Monday, November 25, 2013

The limits of personal responsibility

There is a raging debate over Obamacare in social media. It seems that there is a significant minority of the country bitterly opposed to the expansion of Medicare and Medicaid to include a greater part of the population. Some have openly expressed fear that Obamacare's ultimate objective is a single payer system of medical insurance.

The basic arguments against Obamacare that I see are described as, "why should I have to pay for someone else who doesn't have insurance?" On its face, it's a legitimate question. Further, people are asking why they should be required to buy health insurance? I'm young, I'm healthy, I have even found that doctors offer discounts for cash rather than going through the red tape of insurance coverage. "Red tape"? Isn't that a term almost exclusively reserved for government bureaucracy?

When I boil down the opposition's arguments, it comes down to personal responsibility. Let's look at this a bit more closely. Personal responsibility assumes that I am the master of my own fate. But if I drive a car, and I'm hit by a drunk driver, am I still master of my own fate? What if the health insurance I have limits expenses paid to the point where I lose pretty much everything that I've ever worked for? If I'm paying premiums that I can barely afford, I'm being responsible. What if the insurance company engages in a protracted legal battle to resist fulfilling their responsibility to pay my claims? Who pays for the visit to the emergency room and a week or two in an intensive care bed if I don't have enough insurance or the money in the bank to pay for it?

In a few seconds, I have outlined the limits of "personal responsibility" in this debate. Whether it's an auto accident, cancer, a terrorist attack or a natural disaster, I find it hard to believe that we can all be personally responsible for everything that ever happens to us. We are all, however, responsible for what we do in response to the environment. We can choose to work together or against each other, as free agents in a bag of skin.

I've seen arguments raised in opposition to the "personal responsibility" argument. For example, even smart and educated young people get cancer, have accidents, make mistakes that cost them their health, and so on. Even smart, white, affluent young people have problems, and they don't always have the power to fix it on their own. They need help. Everyone needs help at some point in their lives.

The opposition to Obamacare seems to say, "That's so tough, isn't it? Too bad, because I'm not responsible for them. Can we just let them die? Maybe some private charity will come along and help them. Really."

Sure, you could say, "But the government doesn't have to be the one to help. There are plenty of charities out there who can help." Yes, there are. But are they big enough? "But the wealthy can step in and help." Do they? Where were they in the Great Depression? Did they step in then? Did they step in to set the economy right in the Great Recession? I didn't see them helping out now, did you? Yes, there are some exceptions that you could point to, but no one is helping on the massive scale needed to right the economy, unless you're one of the bankers among the 1%. The government has bailed you out for failed investments that crashed the economy while basically ignoring everyone else.

This is the point I want to make. Private charities are run mostly by and for millionaires and billionaires. These are people who honestly think that the wealth they now hold is something they created all by themselves and that progressive taxation to re-distribute that wealth is socialist. They could be justified in holding that position if the productivity gains in the last 35 years did not accrue solely to the business owners, the top 1%. What happened is that businesses used laws set up to redistribute wealth upward to accumulate wealth, rather than allow employees to share in the productivity gains. But hey, that's not socialism, isn't it? That's capitalism.

If the wealthy crash the economy, putting millions of people out of work, are they accountable? Not if their wealth cushions them from the blows. Not if their wealth can be used to influence the government into a bailout. These same people can abuse themselves to no end and their high-end health insurance will guarantee access to the best health care in the world. They will not notice that there is really a problem with the economy. They have enough money that money doesn't feel like money anymore.

For the super wealthy, the relationship between money and work is so distorted, that personal accountability may not even be in their worldview. But they are quite eager to hold everyone else accountable to them.
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