Okay–consider this my Sunday Sermon….
We know that America has an equality problem. We also have a language problem that makes issues of equality more difficult to discuss rationally.
Pundits across the political spectrum, the so-called “chattering classes,” increasingly use words as epithets, rather than as a way to describe reality. Terms like “liberal”—which used to mean “open minded,” “generous,” or a follower of the philosophy of John Locke—have become a content-free insult to be hurled at anyone favoring a marginally more activist government or slightly more robust social safety net.
When “liberal” gradually lost its sting, partisans moved on to “socialist.”
The problem is, few people using the term these days seem to know what socialism is, and even fewer recognize that socializing the solution to a problem can often be very good for capitalism (another system which few can define with any precision), by ameliorating more savage inequalities and thereby avoiding social instability.
The Affordable Care Act—aka “Obamacare”—is unremittingly attacked for being “socialism.” And it is absolutely true that it’s an effort to socialize access to health insurance. But what does “socialism” in this context really mean?
Rhetoric to the contrary, the ACA is hardly an unprecedented departure from a purely market-based system. (Prior to its passage, governments at all levels were paying nearly 70% of America’s healthcare costs, albeit through a grossly inefficient patchwork of programs.) More to the point, ours is a mixed economy, meaning that over the years policymakers have determined that some services are more appropriately or efficiently provided communally–“socialized” through units of government–while others are best left to the market.
We socialize police and fire protection. Most cities have socialized garbage collection. Federal and state highways and city streets are public goods provided by governments and paid for through (largely redistributive) taxes—that is, socialized. Add publicly-financed parks and museums and public schools. Medicare, Medicaid and Social Security all offer “social insurance.” After some 100 years of policy debate, we have finally added health insurance to the list.
The ACA is far from perfect. Many Americans would prefer a single-payer system similar to those that operate in many European countries. Others fault the law’s complexity. Interest groups that stand to lose profits under the new accounting rules argue about the fairness of those provisions. Such complaints are to be expected when any major new program is introduced. Much as we saw with the evolution of Medicare, we can expect significant modifications going forward.
Policy debates are to be expected. What is much harder to understand is the level of hostility aroused by the suggestion that struggling Americans should be provided with access to affordable health insurance. Opponents of the ACA call it “socialized medicine” (it isn’t; at most, it is “socialized insurance”) as though the very label should be evidence that it is anti-American to use tax dollars to subsidize coverage for those who cannot afford it. People who live on their Social Security benefits and love their Medicare positively froth at the mouth at the notion that America has any obligation to extend the reach of such programs to less fortunate folks.
The irony here is that the very people who are fighting tooth and nail to bring down the ACA—bringing lawsuits, supporting candidates who vow to repeal it—are already among the Act’s beneficiaries. America’s previous non-system—the most expensive in the world by far—was widely acknowledged to be unsustainable. The cost of health insurance was a major impediment to job creation, and a drag on the whole economy. In the wake of the ACA’s passage, the indicators have all improved, benefitting all of us.
The ACA hasn’t just improved our economic health. It has also improved our moral health.
There is something very wrong with a society that rations healthcare on the basis of one’s ability to pay—a society willing to tell its most vulnerable members that they are expendable, that they do not deserve even the most basic medical care. Whatever we call this decision to even the playing field just a bit, to mend this major hole in the social safety net, it brings us closer to that elusive thing called civilization.
If that requires a bit of socialism, so be it.
As far as I know there is not a government in the world that does not employ both capitalist and socialist economics in their mix. The means of production owned by a few or all of the citizenry. The deciding factor is typically that capitalism works fine when competition can be maintained but is typically disastrous in its a absence.
ACA employs both in its mix, but favors capitalism. That’s why the original models for it came from the GOP.
The complaints about it are purely politically motivated, one of many signs of the desperation within the Republican Party as they try to appease their conservative minority.
Not that ACA can’t be improved. It has always been meant to be the starting point not the finish line. As the conservative minority grip on the GOP lessens, other variations of the mix of socialism and capitalism will be explored.
Personally I think that we have a very workable model in Medicare as the next step. Maybe the end point or just another interim step, who knows.
The odds of further progress vs retreat in the near future depend on upcoming elections, both congressional and presidential.
As a White Baby-Boomer at some point in the late 1950’s and the 1960’s I became a Liberal. I know seeing the African-American children trying to go to school in Little Rock protected by soldiers from the crowds of screaming hateful White People influenced me. I remember seeing Jim Crow in all it’s ugliness displayed on National TV. Peaceful demonstrators being beaten by the Police, the murders of innocent people. Forward to the Anti-War demonstrators, and how they were beaten, shot and labeled as Communists.
I saw the angry sullen White Backlash against the Kennedy’s and MLK. Liberal became a vilified epitaph to be spate out of the mouth. The equation for the Reactionary Right became Liberal=Socialist=Castro=Stalin=Mao=Communist.
I am a confirmed Socialist. I read and admire Eugene Debs, and Howard Zinn. I find it hard to believe anyone would consider Obama or Bill Clinton as Socialists. Then again I find it hard to believe anyone would believe from some Cosmic Slight of hand that humans appeared 10,000 years ago, or humans cavorted with dinosaurs.
Oh, thanks alot, Sheila. Get my hopes up just to dash them. Actually, I am astounded at what a good job the monied classes have done (because this is exactly the group who should be afraid) have done in giving socialism, in a democracy, a bad name. The two go together like bread and butter and ham n eggs. No inherited wealth, everybody getting a share and no one taking more than they earn (Jamie Dimon). Why anyone fell for that claptrap from Lee Iacoca about how he EARNED his gazillion because he was some sort of successful turnaround artist deserves their poverty. The union people who provided the lions share of the money behind those ‘turn arounds’ never recovered because it was just smoke and mirrors that took money out of their pockets and pension and paid it to him. Anything left over was paid out in dividends.
I read various articles that purported to prove the case for the Reactionary Right that Socialist Medicine had now proved a failure when the VA imploded early this year. Prior to the implosion Senator Bernie Sanders sponsored a bill to increase funding for VA and institute some reforms. With two or three exceptions every Republican Senator Voted, drum roll please- NO to Senator Sanders Bill.
Now part of an Elected Officials responsibility is over sight. How many times has either of our US Senators or US Representatives dropped in over the last few years to ask Vets at the VA Hospital about their quality of care?? I suspect the answer is zero. Our elected officials are always eager to have a photo-op bracketed by American Flags praising our “Heroes and Warriors.” However, when it comes to seeing the results of their Uber-Aggressiveness our elected officials are Missing in Action.
Your title today is rich in symbolism. “The Russians are Coming; the Russians are Coming” movie was a spoof on McCarthyism. Socialists were painted as Communists, so Socialists had to be avoided at all costs.
One of the historians in the recent PBS series on the Roosevelts (T.R., F.D.R., and Eleanor) opined that FDR’s New Deal saved capitalism. The depression made people desperate the world over. Germany turned to a a charismatic speaker by the name of Hitler who led them to Fascism as the promised rescue from the depression and the ravages of WWI. The USA also followed a charismatic speaker but to another destination – using strategic doses of socialism to prime the capitalistic pump. It cut unemployment in half. When FDR cut back on such funding to balance the budget, unemployment went up again.
The war provided the biggest boost to employment and capitalism – with government funding of
defense contracts to build tanks, planes, jeeps, ships, guns, ammunition and more. People could afford to go to the store again, buy homes or pay the rent, and put money in the bank. Private sector manufacturers were back in business and with 3 shifts of employees thanks to government spending.
After the war, returning vets and our economy succeeded nicely with ‘socialistic’ GI benefits to gain college educations and home mortgages. The economic boom of the war years continued into the 50’s and beyond with this socialistic pump priming.
As our capitalistic system teaches, there is no dividend without investment. Government has financed many investments from which capitalism reaped dividends.
With a husband in medicine, let me tell you how bad the ACA truly is. First of all, we had shortages of physicians prior to the passage of Nancy Pelosi’s famous We have to pass the bill before we know what is in it” debacle. Now it is a nightmare. My husband’s specialty was already one of the worst. Lawyers have made it one of the highest risk areas of medicine. Very necessary, but very challenging. One of his partners recently retired…..and there is nobody to take his place. The older docs are running away from this mess, exacerbating the shortage. It takes 15 years to train a replacement and nobody bothered to increase the supply….but they added 20M new patients. You think you will control costs w a model that increases demand and decreases supply? What school of economics are you studying, Ms. Kennedy? The Disney School? Enjoy the new medical model that allows you 11 minutes w your doctor…..because that is the standard. Bad healthcare for all. That’s the socialist way.
Dawn; doctors need to first take a good, long look at the Republican state medical systems such as we have in Indiana. Applicants were not allowed to apply for ACA till having been denied by ALL health care providers in Pence’s state system. Other than some early applicants being accepted by the state system, too many were refused information regarding their application status tll April or May of this year and in January or February they stopped accepting applications till after March 31st, the ACA deadline. In late June my daughter-in-law, who applied originally in October but her application was lost and reapplied in January, received her acceptance for a family plan at $1,200 monthly and a $12,000 annual deductable. She is a janitor and my son is a seasonal brick mason, not exactly high income status. She opted to re-enroll in her current coverage at $450 monthly with ONLY a $9,600 annual deductable. She is paying monthly for no coverage and paying all the family medical expenses.
As for the additional patients and coverages; that is what ACA was all about – providing health care coverage for those with pre-existing conditions who were previously refused coverage. Also to provide affordable coverage to lower income people. This obviously means there are more patients being covered for more health conditions; it doesn’t take a degree in economics to understand – and expect this result. Primary care physicians no longer practice medicine; they are titled information and referral providers with specialists charging unreasonable amounts to insurance companies, Medicaid and Medicare. The refusal by states of federal funds to expand Medicaid coverage has hit those most in need of health care; many disabled and elderly lost their Medicaid assistance with Medicare costs. Maintaining Medicare takes a huge chunk from their Social Security checks monthly – IF they can pay it and survive on the remaining amount, many cannot. Many also lost their food stamp assistance; you must admit one’s diet effects one’s health status and some must decide between buying food or medication. Meanwhile; health care costs soar, continuing to make it difficult for those who do have coverage to afford what they are paying for but not getting due to outlandish annual deductions. Doctors are supposed to be caring individual who chose the field of medicine to save people, often to save lives. “First do no harm.” This part of the Hippocratic oath has been lost if doctors are quitting due to more patients and more work but not more money; this is certainly doing harm.