After my friend printed his excellent article in a tiny, conservative, Sierra town paper, The Kaweah Commonwealth, there was a flurry of response. Here is the follow-up essay, helping people to understand that the Public Option is not so scary.
tarantula
In his reply last week to my article about health care reform, Steve raised valid concerns, concerns shared by many Americans whether they against reform or for it.
One concern is that government will take over the entirety of the health services industry. The other is that any government involvement at all amounts to socialism.
First, government takeover. Despite the fears stoked by conservative talk show hosts and the big national insurers, a government role in health care does not necessarily result in a takeover. These same arguments were made in the run-up to Medicare legislation the 1960’s, and they turned out not to be true. A measure of proof is staring us in the face right now. Currently, the health care industry is wildly profitable and staggeringly innovative in an environment in which government sponsored coverage (Medicare, Medicade, Veterans Administration, TriCare, SCHIP, the Federal Employees Health Benefits Program, plus state and local plans) currently pays 45% of total national expeditures, while private health insurance pays 36%.
Bottom line? Government already plays a large role and yet health industry profits are at historic highs. New products and techniques are entering the marketplace faster than they can be adopted. Assertions about a government takeover or an erosion of innovation are baseless. We have every reason to expect that most of the health care industry will remain independent, innovative and profitable under a public option, or even under a single payer system.
The socialism concern is more difficult to approach. Government sponsored health care is socialistic. And so is every government program that serves a social purpose and is paid for with taxes. Include the military here. The problem is that extremists vehemently proclaim that health care reform will propel the nation headlong into socialist tyranny, when in fact it won’t.
But perhaps we should pause for a moment. It might help if we had a better understanding of what socialism is, what capitalism is, and where America resides on that spectrum.
In its pure form socialism means government ownership of all services and all means of production—most if not all wage earners on the government payroll. Obviously, we’re nowhere near that condition, and never will be. On the other hand, capitalism in its pure form means no government involvement whatever in regulation, in provision of services or in the means of production. Although America began life more or less in this condition, we are nowhere near it now, and haven’t been for at least a century and a half.
What we have is a kind of hybrid system with both capitalistic and socialistic elements, but which is far more capitalistic than socialistic. This system, which some have called Interventional Capitalism, evolved naturally over 140 years.
From 1797 until 1937 America had buckled under the oppression of 4 severe Depressions, 8 Panics and 17 Recessions. That’s a Depression, a Panic or a Recession every 5 years, and once they struck they lasted an average of more than 2 years.
Even before the 1930’s it had become painfully apparent that lassez-faire supply side economics weren’t working. Despite the claims of its evangelists, capitalism does not self-regulate and the little bit of trickle down that occurs during the Boom part of the cycle is not enough to offset the pain of the Busts.
During the 1930’s, government became significantly more involved in regulating markets (especially financial services) and pushed out the boundaries of physical and social infrastructure. Conservatives, of course, howled. "Socialism! Tyranny!"
Since that time 72 years ago, the American economy has experienced 11 recessions (most of them mild), no Panics and no Depressions, with the average recession lasting just less than a year. That period also propelled the U.S. to become the most dynamic social, political and economic force in human history, a time during which the nation became more open, more democratic, more egalitarian—not less.
Nevertheless, ideological conservatives continued to complain, and still complain, that America has abandoned its founding principles. The America they want is a vision of a bygone era best characterized by Jefferson’s concept of democracy, a scaled-down nation of small independent farmers and artisans, well-educated, well-informed, completely engaged in the political life of the nation, government nearly impotent in the deep background. Any more government than that is socialism trending toward tyranny.
But the Jeffersonian Ideal never existed outside Jefferson’s mind, not even for a minute. For better or worse, the moment we became a nation the realities of the broader world began pushing us in a different direction. Even during Jefferson’s time, urban life, capital-intensive manufacturing and high finance were well established.
So, if the real America—the one we inhabit day in and day out—is a hybrid system containing mostly democratic and some socialistic elements, does health care reform really threaten our traditions of democracy and free markets, as conservatives contend?
Two recent publications from starkly conservative institutions address this issue. One, The Economist magazine’s 2008 Index of Democracy, ranks the U.S. as the 18th most democratic nation in the world. The 17 countries ahead of us exceed us in social pluralism, electoral integrity, individual civil liberties, political participation and government efficiency. All of them have government sponsored universal health care.
The other publication, The Heritage Foundation’s and the Wall Street Journal’s 2009 Index of Economic Freedom, surveys a nation’s commitment to the fundamental principles of free market capitalism. Here, the U.S. ranks 6th. All five countries ahead of us, those with more economic freedom than the U.S., have publicly funded universal health care. Of the top 20, all but a couple also have publicly funded universal health care.
This doesn’t look much like tyranny or like socialism. Tyranny disempowers, but government sponsored universal health care appears to liberate the societies that have it. It has little or no impact on democratic liberties, little or no impact on economic freedom.
This is one of those rare instances in which we really can have it all— freedom, capitalism and universal health care—without conflict.