The state of Colorado will vote on a ballot initiative this fall that would create the first single-payer, universal health plan in the nation for an entire state.
To get the ColoradoCare plan on the ballot, supporters had to gather 100,000 signatures. While not an insignificant indication of support for the measure, Coloradans face an uphill battle in their attempt to pass this historic legislation. Not surprisingly, the business community is rallying to support their colleagues in the insurance industry to fight this initiative in the name of the free market.
Like many important social questions in our country (and our world) the humanitarian or social justice framework of what best promotes the common good is clearly being eclipsed by the drive for profits and the capitalist economic ideology that shapes our national consciousness.
As I have said many times before, profits are important. They are an indication of a well run business or enterprise and they enable the smooth functioning of our markets. Profits enable businesses to pay their employees, improve their facilities, and provide incentives for workers and owners alike.
But profits should not be the central driving force of our economy or of our social provisioning. The social well-being of our community, which involves not only our health care but our education system, our criminal justice system, our emergency services, and many other community partners, should not be contingent upon profitability.
Our collective obsession with profits is less a result of the dominance of capitalism in our culture than it is the rise of neoliberalism and neoliberal ideology that was ushered in as part of the Reagan-Thatcher revolution in the 1980s.
The neoliberal focus on privatization, deregulation, and trade shifted our collective understanding of the social contract from the role of government as a one of ensuring the health, safety, and well-being of our community to one of ensuring the extraction of profits from every possible source of economic exchange imaginable. In the neoliberal world everything is run by the private sector.
Of course, the profit-making potential of our schools, or our prisons, or our health care system is never the lead argument trotted out in these debates. That would be too crass, at least in polite conversation or public discourse. But, make no doubt, the profitability of privatizing our schools, our emergency services, our prisons, and our health care is the primary reason these shifts are taking place around the world.
Public rhetoric will claim increased efficiency, better outcomes, improved services and many other smoke-screens intended to divert public attention from the real motive behind these shifts in our collective commitment to the common good – the ability to extract profits from everything.
While Obama’s original intention in health care reform was to implement a universal, single-payer system, he was unable to fight against the powerful rhetoric of the business and insurance lobbies that used scare tactics and dis-information to confuse the public and frighten middle-class voters into forcing the compromise that resulted in the current form of Obamacare. Data indicates that the rate of uninsured US Americans has dropped to historic low of less than 10%. This has had a significant impact for children whose rate of uninsured has fallen by half among poor and near-poor families.
And yet, there are still many people who either lack insurance or who still find their financial obligations overwhelming. Take the case of of the Wilkes family in Denver. Their son, Thomas, has hemophilia and the thousands of dollars of out-of-pocket expenses that they have had to pay to cover his medical care have far outstripped their income and ruined their credit in the process.
Certainly health care workers ought to be paid well for their education, knowledge, and most importantly for the knowledge, compassion, and care that they offer to their patients. In fact, being paid well for the work that you do ought to be the cornerstone of economy – not the ability to extract profits from that work.
Health insurance companies are not about providing good health care, they are profit-making businesses that seek to make money off of the health care industry. The moral question at the root of this debate goes to the heart of our identity as a country, namely:
What is the moral purpose of profits and when and where are they appropriate?
Profiting off of Thomas Wilkes’ hemophilia or anyone else’s cancer, or heart disease, or surgery strikes me as fundamentally immoral.
The neoliberal celebration of wealth and the maximization of profits is derailing the moral center of our country. It is time for more robust public discussions of how to talk about our moral and economic priorities in this country.
Colorado is in a position to lead the way in this discussion over the next few months as we think about why a universal health care system is a morally preferable model for our communities and our country than a model that pours billions of dollars into the insurance industry rather than directly into health care.
Yes, figuring out a new model for the provisioning of health care that is efficient, flexible, and provides a gold standard of health care for our citizens is an enormous task. Particularly if we reject the notion that profits are the motivating factor for the innovation needed to devise such a plan.
However, this country is full of very smart people. Devising new models may require us to think outside of the traditional boxes of capitalism and socialism that dominate political and economic discussions.
Surely we are up to this task.