[Cross posted everywhere it makes sense.]
George W Bush broke the world. It was pretty fucked up to begin with, after years of laissez-faire economics practiced by all American presidents since FDR, but much more so since Reagan. The conservative philosophy was corrupted by deregulators who's belief in the free market completely left out the fact that most people are greedy bastards who will steal everything that's not tied down.
Now this upper class of well-to-do Reaganites, many of them in the Democratic party, have drained the wealth of this country into their walled communities and private security forces, while they whine about their portfolios being worthless. What did they think when they were doing everything Phil Graham suggested? Did they think we could just trust the robber baron class not to be robber barons?
The profit motive works just fine in a regulated market, where everyone has their cards above the table, and we all play by the same rules, which we can all understand. Old timey conservatives were for stringent regulations, especially capital requirements on banks and the like. To be a fiscal conservative meant, literally, to not take crazy risks. A little risk for a decent return, but nothing crazy.
Well, you guys had your chance and you blew it. But what's funny about it is that Karl Marx basically predicted it. It's not hedge fund science, you know. If you have a bunch of money in one place, and you loosen the rules that protect it, someone will steal it. Human nature--GREED--is not good in a market because the greedy will take down the rest of us in that inter-dependent system.
So, now we're going to try something else. It's kind of like what FDR tried, at least in the sense of the largess, the investment in infrastructure and people, and the like. But it's also like FDR in the sense that he realized that everyone deserves some basic floor to stand on: a starting place so that we are all, indeed, created equal when we become a member of The Class of US Taxpayers. Now some of us might get more out of that system than we paid in, but the ones at the top will still get something out of it. They'll have clean dishes to eat cooked food on in restaurants. They'll have firemen and cops and teachers and those people will have the basic dignity of health coverage, affordable housing and utilities, and the like. If the private enterprise system refuses to charge enough for the products and services so that those people can be paid enough to buy their own coverage, then it is we the people, the government, who must force them to, through taxation.
And if you don't believe that, then your option is to have a whole class of people who are broke, unhealthy, and damn angry about it. In this country, those people vote for someone who will make the playing field fair again. In the current view of the dominant conservative voices, those people can just crawl off and die somewhere. Or wind up in prison where we subsidize their everything.
There will be people at the top who pay for it. That is populism. That is the price you pay for living in a country where we pay people who stock shelves at Wal Mart so little that they qualify for government subsidized health care. I'm sure most free market conservatives would prefer to have Wal Mart take care of their employees. But then how could they be the low price leader?
It's still a free country, and there's going to be a free market for practically anything (including things that are illegal). There will be a free market for health care and those of you who can afford it are more than welcome to sink your dollars into a system that profits from your sickness on one end (the HMOs) and profits from your minimal care on the other (the insurance companies who don't want to pay, they just want to collect). I ask you, which force will drive doctor salaries lower? A government that tries to enforce fairness, no matter how cumbersome a bureaucracy that develops in order to implement that fairness (and, again, medicare does it with amazingly low administrative costs compared to private companies), or a private insurance company that is trying desperately to keep outlays down because raising premiums is just making them lose customers?
I'm all for personal responsibility. I grow a lot of my own food. I own my own small business and work for a lot less than minimum wage. I would require more stringent food requirements on Food Stamp recipients, like me, to eat healthy foods and support local, small, and organic farmers. But when it comes to something as complex as health care, I just don't trust the greedy bastards to run it anywhere but into the ground.
I lived in LA for 20 years. I remember the Enron fiasco during the electricity crisis. We had been sold a bill of goods about privatizing and deregulating the electricity markets that turned out to be worse than a load of horse shit (which is at least good fertilizer). It is a perfect example of how unfettered markets only serve as suet to a bunch of hungry birds like Ken Lay who fly away with the whole chunk if they can.
At that point, I started looking into co-ops, public ownership of utilities, community supported agriculture, and credit unions. I like employee owned companies and try to support them when I can. Guess what all those examples are? Communist! They take the assets, the factories, the power lines, the loan portfolios, and they collectively own them among all the members. Where I live now, we have an electric co-op (a remnant of FDR's Rural Electrification Association). It's great. All the people who get the cheap power own the assets of the power company collectively. There is no profit, but the guys who cut the tree branches out of the way get paid well, get health insurance and other benefits. So does the nice lady who answers the phone. Because we, the owners, have decided that's a good thing to do. There's no profit for any corporation, but there is enough to make sure everyone gets paid what they're worth. If those employees had a government health plan they could choose, and pay for with a tax on their paychecks, then as a co-owner of the co-op, I would be more than happy to give them a raise with the money the co-op saved by not having to pay for their health care.
I'm pretty sure GM would like that too.
Why should health care be any different than the co-op itself? Why can we not use the medicare paycheck tax to pay into a fund that is then used to pay our dues for a medical co-op that fairly and equitably distributes care on a triage basis, and puts a premium on prevention, even to the point of rewarding people who do the right thing for their health (thereby being less of a burden to the rest of the co-op)?
Now a lot of people will say it's a red commie flag there, but if you really think about it, and look back over American history at the collective good that has developed as a ethic in this country, it's conservative. It says YOU have a stake, YOU have a responsibility, and if you do well, you will be rewarded. The fact that we are all owners makes it the ownership society for real. And the fact that it is controlled by a bureaucracy that is built to make it as fair as possible takes it out of the realm of Stalin or other totalitarian philosophies, and puts it squarely in the hands of voters who get tho choose the head of the federal government every four years.
I worked my ass off for big entertainment companies for 20 years. They made plenty of money off my labor: more than I did, in fact. And when that work caused the degenerative disease I have in my big load bearing joints, those company's insurance companies denied that they had caused it, and tossed me out like any old broken cog. In your world, it's toughsky shitsky for Scotty because they have to profit. In my world, the money I put into the co-op would come back to me from the co-op when I needed it. Some guy who profited more from my work might have to pay a little more tax now to fund it, but I'll never get back all the profit I helped him make. That's fine. But when he tries to say he has no responsibility for my care, now that I'm broken down and can't do the physical labor that I spent 20 years turning into a career, I say he's full of it.
But when he says, well, I don't really want to pay into a system where a bunch of jet-setting insurance company executives and HMO executives milk every last dime out of everything in order to feed their Myopic vision of next quarter's stock price, then he has a point. I don't want him to pay them either. I want him to pay my doctor, with as little administrative or other overhead as possible. In fact, less overhead means more for my doctor.
So that's my long and winding explanation of why I want medical care to be non-profit and universal. And I'd like to thank the Ron Paul Republican who's been rattling a few cages around here for setting me off on what was a comment, but turned into a diary. So much for banging out a quick answer and getting back to work!
And thanks to Hunter today for firing up my populist, anti-Randian roots. Sometimes I forget why I hang out here, and then Hunter posts something that makes me feel like writing again.