Many politicians and pundits warned us that the health care reform (HCR) legislation that just became law will destroy America. Government bureaucrats will take over health care decisions, we were told. The old and infirm would be hauled away by death panels. Everything about the way we receive our medical care will change, and change drastically, they said.

Medicare recipients have been frightened by stories that their benefits will be cut. Middle-age people are worried they will lose their jobs when the law’s dreaded regulations, or taxes, or maybe regulations with taxes, would destroy their employers’ businesses.

The truth is, very little will change for most people. If you were insured by employee benefits before HCR, you will be insured by exactly the same policy in exactly the same way after HCR. You will have access to the same doctors on the same terms. “Government bureaucrats” will no more be involved in your health care than they were before.

And the same is true of Medicare, which of course is a government program, although many of the people who opposed the HCR bill don’t seem to know that.

Here are the “cataclysmic” changes to health care that are now in effect, or which will go into effect within the next six months for people who are already in group insurance plans:

• The law says you can’t lose your insurance coverage because you get sick. Before, in many states, if you were stricken with a severe illness such as mesothelioma cancer that would be expensive to treat, your insurer could use just about any excuse to cancel your coverage. That is over.

• HCR has ended lifetime limits on coverage. As long as you are receiving medical care, your insurer pays the bills.

• Your children can be covered on your existing policy until they are 26 years old.

• In six months, insurers cannot refuse to insure people under the age of 19 because of “pre-existing conditions.” This provision will go into effect for everyone in 2014.

And if you are on Medicare, you will be asked to struggle with the following:

• You get a free annual checkup.

• The co-pays and deductibles on many preventive care services are eliminated.

• If you are in the Medicare D “doughnut hole,” doughnut hole,” doughnut hole,” you will get a $250 rebate check in a few weeks. The hole itself will be closed gradually and will be gone by 2020.

But what about all those terrible regulations and taxes that are about to drive businesses out of business? Um, there really isn’t much to report. Oh, wait, here’s one — a 10 percent tax on indoor tanning services that use ultraviolet lamps will go into effect July 1. That’s about it.

However, beginning this year a tax credit will be available for some small businesses to help provide insurance coverage for employees.

Soon the politicians and pundits will start trying to frighten you about the provisions that will go into effect after this year. I assure you they are about as scary as the provisions that go into effect this year, but I will discuss them in a follow-up post.

— Barbara O’Brien

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These excerpts  are from a review in the LRB of David Knyaston’s Family Britain, the second installment of his social history of Britain in the post war period.  The article is exemplary: it takes the subject of the book under review in a critical though not unappreciative manner and expands the analysis to the state of Britain today. I think these excerpts give some of the flavour. Do read the whole  article.

…. the basic configuration of power relations in Britain has changed remarkably little across the last half-century. The route to power lies much where it always lay, while access to that softly carpeted and gently inclined path is scarcely more open today than it was in the 1950s. According to the report of the Panel on Fair Access to the Professions, published last year, ‘the typical doctor or lawyer of the future will today be growing up in a family that is better off than five in six of all families in the UK.’[†] Only 7 per cent of children are educated at private schools, but half of all professionals in Britain have been to one, a proportion that rises to 56 per cent for solicitors, 70 per cent for finance directors and 75 per cent for judges. The cost of sending a boy to Eton or Winchester is currently around £30,000 a year – that’s £50,000 of pre-tax income. Average annual pre-tax income in the UK stands at just over £25,000. The Institute for Fiscal Studies reports that 80 per cent of the population earns less than £35,000. Meanwhile, according to a study by the New Policy Institute and the Joseph Rowntree Foundation, there are now 13.4 million people in Britain living in low-income households earning less than 60 per cent of the national average. For a couple with two children this translates into a net disposable income of £15,000 a year, once all benefits and allowances have been taken into account – half, then, the income needed to send a boy to Eton or Winchester for a year. Only 1 per cent of the population have annual gross incomes above £100,000. And this, of course, says nothing of inherited wealth.The Institute for Fiscal Studies concludes that education and skills – or rather their absence – are the ‘main drivers’ behind the rise in inequality in contemporary Britain. And what the figures indisputably make clear is that elite formation in our society is still powered by a small but formidable educational engine, fuelled by wealth that only a few possess, and since access to the elite means access to wealth, the cycle of elite formation is essentially self-sustaining and closed to outsiders.

[...]

Seven years after the end of the period covered by Family Britain, Granada Television screened the first of that extraordinary series called Seven Up, the original and most remarkable experiment in reality TV, in which 14 children from across all social classes were brought together for a day and interviewed about this experience and about their lives, for the cameras. The idea was that these 14 representative citizens of the future Britain would be revisited every seven years and interviewed again – which is what, more or less, has happened (there have so far been seven such programmes). The first programme is little short of astonishing for the insight it gives into the class structure of Britain in 1964. Although they are only seven years old, the degree of social differentiation in the children is extreme. The sense of radical disjunction between lives and fates is shocking, precisely because each of the children seems unique, while all have evidently already been moulded by the system. Being children, none of them has yet thought that they might be ‘ordinary’ and all are startlingly authentic, not least the three little posh boys. ‘I read the Financial Times,’ lisps one of these delicate angels, while another talks of his destined journey via Charterhouse to the City of London. They seem like little aliens, at the very least mere curiosities from an age long superseded. Yet, while watching them, I had to remind myself that they were actually slightly younger than I was in 1964, and that I too went to a school such as theirs, and that David Kynaston did too, and David Cameron and George Osborne. All of us will, of course, protest that, as Cameron likes to say, where we came from doesn’t matter, it’s where we are going that counts. And, in one sense, this is true. But in another it isn’t, which is why Gordon Brown’s quip about Eton struck such a nerve. Whatever we have become, our most impressionable and formative years were spent in the company of the elect, in a milieu that was continuous with the milieu in which the three little boys in Seven Up sit cosseted. Some of us grew up to write history books, some to review them. Others, to travel first class by train every morning from the Home Counties to the City to collect their bonuses. Yet others became politicians. They are about to form our next government.

via LRB · Nicholas Spice · Don’t Look Down.

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Pierre Bourdieu said, perhaps not as famously as one would wish, that “public opinion” is an “artifact, pure and simple, the function of which is to dissemble that the state of opinion at any given moment is a system of forces and tensions and that nothing is more inadequate for representing the state of opinion than a percentage”. In particular, he charged that the manufacturers of public opinion in fact produce what they supposedly report: a consensus on what the problems are, what the appropriate questions are, how they should be framed, and so on. With that in mind, I give you this recent ABC/Washington post poll, which tells us that American class self-identification is roughly as follows: 39% say they are working class or worse off, 45% middle class, and 18% upper-middle class or better off. And where the poll does an important part of its work is in this question:

“Necessary elements” of a middle-class life

Being able to…

Own your own home – 80%

Save for the future – 78

Afford things you’d like to have – 77

Afford vacation travel – 71

Buy a new car – 67

This is a very leading question, and a considerable amount of thought must have gone into it, at least in its original formulation (I don’t know how long the question has been asked for, in this form). In a previous post, I mentioned research on American ‘class consciousness’ by Vanneman and Cannon, which pointed out that research on the American class structure was heavily shaped by the activities of the state in that field. In the post-WWII period, the US government funded and drove research which sought to create an understanding of class as status, based on certain patterns of consumption, income and education, rather than an antagonistic relationship centred on production. In that bowdlerised sociology, class is like a continuous ladder of prestige and status, which one might ascend or descend, rather than a conflict built into social relations.

It doesn’t actually matter if it was the state or private capital who decisively formulated these conventions, but the poll question cited above is undoubtedly shaped by them. Decades of thought – or doctrine – are embedded in this simple query. It assumes that there is such a thing as a “middle class life”, that it would have as its essential characteristics certain consumption patterns, and that the only real disagreement is over how important each element of consumption is. What’s interesting about these results is that many respondents appear to have defied the implicit bias in the poll, and defined themselves as, say, working class when their income would give them a reasonable chance of access to all of the “necessary elements” of a “middle class life”. The responses would suggest that there are layers of motivation and interest informing the interpretation of the questions, and thus the answers. Even with that, the poll did its job in that, like thousands of other polls framed in much the same way, it obtained a middle class majority.

“It’s called the American Dream because you have to be asleep to believe it” – George Carlin,

via LENIN’S TOMB.

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“If you like to think of America as The Greatest Country on Earth, and you’d rather not examine its claim to that title too closely, The Spirit Level will not be your favorite new book. On nearly every one of its 250-plus pages, a stark, unflattering graph shows the USA topping the charts among developed countries for some social ailment: drug use, obesity, violence, mental illness, teenage pregnancy, illiteracy. But authors Kate Pickett and Richard Wilkinson, a pair of British social scientists, have another, more enlightening point to make. With striking consistency, they say, the severity of social decay in different countries reflects a key difference among them: not the number of poor people or the depth of their poverty, but the size of the gap between the poorest and the richest. (Boston Globe)

via It’s money that matters « Follow Me Here….

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Fast Tube by Casper">The Spirit Level is a very powerful document. NB there is a link to the Equality Trust on this blog (on the right, in the list)

Fast Tube by Casper">watch?v=jsEZr3s1aBA]

The Spirit Level

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Plenty of  people seem to have forgotten, or never to have grasped, what actually happens when you sell off public assets to the private sector. So as a public service I offer you these three key things to keep in mind the next time you hear some wiseacre banging on about the ‘efficient private sector and the  inefficient state’:

(1) Cost to the taxpayer It has been calculated that, in the course of the Thatcher-era privatisations the deliberately low price at which long-standing public assets were marketed to the private sector resulted in a net transfer of £14 billion from the taxpaying public to stockholders and other investors.

To this loss should be added a further £3 billion in fees to the banks that transacted the privatisations. Thus the state in effect paid the private sector some £17 billion to facilitate the sale of assets for which there would otherwise have been no takers. Not an efficient use of public money.

(2) Moral hazard. Private investors are willing to purchase apparently inefficient public goods because the state shields them from risk.  Take the London Underground: Metronet et al. were assured that  they would be protected against serious loss—thereby undermining the case for privatisation: that the profit motive encourages efficiency. The “hazard”  is that the privileged private sector will be inefficient —while creaming off such profits as are to be made and charging losses to the state. Take a look at our rail and underground and you’ll see that this is just what has happened.

(3)  Problem of regulation: Postal services, railway networks, retirement homes, prisons, and other provisions targeted for privatisation remain the responsibility of the public authorities. Even after they are sold, they cannot be left entirely to the  the market. Someone has to regulate them. The private sector has proved time and again that it doesn’t self regulate properly; the danger is that at the moment the state is letting too much of the private sector do just that. And when it the state tries to regulate at all, it too often subcontracts to other private organisations to do this for it (for instance, with accounting).

The state won’t be going anywhere soon. But do we just want to to limit its activities to military and policing duties? That would leave a state whose main job was essentially repression, with all the other relations of life left to the market, or to unprotected individuals in an insecure world, where to be other than well off is a big problem, while to be ill, old or unfortunate and poor is a catastrophe.

Further reading: What is Living and What is Dead in Social Democracy (NYRB), by T Judt, from whom I’ve drawn heavily for this posting.  I don’t share all his politics but he does make a telling case. You can find it elsewhere in Horner’s Corner

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What Is Living and What Is Dead in Social Democracy?

By Tony Judt

The following is adapted from a lecture given at New York University on October 19, 2009.

Americans would like things to be better. According to public opinion surveys in recent years, everyone would like their child to have improved life chances at birth. They would prefer it if their wife or daughter had the same odds of surviving maternity as women in other advanced countries. They would appreciate full medical coverage at lower cost, longer life expectancy, better public services, and less crime.

When told that these things are available in Austria, Scandinavia, or the Netherlands, but that they come with higher taxes and an “interventionary” state, many of those same Americans respond: “But that is socialism! We do not want the state interfering in our affairs. And above all, we do not wish to pay more taxes.”

This curious cognitive dissonance is an old story. A century ago, the German sociologist Werner Sombart famously asked: Why is there no socialism in America? There are many answers to this question. Some have to do with the sheer size of the country: shared purposes are difficult to organize and sustain on an imperial scale. There are also, of course, cultural factors, including the distinctively American suspicion of central government.And indeed, it is not by chance that social democracy and welfare states have worked best in small, homogeneous countries, where issues of mistrust and mutual suspicion do not arise so acutely. A willingness to pay for other people’s services and benefits rests upon the understanding that they in turn will do likewise for you and your children: because they are like you and see the world as you do.Conversely, where immigration and visible minorities have altered the demography of a country, we typically find increased suspicion of others and a loss of enthusiasm for the institutions of the welfare state. Finally, it is incontrovertible that social democracy and the welfare states face serious practical challenges today. Their survival is not in question, but they are no longer as self-confident as they once appeared.

But my concern tonight is the following: Why is it that here in the United States we have such difficulty even imagining a different sort of society from the one whose dysfunctions and inequalities trouble us so? We appear to have lost the capacity to question the present, much less offer alternatives to it. Why is it so beyond us to conceive of a different set of arrangements to our common advantage?

Our shortcoming—forgive the academic jargon—is discursive. We simply do not know how to talk about these things. To understand why this should be the case, some history is in order: as Keynes once observed, “A study of the history of opinion is a necessary preliminary to the emancipation of the mind.” For the purposes of mental emancipation this evening, I propose that we take a minute to study the history of a prejudice: the universal contemporary resort to “economism,” the invocation of economics in all discussions of public affairs.

For the last thirty years, in much of the English-speaking world though less so in continental Europe and elsewhere, when asking ourselves whether we support a proposal or initiative, we have not asked, is it good or bad? Instead we inquire: Is it efficient? Is it productive? Would it benefit gross domestic product? Will it contribute to growth? This propensity to avoid moral considerations, to restrict ourselves to issues of profit and loss—economic questions in the narrowest sense—is not an instinctive human condition. It is an acquired taste.

More via What Is Living and What Is Dead in Social Democracy? – The New York Review of Books.

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How messy it all is

The argument of this fascinating and deeply provoking book is easy to summarise: among rich countries, the more unequal ones do worse according to almost every quality of life indicator you can imagine. They do worse even if they are richer overall, so that per capita GDP turns out to be much less significant for general wellbeing than the size of the gap between the richest and poorest 20 per cent of the population (the basic measure of inequality the authors use). The evidence that Wilkinson and Pickett supply to make their case is overwhelming. Whether the test is life expectancy, infant mortality, obesity levels, crime rates, literacy scores, even the amount of rubbish that gets recycled, the more equal the society the better the performance invariably is. In graph after graph measuring various welfare functions, the authors show that the best predictor of how countries will rank is not the differences in wealth between them (which would result in the US coming top, with the Scandinavian countries and the UK not too far behind, and poorer European nations like Greece and Portugal bringing up the rear) but the differences in wealth within them (so the US, as the most unequal society, comes last on many measures, followed by Portugal and the UK, both places where the gap between rich and poor is relatively large, with Spain and Greece somewhere in the middle, and the Scandinavian countries invariably out in front, along with Japan). Just as significantly, this pattern holds inside the US as well, where states with high levels of income inequality also tend to have the greatest social problems. It is true that some of the most unequal American states are also among the poorest (Mississippi, Louisiana, West Virginia), so you might expect things to go worse there. But some unequal states are also rich (California), whereas some fairly equal ones are also quite poor (Utah). Only a few (New Hampshire, Wyoming) score well on both counts. What the graphs show are the unequal states tending to cluster together regardless of income, so that California usually finds itself alongside Mississippi scoring badly, while New Hampshire and Utah both do consistently well. Income inequality, not income per se, appears to be the key. As a result, the authors are able to draw a clear conclusion: ‘The evidence shows that even small decreases in inequality, already a reality in some rich market democracies, make a very important difference to the quality of life.’ Achieving these decreases should be the central goal of our politics, precisely because we can be confident that it works. This is absolutely not, they insist, a ‘utopian dream’.

Read more here:

LRB · David Runciman: How messy it all is.

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Zizek’s new website

I’m not sure exactly who is running it – not the man himself I suspect – but it’s the hub for Zizek related matters, with a US emphasis, I assume.

Slavoj Žižek —.

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Adam Curtis Films here:

Adam Curtis, The Trap, The Power of Nightmares, The Century of the Self and others….

(You might need to scroll down a little to find them)

All on Rewtube.

you can see his new film It felt like a kiss on his blog, here.

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We’ve had a drug czar for a long time. Various other czars have come and gone. [See update.] But we’ve never had a language czar, not even when William Safire was penning screeds for Nixon. I think it’s time. Moreover, just as according to the Bush Doctrine we must go to war with countries that might at some time in the future support terrorism, so too we must learn to recognize treacherous phrases long ere they cast their sickly pale o’er our powers of thought. Otherwise, the illiterates win.

• green shoots: In mere weeks this metaphor has gotten so tired it has to shoot meth just to keep breathing.
• fell off a cliff: Nothing “suddenly decreases” anymore, or “declines precipitously”—no, we have to watch it go over that damned cliff again.
• animal spirits: When Keynes used it, the phrase was a colorful anachronism. Having been repeated roughly 104 times in the last month, it now has the flavor of theatre-seat chewing gum.
• claw back: Sounds ever so much more exciting than “shrink” or “reclaim”… [Wavy dissolve:] “It was five pm, Friday. I clawed back my change from the vending machine and took my espresso back to the office. What I needed pronto was some animal spirits, 180 proof. Then she walked in, and my green shoots fell over a cliff…”

From:

Philosophical Fortnights.

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* Do not think of your faults, still less of other’s faults; look for what is good and strong, and try to imitate it. Your faults will drop off, like dead leaves, when their time comes.

* Education is the leading of human souls to what is best, and making what is best out of them.

* Tell me what you like and I’ll tell you what you are.

* There is no wealth but Life. Life, including all its ­powers of love, of joy, of admiration. That ­country is the richest which nourishes the ­greatest number of noble and happy human beings; that man is richest who, having perfected the functions of his own life, to the utmost, has also the widest helpful influence, both personal, and by means of his possessions, over the lives of others.

John Ruskin

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I’ve been re-reading some Ruskin this week, while I perspired on the tube to work: Unto This Last. Quite a book for its day (1860), and for our day too, given his polemic against the idiocy of the classical economists, their assumptions about ‘rational man’, and the supposed primacy of narrow self interest  in the market  and in society generally (=‘greed is good’). It was a controversial work, and not at all well received by some of his target audience – the Victorian Bourgeoise. (For a bit more on what Ruskin has to say in this book , see the post I reblogged from Jonathan Glancy on Unto this Last; click on the ‘Ruskin’ tag at the foot of the post).  Reading Ruskin again, I was impressed by another aspect of his polemic.

I was  struck again by the sense that with Ruskin there is an assumption that his audience shares with him a grounding in Christian teaching, particularly the New Testament. Its language and imagery pervades the book (including the title). Of course it’s a Victorian, protestant version and not one that everyone, even at that date, was taking literally. Ruskin certainly wasn’t: he had moved well away by then  from the evangelical creed in which he had been raised. This was due to a number of reasons, but Darwin’s Origin of Species and the accumulating evidence of the great age of the earth played a large part in making the religion of his parents unacceptably simple minded and  narrow. Still, when Ruskin wants to talk about justice, or love, or even the dismal science of economics, he turns to the Bible.

Which leaves me with this thought. What shared language do we have now, when we want to talk about such matters? I’m very far from thinking that no God = no morality, and I’m also alive to the evil Christians have sometimes done. I just wonder whether, when you erase a tradition and a shared discourse in which love and justice find a natural place, you find much left standing. What’s left? economics? evolutionary psychology?

Nietzsche makes a remark somewhere, apropos George Eliot, that the English, having killed their God, were still proceeding as if nothing had changed, that nothing would change in their moral universe. I think he added that they would wake up to what had been lost ‘sometime in the next century’ (i.e. the 20th century). Into the moral vacuum of the late 20th century rushed the promotion of private advantage over the public good. It spoke the language of Gordon Gekko and Milton Friedman  and it  colonised almost every area of public life. Now we live with the results.

This seems to me to be a political and social question, not just one for private moral reflection. Do Darwin, Dennet and Dawkins lead to market fundamentalism? I ask this because it’s a naive piece of liberal ideology to hold that ‘morality’ is somewhow just for the private life, with a neutral state acting as a polceman and the market ensuring the efficient impersonal distribution of goods. The state, for them, has a greater or lesser role in suplying a safety net for the injured, or acting as an equal opportunities  enabler for the less fortunate; it  has no substantive vision of the good life that would go beyond this. That’s the point of liberalism.

But if the only driver for social change lies in capitalism itself, then only the self interest of  persons (increasingly imagined as consumers) will stand against the worst that the market can do to jobs, families, and lives. Liberals were keen to finish off socialism (with its Judeo-Christian and Marxist heritage); keen to launch into culture wars against all that would stand against the logic of the indivdual and the market. But what have they got to show in its stead? The selfish gene?

We need to recover the language, and  practice of public justice, and social solidarity. The promotion of the Good Life that lies beyond the horizons of the dismal science of economics. This is a public thing: the  res publica . And it’s a matter for all of us, as citizens, not mere consumers. So perhaps we need more, not less, of the wisdom of Solomon, the ethic of the New Testament, the polemics of Ruskin and the analysis of Marx. Otherwise what’s left? Sir Alan Sugar? Sir Fred Goodwin? I’m reminded of another of Ruskin’s titles: The  Ethics of the Dust.

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