So it turns out I have really bad eyes. Staggeringly bad. I see double. I’m far-sighted. I’ve worn bifocals since I was six; I have virtually no depth perception. Basically, while each of my eyes works pretty well on its own, they don’t work well together. Which, it turns out, is a problem. I have had an optometrist tell me my eyes are “interesting” all while explaining that I’ve “done really well for someone with eyes like mine.”
As it happens, my optometrist was right: whatever the state of my eyes I have done pretty well. I am economically productive and professionally successful. I have written or co-written six books and numerous articles and book chapters. (Number seven will be out this summer.) This blog is about to pass its 10,000th follower. I have managed to travel around much of the world, at least reaching Melbourne and Istanbul. My family is healthy and happy … most of the time.
Several things have combined to make all this possible. I worked hard, for example. I made good choices. I deserve some of the credit, and no doubt some of the blame, for how my life turned out.
But only some of it. After all, hard work is hardly the whole story of my life’s successes. I am, for example, the beneficiary of 20th and 21st century medical science. No optometry, no ridiculous prescription glasses. No glasses, no life—at least not a life even close to the one I have built for myself.
And hard work and glasses wouldn’t have done it barring an additional factor: I won the life lottery. What I mean by this is that my parents were themselves glasses wearers and were sensitive to the importance of glasses in their own lives. More, they were middle class and thus capable of buying me glasses as my prescription changed and I grew.
I have often thought just how different my life would be without all three of these forces coming together. More particularly, I have thought: “what if my parents had not been able to afford new glasses for me when I needed them? what if they simply hadn’t thought it important? how different would my life be, since it is a life entirely dependent on glasses?”
In other words, what if I hadn’t won the life lottery?
Thinking about this question is evocative of what the philosopher John Rawls referred to as the “veil of ignorance” when thinking about things like social welfare programs. He asked us to imagine that we were designing a future social order … but that we were designing it without any knowledge of what our place would be within that future order. In other words, we would not know if we would be well off or bad off. What kind of society would we create then?
Obviously, we can’t start a new society tabula rosa. It’s not at all clear we should. But I have to believe that there are lots of people out there whose lives might have been more productive and expansive than they currently are had they simply done better in the life lottery—had they simply had better access to things like eyeglasses than they ultimately had.
In the end, this is why I support the basics of the social welfare state. It is absurd to decide as a matter of state policy that one’s opportunities in life ought to be limited simply because one’s ability to access basic healthcare is constrained by the limitations of economic class. We are, as a practical matter, telling poorer versions of, well, me, that we as a society have decided not to support their success because it might cost us a little bit of money.
Of course, I can already hear a conservative counter-reaction. In the background I hear the cries, “just who will pay for the glasses?,” and, “it’s the family’s responsibility!”
That the family ought to be responsible is a point easily dismissed: some can’t afford to, and some don’t want to. So that cry is little more than noise. As for the “who will pay?” question, let me remind you of the notion of economic investment: pay today to gain tomorrow. Or, to do it in the form of a thought experiment: which scenario is likely to generate more success (and more income) for a society? A half-blind person who has skills but can’t develop them because he or she can barely see? Or a person who can see who can develop their skills and talents across an array of social and economic arenas?
I just can’t get over the sense that there are other people out there who have eyes as “interesting” as mine, but whose parents couldn’t or wouldn’t get them the eyecare (or other basic care) they needed. So society should—for its own sake.
Welfare: 2. aid in the form of money or necessities for those in need. (Merriam-Webster online dictionary.)
What most people don’t understand about the federal budget is that it is mostly a shell game. The federal government collects taxes from various sources and then redistributes them across the United States, mostly in one of five ways: to individuals in the form of Social Security benefits; to individuals in the form of Medicare benefits; to individuals in the form of Medicaid benefits; to investors in the form of payments on the national debt; and to investors, corporations and employees (both civilian and military) of the defense industry/department. For the last two years it has spent huge amounts of money supporting investors at various banks, but that is both new and hopefully temporary. Long term, at least since the Great Society of the 1960s, SS, Medicare, Medicaid, interest and Defense have taken the lion’s share of the federal budget.
This pattern has led to some significant distortions in how taxes are distributed across the United States. In general, citizens in those states with lots of: 1) old people (SS and Medicare); 2) military bases and industries; and 3) poor people (Medicaid and other welfare services) end up getting more tax disbursements per person than they send to Washington, DC. They live in net receiver states. By contrast, citizens of states that are better off, lack a significant military presence, and do not have a large aged population end up paying more in taxes per person than they receive. They live in net contributor states.
Which states tend to have lots of poor people, lots of military bases, and lots of old people? (Not to mention lots of farms, which also see significant subsidy in the federal shell game?) Well, you know the answer to that: rural, generally “conservative” ones—like Alaska, South Carolina, Arizona, Florida, Texas, etc. Meanwhile, Democratic-leaning states like Illinois, Massachusetts, California, Michigan and Minnesota get substantially less return for their federal tax dollar than do “conservative” ones.
The simple fact is that the economy in states like Alaska, Arizona, Florida and South Carolina would collapse if the federal government were to stop the taxation shell game and stop subsidizing people who live in those states. Yet, it is clear that the tea party movement tends to be extremely strong in those states. (Texas, as it happens, is an exception since it has a much stronger economy less dependent on federal largess.)
Much of the tea party movement is biting the hand that feeds it. Of course, if people didn’t do that pretty often, no one would have invented the cliche!
Social policies are inevitably controversial: someone’s money is taken away in the form of taxes in order to support someone or some group achieve some good or service they could not otherwise afford or enjoy. Yet Americans seem to be remarkably two-faced in their reactions to such wealth redistributions: programs like Social Security and Medicare enjoy broad support, while welfare and now health care are much more controversial.
This difference is actually fairly easy to explain when you ignore the fact that all four are redistributive government policies, and so fundamentally the same, and instead focus on the notion of deservingness. The logic is fairly straightforward: Americans are willing, even happy, to pay taxes for programs that benefit people and groups who Americans consider “deserving,” and are hostile to programs aimed at the “undeserving.”
So who “deserves” support? The aged, of course—almost 50% of the federal budget is an income transfer scheme from working people to retired persons. (Note that while it is true that retired people have paid benefits to these programs while they worked, inflation, expansion of the rate of benefits, and increasing life spans means retired people almost always draw much more from the Social Security and Medicare systems than they paid in.) Police, fire, military people are generally seen to have earned their benefits—some of which, like retirement at full pay after 20 years, are staggeringly generous. We in the middle class think we deserve our subsidies in the form of public roads, and tax write offs of our mortgages, and (to a decreasing extent) “free” public education for us and our children. We have all “earned” this, and generally think such transfers are perfectly okay.
Who doesn’t deserve support? Those we consider lazy, or abusive of their privileges. Most Americans believe people are poor because they are lazy; as a consequence, welfare programs are seen as subsidizing inactivity. Likewise, poor people are often thought of as drug-users/dealers, and of course the image of the so-called “welfare queen having babies for the government” has been burned into our national consciousness. No money ought to go to such people since they will waste or abuse it. They are undeserving. (And while I don’t think race is the only variable the determines this judgment of unworthiness, to the degree that poverty, crime and other social pathologies are disproportionately (and unfairly) linked to African Americans, it certainly plays a role. Racial/ethnic differences make it easier to categorize someone as “other” and “undeserving.”)
It is also interesting to see cultural opinions of faculty and teachers through this deserving/undeserving frame, although the consequences are much less severe for those of us in the middle class. Many in society want to laud teachers, especially those working in tough schools, but every time a problem emerges, we hear instantly that tenure protects bad teachers, and thus that teachers are the problem. Faculty, of course, are a whole other order of undeserving, since we apparently don’t work for a living and just figure out ways to corrupt the youth of America in our ivory towers, etc. (Let me just say that if I had the power to reach my students that profoundly, I would think of something more interesting to do with it than corrupting America.)
The deserving/undeserving frame can explain a lot that goes on in American politics. One reason that college is getting so expensive is that states have decided college students don’t deserve the subsidies their parents got: students will (hopefully) earn more money in the long run with a college degree than they would with only a high school diploma, so they should pay for it themselves. There’s no need to deal with environmental problems because they happen “somewhere else”; and besides, if you don’t want to live in a trailer park on top of an old landfill (or downstream from one), get a job. Why should I bail out homeowners who took too big a mortgage and tried to use their houses as credit cards? (That one pisses me off a lot, although I get the argument.) And, of course, why should my taxes go up to pay for your health care when 1) you don’t have a job, and 2) are probably drinking/drugging/obese? You haven’t earned it. I have.
So Americans don’t mind social programs. They’ll even pay for benefits for police officers and fire fighters and military personnel most will never possibly enjoy for themselves. We think they’ve earned it. But if you haven’t, the American point of view is very clear: I earned what’s mine. Screw you.
Well, now that the United States has (sort of) entered the world of other industrial democracies and (sort of) created health care for (most) people in America, I thought I’d wade in a bit to address how we came to be here. Why is the US the only advanced industrial democracy that lacks nationalized medicine in at least some form or another?
Answering this question requires a foray into labor history. In the later nineteenth century, labor unrest spread and became violent across the industrialized world—even in the United States. Work conditions were brutal, with 6 and 7 day work weeks and 12 hour work days the norm. Child labor was endemic, and safety standards were nonexistent. People were literally being crushed by the industrial machine, with no safety net to care for them once they were broken.
This is exactly what Marx predicted would happen as rapacious capitalists sought to maximize their profits in a context of relentless competition. Marx thought the demands of competition would make it impossible for capitalists to compromise; they would inevitably drive most everyone into the extreme poverty that would make the communist revolution inevitable.
At which point capitalists proved Marx wrong. As the industrial states developed global empires they were able to extract such wealth from their holdings overseas that they could use a tiny portion of these riches to buy off their domestic working classes. Capitalists accepted lower absolute profits in exchange for labor quiescence they bought in the form of workman’s compensation laws, and child labor laws, and 5 day work weeks, and 40 hour work weeks, and much, much more. (Meanwhile, as Lenin recognized, the real brutality was transferred to the imperial periphery—but the capitalists didn’t live in the periphery. Revolutions there didn’t end with capitalists hanging in the streets in London.)
For legal, cultural, social, economic and political reasons these changes hit Europe first and trickled into the US later. That pattern is pretty much the way things worked with the welfare state: Europe first, and the US only later and less thoroughly.
National health care began to emerge in Europe relatively late in the process of developing the welfare state—meaning that it would arrive in the US, if it arrived at all, much later. Finally, after WWII, only government could provide health care in Europe’s devastated nations. Hence they all developed national health care systems of some kind or another.
Health care took a radically different turn in the US when WWII hit. Labor became scarce as otherwise employable men were drafted and as the American industrial juggernaut grew to meet the demands of war production. However, wages were controlled to prevent inflation. So companies competed on the basis of benefits, including health care.
Thus it was in WWII that the notion that one ought to get one’s health care from one’s employer became the norm in the US. After the war, companies continued to compete for labor and continued to offer increasingly generous health care benefits. Lucky employees ended up in places that had good benefits; everyone else tried to get one of those jobs. Those who got left out suffered in the gaps.
Our economy is no longer booming, of course, and health care costs are spiraling out of control. Companies are shedding health care programs along with labor. I have no idea if this bill will overcome any of these problems, or provide real benefits to millions of people. I am not a health care expert, and I very much doubt that you are, either. But the notion that one ought to get one’s health care benefits from one’s employer is an accident, not the result of a well thought out strategy that somehow or another magically conforms to the ideals of the framers—none of whom, of course, knew anything about health care benefits, or the Industrial Revolution, or the Internet.
Welfare was created by capitalists to protect capitalism. Health support was a part of the system by which capitalists competed for labor and bought a quiescent workforce. There is a backlash against welfare today—some of which makes a great deal of sense. But there are real risks in eliminating it entirely. Which, if the tea partiers turn out to get what they want, we may very well learn. Again.