American Healthcare: a Symptom of the Second Pathology
July 7, 2006
The Health Care issue in America dramatically manifests the second American pathology, since there isn't even an economic argument for the current system. One of the most interesting facts about the Canadian and British health systems is that by collectively realizing a non-economic (social or moral) value, they deliver equivalent healthcare procedures at a lower cost than in America.
Why? Because in the U.S., large profits are taken by the insurance corporations that are required to distribute risk in just the same way as governments effectively spread risk without profit elsewhere. A system that spreads catastrophic risk can be seen as equalizing opportunity, and so enhances, rather than compromises, individual choice, even if it is government-sponsored. A capitalist, in particular, must object to the economic waste of the U.S. "system" in which insurance companies reap unreasonable profits and healthcare providers do the same by pricing their services to take advantage of the large purses of those corporations.
(My favorite example concerns my American ex-girlfriend. She had a mouth-guard made to protect her from grinding her teeth when she slept. Some years earlier, I had exactly the same thing made to enable me to play rugby. The price paid by my ex's insurance company was more than it would have cost her to have taken a return flight to the U.K., and have my dentist in England make it for her privately!)
One of the most bizarre and frightening bills to have been recently passed in the U.S. prevents the government from using its buying power as a large consumer to enjoy bulk discounts on drug purchases to do something that is the entirely appropriate in a market economy! It is precisely by acting as a rich customer that other capitalist governments provide socialized solutions for their populations within the free-market system, rather than at odds with it. In a free marketplace, why should a society deny itself the buying power that comes with organizing to buy treatments, pharmaceuticals and expertise? If it's good enough for Wal-Mart and widgets, it's good enough for the nation and human lives. Such a bill, which deliberately prevents a collective solution to a serious national problem in a manner that preserves the free market, could only be suggested in America, and is an extraordinary symptom of this second pathology, fear of collective allocation for the common good.
Limits of Capitalism?
Anyone who has read my previous entries may be thinking that this pathology is a "special case" of the first - the dominance of ideology in American life. Indeed, a non-ideological capitalist might say that an effective capitalist system, rather than a "pure" one, whatever that means, depends on equality of opportunity across society, which necessitates the collective provision of basic rights, including equal education for all children, freedom from fear of economic devastation due to poor health, as well as those things that America seems happier to spend on, such as effective law enforcement and a strong military to protect all of the above.
I often hear the phrase "level playing field" in the U.S. but extend the analogy just a little and one soon realizes that it only makes for a fair game when the players are equally well equipped, well trained and well tended to when they get knocked down.
Our pragmatic capitalist might also point out that capitalism eats itself when corporate entities have the legal rights of persons without the corresponding legal responsibilities, and when the most successful corporations can exert market control by swallowing up the competition in a manner that begins to establish in the marketplace something more akin to oligarchy than pluralism.
My intent is not to promote "European capitalism." Indeed, I am here now in the U.S. because the American Way commends itself more strongly to me. My purpose is to point out a false dichotomy between collective solutions and individual freedom, which is uniquely American and sets America apart from the rest of the world.
There are of course excellent historical reasons for this American idiosyncrasy. The United States has done more good for the world than any other single nation in modern history. The worst political systems that it has defeated most obviously the Nazis and the Soviet Communists all abused their people by collective power under a socialist banner: America has earned its right to be skeptical of the collective allocation of resources and "socialized" solutions. But defining the future depends on transcending the associations of the past.
American Defense: A Socialized Solution in a Capitalist Society?!
This pathology is all the more intriguing when one realizes that more than any other country on Earth, America has actually been doing collective resource allocation on a grand scale. American national defense institutions represent the single largest collective action in the world. The American defense budget is larger than all of its other discretionary spending combined. National defense is the exception that proves the rule. There is nothing very political in pointing out the tension between the spending of trillions of dollars to protect lives and the lack of similar spending to eliminate the fundamental problems that prevent those lives from being lived without fear and from reaching their full potential. When a bullet is fired by an American soldier with an American gun, it defends all Americans equally. Is it a socialist gun? Does it matter if it is, as long as it gets the job done?
In Conclusion ...
I'll close with a nod to just one more example of American pathology - the public funding of political campaigns. Money isn't literally speech, but in spending my money, I may indeed be expressing myself freely: but then, I might be doing that by firing a gun into the air in Time Square but that doesn't mean I'm allowed to do so and for good reason. All of those donations, the massive lobbying industry and the multi-million dollar, corporate-funded, interest-funded campaigns are largely Americanisms. In Europe, various protections simply do not allow governments to become accountable to anyone but the voters. Such protections can be seen as yet another example of an apparent limitation that, from another perspective, actually protects the freedom of the individual.
What Americans do so brilliantly as individuals taking their own futures into their own hands America could do as a country, standing truly united.
This is my last entry for POV's Borders | American ID. I hope I've given you some food for thought. Thanks for reading.