Wednesday, April 4, 2012

The Death of Wonder

Quick, what do the Panama Canal, the Space Program, the Golden Gate Bridge, the Human Genome Project, the Internet, and the Hoover Dam all have in common? Marvels of science, engineering, and technology? Yes. Testaments to human ingenuity? Absolutely. But more basically, they were, first and foremost, government projects. Know what else? The American Society of Civil Engineers lists seven wonders of the modern world. Six of them were government-sponsored.

Why point all of this out? Well, it has become fashionable to say that our government is too big, that government is the problem, that taxes are too high, that regulations stifle business and innovation, blah, blah, blah. Nowadays, it is a rite of passage and a requirement of office for our candidates to complain about the scope of government and to run against it. But look at that list of achievements and reflect that government can and has worked well, even on immense and seemingly impossible projects, and it has done so with spectacular results.

No private enterprise can assume the risks that a government can, especially risks that have no immediate and obvious application or reward. We assign a very different role to our government (the well-being of its people, land, and resources) than to private enterprise (profit for its stakeholders). This is a good thing. So we should not expect that our government's returns on investment would compare favorably to a corporation's quarterly balance sheet. And as someone who works in corporate America, I would like to disabuse everyone of the notion that private enterprise is always "better" than a public institution. I can say without reservation or hesitation that every large organization, be it public or private, has waste and inefficiencies.

Perhaps even more important than the litany of our nation's technological wonders are its social achievements. In its 235+ year history, it established itself as one of the first modern democratic republics, becoming a template for the world. It ended the practice of legal slavery, granted universal suffrage, created a system of public education, insured worker safety, promoted public health and food safety, and guaranteed assistance for the poor and elderly. It won the greatest conflict of the last century and rewarded its citizen-soldiers with homes and with higher education, which in turn fueled the economic success of the nation for decades.

More abstractly speaking, the freedoms and liberties that we consider to be guaranteed by the U.S. Constitution and the Bill of Rights were actually long in the making; it took more than two centuries of legal battles and legislative reform for the rights we take for granted to be as fully realized as they are today. One could call that an ongoing achievement of our government - its ability to adapt, reexamine, and learn. Wondrous indeed.

Recently, I've heard a lot of noise about the Constitutional overstep of the Affordable Care Act, also known as "Obamacare." Other people have written more informed and eloquent essays as to why this is a spurious legal argument. I'm no great defender of ACA (for the record, I favor a single-payer plan, modeled after Canada, the United Kingdom, and Germany), but I think ACA is better than nothing, and a pretty substantial legislative achievement in our era of partisan gridlock, so I'll simply add this: we are already paying for the uninsured. So how much is my freedom actually curtailed if we collectively provide a more formal mechanism for funding something that is already taking place? On a more personal level, the ACA allows me to insure my adult children, who cannot afford health insurance on their own. So to those who say that the ACA restricts personal liberty, I ask this: how much "freedom" and "liberty" do my kids have without the insurance that I am fortunate enough to be able to provide? And what should be done about the kids who don't have a parent who can provide health insurance?

The mantra of some anti-government ideologues is to "make government small enough to drown." Now, our government isn't perfect. It certainly does a lot of things I'd rather it not do. So shrinking government may eradicate some of the problems that it has created. But the underlying implication of the race to dismantle government is that the sole measure of our worth as citizens and as human beings is merely our naked economic productivity and our ability to compete in the marketplace. I reject that notion utterly. Sacrificing ACA, public education, Medicare, and Social Security upon the altar of "small government" buys us... what? Freedom? Liberty? Economic security? It certainly does not provide any of those things to the impoverished and growing underclass.

Some of our nation's greatest technical and social accomplishments do not look so wonderful from narrowly defined cost/benefit analyses. But they ultimately proved to be invaluable contributions to human knowledge, commerce, security, and collective well-being. From this perspective, shrinking government as an end unto itself is not just problematic. It is antithetical to nurturing wonders of the world.


J G-W said...

I was just having a conversation with a friend at work about this...

Last fall I had a physical -- which is supposed to be 100% covered under my work-sponsored health-care plan. But now the insurer has set up this ridiculously arcane and complicated coding system for every single procedure that takes place in a routine physical, and they will only cover certain procedures. So now they refuse to pay for a portion of the physical, and I've had to waste hours in a ridiculous appeal to get them to cover what has always been 100% covered as part of my routine annual physical. Same basic, routine procedures (urinalysis, blood tests, etc.), but now they don't want to cover it any more.

Here I am, early April, and they still have not resolved this issue from a physical I had last November.

I'm totally underwhelmed by how cost effective and efficient, quick and responsive the health care system is in the private sector.

Knight of Nothing said...

I have the same problem: the physical is covered (i.e., the nurse measures my height, weight, BP, and pulse, then the doctor listens to my heart and lungs and has me drop trou, turn my head and cough). Five minutes of your doctor's time once a year, free! What a concept. The lab work (in other words, the substantial data that they collect from your blood and urine) is not covered. It's an absurd system.

J G-W said...

UGH. Yeah, that's what they're trying to pull on me.

Though I went to our HR person and said, "What gives? Physicals are supposed to be 100% covered?" She agreed, and so did our health insurance broker, and that's why I'm appealing it.

I'll be curious to see what ultimately happens to the appeal. If I win, then I will have to chalk it up to a shameless attempt to make the insuree pay for stuff just through harassment.

Regardless, I'm going to have to say that insurance-company-run healthcare makes me want to puke.