Re: Why health care insurance is so expensive in the US
- From: Michael Scheltgen <mjs818@xxxxxxxxxxxxx>
- Date: Fri, 05 May 2006 05:55:41 GMT
nospam wrote:
then maybe the problem is just that Americans are just too stupid to avoid
extinction.
By Uwe Reinhardt, a health economist at Princeton:
THE AMERICAN PEOPLE
Both you, Kip, and also Bob LeBow portray the American people as more or less hapless subjects of a crony-corporatist "democracy" in which a corporate aristocracy uses its paid political agents to arrange the economy so as to suit the aristocracy's tastes. Unlike similar setups in Asia, however, the American aristocracy is not benign. In Singapore, Taiwan and Japan, for example, such corporate aristocracies at least have installed universal, reasonably egalitarian health insurance systems and first-rate egalitarian systems of education. By contrast, America's corporate aristocracy has left the lower classes to languish on both fronts--perhaps even to make them a more docile servile class.
A skeptic, like me, would wonder what makes the subjugated American plebs celebrate this nasty setup with such enthusiasm every July 4th. The answer might be that the aristocracy has kept the plebs mesmerized with some kind of opium--like religion, Lenin's "opium of the people." In this case, the opium is the myth that anyone in America has an equal chance of becoming rich or the President of the United States, which may be the reason why even the poor favor the abolition of the inheritance tax! Another helpful myth may be that we have the best health system, education system, railroad, cellular phone system, _______ (fill in any noun) in the world, which the average American firmly seems to believe. No matter how miserable an American may be, he or she thanks God for being in America. Powerful stuff, that, and very useful to the conduct of a society with as wide an income distribution as ours. Perhaps that is all it takes to subjugate a people.
Now, is that your vision of American "democracy"? This vision, of course, leaves the subjugated plebs totally off the hook in matters of health policy or any other public policy. It excuses them from informing themselves on matters of public policy, from participating in a conversation on it, and even from voting at all. The excuse is that any exercise of these powers would come to naught in any event.
I am not prepared to go quite that far. To be sure, there is something like a corporate aristocracy in America, and it is growing stronger and more entrenched by the day, as corporate chieftains have learned how to fleece their shareholders legally and to amass vast fortunes in the process. It is also true, as Bob points out, that American health policy has been run much more in the interest of the supply side than in the interest of patients. Leaving millions of American elderly citizens without coverage for prescription drugs is but one manifestation of this bias.
But I believe the American citizen would have more say and and could exercise more power in our democracy--even in health policy--if that citizen could ever bring him- or herself to mature beyond the stage of blissful adolescence. It may be outrageous for an immigrant to these shores to say it, but having lived consciously in two other societies, I am impressed with how juvenile the so-called average American citizen is on most matters of public affairs. To me, the typical American comes across as a permanently exuberant, lovable, sometimes charming and often vexatious adolescent who knows much about personal entitlements and very little about personal responsibility or civic duties. He or she is the rugged individualist who builds a house in the flood plains, only to whine why FEMA takes so long in coming to the rescue when the flood appears. It is also the investment banker in the Hamptons cursing the intrusive government, all the while basking in the comfort of federal flood insurance. As I said, those of us who came from abroad find this basically charming, somewhat amusing and often very frustrating. If America is the corporate aristocracy that you seem to have in mind, it is so mainly because the average American citizen simply refuses to grow up. Over half of them do not even vote or know the names of their state's senators. By European standards, they are pathetic citizens, to use that term loosely.
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