if you see sid, ask him if he wants to buy the postal system too
The front two pages of The Observer’s Business section Sunday featured one story after another dealing with the dysfunction and failure of privatized industries in Britain. It’s become very clear that the privatization of public services – services that in many cases shouldn’t or even can’t turn a profit – only works, in so far as it works, during periods overflowing with finance capital looking for a home. Then again, just about anything can be made to work during a period like that one, but now that cash is in short supply, take a look at where we are:
Perhaps as a minimal claim, right now, we might start demanding that industries that never had any business being privatized – in fact, simply couldn’t be effectively privatized and remain both solvent and accessable – might be returned to their natural states. And further, we might ask that our leftish public intellectuals stop mooning about as if they don’t understand the way the game works.
We could start with Paul Krugman. I can’t for a second understand his (guarded) optimism about the following:
Six major industry players — including America’s Health Insurance Plans (AHIP), a descendant of the lobbying group that spawned Harry and Louise — have sent a letter to President Obama sketching out a plan to control health care costs. What’s more, the letter implicitly endorses much of what administration officials have been saying about health economics.
Are there reasons to be suspicious about this gift? You bet — and I’ll get to that in a bit. But first things first: on the face of it, this is tremendously good news.
The signatories of the letter say that they’re developing proposals to help the administration achieve its goal of shaving 1.5 percentage points off the growth rate of health care spending. That may not sound like much, but it’s actually huge: achieving that goal would save $2 trillion over the next decade.
How are costs to be contained? There are few details, but the industry has clearly been reading Peter Orszag, the budget director.
In his previous job, as the director of the Congressional Budget Office, Mr. Orszag argued that America spends far too much on some types of health care with little or no medical benefit, even as it spends too little on other types of care, like prevention and treatment of chronic conditions. Putting these together, he concluded that “substantial opportunities exist to reduce costs without harming health over all.”
Sure enough, the health industry letter talks of “reducing over-use and under-use of health care by aligning quality and efficiency incentives.” It also picks up a related favorite Orszag theme, calling for “adherence to evidence-based best practices and therapies.” All in all, it’s just what the doctor, er, budget director ordered.
So let’s see. A lobbying / PR organization that represents the health insurance companies circulates a communique saying that they’re on board with the idea of slashing health care costs by rationing access to “some types of health care with little or no medical benefit”, hmmm… After all, you know what Keynes said about this, about what happens in the long run…. Why, exactly, does this excite Krugman? He should read this thing that I know I’ve posted before, from Heart of Darkness. It’s a bit misogynistic – you have to take my word that the misogyny doubles back on Marlow by the end of the book….
“One thing more remained to do — say good-bye to my excellent aunt. I found her triumphant. I had a cup of tea — the last decent cup of tea for many days — and in a room that most soothingly looked just as you would expect a lady’s drawing-room to look, we had a long quiet chat by the fireside. In the course of these confidences it became quite plain to me I had been represented to the wife of the high dignitary, and goodness knows to how many more people besides, as an exceptional and gifted creature — a piece of good fortune for the Company — a man you don’t get hold of every day. Good heavens! and I was going to take charge of a two-penny-half-penny river-steamboat with a penny whistle attached! It appeared, however, I was also one of the Workers, with a capital — you know. Something like an emissary of light, something like a lower sort of apostle. There had been a lot of such rot let loose in print and talk just about that time, and the excellent woman, living right in the rush of all that humbug, got carried off her feet. She talked about ‘weaning those ignorant millions from their horrid ways,’ till, upon my word, she made me quite uncomfortable. I ventured to hint that the Company was run for profit.
“‘You forget, dear Charlie, that the labourer is worthy of his hire,’ she said, brightly. It’s queer how out of touch with truth women are. They live in a world of their own, and there has never been anything like it, and never can be. It is too beautiful altogether, and if they were to set it up it would go to pieces before the first sunset. Some confounded fact we men have been living contentedly with ever since the day of creation would start up and knock the whole thing over.