05 October 2013

Encapsulated in DC, the modern world

One of GK Chesterton’s best-known quotes goes thus: ‘The whole modern world has divided itself into Conservatives and Progressives. The business of Progressives is to go on making mistakes. The business of Conservatives is to prevent mistakes from being corrected.’ It is among his best-known simply because it is one of the best-evidenced. And nowhere is that evidence prevailing more than in Washington, DC.

The Affordable Health Care Act is a manifestly bad law. It’s an utterly convoluted, technocratic mess whose benefits are not readily visible even to those it purports to cover. It lacks the sort of public insurance option (something like Britain’s NHS) which could have helped most to ensure competitive costs – and the evasion by the Administration that the political capital to pass such an option didn’t exist doesn’t pass the smell test, because the Administration expended exactly zero effort to build it.

But more distressingly, it is little more than a bandage designed to hold together a centralised rentier system, and deepens the collusion between insurance companies, service providers and big pharma in ways which, even though they may cut costs for care in the short-term, will nonetheless fail to control them in the long run. In essence, it is a taxpayer-supported direct subsidy to private insurance companies, who will continue to leverage their status under the law to derive profit. The insurance companies depend upon a base of customers who share costs, and the AHCA essentially assured them a much broader base than they already had. This, in turn, opens up a far broader consumer base for the large pharmaceutical corporations which already do multi-billion dollar business in the United States alone. There is no reason to believe this is a bug rather than a feature.

A law which could break the stranglehold of big pharma and big health insurance over our current health system on the one hand, and ensure protections for local options for direct service provision (a guild system for doctors, perhaps) on the other hand, would have gone a long way in the right direction. This wouldn’t entirely solve the intractable problems of the sort of tremendous medical school debt which drives doctors into the arms of big pharma in the first place, however, or our broken patent system with its insane absolutism regarding intellectual property, which keeps generics from becoming widely available. The American health system is something of a Gordian knot that way, and a comprehensive fix will have to involve a sea-change in the culture such that more focus is placed on preventative care and direct community involvement. And for that to happen, costs have to go down first, which requires a change in the culture towards care… and so on, ad nauseam. But there are good fixes and bad fixes, and the AHCA cannot be said to fall into the first category.

All of the above being said, though…

Shutting down the government over a refusal to fund the bill is simply not the proper response. Not only is it infantile. Not only does it demonstrate to the public a dearth of ideas on the part of the GOP. But it encourages the perception – and therefore influences the reality, in that curiously cable television- and Twitter-influenced postmodern way that ‘seeing is believing’, and therefore ‘being is but being seen’ – that American partisan politics is an existential zero-sum game. What’s more, it is seen to be an existential zero-sum game between institutionalised caricatures of what Americans actually believe and want. The only reason the GOP thought that they could get away with this sort of thing was because they were given the impression that it would win them votes.

And while good people – as many as eight hundred thousand of them, including members of the military – who do honest and productive work in the public sector (yes; such a thing does exist, as do the people who do it) are being furloughed, the same people responsible for this entire mess are still drawing their six-figure paychecks.

A slightly less well-known quote by GK Chesterton – but one which, if this sort of nonsense continues, is likely to become much better-known in the near future – is: ‘It is terrible to contemplate how few politicians are hanged.’

EDIT: Although, it appears I may have spoken too soon, and some clemency may be in order; the House has voted to give furloughed federal employees back pay. Still doesn’t excuse what brought about the need for it, though.


  1. Great post. This is the sort of thing that encourages people to give up on formal politics or become completely apathetic.

  2. Thanks, John!

    Yeah, I've been kind of sheltered from it on account of my being in China; but even from this distance it's managed to impress its holistic awfulness on me.