Obamacare, the neoliberal consensus, and a kid fighting cancer

Let me just begin by admitting that my way into thinking about the topic of this post is, well, circuitous.

I was sitting down to email, as I do every day shortly after getting up. I’d made coffee but hadn’t taken my first sip.

And here was an email from GoFundMe, a crowd-funding site, featuring an apparently successful campaign on behalf of a kid fighting cancer.[1] Of course this is good news, but the first thought in my head was, why wasn’t Obamacare covering whatever is going on here?

After all, Obamacare was alleged to fulfill, at least in the greater part, a human right to health care. When we speak of human rights, we are speaking of human dignity, the protection of which is the reason we have human rights. And when we speak of human dignity, we shouldn’t be speaking of people begging for money (“crowd-funding”) from strangers, let alone for when their kid is fighting cancer.

We have started this Go Fund Me account to ease the burden of his parents, Jason and Amanda.  Amanda is six months pregnant and Jason is a combat veteran.  Over the next days, weeks, and months ahead they will need to be at countless doctor appointments, hospital stays and surgeries.   As you can imagine the normal costs of  every day living…such as rent, food, gas, car, etc…the medical costs can be astronomical.

This will enable Vinny’s parents be able to concentrate on Vinny getting well and fighting this wicked disease called cancer.[2]

So, okay. We’re talking about some of the many deficiencies of Obamacare, which was more about Barack Obama taking care of health insurers and the pharmaceutical industry, just like he took care of the banks, than it ever was about taking care of ordinary people.[3]

And of course that means we’re talking about why Obamacare has been so contentious, with Republicans in Congress voting countless times to repeal or defund Obamacare. Conservatives raise a number of objections, but ideologically, the big problem is with “socialized medicine.” This entails a distrust of central authority, which is also the target of Friedrich Hayek’s Road to Serfdom. Centralized economic authority is in fact is how Hayek defined socialism and this is why he thought it’s so evil: He believed that central authority can never be as nimble economically, responding to supply and demand (“market signals”), as decentralized actors. He believed that central authority was simply authoritarian, and that while there might be some social goods that could not be supplied through the market system, the main effects would be servitude to bureaucracy and impoverishment through inefficiency.[4] Modern capitalist libertarians rarely acknowledge even that the market could fail to supply any social goods.[5] Hence, by interfering in the market, government mandates both to insurers to offer insurance and to taxpayers to purchase it are intrinsically evil.

I’m actually not going to talk about the failures of market ideology in this post. I’ve already done that in countless other posts and places.

What I’ll point to instead is a dissonance between the capitalist libertarian objection to centralized authority and the neoliberal view of “the relatively harmless nature of monopoly and the positive role of large corporations. From the Chicago perspective, the more worrying manifestation of monopoly was trade union power.”[6] You’ll notice I distinguish between capitalist libertarianism and neoliberalism here. It’s important here because true capitalist libertarians oppose all monopoly; for them, competition is what drives economic efficiency, such efficiency is assumed to be universally beneficial, and monopolies are—you’ll have heard this word before—anti-competitive.

Neoliberals, on the other hand, think big corporations like health insurance companies, even monopolies, are just fine and competition should only really be in the labor market.[7] Which, of course, is a reason why so-called “free” trade has developed the way it has with corporate-friendly investor-state dispute resolution systems, which Ezra Klein defends with help from (oh, what a surprise) the neoliberal Peterson Institute for International Economics,[8] but which lots of other people harshly criticize.[9] But here’s the problem with that distinction between neoliberalism and capitalist libertarianism: The presently-governing neoliberal consensus was the outcome of a sustained capitalist libertarian effort that took hold when politicians perceived Keynesianism to have failed.[10]

And from C. Wright Mills’s and Christopher Hayes’s perspectives, this all makes sense. While they might occasionally squabble among themselves, the elite have such common interests that, one way or another, they take care of each other,[11] their own friends, and their loved ones even when that means incompetent people are in power.[12]

Neoliberalism, then, is what happens when capitalist libertarians achieve political influence. But with or without neoliberalism, the elite don’t much care about the rest of us except as objects of control,[13] which is how we get “socialism for the rich and free enterprise for the poor.”[14] Neoliberalism enhances that lack of concern by empowering an ideology of a “make-believe, problem-free world in which the pursuit of business gain and self-interest was imagined to be automatically beneficial to all of mankind, requiring of [the wealthy] no additional responsibility whatever.”[15] And that is why, despite Obamacare, that kid’s family had to crowd-fund their expenses while he got treated for cancer.

  1. [1]Ron Desautels, “Victory for Vinny,” GoFundMe, May 11, 2016, https://www.gofundme.com/vinnyd
  2. [2]Ron Desautels, “Victory for Vinny,” GoFundMe, May 11, 2016, https://www.gofundme.com/vinnyd
  3. [3]Neil Barofsky, Bailout: An Inside Account of How Washington Abandoned Main Street While Rescuing Wall Street (New York: Free Press, 2012).; Brad Jacobson, “Obama received $20 million from healthcare industry in 2008 campaign,” Raw Story, January 12, 2010, http://www.rawstory.com/rs/2010/01/12/obama-received-20-million-healthcare-industry-money-2008/; Gaius Publius [pseud.], “Obama Got $20 Million from Healthcare Industry in 2008. Was Killing Single-Payer Part of the Deal?” Naked Capitalism, February 5, 2014, http://www.nakedcapitalism.com/2014/02/gaius-publius-obama-got-20-million-healthcare-industry-2008-killing-single-payer-part-deal.html
  4. [4]F. A. Hayek, The Collected Works of F. A. Hayek, ed. Bruce Caldwell, vol. 2, The Road to Serfdom: Text and Documents; The Definitive Edition (1944; repr., Chicago: University of Chicago, 2007).
  5. [5]George H. Nash, The Conservative Intellectual Movement in America Since 1945, 30th anniversary ed. (Wilmington, DE: Intercollegiate Studies Institute, 2006).
  6. [6]Daniel Stedman Jones, Masters of the Universe: Hayek, Friedman, and the Birth of Neoliberal Politics (Princeton, NJ: Princeton University, 2012), 7.
  7. [7]Daniel Stedman Jones, Masters of the Universe: Hayek, Friedman, and the Birth of Neoliberal Politics (Princeton, NJ: Princeton University, 2012).
  8. [8]Ezra Klein, “What Bernie Sanders gets wrong about Obama’s trade deal,” Vox, November 6, 2015, http://www.vox.com/2015/11/6/9683852/bernie-sanders-tpp
  9. [9]Jeronim Capaldo and Alex Izurieta with Jomo Kwame Sundaram, “Unemployment, Inequality and Other Risks of the Trans-Pacific Partnership Agreement,” Global Development and Environment Institute, January, 2016, http://ase.tufts.edu/gdae/policy_research/TPP_simulations.html; Democracy Now! “Full Text of TPP Trade Deal Revealed — and Critics Say It’s Even Worse Than They Thought,” November 6, 2015, http://www.democracynow.org/2015/11/6/full_text_of_tpp_trade_deal
  10. [10]Jacob S. Hacker and Paul Pierson, Winner-Take-All Politics: How Washington Made the Rich Richer—And Turned Its Back on the Middle Class (New York: Simon and Schuster, 2010); Daniel Stedman Jones, Masters of the Universe: Hayek, Friedman, and the Birth of Neoliberal Politics (Princeton, NJ: Princeton University, 2012); George H. Nash, The Conservative Intellectual Movement in America Since 1945, 30th anniversary ed. (Wilmington, DE: Intercollegiate Studies Institute, 2006).
  11. [11]C. Wright Mills, The Power Elite (1956; repr., New York: Oxford University, 2000).
  12. [12]Christopher Hayes, Twilight of the Elites: America After Meritocracy (New York: Crown, 2012).
  13. [13]John H. Bodley, Victims of Progress, 5th ed. (Lanham, MD: AltaMira, 2008); Riane Eisler, The Chalice and the Blade (1987; repr., New York: HarperSanFrancisco, 1995); Christopher Hayes, Twilight of the Elites: America After Meritocracy (New York: Crown, 2012); Gerhard Lenski, Power and Privilege: A Theory of Social Stratification (New York: McGraw-Hill, 1966); C. Wright Mills, The Power Elite (1956; repr., New York: Oxford University, 2000).
  14. [14]Andrew Young, quoted in Southern Christian Leadership Center, “Socialism for the Rich, Free Enterprise for the Poor,” King Center, February 1, 1967, http://www.thekingcenter.org/archive/document/socialism-rich-free-enterprise-poor
  15. [15]Charles A. Reich, The Greening of America (New York: Crown, 1970), 56.

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