By Steve Schulte of
Health Advocate Solutions
(213) 999-1227
"You're a socialist!" "Your hands-off free market has failed!"
Sound familiar? The din of endless---and noninformative---epithet hurling.
There is no "bright line" between those who support healthcare reform wholeheartedly and those who adamently decry the legislation. Opinion runs more on a spectrum of views.
There are good reasons for this, with better or less good information being only one. Only a portion of the disagreements have to do---in the long run---with informed political viewpoints. At the end of the day the pragmatic streak in American political life values what works well. This points to how the law is eventually carried out in our own neighborhoods: implementation.
For example, with any public policy change one has to distinguish early on between the "politics" of the policy (why and how it passed) and its "implementation" (how it will work in the real world). But it is essential to stress the difference.
It is huge bureaucracies---state and federal---that will implement healthcare changes---along with private insurers and providers. But whether the philosophical direction looks good or silly and wasteful years from now will point to how Democrats and their particular views succeed or fail in our eyes. That ulitmately reflects philosophical and political views.
Early on most argued in favor of providing broader access to healthcare in this wealthy, highly industrialized country of ours. Thats' where agreement ended.
Some argued for letting every household help themselves once they were able to do so (self-reliance and the free market all the way). Others wanted a single payer system which contains the range of options from government ultimately paying for the bulk of the care to the complete startup of a new healthcare system without insurers---much like Cuba, for example. (Just a whiff of socialism?)
Enter "socialism" versus "capitalism". Two words that were bandied about heavily during the Congressional healthcare debates, but which have far more complex meanings and histories than most care to admit. Even if they know.....
As a departure, let's take a look at the words and the concepts behind them. Perhaps there will be some light there.
Both capitalism and socialism are legitimate political concepts. Each addresses both an economic theory and a political idea. Ways of dealing with everyday problems that people face in finding work, educating their kids, having enough food and so on. No budging on this shared legitimacy.....sorry. There's plenty of history for both schools and they both can show valid experiences.
Capitalism emphasizes self-ness, knowing one's needs and desires---and energetically pursuing them. As a consequence, mysteriously perhaps, the rest of the population benefits. Democracy and capitalism often work well together. But one cannot ignore the busted businesses, the unexpected layoffs, the inequality. Sometimes Know-Nothings show up for the fun during elections. Think of healthcare. All part of capitalism.
At the simplistic rhetorical level, one could hold the view that capitalism makes people selfish and self-absorbed, unmindful of what others need to share a good life.
Socialism, on the other hand, does not trust the individual. A larger force--the state, perhaps---has a better grasp of the common good. With its wiles and planning and force the state seeks for ways to find better, more equal distribution of goods and benefits. But, stagnation, apathy, monochromatic output and, sometimes, totalitarianism---these too go with socialism. Bright red, then, but not pure. Think: the charges against state-run healthcare systems or how bad the Soviet economy ran down.
So, again, at the simplistic rhetorical level, one could feel that socialism makes people dependent automotons, fearul of their government and wary of being on their own.
It would be nice to think that our very own American healthcare debate was so innocent as to be between clear concepts of capitalism and socialism. Ah, but that is a distraction.
Twenty-first century America has its economic theories and political ideas, but these barely escape taint from corporatism, the bottom line, multi-million dollar lobbying and greed. Too bad, too. In a way, pure capitalism or outre socialism would be welcome at this party.
If only our debate had a Eugene V. Debs or two; perhaps a Michael Harrington or an Upton Sinclair. And no political debate would be complete without Adam Smith. Or several. Where are our present-day Jefferson and Hamilton?
So, at the end of the day, we Americans often get shrill dabates, name-calling----and, usually, something slightly different than the over-simplifying sides originally demanded. We get compromise. Sometimes this works well (e.g. Medicare) sometimes it does not (e.g. anti-poverty efforts).
The bottom line: most of the name-calling is pointless and uninformed. There certainly are strong philosophical and political differences that can be traced and debated here. That debate is essential to a healthy, well-running democracy.
We will hear lots of noise, obfuscation, even some ignorance. But with such a complex subject we need something more.
Let's start by separating out what one person thinks is correct versus what another might---and focus for a while on how to carry out this law so that both patients and providers are better off. At the end of the day it's what works well for the public good that counts.
To respond to this blog, email steve6schul@yahoo.com
