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Wednesday, August 12, 2009

Getting Consistent

Jeering and howling, the ugly faces of the indignant and the ignorant are ambushing congressmen and townhalls across the country. They cannot abide this socialist administration trying to force health care upon its people. They spread misinformation and shout down opposition. If you read the news, it sounds like they're trying to start a goddamn civil war.

At first, I came here to make a tired argument. It goes something like this: We do not need to fear government-run programs. Everyday we take all kinds of government run programs for granted. We count on the mailman and the fire department and the school teacher and the police department and the coast guard to keep society safe and running smoothly. Cue the 1950's music and old educational video montage. We count on government programs to provide social security and Medicare for our elderly, student loans to our youth, and to preserve green spaces for everyone. The government makes sure that streets are paved, homes have electricity, and that we're notified if a child molester moves in next door. These programs have all been run by the government for years, and they work. They work quite well. So you see America... there's no reason to fear socialized medicine... you've been enjoying a socialized fire department for years!

As I was rehearsing this argument, I was struck by a thought. Why the hell have we allowed so many critical aspects of our society to be run by corporations instead of the government?! The government exists to ensure the public interest... and they have been the only ones we can rely on to provide many fundamental services that were too important to leave to the marketplace.

Clearly there are many systems that private corporations would love to get their profiteering hands on. Corporations love running prisons (they not only get government money to handle the prisoners, they also get to use the inmates as slave labor in sweatshops... it's win-win!) Frankly, there's good reason to fear corporations running the programs that we rely on to keep society running smoothly. They may handle things more efficiently, but they also take greater risks and don't have a strong track record of planning for sustainability. Their motivations are not ultimately to serve the public interest. While I think corporate competition and innovation are great for fields like movie-making, restaurants, biochemistry and car manufacturing... There are certain services in our society that shouldn't be left to chance or influenced by corporate ethics.

What are they?

Well, there's education. I'm very happy that we have a public school option all the way through university studies. I'm not saying we shouldn't have corporate or religious alternatives; I'm just wedded to the idea that there should ALWAYS be a government option.

There are the police and armed services. I'm not always very happy with them, but I'm VERY thankful that they are operated by the government instead of private industry. Just look at Blackwater's record to see why.

There's... um... waste management. And environmental protection. We NEED clean air and water to survive. What else are requirements for survival? Obviously, there's food, clothing and shelter. And here's where I'm flabbergasted. For all these years we've allowed food, clothing and shelter to be run by corporations. America seems to nurture a fear about Soviet living... that we'd all be wearing burlap sacks, chowing on Soylent Green and living in miniature gray hexagonal pods if the government had its way. But that is nonsense. Except for maybe the hexagonal pods part. That could really happen. I suppose there has been a "government option" in these fields... the government has subsidized food and clothing banks, and there are a lot of subsidized housing projects. But these are government/private partnerships at best. I think we need a genuine, 100% government-controlled, non-profit option in these fields.

And I'd add energy to the list. Sure we have some state-run electrical grids... but I mean gasoline, oil, and natural gas. And high-speed internet, and cell coverage, and mass transit. These things are too important to be left to the whims of the marketplace. Maybe you can think of some other things that I'm missing?

So, I started out thinking that all this paranoia about a government option for health insurance was silly... but now I'm feeling more and more outraged. Why are we not demanding a public option for a variety of other services we all depend on? Let's get consistent on this!



At 8/16/2009 06:10:00 AM, Blogger lowcoolant said...

Made the last 17 years a lot easier, huh?

At 8/17/2009 10:23:00 AM, Blogger John said...

Not sure what you mean here. Are you asking if the government has assisted me in the last 17 years?

They have.

Public education options and low-interest government student loans allowed me to get a master's degree that gave me access to a career track.

And, thankfully, they've been taking a slice out of every paycheck to make sure that I'll get some sort of guaranteed pension when I'm a senior citizen. Knowing that I'll get health care and an income after I've retired is a wonderful feeling. I haven't had to tap into government-mandated unemployment insurance, but I've been glad it was there a couple of times.

Several of my loved ones have health care coverage through Basic Health, a state-run health insurance option for lower income folks. That has helped give me significant peace of mind.

What I can't think of are instances where the government has screwed me over. I guess a couple of the parking tickets I've gotten in the last 17 years felt pretty bogus. My dad calls things like that "stupidity tax." And he's right... it's not that hard to follow the laws. Sometimes we get busted breaking these laws, as silly as they might seem, and have to pay a penalty.

At 8/18/2009 05:13:00 AM, Blogger lowcoolant said...

I was referring to a change you made in the header of your blog.

At 8/19/2009 01:35:00 PM, Blogger John said...

Oh... the "Refusing to curate reality since 1992" is a reference to the time in my life when I stopped feeling like I needed to know exactly what has going on... when I opened up to the idea that relativity was more powerful than reality... when mythology was more powerful than truth.

I think it did make life easier... as I don't get nearly so anxious when new information comes along and threatens my world view.

At 8/23/2009 11:09:00 PM, Anonymous Andres said...

I'm not sold yet one way or another on the single payer v market forces argument. Frankly, I haven't spent a lot of time yet to really get educated on this issue to make an informed decision one way or another, but I'm not convinced who is going to be better at providing care and controlling costs, the feds or private industry.

I would point out a few things though about your argument.

Most of the government entities you mention are locally run, locally controlled. Police, Fire Departments, Garbage, education, ect are mostly run by local entities in local markets. Local accountability. You don't like the snow removal process from last winter, vote the mayor out. Even things like the federal highways are maintained by the local state agencies. Sound Transit, federally funded, locally run. Univeral health care controlled from the federal level would be putting Washington DC in charge of something very personal, very local for each and every person in this country. Things controlled at the macro level tend to leave everyone unhappy.

At 8/24/2009 10:02:00 AM, Blogger John said...

Yes, the police and fire department are locally run. Thankfully, municipal, county, state and federal government systems have all provided various programs for our benefit. It's amazing that they work together as well as they do!

At the federal level, there are far fewer programs. There're social security, medicare, the military, HUD, the FBI/CIA, international embassies/diplomacy, standards-setting agencies (like the EPA and the Dept. of Education), the supreme court (thank god they've mostly gotten things right) and all the pork: subsidies for struggling industries, infrastructure projects, R&D grants. There are plenty of other programs (like NASA) but I don't know how much they impact you and me. On the whole, I would tip my hat to this set of programs. They are remarkably efficient and well-designed to address the needs of the populace. They've evolved over hundreds of years. They reform themselves as needed. They aren't ripping people off or sucking the blood out of the economy (with the possible exception of the military-industrial complex.)

I just got my SS notice yesterday. It says I will be awarded $1200 per month to live on if I become permanently disabled (think major head trauma here.) I'm pretty effin' thrilled to have this controlled at the macro level. I'm pretty effin' thrilled that this insurance hasn't been privatized to some company that has a strong vested interest in screwing me out of my benefits.

Lastly... having your health insurance run by a federal agency DOES NOT put your health care in the hands of the remote wonks of DC. You still see your local doctor. You still have access to prescriptions, tests, etc. as your doctor would prescribe them. You (and your doctor) can just feel a lot more at ease about how it's going to be paid for.

BTW, I know how kick-ass M$ benefits are. They have a premium package. NO ONE gets that sort of coverage anymore. 90% of the people I talk to about insurance have plans that cover 50-80% of their costs with caps and copays all along the way. If I had M$ insurance, I'd probably forget how frustrated most people are with their insurance companies.

At 8/24/2009 01:03:00 PM, Anonymous Andres said...

You are really happy with how things are handled at the federal level? You are happy with the laws and rules with regard to environmental protection in this country. You are happy with the farmer subsidies programs, with how polution standards are set at the national level, with how the VA provides benefits to Veterans, with the quality of care they receive. You are happy with how the federal level can approve clear cutting of old growth forest? I'm not happy with any of that and I'm definately not convinced creating the largest government agency of all time is going to be easy or really save us money/control costs or provide better care. You say we'll have local control. We'll have local access, but the rules are going to be written and controlled from DC. One set of rules for all of to live by.

You are right, I do have a good health care plan, but if you think I don't care about this issue you are wrong. From a pure economic/social cost we have to do something about health care. The is kind of cold and unfeeling, but the reality is that between medicare and social society we are facing a financial crisis in our life time that will make today's deficits look like small potatoes. That needs to be addressed one way or another for all of our qualities of live and our childrens.

Also don't think I like the profit element being in health care. I don't. I don't mind the inefficiencies of large government areas that have little day to day impact on our lives, but health care is a lot more personal, a lot closer to everyone's lives. I'm not convinced yet giving all that power to the government in a single payer plan is the best option.

Have you talked with anyone who works or has been through the VA. It is the one health care system that is currently run by the Feds. I'm not impressed by what I've heard from folks I have talked to there tell me.

At 8/29/2009 05:45:00 PM, Blogger John said...


Sorry I couldn't write back sooner. I've spent the last week hiking and camping in our gorgeous (federally controlled) national parks and forests.

I know you mentioned being unhappy with the federal system which allows limited logging in old-growth forests. I share your frustration, but I was struck by something while driving around the Olympic Peninsula. Every time I passed a sign that said "Now Leaving X National Forest" I was suddenly surrounded by clearcuts. Massive clearcuts. The Gifford Pinchot model of managing national forests may not be perfect, but it does a damn good job of ensuring the sustainability of our timber resources and providing some environmental controls as well. And our national park system just plain rocks. Without some government regulation, we'd be as barren as Europe. And that would suck.

I think a key difference in our perspectives is that you're casting the government in the role of "controller". I'm viewing them as "provider". They can offer us healthcare without taking over the market. People can, and will, supplement with their own private health care. The government would just be setting a minimum standard of coverage that every American is entitled to.

Setting a minimum standard is a good role for the federal government. Having Social Security doesn't mean we should cash in our pensions and IRAs. It just means you won't be destitute as a senior. You'll be a lot better off combining your federal SS benefit with your own mix of savings/investments/assets. Our state, being relatively rich, sets a higher minimum wage than the national minimum wage. That doesn't mean the national standard is useless... it just means it shouldn't limit us. California has a more strict definition of "organic" than the USDA. Kudos to California for doing that... and many informed consumers know that "California certified organic" is better than just "certified organic". The federal system of creating a "floor" or minimum setting for these sorts of issues is important.

Confusing this debate is the secondary issue of making our health care system more efficient and eliminating price gouging. I don't know who would do the best at reining in the costs of health care... but I have my suspicions that insurance companies don't have much incentive currently.

One possible fix is for Americans to start buying all of their prescriptions internationally. Many people do this already because of the massive savings. If we could all buy our drugs from Cuba's pharma industry, that would sure drive down costs.

Seems like any "fix" means that some segment of the population is going to get screwed. Lumberjacks, big pharma researchers, military contractors... wherever you see "waste" and cut back, you're hurting someone. I don't know what the goverment or insurance companies can do about it. But inevitably, some people are going to be very unhappy.


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