A Recipe for Consumption (The Blog is Back!)

The Republican talking points on our nation’s economic woes have been bothering me for some time now, and the effect that their policies have had on my family and on many whom I know has moved me to reactivate this blog and to write about what is wrong in that rhetoric.

If you listen to the Republican politicians and punditry, they will tell you that there is such high unemployment in our current economic climate because the United States has too high a level of debt causing businesses – they frequently cite small businesses – to be uncertain of their future tax burden and, thus, hoard their wealth rather than spend it on new hires.  Without doubt the debt of the United States is too high and, I would concede, there are surely firms and corporations who are worried about a potential future tax burden when they make their decisions on hiring and firing.  The vast majority of businesses, however, have no time to worry about a potential future tax burden because they are much too fearful of their current economic situation because they see their customer bases and clientele shrinking.

This is why the Republican recipe for the future that opposes increased revenue flows and favors government spending cuts is not only stupid, but utterly damning to the very business interests that they claim to be supporting.  Yes, small businesses (especially the very small ones) are amongst the biggest victims of Republican policies along with, of course, the unemployed and their families.

My parents’ business – which, it makes me proud to say, has done its best to keep its employees employed to the detriment of my parents’ income – is an example of just the type of business that is most harmed by the Republican response to our hard economic times.  Despite maintaining the same level of quality in both their many dishes (it is an Italian restaurant that makes my favorite food in the world) and customer service, the restaurant has seen is fortunes continuously decline since the crisis began.

And the responses of the Republicans who have held power in my home state of Florida for far too long now have only exacerbated the problems they’ve faced.

Each round of government cuts – with some the most horrifying coming from the states, though the numbers are hardly as egregious as those coming out of Washington – causes for a loss of government jobs.  When politicians cut spending levels, they are not miraculously making the bills go down simply by ceasing the printing of certain manuals or decreasing the number of “unnecessary” personal working in the EPA; they are sending people from their desks or workstations and into the unemployment line. 

The community in Florida that I am from and my parents’ business has been a part of for more than two decades is the northeast region of Volusia County, which has consistently had an unemployment rate higher than that of the national average – it is currently at 10.9% – since the beginning of the crisis.  Volusia County has little industry, and largely subsists on the many members of the region’s service industry – it’s an area whose economic fortunes are rooted in tourism – patronizing (the polite kind) each other.  One type of outside money coming in to Volusia County, however, is the state’s funding of education.  Unfortunately, the cuts of the Conservative legislature and governor have sent teachers from their classrooms and retarded the progress of an already underfunded education system.

Each person newly out of the job is now substantially less likely to be a consumer of the same products or a customer of the same businesses that they were when they had a job; this is simple common sense, as they cannot enjoy the same things without the same income.  With fewer consumers, small businesses that depend on local clientele become more and more cash-strapped, causing the owners to have to make the difficult decision of decreasing their own income or decreasing their biggest expenses: their employees.  Either way, we still get fewer consumers in the broader economy of a small area like this, because those employees who were fired have no income and those bosses who chose to lower their own income, like my parents, now have less disposable income to be patrons of their fellow businesses.

Talk to any small business owner why they aren’t expanding their enterprise or hiring new employees, and the honest ones (read: those not parroting the Chamber of Commerce talking points) will not tell you the that either the massive government debt or the “threat” of looming regulations scares them, but rather that their lack of customers has them scrambling just to make ends meet for their businesses and their families.  The problem we our nation currently faces is a deficit of consumption.

This is why the Republican “plans” to create jobs will not only not work, but cause our economy to further decline.  Every effort that the Republican members in Congress have made has included an attempt to decrease the debt or deficits, meaning that every plan to “create” jobs actually eliminates Federal (or Federal contractor) jobs in the process.  While the looming debt is a problem for our country, it is not the proper time to address it; even the President’s deficit commission mentioned this.  For now we should focus on creating an appetite for consumption in our economy.

Ideally this would be done by the biggest corporations using the vast wealth they’re sitting on to build new factories or offices, hiring people to build them and run them, but three years into our crisis it is apparent that the corporate “persons” do, indeed, lack the humanity necessary to expand when they’ve increased the productivity of those employees they haven’t laid off.  Since we cannot look to private wealth for the boost we need, we should focus on building a path towards future economic fortunes in ways that boost consumption right now.  I’m talking about building new bridges and renewing old highways, expanding aged airports and laying the tracks to a faster rail system, and, above all else, affirming our commitment to educational excellence by introducing new innovations to the classroom.

All these things would not only get people back to work today, but they would lay a foundation for prosperity in the future.  The influx of new money would whet the appetite of consumers in communities all across the nation, allowing small businesses relief from the consumer crunch.

In Volusia County, Florida, this would mean that construction workers who haven’t had a job since the housing bubble burst would get to go back to work building roads and schools.  In Volusia County, this would mean would be looking over the long lines on the tests of their students, rather than the meager lines of job offerings in the community.  And, when they get hungry, they could go to my parents’ restaurant for a slice of the best pizza outside of the Five Burroughs.

 

Author’s note – Yes, I am aware of my bias concerning my parents’ restaurant, but I’m okay with that.

The Country That We Shall Become.

“This is really not a debate about prices, coverage, or choosing doctors, this is ultimately about what kind of country we are going to be in the 21st century.”  Those words were spoken on Sunday, March 22, 2010, by Republican Representative Paul Ryan of Wisconsin’s 1st Congressional District.  Truer words were not spoken in climactic final hours of the healthcare debate that took place on that unprecedented Sunday session of the House of Representatives.  The 219-vote passage of the Senate Healthcare Reform Bill – and the 220-vote passage of the Reconciliation bill – was indeed a statement on what kind of country we are going to become in this new millennium.  It would seem that with this narrow majority of 51% of House members, the debate’s central question was answered; it would seem that the United States, in the 21st century would finally be taking steps towards joining the rest of the civilized world in the guarantee of healthcare to all citizens.  This was not a victory of Democrats over Republicans, despite the highly partisan vote that saw the minority party as being unanimous in its opposition; this was a victory of progress over a failed status quo.

Let’s get one thing straight right off the bat, however: this is not really a healthcare reform bill; this is a healthcare insurance reform bill. In fact, in terms of truly reforming the healthcare system in the United States – which costs the most money in the civilized world, but regularly produces the worst results in the civilized world – this bill falls rather remarkably short.  This is not the government takeover of medicine that some have claimed it is, much to my chagrin.  Instead, this bill is one that ensures that 95% of Americans under the age of 65 (as seniors already have Medicare) will have access to health insurance.  Gone are the days where an insurance company could turn you away because of a preexisting condition, forcing you to pay for all of your expensive coverage and driving you towards bankruptcy.  Gone are the days when actuaries of the insurance companies can find such preexisting conditions where none existed, just to get out of paying for the procedure you desperately need.  With more people having access to primary care through health insurance, fewer people should be placing a burden on the rest of society by over-utilizing the emergency room.  Indeed, there are several good aspects to this bill.

That being said, this bill, as I mentioned above, is far from perfect.  For a start, the mandate seems particularly unsavory.  I do not think that requiring coverage is, itself, a bad thing; as I mentioned above, with more people using primary care, the burden on emergency rooms will lessen and the cost that is currently passed onto society will diminish.  My problem with the mandate is that we are requiring the purchase of a good, without offering a government option in case we do not want to continue the patronage of the insurance companies.  Surely, this bill includes subsidies for those who will need the most help in buying insurance and also increases access to Medicaid for the particularly destitute, but the lack of a public option to further drive prices of insurance down is a sorely missed idea.  Without the public option, we cannot be sure that the prices of insurance plans will not, in fact, go up.  The state-based exchanges wherein insurance companies basically compete for the business of the state’s citizens should drive the cost down, but I am skeptical.

Ultimately, my biggest disappointment with this bill is that it is not what we truly need: comprehensive healthcare reform.  The healthcare system in the United States will continue to be dominated by insurance companies.  This system of risk management rather than true healthcare is both troublesome and hard to rid ourselves of.  Every other nation in the industrialized Western world has established a system of universal healthcare wherein the government takes a leading role in controlling costs and properly compensating doctors – including fully paying for medical school for those who want to do the work of healing.  Medicare for all should have been our battle cry, though I’m sure that’s a fight we would have lost.

We would have lost that battle because it is true that Americans are seemingly not ready for such a government takeover.  The thought has pervaded society that everything the government touches becomes ineffective.  This thought reigns despite the obvious success displayed by the military, the post office, the interstate highway system, intra-city mass transit systems (Washington’s is one of the best), the electric infrastructure system, clean water monitoring, waste management services, the criminal justice system, and the national park system.  It was a Republican president – the greatest American President – who reminded our country that our system of government was of the people, by the people, and for the people; but it is his successors who have so successfully turned the people against themselves.

That being said, the passage of the HR 3590, the Patient Protection and Affordable Care Act, by both houses of Congress is a momentous step forward for America as a society.  The bill’s passage has shown the American people that progress can be made by our great nation.  Its passage has indeed shown us what kind of country America shall be into this new century, just as Representative Ryan said it would, and it would seem the United States will be a country of progress and hope, to move us ever closer towards being that perfect city on a hill.

My Stance on Healthcare

Here in the United States, the wealthiest nation on Earth, there reside somewhere around 45 million uninsured people. Regardless of whether or not that includes a healthy number of persons here illegally – as our broken immigration system is a subject for another talk – that number must be staggering to anyone. To put it in some sort of perspective, that number is roughly equal to the combined populations of Massachusetts, New York, New Jersey, and Pennsylvania. Though that number is surely staggering enough, to properly show the extent of just how broken our health care system is we must add to that number the number of people who are underinsured – those who have health care coverage with insufficient funds to pay for the gaps in their insurance or simply pay too much of their annual income in health insurance coverage. The number of uninsured is estimated to be as high as 25 million, or roughly the population of Texas. Thus, all said, there are somewhere around 70 million residents in the United States of America who are either uninsured or underinsured.

To put it another way, there are 70 million Americans who may go bankrupt just trying to recover from a serious illness. There are 70 million Americans who, in these trying financial times, may have to make the choice between eating and getting stitches. There are 70 million Americans who must go to sleep every night and pray with all their heart and soul that no one they love falls ill the next day. As a country with impeccable moral traditions and deeply held values of cohesion, we are failing our moral imperative by allowing such a travesty to take place on our shores.

I am writing today because I have become utterly disappointed in the remarkably low level of debate in the country on this issue. Not only are Americans shouting down those who would seek to talk to us (or shouting and using indecorous theatrics to undermine the President of the United States while he tries to address a joint session of Congress), but some of our esteemed citizenry are completely deaf to reason. That is not to say that those who disagree with the details that proponents of healthcare reform, such as myself, espouse are inherently unreasonable. Rather my feeling is that even though we may try to sit calmly down with others at a table to try to discuss this most pressing issue as equals, we find that swaths of the American populace have simply stuffed their fingers in their ears while humming loudly to themselves. The purpose of my writing is not to merely point partisan fingers at petty obstructions, however, but rather to try to address any willing to listen as an equal.

So what’s wrong?

To begin, there are a few very important numbers to talk about, specifically those numbers are: 8.2, 10.6, 11, 10, and 15.2. Anyone who is familiar with the healthcare debate probably already knows these numbers, for they are the percentage of Gross Domestic Product (GDP) – or the amount of money made in a given country in a single year – spent on healthcare in the countries of Great Britain, Germany, France, Canada, and the United States, correspondingly. As you can clearly see, we in the United States spend almost 1.4 times as much as the next highest industrialized nation on that list. The difference in healthcare coverage, you may ask? We have 45 million uninsured in our country, and each of the aforementioned other industrialized nations have none.

Perhaps that is attributable to the fact that our population is much larger than any of those nations. This is a rather credible objection to my statement. However, the facts are not there to support such an assertion, as the number of dollars spent per person on healthcare costs in each of these five countries is equally as disturbing for us Americans. In keeping with the previously established order; Great Britain spends $3 332 per Brit, Germany spends $3 718 per German citizen, France spends $3 420 per Frenchman, Canada spends $3 917 per Canadian, and the United States spends $6 719 per American citizen on healthcare. The disparity should certainly be eye-popping, though admittedly it would be less so if we truly had “the best healthcare system in the world” as we have been hearing from that other Party so often lately.

Unfortunately, the statistics still do not follow that seemingly logical line of reasoning. While our little boys and girls can expect to live an average life of 76 and 81 years, respectively, from birth, those other four industrialized nations I continue to point to for comparison yet again have us beaten. In Great Britain and Germany, baby boys can expect to live for 77 years from birth, while baby girls see an average of 82 years. French boys can also expect to survive 77 years, but French girls see an average of 84 birthdays. Canadian men live the longest of this group, with an average of 78 birthdays before they are buried, while their women live for 83 years.

Another common indicator of healthcare is the nation’s infant mortality rate – the number of infant deaths within a year of birth per 1 000 live births. Canada and Great Britain each see 5 unfortunate losses per 1 000 births; France loses 3 children to far too early deaths per 1 000 live births; Germany loses 4 of its youngest citizens within their first year per 1 000 youngsters born; but the United States, with its healthcare expenditures leading the industrialized world, sees 6 innocent youths lost to the world within a year of birth per 1 000 born. Thus in each of the three measures – male life expectancy, female life expectancy, and infant mortality – normally used to judge a nation’s healthcare prowess, we lag behind despite vastly outspending our Western brethren.

So what do we do?

Perhaps you can, in fact, recognize the dire situation that our healthcare system is in; we spend far too much money on healthcare with, ultimately, subpar results. Yet you find yourself suspicious of what government involvement may do to your level of choice in terms of physicians. Surely these countries that spend less than we do on healthcare cannot attract near as many physicians per capita as we, here in the United States, can with our high expenditures. Again, however, reality fails to follow such seemingly sound logic. With our remarkably high expenditures on healthcare, both in terms of percentage of GDP and dollars per person, we have somewhere in the neighborhood of 26 physicians per 100 000 American citizens. France and Germany, which I reiterate have far lower healthcare expenditures, each have 34 physicians per 100 000 citizens. To be fair, both Great Britain and Canada lag behind the United States with 23 and 19 physicians per 100 000 people, respectively. I feel compelled to ask, however, if the 7 extra doctors are worth us paying 1.5 times as much of our GDP in healthcare than Canada does.

What this does illustrate vividly though, at least in my mind, is that there is hardly a noticeable effect on choice of physician when one looks at nations wherein there is a national healthcare system that ensures that all the citizens of the country have some amount of healthcare coverage. In fact, it may even mean there are more physicians to choose from, such as is the case in France and Germany. Thus the fears that some Americans have about choice of healthcare, which I submit are among the most deeply held in this debate as we are remarkably weary (and rightfully so) of any infringements on our freedom of choice in this country, are unfounded.

None of this, however, changes the fact that we American citizens are the bosses in our government. Our voices, heard through our votes or our shouting, are truly what make policy here in this country and that is precisely how a democracy should be. The problem is that here in America we are naturally frightened of significant government expansion (which I truly believe is one of our most distinguishing qualities, for it boils down to our strongly held belief in freedom) until after the government has put into place the programs responsible for the expansion and they prove to be benevolent, not malignant.

That being said, we cannot allow our fear of government expansion to hinder our society’s progress towards a better tomorrow. Thus, I would offer to the American people a compromise. My compromise would not come in the form of Senator Max Baucus’s plan for a bipartisan reform bill – which, I feel compelled to add, has garnered very little of the support it was aimed at attracting – but rather a compromise in the form of a timeline for approval. While my preferred plan would be in the form of a national healthcare system in which each American has coverage under some form of insurance similar to Medicare with the option of buying supplemental insurance from private companies to fill in any perceived gaps (though my ideal policy would have none), I can understand that such a dramatic leap would be far too radical a change for the American system of healthcare to gracefully adjust.

Therefore, I would propose a system very similar to President Obama’s plan, though with a much stronger public option on tap for Americans to choose to join. This piece of policy would bear a 10 year renewal date, so that the American people can truly get a sense of how the policy works and if it is too intrusive for their comfort levels. The 10 year period of time would be a trial period for the American people to try out a national healthcare system. When the renewal date would come up, it would be the duty of the American people to ensure their voices are heard in the election prior to the date so that our representatives in our government would know whether to continue the program as it is, scrap the program, or perhaps even to expand the program to a model closer in likeness to the one I envision as ideal.

Such a solution is not only sensible when one considers the hesitance with which we Americans approach government involvement in our lives, but it also treats voters as adult and forces those with strong feelings to exercise their civic privilege of voting. This is not a notion of Democrats or Republicans, but merely allowing the driving force of democracy – the people – truly have an educated voice when trying to decide on policy, for how are we to know if a system works for us until we try?

This problem extends far beyond partisan bickering, yet there are those who would use this issue as a wedge to drive voters against our nation’s President. A defeat on healthcare reform, they said, would be President Obama’s Waterloo. Their belief is that such a failure would destroy his presidency and his Party’s chance at winning the next election. Such games are remarkably dangerous to play. In times so uncertain as these, so dangerous a game ought not to be tolerated by the American people, and yet the misinformation and fired up passions are still winning the day. We should, all of us Americans, realize that a failure to reform will not just ruin a presidency or score a partisan victory.

Failure on healthcare reform will not be just President Obama’s Waterloo, but the Waterloo of the American people.