand this into a blog.
And thanks for the very thoughtful reply.
August 9, 2009 3:31 PM | Reply | Permalink
What the hell's going on here?
Me agreeing with the idea of an expanded post?
What is the world coming to?
I feel a hemorrhoid coming on.
August 9, 2009 9:43 PM | Reply | Permalink
What's wrong with the 60's? In the 60's I got a free ride to the state U and my parents weren't even poor. Heck they could afford health insurance! All I needed was great grades.
Why can't we do that now? I don't get the blame the 60's thing. Sure, there were some dumb ideas. Forced busing was the dumbest. Some of the urban projects rank right up there. But at least we were trying to do some things. Some things even worked, like Medicare. It's a bit pricey, I admit, but it works.
It wasn't the 60's thinking that slashed educational aid to students who demonstrated the ability to achieve. That was Reagan thinking.
And we did provide genuine opportunity to women and not a few minorities as well. We do not know how to change the culture of an underclass be it in urban ghettos or in the backwoods of Apalachia.
But we DO know how to provide opportunity to people who are not held down by cultural expectations. We just aren't providing it.
August 9, 2009 7:37 PM | Reply | Permalink
We threw money at everything, because we had it. And whatever we spent on public programs was dwarfed by DoD funding of military projects.
Public education: The US attempts to educate all children through HS, while a lot of countries weed out non-academics earlier. In doing so, they've turned learning into an assembly line process. We had success with assembly lines and have tried to apply that model to everything. So instead of weeding out the low-end students, we hold back the high-end students. The genius of my private school was that I was in a class with twenty guys as smart as me, which challenged me to work harder just to keep up.
Housing: Most people admit that Urban Renewal ruined cities, but as bad as urban renewal was, private development has mostly given us bleak suburbs and shopping malls. The "successes" of private development are generally based on recreational shopping.
Health Care: Has private health care been any better than Medicare? VA is underfunded, but seems to have learned to serve their clientele.
August 9, 2009 8:22 PM | Reply | Permalink
We spend more on health care than any other country in the world with worse outcomes. Insurance company profits have increased 400% from 2000 to 2007, while wages have stayed flat. Premiums have gone up, but people get dropped if they become too ill to keep their jobs, and anyone with a history of serious illness or any chronic problem is uninsurable unless through a group type employer plan.
Most bankruptcies occur for devastating health issues, and most of them are people who HAVE insurance. Without affordable health care, prevention gets left out, and it is more expensive to treat established illnesses than to prevent them.
Labeling universal health care "socialism" is a simple-minded argument. Socialism is an economic philosophy that goes across the board of a society and does not exist within capitalism, which I don't think even farrar would suggest we have given up.
The common good is just that, and just like an educated populace, a populace that has access to health care is for the betterment of society as a whole. We are the only developed country in denial over this, and it is also hurting us from a capitalistic point of view. Our car manufacturers can't compete with the prices of cars in countries that don't have the burden of employer-provided health insurance.
What are these people like Lalo, Farrar, et al so afraid of? That they will have to wait in the waiting room with the hoi palloi?
Our system is broken, and the way to fix it is NOT to reward the industries that through greed and short-term decision-making managed to get us into this mess in the first place.
August 9, 2009 11:16 AM | Reply | Permalink
Matthew - I endorse your conceptualization of the issue, and although I don't always assign right-vs-left categorizations to your alternatives, I think you are correct in your assignment in most cases.
It's important to realize that this argument is not taking place in a vacuum. We have the experience of both history and the rest of the modern world as a guide. History tells us that ideologically pure capitalism and ideologically pure socialism are always catastrophic failures. Nineteenth century America wasn't purely capitalist by a long shot, but it was relatively close, and we've come very far since then - with social security, unions and fair labor laws, bank regulation, and the like. (Well, maybe not bank regulation, but you get the point). The failure of the Soviet socialist experiment is familiar enough to need no repeating.
As a consequence, every democracy has moved into a balance between the communal ("socialist") and individual ("capitalist") elements of society. Among the democracies, we are more unbalanced toward the capitalist end than almost all the nations of western Europe - Scandinavia, Germany, Holland, etc. In general, when adjusted for natural resources, which we have in abundance, these nations have achieved societies that are superior to ours in many ways. Despite their market-based economies, they provide better safetly nets for the disadvantaged, enjoy a high general standard of living, and since healthcare is a current topic of debate, they provide healthcare coverage to more citizens at far lower cost, and with better health outcomes.
None of these societies is less "free" than we are, unless freedom is taken to mean unrestrained permisson to accumulate excessive wealth. They are certainly more free when it comes to freedom from illness, malnutrition, inadequate education, homelessness, and death by gunshot.
What we should aspire to is not to live somewhere else, but to do better than the somewhere elses when it comes to living here.
August 9, 2009 11:27 AM | Reply | Permalink
"As a consequence, every democracy has moved into a balance between the communal ("socialist") and individual ("capitalist") elements of society"
- As a consequence of what, tough?
It's not true that Europe moved towards a different social order because someone realized that socialism and capitalism are bankrupt theories.
Europe was completely destroyed during WWII. In the UK, food rationing persisted long after the end of the war.
Europeans had to find a way to rapidly rebuild the country after a catastrophic event, when their entire infrastructure was wiped out.
But the worst part of Fred's argument is "excessive wealth". It means everything and nothing at the same time. It is defined as $250,000 and it implies a major character flaw in those who got there.
August 9, 2009 11:46 AM | Reply | Permalink
Don't put words in my mouth, Lalo. I didn't define the pursuit of wealth by individuals as a character flaw. Rather, it is a societal flaw for that effort to predominate over societal obligations to ensure an adequate existence for all citizens to the extent that resources permit. Both are legitimate, and it is the imbalance that is troubling.
Your comment about European societies is interesting, but I don't see it as anything but reinforcing my point. If nations with fewer natural resources to start with were devastated by the war far more than we were, and then rebuilt their societies into something better than what we have here (at least based on criteria I cited above), I hardly see that as an indictment of their social welfare model. If they can do it, why can't we?
Perhaps an even greater concern is that we seem to be moving in the opposite direction. Our wealth disparity - between the wealthiest and everyone else - has always been anomalous, but it has grown larger every decade. Even if we merely went back to the extent of disparity we had during good times in the past, it would be an improvement over the direction we're taking.
August 9, 2009 1:02 PM | Reply | Permalink
"I didn't define the pursuit of wealth by individuals as a character flaw"
- But Fred, you did!
You said: "unless freedom is taken to mean unrestrained permisson to accumulate excessive wealth."
(1) You split wealth accumulation into "normal" to "excessive".
(2) You advocate for restraints on "excessive".
(3) You don't explain what "excessive" means.
You can define "excessive" as a dollar amount, which is what our government is doing with the $250,000 threshold. I assume this is what you describe as preventing or re-dressing some kind of social imbalance.
But the reason such imbalance exists in the first place has to be some kind of flaw - because wealth accumulation at $100 has the same underlying personal motivation as wealth at $1,000,000. You simply trade a two-bedroom colonial in surburbia for a McMansion, and a Ford for a Ferrari.
Taken to its logical conclusion, your position means that the character of someone who comes to America with "a dollar and a dream" is flawed for wanting to accumulate wealth because sooner or later this will lead to something "excessive".
If it wasn't flawed, why would anyone want to create a social imbalance? If it wasn't based on some kind of flaw, why would wealth accumulation become "excessive"?
August 9, 2009 1:42 PM | Reply | Permalink
And by the way, what kind of freedom is it where its definition is restricted?
Typically, if I do something that violates your freedom, I will face consequences, either criminal or civil. That's the only restriction on freedom that I know - restriction on something I could do that would violate freedom of another.
If my freedom to accumulate excessive wealth violates you in any way, shouldn't it be a crime??
August 9, 2009 1:59 PM | Reply | Permalink
Not a crime, Lalo, but simply restrained by appropriate policies such as the tax policies utilized in other societies that do better than we do in ensuring the welfare of all, while remaining highly productive. Or even tax policies we once had during times that were both prosperous and more equitable. It's not as though we lacked examples.
August 9, 2009 2:20 PM | Reply | Permalink
Jeez, Fred, if you were alive and at the wheel during the american revolution, we would have become a monarchy, the European benchmark of the day.
August 9, 2009 2:29 PM | Reply | Permalink
The reality of too much of one way or another doesn't work.
The corruption in our current system is rampant. We cannot survive a continuation of it. The abuse of law by the rich and powerful is out of control. We cannot survive a continuation of it.
Our media is now mainly owned by people like Rupert Murdoch who is perfect comfortably lying to people and scaring them to death in order to fulfill his vision of what the world should look like and who should have all of the money and power. Our democracy cannot survive with a media like this.
The stealing from the middle class to give to the self-designated elite, is unsustainable i.e they've gone too far and now we can't afford to take care of ourselves and one main reason for this is the rampant greed and abuse at work in the health care system.
The majority of the country has been used and abused and the greedy, power abusing elite have taken it too far.
If they were smart they would give us universal health care right now and then maybe we might go back to putting up with the regular abuses. But clearly they are not.
I see where the free market and sick tyrannical leaders have gotten us and I seriously don't think we could survive another raping and pillaging like the one we just got from Bush and Cheney. I am not clear that we will survive what they have done to our country as their is a serious lack of will to take strong action to put things right.
August 9, 2009 1:04 PM | Reply | Permalink
"The stealing from the middle class to give to the self-designated elite, is unsustainable ..."
but, hey, they gave us cash for clunkers, so at least we'll have a nice new car to sleep in.
August 9, 2009 3:23 PM | Reply | Permalink
Yeah
so the if the teacher I know who worked all of his life and ended up sacrificing over $120,000 of his life savings to the wall street thieves gets a decent car, at least they'll have a roof over their heads. Guess we should be grateful for bread crumbs.
August 9, 2009 3:48 PM | Reply | Permalink