If my neighbor gets a new diamond ring, no ‘diamond-ness’ comes my way as a result.
If my friend gets a new car, I am not likely to get ‘car-ness’ as a result.
If a co-worker gets a new pair of shoes, I’m not going to get ’shoe-ness’ as a result.
But if my neighbor is sick, I’m quite likely exposed to ’sick-ness’ — even though I don’t want any of it!
Diamonds, cars, and shoes can be obtained in markets.
But when is the last time that you went to the store for ‘a quarter pound of sick’?
And when is the last time that you picked up ‘a pound of wellness’ at the local shops?
Commodities: Shoes, Cars, and Diamonds.
Certain ‘things’ can be exchanged in markets; we call them ‘commodities’.
With commodities, if you’d like one, you buy it.
If you don’t want a commodity, or if you cannot afford it, then you don’t have one.
However, if someone else has a commodity like a pair of shoes, or a car, or a diamond, their possession of that ‘thing’ does not transfer itself to you.
However, not everything that we currently sell in markets is actually a commodity.
Health care and wellness care are offered in ‘markets’, but that market system does not increase the ‘wellness’ of the population as a whole.
You can’t buy ‘a pound of well,’ and I can’t sell you ‘a gallon of sick’, because those two things are not commodities in the same way that a pair of shoes, or a car, or a diamond are commodities.
This basic confusion about what is — and is **not** — a commodity lies at the core of far too much of the Congressional ‘debate’ that I’ve watched on health care reform.
Senators on the conservative end of the spectrum don’t appear to have much ability to distinguish between things that ARE commodities, and things that ARE NOT commodities. They never seem to ask themselves: could ‘health’ be poured into a gallon container, or worn, or driven?
And if it can’t be worn, driven, or poured…well… then maybe ‘health care’ is actually NOT a commodity.
Why Conservatives Will Never, Ever Be Able to Deliver on Health Care Reform
Which raises a problem for conservatives: if ‘wellness’ is not a commodity, then a market system actually won’t be able to deliver it very well.
This puts the conservatives in the uncomfortable position of never, ever being able to deliver on promises for things that are **not** commodities. Like wellness care, or health care.
I find it perplexing that they can’t see the obvious, but I assume that their Free Market Fundamentalist ideology has blinded them to this basic fact: not everything lends itself to market activity.
Markets claim to produce ‘the greatest good for the greatest number’ and one could claim that this works for commodities.
Unfortunately, for things that are not commodities — things like health care — markets have the opposite effect: more people end up with less. (Which is another hint that whatever you’re dealing with is **not** a commodity.)
America’s conservatives assumed that health care was a commodity and that ‘The Market’ would distribute it at a fair price. The fact that their theories have **not** produced ‘the greatest good for the greatest number’ was a clue that the market does not work for health care.
Instead of calmly recognizing this fact, they seem to think that some variations of market finagling will do the trick. That a ‘better market’ is the correct solution to uninsured Americans.
It’s kind of embarrassing to see how badly their economic beliefs have turned out, but this is the kind of thinking that fails to distinguish between selling shoes, and creating a system in which everyone is more healthy because… everyone has access to wellness care.
The conservatives have forgotten the wise, kindly advice of Mr. Rogers, "One of these things is NOT like the others…"
Broken Promises and Market Failures
It might be funny to watch the conservatives repeatedly fail to deliver on their promises, if it hadn’t become so sad, and so expensive, for America.
It does not require any great spark of genius to recognize that although we can all pass around a ‘sickness’, no matter how hard we try, none of us can pass ‘shoe-ness’, nor ‘car-ness’, nor ‘diamond-ness’ to our friends and neighbors.
Markets are designed to produce profits.
But that does not mean they are good at providing better public health.
For better public health, you need something that is kind-sorta-marketish, closer to a utility. Like a public option, because you can’t buy health by the gallon, nor wear it around…
And that’s another problem the conservatives have: they think everything is EITHER/OR.
They incorrectly assume that if health care is not delivered in a ‘market’ then it must automatically be some kind of BigScaryGovernmentProgram.
Which is silly nonsense; just because you don’t buy health in a ‘market’ does not mean that the government has to provide it — the government can regulate non-profits, or other organizations to make sure they meet certain standards.
If the government can regulate weights and measures, fuel standards, and highway speeds, then it can regulate health care — without becoming the health care provider.
Governments can be good at setting standards, and making sure that organizations meet them.
Government could regulate health insurance and wellness programs, without actually providing those services.
The inability of conservatives to recognize very simple economic facts has become fascinating, in a morbid, spine-tingly, I-can’t-believe-they-actually-believe-this kind of way. Their confusion about the nature of something as simple as the difference between a commodity and a ‘public good’ (i.e., health care) reveals the power of their ideological blinders in a way that few other issues do.
Their confusion about the nature of things causes terrible mischief.
What self-respecting politician would look at the stark statistic of over 40,000,000 uninsured Americans without failing to question the Magnificence of Markets? Yet rather than blame the markets, they find all sorts of other reasons to explain this grim number.
Conservatives Offer Us More Shoeness, More Diamondness; We Just Get More Sickness From Their Bad Economic Beliefs
I sometimes wonder as I watch these ‘health care debates’ whether conservatives understand how confused they sound: don’t they realize that we’re tired of being offered ‘shoe-ness’ and ‘car-ness’ when what we need are solutions to millions of people grappling with sickness: financial, emotional, and physical?
Do they honestly believe that after economic disasters of the past decade, that we’ll believe their promises that we can have ‘shoeness’ and ‘carness’, and that monopolistic, anti-trust protected, profit driven giant corporations will ever — in a million years — be able to provide us all with more wellness…?
I doubt they realize how foolish they look to those millions of us who know perfectly well that just because we are able to buy a pair of shoes, or a car, does NOT mean that markets are the best way to deliver more American ‘wellness’.
Many activities that are critical for healthy lives are not best supplied by market activity; and until you can pick up ‘a gallon of wellness’ at your local store, health care will remain one of them.
If someone wears lovely shoes, I don’t get any shoe-ness from their wearing them.
But if they cough on me, I’m quite likely to get their illness.
That means the best way to maintain my own health is to be sure that all the people that I’m in contact with (or that my food is in contact with) are able to see a qualified medical care provider, and obtain medicines when needed. [I am not speaking here about exotic meds, nor chronic conditions -- I'm talking about reasonable public health.]
For-profit health care corporations are a way to make a few people very, very wealthy at the expense of an entire society.
For-profit health care is based on the assumption that buying health care is pretty much the same as buying shoes.
Which is pretty much the same as buying a car.
Which is pretty much the same as buying a diamond.
Questions for Conservatives, starting with Senators Grassley, Hatch, and Shelby
I would love to see Sen. Grassley, or Sen. Hatch, or Sen. Shelby, or any other Senators answer these questions:
"When, Senator Grassley, was the last time that my buying shoes put shoes on your feet, thereby providing you with ‘more shoe-ness’?
"When was the last time that you, Senator Shelby, got ‘more car-ness’ simply because I bought a new car?"
"When, Senator Hatch, was the last time that my new diamond ring provided you with ‘more diamondness’?"
And when, Senators Grassley, Hatch, and Shelby, was the last time that any of you picked up ‘a quarter pound of sick’ when you stopped by the store?
And when, Senators Grassley, Hatch, Shelby, did any of you find a quarter pound of ‘wellness’ at your local market?
And if you didn’t find any ‘wellness’ or ‘good health’ at the shops, if you were not able to find ‘a gallon of sickness’ at your store, then why on earth do you continue to assume that the rest of us believe outdated, ideological hornswoggle about ‘for profit’ corporations improving the overall health of the American population?
And for extra credit – do you ever ponder why so many people are being diagnosed with cancers? Do you think that there might be some relationship between your irresponsible cowardice on pollution legislation, and rising cancer rates in this nation?
When is the last time that Wellpoint, or UnitedHealth faced down a polluter on the grounds that they didn’t want to have to cover the medical costs of people poisoned by arsenic? or lead? or cadmium? or petrochemical pollutants?
The irresponsible nature of this health care ‘debate’ is appalling. The economic assumptions of the conservatives, long blinded by an economic ideology that leads to looting Public Goods (health care, forests, fisheries, clean water supplies…) will never deliver better health care for the American public.
Their mistaken belief that public health is a commodity lies at the core of their inability to deliver any reasonable, well-founded public services, nor protect America’s most precious resources and extraordinary wild lands.
Conservatives Can Never Deliver, Because They Don’t Understand The Essential Value of Public Goods
Public goods: fresh water, health forests, public health, have been ‘hard to price’, and as a result, they’ve been ignored or demeaned by conservatives.
This has made it possible for monopolistic, inefficient corporations to use their lobbying and political influence to capture, control, and constrain public goods.
And health care is an excellent example: UnitedHealth is unable to deal with Public Goods: it has not cleaned up one single river, nor one Superfund site, nor has it ever insisted on using its lobbying clout to address the problems of pollution and toxins that are the direct causes of many health problems today. It does not concern itself with improving the quality and value of Public Goods; it exists solely to create profits from the health problems of millions, while at the same time failing utterly to address improving the quality of the environment, working conditions, or communities for which they offer medical insurance.
At least starting with a public option, with everyone insured, would begin to start making pollution **everyone’s** problem, insist on more accurately pricing the costs of pollution, and help people realize that ‘health care’ means a whole lot more than offering up more profits to the Gods of Mammon on Wall Street, and enriching healthCo CEO’s.
A public option would lead to health care models that recognize your health and mine are connected; it would reduce your chances of getting sick from your neighbor’s cough.
You can still have yours shoes, cars, and diamonds.
But you’d be more likely to enjoy them in good health if you lived in a nation with a public option for health care.