Monday, March 29, 2010

Issues Raised By The Health Care Fight

I started typing a comment to last Monday's post, but it was getting a bit long. And heck, I think the issues here are front-page worthy. So here it is:

Piecemeal Reform vs. Comprehensive Reform

I think Caterpillar, and the few companies who've made similar statements (about how the health care bill will cause them to lay off lots of workers) are playing a little fast and loose in order to make a point. Here's a story today about Congress kind of calling their bluff by asking them to come defend their claims before the House Energy and Commerce Committee. But even if the claims were perfectly true, it is a conversation worth having. Is guaranteeing health care for every American worth the price Caterpillar is claiming? I think it is.

But if the health care bill did in fact cause large companies to lay off workers, it would highlight a bigger issue: It's hard to win social justice one step at a time through piecemeal reforms. As Elizabeth pointed out in comments, Caterpillar would be laying off workers while it's executives continue to make millions. Or, what if instead of laying off workers they decided to cut costs by ignoring environmental laws? Or moving to Burma? It turns into a game of whack-a-mole, with democracy and social justice trying to bop capitalist excess every new place it pops up.

What we need instead is comprehensive economic reform. Instead of a system where we try to milk universal health care, living wages, and environmental standards from entities that have no interest in such things, what if we started with universal health care and a decent life for everybody as the first priority. Then we could allow corporations to rise up, and we could treat them as luxuries that only add to the basic foundation of dignity and security for every person. And if they ceased to do that, we could dissolve them. That way, we could make corporate capitalism serve us instead of the other way around.

Name Calling vs. Truth Telling

I think almost all who followed the long health care battle closely would say it was a draining experience. Such intensity from both sides. And often our politics feels pretty removed from our basic humanity, with the harsh rhetoric from every direction. But this nasty fight over the last year just won quality medical care for tens of millions of people who didn't have it. We should be reminded that some things are worth fighting for. And health care is one of them. And I agree with new commenter, What Blue Dot?, that name calling is a waste. But I hope you'll agree that we ought to have the guts to speak the names of our oppressors. If someone is standing on my neck or my neighbor's neck, I'm going to call him out. If someone is standing on my neck or my neighbor's neck by virtue of a social or economic system, I'm going to call out the system. The question is, can we call out the oppressor or the system without turning off the people we need to stand with us? Often, no.


Solid said...

I appreciated Elizabeth's comments as well. They hit on a fundamental difference between Republican and Democratic economic philosophies.

But saying CEO's should cut their own salaries to take care of their employees...I mean, that's a great solution, but isn't it the same as saying prison overcrowding can be solved by people not committing crimes?

(I should note that I have a vested interest in this. Caterpillar laid me off within the last year.)

Dave said...

Solid, I see your point. I think we're talking about at least three different issues here:
1. Will the health care bill cause companies to lay of workers?
2. If the health care bill does cause companies to lay of workers, what can we do about it?
3. What bigger issues are at play here?

As for #1, I think the companies that have come forward are exaggerating to help the Right make a political point that the health care bill and Democrats in general are job killers. "Jobs, jobs, jobs," is going to be the big issue going into November, so their timing is good in that regard. Currently, big companies get government subsidies to provide prescription drug coverage to retirees, then they get tax write-offs for providing that coverage. The HCR bill would prevent them from being able to write it off, and that is what the companies are complaining about.

In the big picture, every American having health insurance is going to add mobility and security to the workforce, which will make America more productive and improve the jobs situation. But I think we should take another step to unburden companies by having the government provide health insurance directly to the people, instead of continuing to rely on a complex system where most people get insured through their employer. We could do that with a Medicare-For-All-style single-payer system. Then Caterpillar and the others wouldn't have to worry about this at all, because the health costs of the nation would be spread out as widely as possible over the whole population.

BTW, sorry to hear about you getting laid off recently. I guess that makes this whole issue more than just theoretical. I hope things are going better.

What Blue Dot? said...

I do agree with you, Dave. I just wanted to state how concerned I am with the level of cruelty that is passing for rhetoric these days. I think it is important for us to be mindful of our words. My response was mainly in how closely in one sentence you put the CEOs and the KKK. I think the nearness overstates the issue. I'm a nitpick, I apologize.

I get beyond annoyed when the business voice reacts to policy by throwing out the "OH NOES! We'll have to lay people off to survive!" as though their primary interest is in providing jobs at all. I worked at Walgreen's for about a year (I don't even shop there anymore), and if they could have replaced me with a "Yes, I'll perfectly develop your film that you stupidly sent through the x-ray machine" robot for less than the $6.75/h they paid me, they'd have done it in a heartbeat. If they could have no employees and save all their money for destroy marriage campaigns, they'd be thrilled. I'm readily ill of the idea that corporations are the saviors of history and the sole deliverers of the future.

That said, I think it's important to remember that these are people, not goblins. We may disagree with many of them, and heartily, but they are no more monolithic than we are and I cannot presume that their interests are anything other than what they state them to be.

On to the next discussion, then. I wholeheartedly agree that we need to relieve the business world of the burden of healthcare provision. It simply doesn't make any sense that we have made our employers the arbiters and bearers of our health choices and needs. The trick may lie in selling a single-payer system on its merits in reducing the expenses and responsibilities of employers. But, the HR industry may have a fit, since it will likely reduce their demand.

As it stands, placing healthcare in the hands of our employers was one more piecemeal change that served its purpose but now needs to be corrected as well. Unfortuntely, we have to fight the battles we can win. But, I wonder if we don't underestimate our ability to win. This bill we just passed is reportedly nearly identical to the plan the Republicans had in response to the Clinton healthcare efforts (I don't remember, I was busy being in middle school or something). Can it be that we've really walked that far backward? Can we really call this progress when we're fighting for what we fought against years ago? What if we'd pushed harder then? Could we have pushed harder then? Could we have gotten even this deal then and skipped all these years of preexisting condition slaughter? We had majority public support for the public option in July of last year. Had we managed to pass it, we'd be that much closer to a single-payer system. How did we go so wrong?