Friday, July 31, 2009

The Great Divide

I found this Joan Walsh article via Reclusive Leftist who doesn’t think much of it, although for very different reasons than mine. I do think one of Walsh’s argument is worth examining:

There is one main reason the U.S. doesn't have the social democratic traditions and programs enjoyed by most Western democracies -- we are the only such nation without some kind of universal healthcare -- and that reason is our history of ethnic, racial and class strife. (The bounty of the eternal frontier and American exceptionalism fit in there too, but I'd pick our fractious and well-manipulated heterogeneity as the top reason.)

The history of the 19th century and early 20th century is the history of labor and political coalitions splintered by divisions between Northern Europeans and Southern Europeans, between middle-class Germans and less well off German Jews, between the Irish and everyone else, and, increasingly after blacks won something akin to freedom, between all white ethnic groups and African-Americans. Latinos and Asians came with their own demands and baggage and relations got more complicated still. Barriers of language, culture, class and skin color thwarted many efforts to grow labor unions and build a social-democratic majority.


This is The Great Divide in American politics today. Not that some people think we should have “social democratic traditions and programs” like universal health care and some think we shouldn’t. No, The Great Divide is that some people think the fact that we do not have such traditions and program is, ipso facto, a failure. Walsh clearly believes that if we were a normal nation, a healthy nation, a decent nation, we would have been able “to grow labor unions and build a social-democratic majority.” To her, the fact that our history prevented us from doing so is a tragedy.

On the other side are people who think our lack of social democracy is a largely desirable result of our unique history and a vital source of our strength. I come down primarily on this side. I have never understood either Americans or foreigners who admire, respect, envy, desire, or seek to make use of America’s wealth, America’s power, and America’s products while simultaneously decrying the shape of our social structures; our lack of full government involvement in all good things from art to daycare; and our messy, contentious, and often unkind intersection of government, politics, morality, religion, economic interests, ethnic groups, racial groups, economic groups, high-minded ideals, personal ambition, straightforward greed, and astonishing generosity. It seems never to have occurred to them that it is the very characteristics they disdain that have created the money, might, and merchandise they seek to emulate, own, profit from, or employ for their own purposes.

15 comments:

Poeschl said...

RE: Downloading this blog onto another Blogspot site -- Not permitted?

I have tried to download your blog via the Blogspot function 'Blogs I'm Following' onto my own Blogspot site, using the correct URL, but Blogspot indicates that it can't find a feed.

If you prefer that Blogspot bloggers not download your blog,
then I'll stop trying to download it.

This is an exceptionally well-informed blog and it deserves a wide readership.

Anonymous said...

Hear, hear. It's the old conflict between security and freedom. In the American system that some of us value, you get the security you need by dealing voluntarily with free men and women. You create as much collectivized security as you absolutely need, so that a military defends your borders and a police force makes it reasonably possible to go to market without being hit on the head by highwaymen. But you try to rely as much as possible on arrangements that individuals make among themselves on mutually agreeable terms. That means that it's no one's responsibility but your own to minimize the risk that you'll get caught without the food, shelter, or medical care that you need to stay alive.

For most people things work out best if they pool risks and resources. So I think sometimes we make the leap to the idea that the whole country (if not the whole world) should get into the same pool. In real life, though, the pools don't seem to work unless they're voluntary, and they're not voluntary unless they're of a manageable size and contain people we feel pretty close to. For the most important kinds of dependence, nothing much over the size of the nuclear family works all that well. We can deal with somewhat larger groups of relative strangers to meet needs that aren't so critical.

-- Texan99

Elise said...

Poeschl - I believe I have now enabled site feed. If you still have problems, drop me an email.

Elise said...

Texan99 - Health insurance is an interesting collective. Although we do deal voluntarily (leaving aside government interference for the moment), we are dealing with large groups of people we know nothing about.

Anonymous said...

Absolutely -- and health care is extremely important to us, so lots of us require a lot of formal protection in relations with our doctors and insurers. It's uncomfortable, for instance, to believe we're dealing with a single, powerful monopoly. At least for me, it's much safer to deal with a large market in which I have a lot of choice as a consumer and I know the doctors and insurers have to keep an eye on losing customers if they deliver poor service. I'd expect the discipline of requiring free people to deal with free people to protect me.

If the doctors and insurers and insurance pool were my own brothers and sisters, I'd put up with a system that required more trust and granted me less freedom.

-- Texan99

Elise said...

Texan99 - I think trust is a key issue here. One of the Sunday morning talk shows was discussing the new strategy for getting a Democratic health bill passed: make insurance companies the enemy. So the idea, I guess, is to make people mistrust insurance companies so much they'll trust the government instead.

I think your approach is much safer. Not only do we have competing insurance companies, we have the government available to regulate truly horrendous behavior on their part. If the government is the only - or even the major - player, there is no watchdog that can regulate it.

I really need to think through Medicare more thoroughly, though. That is the strongest argument the Democrats have for why government-run health care is not such a bad thing. Any thoughts on that?

Anonymous said...

Just that Medicare is collapsing in on itself. And why should I expect anything different from a mandatory program? It's true that doctors can opt out (if they jump through enough hoops), but patients can't. The best patients can do is buy MediGap. Doctors are starting to bail out of MediCare, but what do we patients do? If we go to an opted-out doctor, we can't even use MediCare for the portion of his bill that the government has arbitrarily decided is the "right" price. And as I understand it, though I'd love to learn differently and I'm researching it, I can't buy non-MediCare insurance after I'm 65. I can buy only MediGap, which is not the point. What I'd like is regular insurance for opted-out doctors, with a high deductible, so that in most years I simply pay my own bills directly to the doctor in cash, but I have some protection against a real medical catastrophe.

-- Texan99

Anonymous said...

I finally found some information on this business about whether Medicare is really mandatory after age 65. My insurance carrier has always insisted that it couldn't keep me as a customer after age 65, but I think what they were really saying was that they couldn't cover me once I became covered by Medicare.

It turns out you can opt out of Medicare. Here's the catch: the only way to do it is to forfeit your monthly social security benefits! How's that for a deal! Not only do you keep paying for private insurance, but you get penalized in the amount of your paltry SS benefits. Well, if they're paltry enough, and if the system's going to be broke by then anyway, maybe that choice will get more palatable. At least if you opt out of Medicare, you can pay cash for access to doctors who are popular and skilled enough to command cash prices at a market rate, and you can still buy catastrophic medical coverage. It will be pricey, but it beats enrolling in Medicare and pretending you have health care when what you really have is access to a dwindling pool of doctors who didn't have what it took to make the plunge out of the half-pay system.

I never included my SS benefits in my retirement planning anyway. I never believed I'd really receive them.

There's a lawsuit, filed last October, challenging the requirement to forfeit your SS benefits in order to escape the clinging grasp of Medicare. Apparently it's just now starting to get some publicity. More people should know about this. I'd like to hear some shrieking about it at town halls meetings this month.

-- Texan99

Elise said...

Very interesting about being able to opt out of Medicare. And it stinks that you have to forgo SocSec benefits to do so. I'll keep my fingers crossed the lawsuit is successful.

I guess my question would be whether private health insurers would be willing to sell health insurance to people over 65. The odds you will cost them a fair amount of money go up with age. I always thought one reason for Medicare was the difficulty in getting private insurers to take on older customers.

If you opt out of Medicare, can you opt back in?

Anonymous said...

That last question is a really excellent one. Every year a Congressman (Sam Johnson, I think) introduces a bill to amend the SS law to permit opting out, but the copy I saw didn't address opting back in.

It might be hard to get insurance for the first time once you're past 65, but if you already have it, the terms usually don't permit them to drop you other than for non-payment. Normally your premium changes only with the premium for the whole group.

If you're on employer-provided insurance, you'll be in real trouble, of course, because you'll be starting from scratch at age 65 and probably with a pre-existing condition.

My dad was old enough that he'd had the opportunity to opt out of SS and therefore never got into the Medicare system. He kept his private insurance until he died at age 75.

-- Texan99

Elise said...

Very interesting. I wonder what happens to people in unions where their employer health insurance continues after they retire. Do they get to have both Medicare and private health insurance? Or are they able to opt out of Medicare without opting out of Social Security? I can't imagine they all opt out of Social Security.

Anonymous said...

Good question. The impression I got after talking to a lot of insurance companies, brokers, and consultants was that insurers couldn't or wouldn't write policies for people who were covered by Medicare. Maybe that means that most people with union-provided insurance after retirement are on Medicare; the union provides, at most, Medigap coverage. Like you, I can't imagine that many of them are waiving their SS benefits or that (if they were) we wouldn't have been hearing about it.

-- Texan99

jason said...

Holy crap!

I found your site via Snopes, and this post should be read by everyone.

The divide is so fundamental, I have difficulty even discussing specific issues (Health Care and Cap/Trade lately) because I have to basically attack their bedrock beliefs in entitlement. I don't have all damned day!

I really do feel like an alien sometimes. Whether it's the RNC or the DNC, the assumptions both sides make about what is their "right" are simply...well, wrong.

Elise said...

Jason, thanks.

I know what you mean about not being able to discuss large swathes of public policy because talking to people who hold a different position is like talking to a Martian. It's funny in some ways but in others it's truly scary. How can we live in a civil political society if we can't at least acknowledge that "the other side" has political beliefs and policies that are as legitimate as our own? In other words, they may be mistaken from my point of view but they are not immoral, stupid, or monstrous.

Anonymous said...

Well, some of them are immoral, stupid, and monstrous.

-- Texan99