Sunday, January 2, 2011

From the Archives: Private Interests Masquerading as Universal

From 2009:

Imagine if the U.S. Chamber of Commerce had said the following about why they uncompromisingly opposed the EFCA ("the card check"):
"We the U.S. Chamber of Commerce, represent the interests of a small group of financial and business elites who own large capitalist enterprises. We care, first and foremost, that we are earning as much money as possible. Take note of the "we" in the last sentence, for if someone else were to reap the returns of the institutions we own and control, this would be unacceptable.

Now it seems to us that if the EFCA passes Congress there is a very good chance that more workers will form unions, which means that we will have to cede some of our profits because unions will require that we pay better wages, benefits, pensions and so forth. Moreover, they will curtail our ability to most efficiently manipulate workers (e.g. arbitrarily terminate employees or downsize to maintain profit margins) in our quest to maximize our profits.

At the end of the day, we as extremely wealthy and powerful capitalists will lose measures of our wealth and power if this bill passes. Hence our uncompromising hatred for the bill."
If they had said this, most people likely would have said: "Shove it, you rich assholes."

So of course, they cannot simply assert their narrow interests as capitalists in making a public argument about policy. To be heard, they have to make up some story about how their interests are in fact not really their interests, per se, but universal interests. That is, generalizable interests that at least appear to have some relevance to the lives of the 99% majority of the population who aren't part of the ownership of a massive private corporation. Hence all of the endless drivel about 'secret ballots' and so on.

Now fast-forward to the "health care debate" that's ensuing over the so-called "public option".

Anyone familiar with the AMA's history, recalls that they pulled every stop out in the late 1940s and early 1960s when health care reform was on the table. That is, they went apeshit and started babbling about 'totalitarianism' and employed Ronald Reagan to do commercials claiming that Stalin was coming to eat America's babies. This is what they said about Harry Truman's post-WWII plan to institute single-payer:
"all forms of security, compulsory security, even against old age and unemployment, represent a beginning invasion by the state into the personal life of the individual, represent a taking away of individual responsibility, a weakening of national caliber, a definite step toward either communism or totalitarianism"
Who is the AMA? They are a large, influential political organization who represents the interests of the most powerful, wealthy and politically-connected doctors in America. They do not represent all doctors. See, for example Physicians for a National Health Program, who see the interests of the private insurance industry as fundamentally opposed to the role doctors ought to serve in a just society. They are staunch supporters of Single-Payer.

Now its not hard to see what the AMA wants. This organization, as the representatives of the most powerful and wealthy doctors, exists primarily to defend the power and high earnings of those whom it represents. So, its not difficult to take them seriously when they come out and say that they don't like paying Medicare rates (they can exploit markets to get even higher rates, so why should they settle for such lackluster earnings?).

But we would be making a seriously obtuse mistake if we thought that the AMA sincerely cared about things like:

-Whether our health-care system is well-ordered and just
-Whether profiteers run insurance institutions and routinely deny claims
-Whether everyone is getting the care they need
-Whether access is universal or guaranteed
-Whether everyone can afford healthcare

We have no reason to think that they care for anything of these things in themselves. And, as Ezra Klein points out, we have very strong reasons to think that they would oppose any of these considerations if they conflicted with the material interests of wealthy and powerful doctors. The class dynamics underwriting their Association notwithstanding, the history of the AMA's political interventions speaks for itself.

So what role does the AMA play in public debates? Of course they can't make public interventions that lay bare their narrow, strategic interest in manipulating discourse so that they can maximize their earnings. So they have to say stuff like this:
“The A.M.A. does not believe that creating a public health insurance option for non-disabled individuals under age 65 is the best way to expand health insurance coverage and lower costs. The introduction of a new public plan threatens to restrict patient choice by driving out private insurers, which currently provide coverage for nearly 70 percent of Americans.”
Interestingly, they opened this statement by saying that care ought only to be "provided through private markets, as it is currently." Can anyone say 'dogmatic'? If they really cared about "the best way to expand health insurance coverage" why all the whining about the need to have "private markets" and "private insurers" front and center?

My, these business types are so big on the rhetoric of "choice". You can choose to be either insured by some moronic for-profit institution, or you can choose some other such firm of the same ilk. Or you can fucking wither and die. You pick!

To bring this post to a close, I want to tie this thought about narrow, stategic private interests into recent discussions of the 'power plays' being made in the debate over the "public option" bill in Congress. I sometimes hear, as on this Ezra Klein vs. Libertarian 'blogging heads' thing, that "the Democrats really want single payer, but..." or that "liberals really want SP but...". Nevermind the question of who these 'liberals' are and where one finds them. But if the Democrats, i.e. the party who has control of both chambers of Congress and the White House and has trounced the opposition party in the last two elections, want single-payer I find it hard to see what's stopping them.

But let's entertain the fantasy of liberal bloggers about how our government works for a moment. Let's say that the Democrats really do, deep down, get all warm and fuzzy when they think about single-payer. Why can't they just get it done? The answer can't be that the Republicans will oppose it. They already oppose the current reform. They opposed Obama in the last major election. They suck, that's why they keep getting hammered at the ballot box. So the answer can't be that the Democrats just don't have the votes.

What, then, is the holdup? Well it can't be, as Ezra Klein claims it is, that the problem is just that there is "status-quo bias" and "people don't want to lose the health insurance plan they have". That may be some small part of it. But this ignores the 50 million Americans without any insurance; surely they aren't biased towards the current situation. Moreover, this 'status quo bias' hypothesis contradicts Klein's frequently-made (and correct, in my view) point that "health insurance corporations are among the most hated institutions in America".

The pink elephant in the room here has got to be the entrenched, extremely profitable, powerful private health insurance industry who would cease to exist under a single-payer plan. The powerful class in charge of (and profiting from) these massive institutions are the biggest reason why reform would be so difficult to achieve. They aren't going to go down without a fight. They aren't ever going to play nice without being forced to. And we know they aren't going to put their eggs all in one electoral basket; they're going to hedge their bets. That's why the give millions to Democratic members of congress.

In short, we can't ever forget that these industrial giants uncompromisingly hate single payer, since they wouldn't be industrial giants any longer if the plan were adopted.

So why isn't this obvious fact ever discussed in the 'public debate'? Why is it so hard to believe that if the narrow interests of those who profit from the status-quo were nakedly asserted in the public sphere, most people would balk? Why not simply discuss, incessantly, the amount of money these assholes make a year? Why not place our moronic system in a global context and rank our performance against virtually every other major industrial capitalist country in the world (all of whom do not have profit-driven commodified insurance the way we do)? Why not ask why it is that people in those countries would NEVER accept the insecurity, uncertainty, and inhumanity of the sort of system we have?

No comments: