Trust, Government and Health Care

There's currently something going on in Washington that Twitter has called "912dc" (New York Times story); it's a protest against not any particular act by government, but against government itself. More Jeffersonian than anarchistic, though.

This protest bothers me a lot, and I thought that maybe if I wrote down my ideas as to why, it'd bother me less. There are a few reasons why people protest what they call "big government":

  1. They feel that they don't need the services provided. -- This covers a lot of the rich-white-libertarian group and doesn't get a response
  2. They feel that private industry can provide the services better than public government.
  3. They actually only disagree with some action of the government, but are protesting the whole thing anyway. — The foreign-born-Obama and 912dc intersection falls here
  4. (most rarely) They actually think the government is too big.

I'm sure that there are people at this rally for all of those reasons (and probably a few that I haven't considered), but there's really one that bothers me, and it's one that I hear espoused a lot.

Private vs. Public

A lot of people like to bandy around the term "socialism". The OED defines socialism as

A theory or system of social organization based on state or collective ownership and regulation of the means of production, distribution, and exchange for the common benefit of all members of society; advocacy or practice of such a system, esp. as a political movement. Now also: any of various systems of liberal social democracy which retain a commitment to social justice and social reform, or feature some degree of state intervention in the running of the economy.1

Now, I would argue that none of the things variously called socialism (bail-outs of the banking industry, or even a public option for insurance) really count as socialism -- they certainly lack the Marxist focus on "means of production", and we've still got more than enough capitalism to go around.

Nonetheless, I think this definition lets me make an important point. Our government, in its very constitution, defines its own purpose.

We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.

(emphasis mine). The goal of our government is, among other things, to "promote the general Welfare". One of the idealistic goals of socialism is to benefit all of society. And what about business? What is the goal of corporations? To make money. To provide for the good of their shareholders. So I have to ask, all of you who insist that private industry is always better: why? Why do we think that a system of competing selfish interests is better than a system designed to provide for the good of all? It's true, there have been plenty of instances of corruption, of failure, in government, on both sides of the aisle. But is it so crazy to prefer to hope that government can meet its stated goals rather than to have some crazy wish that corporations will exceed theirs? Does having that preference make me a socialist? I don't think Marx would think so, but I think a lot of the people out there in Washington today, and a lot of the people at these "health care town hall meetings" (which aren't about health care, aren't town hall-style, and really aren't meetings) would.

Health Care

Of course, this all comes back to health care. It's the hot-button issue right now, and, really, it's been an issue for decades. Nobody's arguing that Americans pay more for health care than people in other first-world countries. Nobody's arguing that there's waste and excessive cost throughout the health care system. Nobody (at least, nobody who's actually lived there) is seriously arguing that places like Canada and the UK have bad health care. So what are we arguing about? Partially, we're arguing about things like "death panels" that are slogans to mobilize the feckless masses. The level above that, we're arguing about whether it's right for the government to assume the "socialist" position of supporting health care reform. And, in the end, I think we're really arguing about trust. Do we trust that the government will do well by us?

Leaving the "public option" aside for a minute, let's consider another contentious part of the health care plan: comparative studies. Nobody in their right mind thinks that comparative studies themselves are bad. When there are two options for solving a problem, every first grader knows that you compare them and pick the best one. But comparative drug studies inspire a lot of fear in some people; fear that essential drugs for a disease will be rationed because they're too expensive. Fear that those with rare maladies will be left untreated. Those fears sort of make sense to me. However, the supposition that somehow private insurance (which we all know already excludes the sickest, and doesn't even pretend to find the best drug for the illness) will do better — that boggles my mind.

And now the public option. I personally fully support it. No, not even that. I support a full single-payer system. No hobbled public option that's not allowed to use Medicare/Medicaid resources. No limitations that try to let a bloated insurance industry compete with government (side note: if you're bad enough at your job that a federal bureaucracy can do it more efficiently, you don't deserve to compete). The government provides your base insurance, bottom line. If you want additional insurance, then you can purchase a supplement plan. Now, there are lots of logical reasons for my position (efficiency, cost, compassion). Perhaps there are good reasons to be so strongly against a public plan that almost half of Congress is acting like they're three years old and sticking their fingers in their ear (at taxpayer expense!) all day, but I don't know them.

Conclusions

So, what do I think is going to come out of all this? I think that the Democratic Congress isn't unified enough and isn't strong enough to push through what I suggest in the paragraph above, even if they could agree to like it. I don't even know if they're strong enough to push through a highly-limited public option. I think it's more likely that we're going to get a 10,000 page bill that subsidizes everybody who asks for it, achieves almost nothing, and gives us a resounding Republican victory in the 2010 midterm elections. Which is sad.

I think we've managed to radicalize a whole group of people, young and old, by providing fodder for the likes of Rush Limbaugh and not providing any solid response. President Obama is intelligent, literate, and persuasive — everything that Bush wasn't. So why can't he do a better job of winning over his political opponents than W.? Why do we have people chanting in the streets whose information on the issues comes out of a place of hate and fear? Where is the compassionate, bi-partisan response? Hm?

I don't know all (or even many) of the answers. But I still feel better having written this. So, after all that, I think I'll leave you with some humor. Angry Town Hall.


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