Sunday, June 18, 2017

Pity the Poor Upper Middle Class

By the time I finished reading the third page of Richard Reeves' Dream Hoarders (Brookings Institution Press, 2017) I realized that I was an interloper. At worst, I felt a bit like a burglar rifling through the silver in a McMansion; at best, I felt like the hired help eavesdropping at a centrist Washington cocktail party That's because the author of this neoliberal cautionary screed makes it abundantly clear right at the outset that I, a widow on a fixed disability income, am definitely far, far outside his target demographic.

But rude upstart that I am, I barged right in.  Somebody had better call the Class Police before this slim volume gets into even more unqualified hands than mine! Seriously though, I did learn a lot of Inside Info, much of it distinctly unflattering to the "American dream-hoarders" of the top quintile. Their enrichment, by about 44 percent over the past half-century, is largely the result of the decline of trade unions, a shift away from full employment, downward pressure on wages from globalization and job outsourcing, and something Reeves calls "skill-biased technological change."

Reeves studiously avoids mention of the class war and class struggles originating from the bottom, and he never mentions the dread phrases "democratic socialism" or "income redistribution". Instead, we learn that "human capital development gaps" begin in the womb, because wealthier, more educated parents are more likely to have planned for a baby from within a distinctly Brave New World-ish framework. The following segment is apparently not parody:
"A couple I know gave a name to the task of raising their daughter successfully: Project Melissa. This began with the vitamins they both took before they even started trying to get pregnant., continued through the educational games of the early years, selection of great K-12 schools, vibrant family dinners, help with homework and college applications, through to helping Melissa land a plum internship. Project Melissa has lasted a quarter of a century (so far); but it started with the care with which she was brought into the world in the first place."
Reeves' stated purpose in writing his book is not so much to champion the struggling and the destitute as it is to warn the "merely rich" that their privilege does have some built-in dangers and social costs. Consider it a friendly reminder to the haute bourgeoisie that without a little more voluntary empathy and a little less conspicuous snobbery,  the rabble will only grow more boisterous. After all, enough of them voted for Donald Trump.
"Trump exuded and validated blue collar culture and was loved for it. His supporters have no problem with the rich. In fact, they admire them. The enemy is upper middle class professionals: journalists, scholars, technocrats, managers, bureaucrats, the people with letters after their names. You and me."
Roughly defining the upper middle class as the top fifth of the population who earn six-figure incomes, Reeves gently admonishes his readers to at least become more "woke." Anything less than solicitous finger-wagging on his part might hurt his book sales, after all. He even mentions that a friend had begged him to hold off on publication last month until his daughter secured an unpaid internship at an organization which his charitable foundation funds.

Aspirational critic of haute bourgeoisie greediness though he may be, Reeves still can't avoid more than a little humble-bragging snobbery of his own. In case you missed the exclusivity message the first time, he keeps reminding you of it at regular intervals. Take this placatory goo for the unduly sensitive:
"As a Brookings senior fellow and a resident of an affluent neighborhood in Montgomery County, Maryland, just outside of DC, I am, after all, writing about my own class. This is not one of those books about inequality that is about other people - either the super-rich or the struggling poor. This is a book about me, and likely, you, too."
I think that might have been my cue to quit reading a book that is above my pay scale and social station. But I forged ahead anyway. It's a very slim volume, and about a quarter of it is footnotes from other neoliberal sources, like the New York Times and the Brookings Institution and the Heritage Foundation.

So let's get right to it.

The prelude to Reeves' seven-step recovery program for the merely rich is to simply acknowledge that they - oops, I mean you - have an addiction to advantages, and that everyone else is being left behind in the dust. So please do stop your whining, Upper Middles. Just because you're not a plutocrat doesn't mean you're a pauper. After all, $2.7 trillion of the gains since the economic crash went to the 19 percent right below the top 1 percent. You now hold more than half of America's wealth, So stop being so resentful, claiming that the oligarchs are gaining at your sole expense. Believe it or not, there are actually people worse off than you.

It is this strange resentment which the merely rich harbor for the super-rich that makes so many Upper Middles determined that their own children will one day reach the ranks of the plutocracy, if not the actual Forbes 400. Reeves describes the manufacture of a "glass floor" to both shield merely rich kids from downward mobility, and to prevent poorer children from upward mobility. This glass floor/ceiling can take the form of wealthy school districts funded by high property taxes on big houses, private lessons and activities, and the cult of unpaid internships giving richer kids an unfair head start in the job market.

Reeves views this institutionalized privilege as undesirable because after awhile, the less intelligent Upper Middles will end up running things to the ultimate detriment of the Upper Middles as a class. "We have to stop rigging the market in our children's favor," he warns.

Since Mister Meritocratic Market God will remain our Lord and Savior, we can forget about a new New Deal, when neoliberal concern-trolling of the poor can serve as a glossy substitute. Because goodness knows, the poor cannot help themselves, especially since "we" are so averse to legislation guaranteeing a living wage, a universal guaranteed income, and universal guaranteed health care. Privilege has its privileges, and human rights have little or nothing to do with it.

Flitting off into the safe space of the Extreme Center, Reeves suggests seven steps to close the "class gap."

1. Since poor women shouldn't be reproducing themselves so much, give them more contraception. Meanwhile, let the Upper Middles turn marriage into an affluent "child-rearing machine for the knowledge economy." Thus we may avoid what Nobel economist James Heckman has called "the biggest market failure of all: picking the wrong parents."

2. "Invest in" visiting the abodes of the poor in order to lecture them on proper Upper Middle parenting skills. Reeves gives a plug to programs which outfit indigent parents with language pedometers to bring their children's vocabulary up to satisfactory levels and bridge the "word gap."  Besides being demeaning to poor people and an invasion of their privacy, it's been largely discredited, based as it is on a study of only six families.  But maybe Project Melissa can lend a hand.

3. Pay "the best teachers" to work in poorer schools. He doesn't say where, how much, and when. Vagueness suffices; what else is a Post-Truth Society for?

4. Make college funding "more equal." Remember, though, that some animals are more equal than others. Rich people with high IQs tend to marry other rich people with high IQS and thus they tend to have high-IQ children. All the children are at least above average, and some children are more above-average than others. Although, of course, if given the right opportunity, high-IQ poor children can also succeed once given a ladder and a level playing field and an equal head start.

5. Make land use regulation more fair by doing away with "exclusionary zoning" and related tax breaks based solely upon property ownership. This doesn't actually include guaranteed housing, of course, but it is a warning to affluent zoning boards that the rabble is noticing what they're up to.

6. Abolish "legacy admissions" to expensive colleges and universities. Reeves specifically points to Trump son-in-law Jared Kushner who, despite  his "less than stellar" grades and SAT scores, got into Harvard based mainly upon his father's generous donation to the institution.

7. Open up internships to the lower classes by subsidizing a few of the positions.

Sure, there are "price tags" to these trickle-down incremental policies, but the Upper Middles can help. "We" can afford to. The only thing standing in the way is a resistance to recognizing one's own privilege. Do we want to be selectively and minimally generous, or do we want to be downright mean, yanking up all those ladders of opportunity to keep the Lessers out? Do rich liberals really want to come off looking like a watered-down version of the Trump dynasty?

The main thing to worry about is the reputation-salvaging of the "elites" during this perilous time of Trump-inspired resentment. While the Upper Middles are easily ridiculed for such things as the Melissa Project, they should not be mocked for treating child-rearing in terms of the stock market. They are indeed superior parents. After all, they've actually succeeded in turning "parent" into a verb.
"It is easy to parody overzealous affluent 'helicopter' parents shuttling our children from after-school tennis practice to cello lessons to a Chinese tutor. But the truth is that we are doing a lot of things right. High-income parents talk with their school-age children for three hours more per week than low-income parents, according to research by Meredith Phillips of UCLA.
This investment goes well beyond numeracy and literacy. The skills required to ensure upper middle class status are not just 'book smarts' but also social skills, self-regulation, and a wide cultural vocabulary. Oh, and a strong work ethic, too. This is an important point: we are not talking about a leisure class here. Most of us in the upper middle class work very hard indeed, both at our day jobs and also at our evening and weekend job of cultivating our children's life chances."
Methinks Reeves might be protesting a bit too much here, not least because he never explores in his book why poorer parents allegedly don't spend as much time with their children. He doesn't mention that too many moms and dads have to work several low-wage jobs or "gigs" simply to make ends barely meet. Many are just too dog-tired and stressed out to have sparkling dinnertime conversations with their offspring. Many are too cash-strapped to even buy, cook and serve decent, regular meals. At least a fifth of all American children are considered food-insecure, with lack of nourishment a prime cause for their failure to learn. Level playing fields are the least of their problems.

Still, Reeves plods on, alternating between pretend-scolding his cohort and defending them. Although he and his fellow Upper Middle dads absolutely adore the hit TV series Mad Men, for example,"we don't come home to drink a cocktail, we come home to help with the homework: to Mandarin, rather than to a martini."

Well, good for him.

No wonder that Reeves includes those subtle yet implicit "may not be suitable for all readers" warnings at the beginning of his book. Not only is parent now a verb, but you can only be a successful parenting unit if you're proficient enough in Mandarin to help your kid with it.

If his class really were that virtuous, of course, Reeves never would have needed to publish his book in the first place. But I'll give him credit where due: he does at one point chide the parents in his own wealthy school district for some pretty grotesque selfishness:
"Suggestions a few years ago from our local school board members that parental contributions should be pooled so that resources could be channeled to those most in need were met with a combination of incredulity and fury. And this is a liberal area."
He is careful to somewhat disown Randian writer Charles "The Bell Curve" Murray, while agreeing with him that the merely rich merely should consume less conspicuously and develop better moral sermonizing skills in order to keep themselves secure in their class niche and the lower orders in theirs. But Reeves boldly brings it up one meager virtue-signalling notch:
In fact, Murray explicitly says, 'I am not suggesting that they should sacrifice their self interest'. I (Reeves) am suggesting that we should, just a little.
That is also the agenda of the Democratic Party, of which the Brookings Institution is an integral, policy-making part. Rather than the "fierce urgency of now," the Upper Middles are merely advised to press the pause bottom, and reflect upon a further bare minimum of cosmetic sharing in order to keep the neoliberal idea (and the Democratic Party serving it) surviving against all odds.

Meanwhile, there's still the inconvenient bottom 80 percent of us.

18 comments:

Zee said...

I didn’t buy the book—and won’t—but those of you who want a cheap “taste” can find it here:

https://www.nytimes.com/2017/06/10/opinion/sunday/stop-pretending-youre-not-rich.html

But to return to Karen’s commentary:

“In fact, Murray explicitly says, 'I am not suggesting that they should sacrifice their self interest'. I (Reeves) am suggesting that we should, just a little.

Well, that is one of the great, eternal theological/philosophical questions, isn’t it? How much is “just a little?” and is it “enough?”

How much “giving” and “caring” is enough, versus one’s own need for self-survival—and that of one’s progeny? The latter two of which are dictated, to some extent, by (more or less) unalterable “human nature?” (Sorry, but that’s just the way I see it.)

And how do we promote (or enforce) “giving?” Or is “giving” even the answer to “social inequality? “ And is “enforcement” the "right" answer?

(I’m neither theologian nor philosopher, so if any of you out there have the answer, please feel free to “step up to the plate.” )

But haven’t we been debating “charity towards all” versus “social darwinism” and “enlightened self-interest” at least since Christ met Rome—and probably long before?

How do we change things?

I find it hard to criticize Reeves for once again asking the eternal question, even if it comes across as a little bit self-serving and, yes, tirelessly repetitive. (And, of course, with a need to sell books. He's gotta eat, too!)

And even though all of his questions may have already been answered in The Old Testament.

So who has a more sophisticated answer?

stranger in a strange land said...

@Zee: Liberterian Socialism

Jay–Ottawa said...

How much is enough? The French writer Maurice Zundel, commenting during the Great Depression in Europe, offered an answer that might still bring sense to our own day of wild disparities. His lifelong concern was that it had become acceptable by governments and the larger society that the masses were never allowed enough space to develop to their full potential as human beings.

One of his early books was not 'Do you believe in God' but "Do You Believe in Man." He was of a mind, now out of fashion by the top 20%, as well as by those who admire, defend and aspire to that class, that the other should not have to struggle endlessly just to survive. People living under constant stress and want cannot do much with the gift of humanity. "What will be left of the citizen if, after being treated like a factory machine and having his spiritual sensibility kicked to the gutter, nothing more remains to be brought forth from within him but the howl of the beast?"

"[P]eople must be shielded from material extremes and vicissitudes in order that they may live as humans were meant to live."

Zundel's goal was that each person have a little more than just enough, the extra not being banked away in a private account or spent on nonsense but used somehow for acts of grace. That, to his mind, was a step towards developing the full potential in humans. Again and again in his books he offered the same prescription boiled down to this line, that everyone enjoy a "level of security that promotes a measure of generosity."

I count the guaranteed minimum income (GMI) as a variation on Zundel's idea. Progressive taxation is a practical step making the GMI feasible in big societies like our own. It's not communism, it's not socialism, it's not libertarian and it certainly isn't capitalism. It's just human to provide everyone with "a level of security that promotes a measure of generosity."

stranger in a strange land said...

From The Second Bill of Rights:

We have come to a clear realization of the fact that true individual freedom cannot exist without economic security and independence. “Necessitous men are not free men.” People who are hungry and out of a job are the stuff of which dictatorships are made.

stranger in a strange land said...

From Slaughterhouse Five:

The Population Reference Bureau predicts that the world's total population will double to 7,000,000,000 before the year 2000.

I suppose they will all want dignity, I said.

stranger in a strange land said...

...and from Emma Goldman (last one, sorry - didn't have composed for a single comment!):

People have only as much liberty as they have the intelligence to want and the courage to take.

Jay–Ottawa said...

Zundel, FDR, Goldman––Hey! We're on a roll, answers to eternal questions popping up all around.

But wait––the rich and their enablers will convince the more tender minds among us that none of those ideas are as fair or workable as the status quo. Oh well, what's for dinner?

How much is "too little" when 1 out of 5 children in the US is "food insecure"? Where's Plato when you need him?

Harvard Study: 45,000 deaths per year related to lack of health insurance. Duh… Another tough one to think through. Forget single payer or copying the programs of other western nations. SP might impose unfair taxes on the rich and well off. Very un-American.

The US has enough nukes to destroy the globe a few times over, yet Obama signed the bill for an expenditure of $1 trillion over ten years to update our stockpile of nukes. Who here is against self-defense? I doubt anyone could think up a better idea of what to do with $1 trillion to keep people alive and well.

Then, for especially unimaginative seekers after truth, there are sites like Inequality[dot]org that will flood you on a weekly basis with examples of what is "too much" and what is "too little." Subscribe (it's free) and you may eventually have a clue about what to do.

Kat said...

The home visits-- I keep reading about this like it is some new approach. I've heard the term "personal coach" used. Whatever they call it is so 1917. Of course, they totally ignore the idea of wealth. It is all about income. Liberals don't help when they attribute pretty much all their advantages to the fact that "I was able to go to college"-- whether because it was cheaper of parents helped pay for it.
When we talk about food insecurity, what we are really talking about it is the price of everything else being so high-- and the biggest crisis is housing. Housing is not seen as a social good. It is a commodity and it is a retirement plan. It is not like you can blame people for viewing their housing as security.
The construction of public housing has been off the table for years. There is this belief that it serves as a cesspool of pathological behavior. And then there are still many who believe poor people get free housing all the time. School vouchers has caused a stink, but the move to housing vouchers ("portable", "choice") seemed to go off with nary a peep.

Zee said...

Basic Minimum Income, Part i

Not all of us “truth-seekers” are as obsessed with “inequality” as we are with everyone simply having at least enough to live a life with a modicum of dignity and security.

This, it seems to me, is perhaps what Jay’s author, Maurice Zundei, was getting at, rather than completely leveling life’s inequalities across humanity; though of c9urse I could be wrong:

Maurice Zundel’s goal was that each person have a little more than just enough, the extra not being banked away in a private account or spent on nonsense but used somehow for acts of grace. That, to his mind, was a step towards developing the full potential in humans. Again and again in his books he offered the same prescription boiled down to this line, that everyone enjoy a "level of security that promotes a measure of generosity.” ‘ (My bold emphasis.)

That’s in line with the fundamental question that I was asking when I asked “How much is enough?” Most analysts who try to do real realistic cost estimates seem to assume that bringing everyone up to the “poverty threshold” with a Universal Basic Income (UBI) is enough. But is it? Twice the “poverty threshold” strikes me as, perhaps, a more humane amount.

Being one of those “less-imaginative”—though perhaps more analytical—“truthseekers,” I like a working definition as to what is “enough,” and spreadsheets, tables and graphs that tell me how we will get to a state where everyone “has enough.” And, of course, a realistic political path to reach that desired end-state would also be helpful, if not necessarily possible.

Perhaps it’s unimaginative of the mediocre amongst us to fret that we might need more than general statements about “raising taxes on the rich” or “cutting back on nuke refurbishments” before diving in, head-first, towards a Promised Land that has doesn’t even have a clear definition.

I DID briefly look at “inequality.org" to find an answer to my question, and instead found a hodgepodge of white papers by unknown authors regarding the multifarious psychological and physical impacts of inequality, both local and global. But no graphs, spreadsheets, tables or any realistic discussion that informed me as to how to [realistically] get to a UBI.

Though I admit that I did not spend much time on the site; I quickly get bored with websites without clear a clear “site map.”

Perhaps I will look further as time permits or if someone can point me to specific articles.

Looking a bit further on the web, I did start to find the calculations, graphs and tables—along with the necessary increases in taxes—that would be needed to bring every American up to the POVERTY LEVEL. (Which, for the record, is inadequate in my view: IMHO, twice the poverty level is what is necessary to provide every American with a decent life.)

You might look at:

https://basicincomenow.wordpress.com/2014/12/15/how-to-fund-a-universal-basic-income-in-the-usa/

and

https://www.quora.com/How-much-would-a-basic-income-guarantee-cost-the-US

for some more thoughtful—if admittedly amateur— estimates as to how much a Universal Basic Income might cost o keep everyone at the poverty level. And then, perhaps, DOUBLE those estimates because life AT the poverty level is not a life with security and dignity

(The former article also looks at changes to the tax structure that would also have to occur, though in far less detail than I would like. Of course.)

The first article concludes that to provide a UBI for every American at the poverty level would cost $3.056 trillion, on top of a current federal budget of $2.863 trillion, the latter having been adjusted for certain savings that the analyst took into account owing to the existence of the UBI. (According to this post, the year was 2014.) The total cost is more than double the then-current federal budget.

Then, using his sketchy tax proposals, the analyst claims that this is “do-able.”

Karen Garcia said...

Zee,

The Washington Post, which is owned by one of the world's richest oligarchs, wrote a smear job re single payer health insurance. The fact is this: American health care, without single payer, is by far the most expensive system on the planet. You pay through taxes or you may through the predatory middleman, either way you pay.

Right now, if you have Medicare, you pay your extremely modest premium directly to the government. If you are a poor senior or disabled person, your premium is subsidized, as is your 20 percent copay (via Medicaid).

Under a single payer system, everybody would pay according to ability - even the moneyed middle class. So what?

More info on the orchestrated plutocratic campaign against universal health care can be found here:

https://www.jacobinmag.com/2017/06/single-payer-health-care-universal-medicare-for-all

It contains no charts or math, however, so I reckon it would be suspect for those interested in confirming their preciously held biases against anything even remotely socialistic.

Final observation: ever notice how those who worry so much about how "we're" gonna pay for universal health care don't show similar concern about all the blood and money wasted in "our" endless wars of occupation and predation?

Oh, so Cali and Vermont tabled their single payer legislation, therefore everybody should just shut up and give up in despair. Thanks, but no thanks.

Zee said...

@stranger in a strange land--

Thank you for your reference to "Libertarian Socialism." I am always interested in learning more about different socioeconomic theories of government--or lack of government thereof.

However, I confess that I got bogged down in the multitude of variations on Libertarian Socialism, e.g. "autonomism, communalism, participism, guild socialism, revolutionary syndicalism, and libertarian Marxist philosophies such as council communism and Luxemburgism; as well as some versions of 'utopian socialism' and individualist anarchism."

I have had a difficult enough time trying to understand how "simple anarchy”--if there is such a thing--might work.

Some time ago I had a discussion with a past Sardonicky contributor--The Black Swan--about how "anarchy" might work. He (She?) suggested reading Ursala K. Le Guin's book The Dispossesed as a way to understand how "anarchy" might successfully function,

While I enjoyed the book--and the others that I subsequently discovered in “The Hainish Cycle”—I still never fully understood (or liked) how anarchy is supposed to work.

It’s been some years now, but as I recall there STILL had to be some central authority who strongly “suggested” (Read: 
“voluntold,” as a friend of mine who served in the military once described it) that people with certain skills go where they were needed.

As I recall, that is how Shevek—the main character—effectively lost his mother, only to have her reappear out of the distant past and try to reclaim a relationship with her son. Again, as I recall, Shevek essentially told her to “get lost;” His father was the one who stayed with him—even though Shevek was essentially raised in an unloving, sterile “daycare” system—while his “mother” was now nothing to him. This absence of “family ties” in anarchy effectively soured me on the whole proposition. But I’m open to more thoughts on the topic of anarchism.

Thanks also for the reminder of Emma Goldman’s great quote:

“People have only as much liberty as they have the intelligence to want and the courage to take.”

Perhaps if the 40% of the American public who choose NOT to vote actually did not, peaceful change—to their benefit—might actually occur.

Otherwise, we just may be headed toward the “catastrophe” that I mentioned that brings lasting positive change, or the “dictatorship” that is referenced in FDR’s Second Bill of Rights.

Which will it be?

Elizabeth -- Marysville said...

Exactly, Karen. Where is all the research on funding the MIC? Where was the planning to make sure the casualties would have health care? (And the standard for health care should be the cadillac plan the corporate whores get at taxpayer expense).

The Deep State uses a false flag to gin up support for more war. No false flag needed to gain majority taxpayer support for single payer, but somehow the research isn't there. The determination to get the research isn't there, either -- or it just takes one measly politician to sink it.

If you haven't heard of Caitlin Johnstone, here she is: https://medium.com/@caityjohnstone/the-real-reason-the-elites-keep-killing-single-payer-1fbaa24c2c22

There is no good reason we don't have single payer. There is no good reason we don't have affordable education. There is no good reason we don't have healthy, affordable food. There is no good reason there are homeless/houseless people. There is no good reason we continue to murder people in other countries. There is no good reason we let our police murder with impunity. There is no good reason glyphosphate and its makers/marketers haven't been rounded up and destroyed. There is no good reason the war criminals in our government continue to walk freely.

Zee said...

Karen--

I don't know that I said that "everybody should just shut up and give up in despair." What I did say is that as I understand the current "single-payer" models--or, for that matter, the "Basic Minimum Income" models--they both appear to me to be unaffordable at the moment. Even if we were to make HUGE cuts to the Federal budget in other areas.

It doesn't really matter that the oligarchic WaPo may have done a "smear job" on SP. Vermont's and California's very real numerical experiments seem to me--an experimental scientist myself--to have been sincere efforts that, by both states' own admissions, failed.

That doesn't mean that other models couldn't succeed.

I will take a look at the Jacobin article and tell you what I think. At the outset, it doesn't really matter that there are no tables, spreadsheets and graphs: every great idea starts as pure imagination.

But in the end, to persuade others and, ultimately, to bear real fruit, it still comes down to the equations, the spreadsheets, the tables and the graphs that can be analyzed by others for credibility.

Otherwise, the American public will wind up being "Grubered," just as it was with the so-called Affordable Care Act. All the hope and trust in the world won't alter the need for real numbers.

And I regard it as a remarkable diversionary tactic to shift gears--midstream--and wonder

"how those who worry so much about how ‘we’re’ gonna pay for universal health care don't show similar concern about all the blood and money wasted in ‘our’ endless wars of occupation and predation?"

While I support a strong national defense, I, too, am sick of our "endless wars of occupation and predation." While I have admitted that I have been fooled in the past, I don't think that I have ever said in this forum that I still support our endless wars.

Nor do I have any reason to believe that the various analysts whom I cited for research into the costs of the BMI and SP had any special interest in promoting endless war at the expense of the BMI and the SP.

So why the accusatory “diversion?” I’ve only been speaking for myself, not the rest of the country.

Karen Garcia said...

Zee,

Universal health coverage is by no means "unaffordable" just because it will cost a lot of money. Unaffordable to whom, I wonder.

Universal care and Obamacare are not the same thing, not by a long shot. Obamacare actually drives costs up even further, because insurance companies are upping premiums and deductibles to offset the requirement that they cover pre-existing conditions. Costs are driven up because healthy younger people are refusing to buy worthless insurance product, thus reducing the pool.

There are plenty of studies which prove that a single payer insurance program would be cheaper without the inclusion of the for-profit insurance cartel. For starters, governments with Medicare for All-type systems can negotiate prices with drug companies more effectively. Look at the Canadian health insurance law. It's whole 12 or 13 pages long.

Physicians for a National Health Plan is a good source re costs. So is HR 676.

The upshot is whether you view health care as a privilege or as a right. I view it as a right, and so do most other civilized countries which provide health care to all their citizens.

Calling for years and years and years more of cost-benefit analyses seems to me the diversionary tactic here. You can't put a price on human life and health. You just can't.

And that's all I'm gonna say.

Karen Garcia said...

Elizabeth,

So well said!

Zee said...

“You can't put a price on human life and health. You just can’t.” —Karen Garcia

Of course one can put a price on human life and health. Whether it’s done under our inefficient “free market” private insurance system, a single-payer system like Canada’s, or the United Kingdom’s National Health Service, “rationing,” i.e., placing a “cost” on a single human life relative to the “health” of everyone else is done all the time.

Even Physicians for a National Health Plan acknowledges this, though it minimizes “rationing” anywhere but in the U.S.

But consider this recent article from The Guardian:

https://www.theguardian.com/healthcare-network/2015/apr/24/rationing-care-fact-of-life-nhs

And then this older article (1984) is from the WaPo, perhaps before it was owned by an odious oligarch determined to smear single-payer:

https://www.washingtonpost.com/archive/lifestyle/1984/10/24/cutting-costs-by-choosing-who-lives-who-dies/b658b052-d35a-4175-98bd-50fc4ae4ac09/?utm_term=.a60a7bc2a190

I especially liked the line

“Asked how he [a British physician] could turn away over-55 kidney patients from life-saving dialysis, one doctor told Aaron and Schwartz [book authors interviewed for the WaPo article] : "What you don't seem to understand is that everybody over the age of 55 is a bit crumbly.”

At age 66+ I have my infirmities, but I also don’t feel all that “crumbly” that some second-rate sawbones should decide that it’s time for me to die when straightforward technology is there to keep me going. How about you?

But enough of that. I have commented before on both the “Physicians for a National Health Program” website, and H.R. 676, which is cross-referenced on the PNHP website.

I can’t recall exactly what I said, but a review of the PNHP website is very sketchy as to how things will be funded. H.R. 676’s explanation as to how things will be funded is equally vague:

“The program would be funded through a combination of existing federal and state health care spending, a modest payroll and income tax based on ability to pay, and surtaxes on very high-income groups. Payroll taxes would be fully offset by a reduction in premiums and the virtual elimination of out-of-pocket expenses. (My bold emphases.)

In other words, “Trust us.”

Having spent an entire career using numbers, tables, graphs and spreadsheets to make my case(s) where suspicious scientists doubted me, I won’t change soon.

I don’t in any way equate single-payer with ObamaCare. But if a lack of analysis could screw up the latter, it can equally screw up the former and land this country in a terrible lurch.

And that’s all I will say on the topic, too.

stranger in a strange land said...

@Jay, Kat, Karen, Elizabeth (and, presumptuously, on behalf of Zee):

OK, we've got the "intelligence to want" part figured out - on to "courage to take" - what's the plan?

Zee said...

stranger in a strange land--

No, you are not speaking "presumptuously" on my behalf. Although it may be hard for most in this forum to believe, I still think that single-payer health care (SP)--and a Uniform Basic Income (UBI)--are directions towards which this country should work. If I have seemed doubtful in my preceding remarks, it's because I really am a scientist, which means that I am also a professional skeptic.

That's what we do: ask questions about the nature of...well...nature, doubt the answers that we give each other, and then test them. We work our way toward the truth via our successes and failures,

Karen accuses me of "Calling for years and years and years more of cost-benefit analyses" as a diversionary tactic to avoid SP or UBI altogether. That's simply not true.

Do any of you out there recall a Robert Redford movie titled "The Candidate?" You can read the synopsis here:

https://en.wikipedia.org/wiki/The_Candidate_(1972_film)

In the movie, a quite shallow leftist senatorial candidate wins his election based mostly on his good looks and legacy family name, and the movie closes with The Candidate plaintively asking his campaign manager

"Marvin ... What do we do now?"

Well, history, too, seems to have plenty of "Whut now?" moments following staggering revolutionary victories, wherein things went all to hell for lack of any real advance planning and preparation.

Think: The French Revolution, which led to mass slaughter, internal infighting and assassinations, and the eventual transition of the revolutionary government to Emperor Napoleon and years of wars of conquest;

The Russian Revolution, that may have started with pure intentions but which also led to internal conflicts and assassinations, Stalinism, and the Gulags in which millions died, followed by the collapse of the Soviet Union and the transformation of Russia into an oligarchy;

The Chinese communist revolution, which led to the Cult of Mao, tens of millions of deaths in the name of bogus national projects such as The Great Leap Forward* and the eventual replacement of "communism" with statist capitalism. And the list could go on.

I have some thoughts on "courage to take," but they all also involve careful thought and planning prior to the "tak[ing]," rather than idle expressions of outrage as to "what ought to be." We may not be able to test our theories prior to adopting them, but we can try to do the best job possible to plan for success, and to anticipate unintended consequences.

None of which was done, of course, prior to the adoption of Obamacare. Hence our current mess.