First, back to Sirota. I'm guessing he got a lot of heat over that column from people he knew and admired. So it's in a kind of apologetic tone that Sirota took pen in hand to try and explain the differences between his stance and the legislation's supporters' that wasn't so dismissive of people he disagrees with. To do so, he turned to his old topic of "liberal vs. progressive" to define who the different groups on the left who battled over health care reform:
Economic liberalism has typically focused on using the government's Treasury as a means to ends, whether those ends are better health care (Medicare/Medicaid), stronger job growth (tax credits) or more robust export businesses (corporate subsidies). The idea is that taxpayer dollars can help individuals afford bare necessities and entice institutions to support the common good.
Economic progressivism, by contrast, has historically trumpeted the government fiat as the best instrument of social change - think food safety, minimum wage and labor laws, and also post-Depression financial rules and enforcement agencies. Progressivism's central theory is that government, as the nation's supreme authority, can set parameters channeling capitalism's profit motive into societal priorities - and preventing that profit motive from spinning out of control.
The crafters of the healthcare bill are, of course, "liberals," throwing money at a problem. Opposing them on the left are the "progressives," who wanted to institute regulatory mechanisms to fix the problem: "premium regulation" and the public option. And certainly "liberal" is a far cry from corrupt "sheeple." Of course, Sirota's distinction between "liberal" and "progressive" is his own. You won't find any reference to "liberalism" equating to taxation or budgetary philosophies in the Standford Encyclopedia of Philosophy.
To me, the essential difference between the factions on health care is clear. The solution - the health care legislation - preserves, even props up the status quo. Those opposed want to reshape our health care system.
There are lots of arguments for either view. Some legislation supporters simply want relief for the uninsured; whether it takes subsidies or single-payer doesn't matter. Others believe there are huge systemic problems with the way health care is delivered, but believe, given the political climate in DC and the strength of insurance lobbyists and their allies, that this is our only recourse right now. Some of the legislation's opponents believe that our economic system is inherently immoral, that goods and services are distributed unfairly. Others believe that, without systemic changes to the way we deliver healthcare, our healthcare problems won't be solved, that this bill is, at best, a band-aid on a gaping wound, or, at worst, a permanent obstacle to a workable solution.
Jane Hamsher, a virulent opponent of the health care bill recently wrote:
But the larger problem, which David and I were discussing yesterday, is that our language is inadequate to describe the political dynamic. The left-right paradigm is insufficient, in that it presumes everything can be explained within the context of back-and-forth shots fired between political "tribes" that have coalesced within the two party system. But they're firing past the larger corporate players who operate freely within both camps, whose role is rarely accounted for. And it should be clear by now that they have captivated leadership on both sides, who openly boast about that alliance.
There's something to this, of course. Both political parties have sizable anti-corporate populist factions. And it's always been this way, that political parties have had a number of different competing groups. And it's absolutely true that the media has covered healthcare reform especially poorly, dividing everyone into "Republican" and "Democrat" and, say, assuming everyone who opposed the bill fell into the "Republican" camp.
But...there is unity in belief on the left. There are shared core values that Hamsher overlooks.
From "The Future of Liberalism" by Alan Wolfe:
...Modern liberalism promises equality through what Berlin calls a "positive" conception of liberty: it is not sufficient for me merely to be left alone, I must also have the capacity to realize the goals that I choose for myself. If this requires an active role for government, then modern liberals are prepared to accept state intervention into the economy in order to give large numbers of people the sense of mastery that free market capitalism gives only to the few. Positive conceptions of liberty hold that human beings ought not to be reduced to their passions or even their interests. They live for some higher sense of purpose than getting and spending and ought to be able to realize those ideals in the here-and-now through their own collective efforts.
...But the liberal proposition, tested by long experience, is that whatever dependencies result from using public policy to address modern inequalities, the resulting gains in individual mobility, development of physical and mental capacity, and racial and gender equality far outweigh them. This is why [Adam] Smith, writing in the eighteenth century in opposition to the regulation of business by government, and Keynes, writing in the twentieth century in support of it, were, substantially speaking, both liberals. Their disagreements were over the means by which large numbers of individuals could achieve control over their lives, not over whether they should.
The rift, then, in the arguments over health care on the left is only over how effective in achieving "positive" liberty the legislation will be.
That is, I don't really believe there's a difference between "liberal" and "progressive." If I were going to label the competing factions, I'd argue that those who crafted and supported and passed the health care bill were a kind of "liberal conservative" faction, wherein they sought to advance positive liberty - universal access to health care, and easing of costs for the least wealthy - but while preserving an existing institution.
I have to say, though, that I suspect people's efforts to preserve the existing system aren't grounded in any kind of moral world view. I think it's largely practical. As James Surowiecki describes in a piece on how the capital gains tax break for hedge fund managers has endured despite its inherent unfairness and illogic:
If we were starting from scratch, after all, it seems unlikely that the Senate would choose this particular moment to pass a bill subsidizing money managers to the tune of billions of dollars a year. But, because the tax break already exists, it exerts a kind of gravitational pull that makes it hard to get rid of. In part, that's simple economics-those who benefit from the tax break have more money to lobby for it to be kept in place. Furthermore, while the cost of subsidies is spread out among all taxpayers, the benefits are highly concentrated, so, naturally, opposition is generally diluted and diffuse while support is intense. If you work in private equity, it's possible that nothing the government does matters more than keeping this tax break intact. And this pattern is true not just of subsidies but of government programs in general: every government action creates a constituency with an interest in keeping that action going.
Our health care system endures largely because its support is concentrated and well-funded, while reform comes in many shapes and flavors, and has a diffuse support of oftentimes ideologically opposing viewpoints. Also, consider the risks inherent to, say, instituting single-payer health care, which would mean making the multi-billion-dollar private insurance industry vanish overnight. How many layoffs would that mean? How many busted pensions? Gutted office buildings?
Whatever. Personally, I fall into the camp of believing this bill is a temorary fix to the symptoms of a larger systemic problem. Yes, it achieves some good goals and should have been passed, especially if the alternative was nothing. But I think we'll be having this debate again. |
