Not Another SOTU Speech
Our annual ritual is upon us: The President’s incantation of hope, recovery and promise, tinged with the need to do more will be met with applause of Congress—half of it, anyway. Television will recap in a postgame show analyzing the Republican and Democratic parties’ team scores.
How is our Union, really? Torn asunder. Going down for the third time. Circling the porcelain. Is there a post-speech Washington cocktail party discussing that? Probably not, as the Capitol does not live in the reality it creates.
Our Union was not one of states only, but a promotion of ourselves to be both the sovereign—self-rule—as well as a slight demotion of the individual—rule by law instead of a free-for-all. We claimed both individual freedom and government power, and reconciling these was never going to be easy.
The “It’s a Republic” team championed outsourcing and downsizing, and claimed that trickle-down economics and privatization worked. When prosperity came to the few and not the many, this team then advocated for those few not to be taxed, even as they gained political power. They thought that media monopoly was fine, no contra-corporate views were needed, and civil service could be replaced by tax-deductible think tanks advocating special interests. Bribery became speech, and a series of favors to donors was equivalent to serving public office.
The “It’s a Democracy” team played catch-up as Congress’ deliberative duties morphed into full-time fund raising. They, too, dropped governing for the greater good, but replaced it with government programs for the poorest—even as this added to the tax burden on workers, causing many to turn to the R-team in hope of relief.
What both teams forgot was the fundamental proposition that government’s legitimacy arises from representing the people’s interests. That is what office is. What has also been lost is the need for free discussion of what our interests are.
Our modern press, television, held America’s arms behind its back for the mugging. Watch the evening news for content. Bad weather is the only news they can competently cover. Mostly they tell lies of omission, the vacuum filled with tales of heroic children and feel-good stories to enforce the social injunction against complaining. Their pabulum oozes between prescription drug commercials, so much so that I wonder if the news outlets would have gone bankrupt without taxpayer-subsidized drug ads pumping in revenue.
Prescription drugs illustrate what ails our Union.
Drug ads are not the worst abuse of healthcare dollars, but one that should have been easy to fix, or ideally, never should have happened. Much worse, Congress mandated in 2003 that Medicare not negotiate drug prices, even as the program increased demand because patients now paid only part of the cost. Suppliers were given free rein to raise prices. The Affordable Care Act (ACA) reform continues to let these prices, secured by lobbyists, masquerade as free market prices. Only taxpayer subsidies make them “affordable.”
Imagine if every prescription and every doctor’s visit were paid out-of-pocket; the free market would have set dramatically different prices for medical care. It would be brutal, of course, but Libertarians say they support this medical Darwinism for patients, although they would never accept it for the market, for it would end the fabulous merry-go-round of IPOs, mergers and acquisitions, stock options and bonuses. It would crash the economy.
Not that long ago, medicine was mostly charitable, truly non-profit, unlike today’s profitable nonprofits. It was turned into a marketplace because Congress and special interests claimed they would make healthcare more affordable through competition. They were wrong.
Now government money pours into the medical industry’s resulting boom, while patients’ access to care is metered out in protection schemes and rackets that would make a mobster blush. It is a completely irrational labyrinth of profiteering, yet omitted from reform discussion. Media urges us to blame each other: the boomers, the aged, the young, the uninsured, the poor. Never does it point to the lauded bipartisanship of Washington whose pay-to-play contraption delivers more profit than care.
The D-Party favors more subsidies to unrepentant drug companies, voracious insurers, and ever more complex cartels of providers whose prosperity is reflected in the cost of care. This is then compounded in a complex schematic of those deserving a subsidy to afford the resultant unaffordable care. In the latest twist, the ACA Medicaid expansion says that those under 55 years old who are poor deserve free care. If you are 65 years old, you deserve Medicare, such as it is. But for the decade in between, if healthcare is unaffordable then you are undeserving, so ACA mandates that your estate be confiscated to pay for your care in full, without subsidy.
Apparently (I’m just guessing here as no one wants to step forward and take credit) a bipartisan effort to control costs was made by deciding to squeeze every last drop of profitability out of the patient. So, in another unethical nod to frugality, the ACA mandates that if you can’t afford your Medicare Part D drug coverage, that shortage will also be taken from your estate. Voilà, the ultimate solution to provide more revenue for the drug industry is patient asset stripping. Witness the birth of a new government-corporate racket.
It’s odd that the R-team would favor this as they were bitterly against the Death Tax on the rich. Yet the ACA reform includes the mother of all death taxes, as it could easily amount to 100 percent. Of course, it will create another opaque business, rich in fees for the assessment and collection of the detritus of the dying middle class. It won’t be pretty but it will be lucrative; best to keep it behind closed doors.
It is also odd that Republicans neither see the perverse incentive for the working class nor acknowledge the role inheritance has played in building the working and middle classes. Many working poor get by because they own their homes. While each estate may be small, in aggregate the upcoming wealth transfer will be huge, except that now it will go to subsidize healthcare industry profits instead of passing to the next generation.
Do you see the problem? The Union formed for citizens’ benefit has shifted to one using citizens as assets to be exploited. Another way to make this contrast is to look at how differently a government serving its people might manage prescription drugs. There are numerous examples, outside the scope to detail here, of orphan drugs that companies say don’t have a big enough market to make, generic drugs being re-patented and becoming expensive, or new drugs that could save the State big money by preventing expensive patient outcomes such as liver failure. We could create national pharmacies to make and distribute these for our Union’s benefit. We could even use eminent domain to take over exorbitantly priced drugs.
Shocking to talk this way, I know, but why is it acceptable for a corporation to overbill the captive national client for billions of dollars, but unacceptable for the citizens to exercise their power over the cost?
We used to regulate any business practice that crossed the line between contributing to society and harming it: bribery, usury, market rigging, windfall profiteering. Now money writes its own law, using those sworn into public offices meant to serve us. Money has impersonated us and stolen our sovereignty while its media accomplices misdirected, goading the two teams’ fan bases into fighting each other instead. Our rights, voices, interests and grievances go unheard. Our servants, holders of public office, respond only to their patrons. It is not government of, by, and for the people, but government against.
The R-party talks of getting government off our backs, as they believe in the Market, but they don’t want to stop all that beautiful money flowing into the Market, which has given us the “best healthcare in the world.” Well, it has given us an industry worth close to 20 percent of the GPD. Never mind that we pay more than European countries while still having massive lapses in care coverage. Never mind that insurance is the greatest tax levied on the working class. And never mind that citizens of no other wealthy nation carry such a burdensome cost-share, one often resulting in bankruptcy, even if it is stayed until after death.
Tweaking cannot perfect our union. Renaming R-team “enterprise zones” as D-team “promise zones” isn’t going to get it done. The first step in dealing with a problem is realizing you have one. Congress, you have a problem. The problem is bipartisan corruption. You have lied to us, to each other, and to yourselves. Fidelity to your oath and office was essential, but bit by bit you’ve sold what wasn’t yours to sell.
You say nothing can be done, each team pointing at the other. What needs to be done is to rid politics of the money that has turned representative government into an auction house. Imagine what would be possible if Congress spent its days raising ideas instead of money. Stop the revolving door and limit movement from public office to private profit from it. Bring back civil service that serves the public, not the industry it regulates.
Possibilities include ideas like writing a national charter of incorporation that defines what citizens will accept. Make corporations serve us, not the other way around, and end their tyranny of profit. Define a ratio of CEO to workers’ pay; base it on foreign wages if they employ foreign workers. Require that they outsource management if they outsource labor. Remove lobbying rights from corporations that are no longer mainly domestic. Why can’t Congress levy user fees on finance when it can for public parks?
Tax those who seek to use us as a market but show no loyalty to us as a people. Give the breaks to those paying good wages and training to fill jobs instead of lobbying for more visas. Reduce the tax on micro-businesses, proprietorships that pay heavy taxes when they should be rewarded. Reduce corporate taxes on employee-shareholder owned businesses that share the prosperity. Do anything like any of this, but do not tell us that nothing can be done. Do not allow money to censor the discussion.
If someone must be invaded, make it the Cayman Islands. Stop tolerating offshore banking, money laundering and tax evasion. Make a regulated industry subject to regulation instead of allowing them to lawyer up or choose incompetent regulators. End the complexities of shell companies and hire an army of accountants.
Why do we allow a system that mints billionaires? The world will have trillionaires before too long. There is no good reason to continue this other than the fact that this money has already co-opted too much power. Billionaires are mostly created at that juncture between business and government where Congress colludes while spouting inanities about job creation.
And to return to drug prices, taxpayers shovel billions into Medicare as well as what the elderly pay, and yet Congress can’t make the corresponding restraint on prices. Congress can’t even allow importation from a nation that does. You say it is not possible? That is the problem. That is the corruption. Congress has a drug problem. Take the first step and admit, “Money controls this office.”
The Constitution is not a quaint document. September 11, 2001 did not nullify it. A nation dedicated to self-rule cannot survive the rule of money, an anti-national sovereign of billionaires. Bipartisan pandering to money has created a supra-industry some refer to as financialization. In this, healthcare is not different from other societal needs now ruled by money: housing, education, defense and—well, finance itself. Every aspect of our lives is carved out for profits, followed by the D-team’s token alms for the poor. This has Balkanized response-ability to our Union, as if an overarching national interest was unspeakable.
We the people, the Union, the legitimate sovereign of the nation do not deserve to be sacrificed to the politics of profits, to see its power over government strengthen even as the citizen-patient’s health, as a wage earner, taxpayer, and premium payer, weakens. There will be more misery and worry, more suffering and bankruptcy, even if it is hidden in one’s estate. Congress’ only response must not be to apply more leeches.
Refuse to be their co-dependents. Refuse to play their games or fall for their divisive tactics. Intervene. Insist that your representative be reminded of the most fundamental principle of our Union: government works for us. Insist that, whether incumbent or candidate, your representative answers the question: What are you going to do to end the system of corruption in Washington?