Lessons Learned?

What can be drawn from this recent election that speaks to America?

To listen to the bombast, this election is all about money.  Who has it, where it comes from, what it’s to be spent on, when to cut it off.  An angry electorate looking at massive job loss and all that that implies tossed out the previous majority in Congress over money.  This is not difficult to understand.  People are frightened that they will no longer be able to pay their bills, keep their homes, send their children to college.  Basic stuff.  Two years into the current regime and foreclosures are still high, unemployment still high, fear level still high, and the only bright spot concerns people who are seemingly so far removed from such worries as to be on another plain of existence.  The stock market has been steadily recovering over the last two years.  Which means the economy is growing.

Slowly.  Economic forecasters talking on the radio go on and on about the speed of the recovery and what it means for jobs.

Out of the other end of the media machine, concern over illegal immigrants and outsourcing are two halves of the same worry.  Jobs are going overseas, and those that are left are being filled by people who don’t even belong here.  The government has done nothing about either—except in Arizona, where a law just short of a kind of fascism has been passed, and everyone else has been ganging up on that state, telling them how awful they are.  And of course seemingly offering nothing in place of a law that, for it’s monumental flaws, still is something.

Throw into this mix the new healthcare law, which has as one its most unpopular features that everyone will be required to buy policies.  Among people who are already scrambling to pay inflated mortgages and don’t know if they’ll still have a job next week, this is salt in the wound.  How dare the federal government burden me with essentially a new tax and then do nothing—nothing—to fix my economic situation!

On top of that are complaints about both the TARP program and the stimulus package, the former of which carries more than a little appearance of gross unfairness, the latter of which is purported not to have worked.

And finally, the Supreme Court overturned decades-long precedent that barred unlimited spending by corporations in political campaigns, declaring that, well, we can’t see any difference between a corporation and an individual and to restrict the presumed rights of one is to do so to the other.  Whether you agree with that decision or not makes no difference, it is still the same issue—money.

There were other, non-monetary issues that drove voters—same-sex marriage, possibly Don’t Ask Don’t Tell, the state of education.  If you work at it you can connect those to money as well, but for most people I think it’s fair to say that at first glance the connection is dubious at best.

So.  Establishing the chief cause of the recent election, what can we learn from it?

Mainly, that people will vote on that basis and then apparently refuse to consider the ramifications of the problem.  With a clear track record of pro-business support, the Republican Party appears to be the least likely to do anything on behalf of working people that does not also feed the coffers of Big Business.

Consider: health care costs have been spiraling out of control for decades.  Partly, this is a consequence of technology and the expansion of choice.  Medically, we can do more now than ever before, so logically people expect it.  They expect it regardless of cost.  They make a demand on the industry based on (loosely) moral grounds—I have a right to the best shot at a longer, healthier life, and no one has a right to deny it to me—that must then find a way to provide these services based on financial realities.  As the price goes up, people fall out of the program because they can’t afford it.  Businesses also stagger under the weight of increased premiums, because the demand on the industry doesn’t automatically go down just because people can’t pay.  This is one industry where by law the services must be provided regardless of circumstance.  If you stagger into an emergency room, bleeding freely, they have to take care of you.  The cost gets shifted to those who can pay, hence premiums keep going up.  Not only that, but hospitals place liens on families under circumstances where there is clearly a source for payment.

Of course, if you’re in a plan, the insurer can negotiate with the providers to get the costs down, but that just shifts things around again.  It has become a continual game of Peter-and-Paul and no one is happy.  More and more people drop their insurance because they can’t afford it, fewer and fewer young, healthy people buy policies, so the shortfall has to be made up from those who can pay, and hence the spiral.

One can complain about the pricing practices of big pharma, etc, but that doesn’t mean the problem of smaller and smaller pools of paying customers supporting an industry that keeps growing isn’t real and basic.

Okay, so we need a solution.  The simplest would be to somehow turn everyone into a customer, which, expanding the pool of payment, would lower the cost per person.  But in order to do that, conformity to a standard must exist, which suggests that either the entire industry sit down at the table and come up with a single method, or some outside entity imposes the method.  What might that be?  Well, the only that can is the federal government.

Simple.  So-called single payer.

Except.  The common sense solution is met with massive resistance that casts the problem in terms of national identity.  We can’t take choice away from individuals.  (Even though it is taken away by the current system simply by pricing people out of the pool.  They then have two choices—be sick or go to emergency rooms.)  We can’t take away the autonomy of the Market.  (Despite the fact that in this instance the Market has demonstrated a persistent inability to address this problem, since the driving force of the Market is maximizing profits.  Change only happens when a method is shown to be counterproductive to that goal.  In other words, broken.)  We must not abandon the myths of autonomy from which we draw our common sense of identity (in spite of the fact that such myths are exactly that and even in those instances where substance can be found it is substance based on conditions long out of date and largely inapplicable to present reality).

So the solution was compromised by an insistence that nothing change, even in those matters where for any solution to work change is the only way.  The insurance lobby, in the person of spokesperson Karen Ignani, argued, cajoled, threatened all through the debate to guarantee that Washington would not set price controls, that Washington would not offer a single-payer option, that government would end up doing nothing but guarantee more customers for private insurers.  Obama and his people caved in just to get a bill, which is the currency of politics, and when the smoke cleared from the battlefield no one was happy, even though most people did not even know what was in the bill.

So again, the issue was money.

The irony of the vote is that while everyone recognizes that the issues all in one way or another come down to money—whose and how much and what will it be spent on—that recognition did not translate to a rational outcome.   Instead of insisting that the government stand up to the money interests, voters condemned government for getting in their way, as if somehow Washington standing up to Big Business is exactly the same as oppressing people who have to hold a job.  The masterful propagandistic coup on the part of Big Money in the last couple of decades is impressive.  One can admire it on the level of achievement to purpose. chalkboard

But what has been played on here comes down to a betrayal of everything about us that is not—at least, in our individual view—tied up with money.  The United States has been one of the most cooperative communities on the planet.  We have a rich history of coming together to solve problems, stand up for rights, and work together, even when the work demands that we change our fundamental view of ourselves.  Yet a significant number of us have been convinced that in this climate to cooperate is to somehow betray ourselves.  We have been convinced that the only thing that will work is to allowed to stand alone.  We have been told that cooperation on these issues leads to a political condition which will undermine our fundamental identity.

An identity we barely understand in any cogent fashion anymore.

In desperation we have been driven to defend myths and reject solutions.  Of course this has happened before, but never so egregiously.

One of the myths is that the individual states and can do these things better than a Washington-based effort.  The problem with that is that it has no basis in historical fact.  Maybe states would be better at managing their own affairs and finding solutions, but the fact is that for the really big ones the states almost never have tried.  They have retrenched, defended the status quo, and resisted solutions.

The solution for slavery would have been for states to pass laws abolishing it.  They did not.  When pressed, they seceded.  Emancipation was imposed by Washington.  No doubt there were mistakes made along the way, but when the choice was to leave everything alone or free people, the states failed.

The solution for female enfranchisement would have been for the states to begin granting the vote, but with one or two exceptions they refused.  A national solution in the form of a Constitutional amendment was required and Washington has had to police it ever since. The same with general enfranchisement where individual states, in order to maintain the power structures as they were refused to do anything about voter oppression.
The solution for segregation and the mindless bigotry that resulted was for states to start implementing desegregation on their own, perhaps county by county.  They refused.  Washington forced the issue.

Pollution and other environmental issues are, case by case, localized problems that eventually grow into non-localized problems.  No one liked the EPA when Nixon created it, but that fact was states did not step up to the plate to address problems in their own back yards.  Washington did.

In order to compete in the world, educational standards had to be brought up to a national level.  States cherry-picked what they wanted in the classroom.  (They still do.)  Actions that redressed shortfalls came out of Washington.

We are still fighting equal pay arguments.  Now we have issues with outsourcing that is ruining local economies and robbing us of good-paying jobs.  Does anyone honestly believe that states will do anything to force businesses to conform to local hiring standards?  No, that would smack of fascism if the state begins telling business who to hire.  Yet there are many national solutions that can be brought to bear to make it more feasible for businesses to hire local which will not be addressed because everyone is so terribly frightened of a Washington solution that might actually work that won’t fit the ideal image of what America is.

I do not for a minute suggest that even in the above list Washington has done a wonderful job, but I do not buy the argument that if left alone states will do the necessary work of taking care of citizens who live below certain income levels.  They will, as they always have, take care of the citizens Who Matter.

It comes back to the money.

When America was the biggest and most capable player on the global scene in manufacturing and distribution, when the rest of the world looked upon our manufacturing engineering with envy and our capacity to create goods and ship them anywhere with admiration, many of these issues did not rise to the surface.  That’s no long the case.  The rest of the world is catching up.  We’ve been helping it.  But the industries that once made most of their profits by the handiwork of their factories are now making it by the dexterity of their procurement and distribution and much of that is no longer here.  They are competing with global competitors that can do the job pretty well, which means we no longer have a lock on expertise and can no longer depend on a situation-normal attitude to maintain ourselves.

But that does not mean the methods by which American companies continual increase their quarterly profits at the expense of the American middle class are inevitable or desirable.

Not all companies are like this, but we have allowed to come into existence a savagely predatory environment that feeds cannibalistically on itself whereby companies must have the highest possible profit margin or risk dismemberment.  We have, even while apparently rejecting evolution emotionally, embraced a discredited form of social Darwinism that condemns us to self-immolation.  This recent election reveals an impulsive dependency on the stories of the lone gunman and the industrial captain that we all would like to believe in at least a little bit.

The Republican—or should I more properly say the Conservative—approach these days seems to be to privatize everything.  This is American.  This is Who We Are.

Really?  Or is it more like handing the keys to the town over to Billy the Kid and abandoning any notion that civil society requires civic controls?

I think a good motto for the coming struggles might be:  money should be in service to principle,  and a principle is not fungible.

We have some large problems.  They require large solutions.  It might be a good idea to stop thinking impulsively and stop using the same old cookie cutter metrics to judge every proposal.  But based on November 2nd, 2010, we don’t yet seem ready to do that.

There’s just too much money at stake.

(cue Joel Gray and that Kurt Weill number.)

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Mark Tiedemann

Mark is a writer and musician living in the St. Louis area. He hit puberty at the peak of the Sixties and came of age just as it was all coming to a close with the end of the Vietnam War. He was annoyed when bellbottoms went out of style, but he got over it.

This Post Has 2 Comments

  1. Avatar of Niklaus Pfirsig
    Niklaus Pfirsig

    Mark,

    I certainly agree that most people don't consider the ramifications of their actions.

    BUt there is a major contributor to the rise of health care costs in America that most people seem unaware of: The insurance companies.

    Insurers work out contracts with hospitals, clinics and pharmacies that require the health care providers accept partial pay from the insurers as payment in full and write off the difference. In return for this write-off, the providers become preferred and the insurers steer customers in their direction. Theoretically, the increase in the number of patients should offset the amount written off for contractual requirements. The problem is, however, that the write-offs are on the order of 80 to 90 percent of the billed amount.

    In other words, if you are in the hospital and your bill (after the copay or deductible) is $1000, The hospital only get $200. When multiplied by the number of patients they average per day, that may still seem like a lot, but from that money, the hospital has to pay the doctors, nurses, orderlies, and everyone else on the staff, along with the supplies, buy equipment pay utilities and other plant expenses.

    So the hospital has to raise its prices to cover the written-off amount to cover costs and show a profit for its investors. That $1000 becomes $5000,

    that 20% is back to $1000 and it appears that the insurance company is back where they started.

    Or so it would seem, but that is not the case. The high cost of treatment benefits the insurers. Artificially forcing the cost of health care up increases the demand for health insurance which brings in more money for the insurance companies. This inflation provides a rationalization for the insurers to raise premiums, raise deductibles and reduce benefits.

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