The great healthcare debacle has provided a disturbing tour through that dark and strange terrain, the American psyche.
Why is this such an ordeal for us? Why are we acting so badly?
It must seem to the rest of the world like we’re flunking a national IQ test. No one challenges the well-publicized rankings showing that every country which has single payer, government- run healthcare produces universal access and high degree of satisfaction at a much lower cost per capita than we do. And yet the argument persists that if we change the sort of system we have in the direction of those successful systems, things will get worse.
Why would we be the only country who could so bungle public healthcare that we would end up spending even more than we do now for even worse quality? Such fears seem to float without relationship to any facts or logic.
A major factor in the debate continues to be the apparently successful use of “socialism” or “government”as bogeyman to scare people, as if a public option would be Satan’s foot in the door. In fact, as Nicholas D. Kristof pointed out in a recent column, much of our everyday life has forever worked just fine in public hands: police, fire, post office. (They’re not perfect, but we are comfortable enough with them.) According to polls, Medicare scores a much higher percentage of satisfaction than privately insured healthcare. Why should we be so frightened at the application of what is so familiar and approved to healthcare in general? Makes no sense at all. But this debate clearly is not about sense.
Bizarrely, perhaps a majority of us seem mired in the inability to imagine life without an insurance industry. We are like the prisoner so long incarcerated that when released he’s uncomfortable without bars. Few outside the industry itself are arguing its virtue. And yet healthcare delivered any other way seems to make us nervous, a nutty case of “better the devil you know.”
A powerful wacko factor seems to be successfully skewing the debate. Civilization, society, democracy all depend on the commonsense of the people–the commonsense, at least, of self-interest, of knowing when you are being ripped-off or lied to. This seems lacking here. It’s as if we have lost our grip on the basic logic of government.
In mid-August President Obama was quoted as saying “I know that in a time of economic upheaval, the idea of change can be unsettling, and I know that there are folks who believe that government should have no role at all in solving our problems.” There it is in a nutshell: the craziness of thinking that government should not be involved in solving our problems…when the only reason for government is to solve our problems. It’s why we had the revolution we celebrate on July 4th: to kick out a government experienced as acting against our interests and create one that would serve our interests. Of, by and—yes– for the people, all that good stuff.
The French revolution is only a few years newer than our own, but the French seem to have stayed truer to its spirit and logic. They are much more likely to hold government to account, to insist that it serve the p eople. If it doesn’t, it gets reminded of its job with massive strikes. The French don’t suffer from our idiotic idea that government that fulfills its basic logic of providing benefits for people— mandated vacations 2 or 3 times as long as ours, generous maternity benefits and childcare, and comprehensive, effective and economically efficient healthcare —is pampering its constituents.
It’s not about whether government should get into the insurance business. Insurance is the only business of government, why democratic government is established: insurance against fear, against hunger, against lawlessness. And against the dysfunctions of the private enterprise system (such as insurance companies).
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