Does Health Care Belong in the Mass Market?

The Question Never Asked or Answered. Does Health Care Belong in the Mass Market?

There’s a very particular critique of the post-World War II West that’s been on my mind lately. It’s a critique you see cropping up again and again in the worlds of popular music, art, films, standup comedy, books, scenes, zines and even comic books. And, clad in a variety stripes and guises, this critique is most often about mass-market commodities -- specifically the stultification, stagnation and actual danger that seeps into our lives when some of our most basic needs and vulnerabilities – a desire to be part of something greater than ourselves, the need to eat, the hunger for sex, the precarious health of our bodies – become the site of a mass-produced marketplace.

I won’t go through 300,000 examples of this critique, but a few come to mind. One is the work of George Carlin, our forever irreverent and deconstructive linguist/comedian. Man, did he ever see the mass market as a threat to a fully realized and authentic life! He screamed it from the rooftops right up until the end of his life.



Others, as do so many powerful critiques, come from the world of popular music. (I could write a whole treatise on punk and indie rock, here) But, really my brain goes right to the late 60s and Joni Mitchell’s humorous lament about love and the mass market, “Big Yellow Taxi”.

The end of the song is fairly devastating, as Joni joyously sings the final refrain “they paved paradise, put up a parking lot!” and then bursts into pixie-like laughter at the absurdity and sadness of it all. Dylan’s lyrics to the song “It’s Alright, Ma” also hit you in the face with his anger at the commodification of near everything:

Disillusioned words like bullets bark

as human gods aim for their mark

made everything from toy guns that spark

to flesh-colored Christs that glow in the dark

it's easy to see without looking too far

that not much
is really sacred.

As I’ve followed the ups, downs, and sideways of the debate on health care reform, this critique of commodities and the mass market cuts me even deeper. Here’s what I mean: As it appears right now, Obama’s drive for health reform has reached an exceptionally narrow place. And we can go into all the specifics of what makes the bill that will probably get through Congress so narrow in scope, but others have done that much better than me, so you can check out a good piece of analysis by Paul Krugman here.

Suffice to say that systemic reform looks unlikely. A healthier America looks unlikely. Why? In large part, because there’s a basic issue that needed to be explored collectively at the beginning of this debate -- by us (and by this I mean you and me), President Obama, his advisors, the policymakers in Congress, and corporate CEOs, too. The issue? Is it possible that there are things in this world that are sacred enough that we should refrain from commodifying them? And is our health one of those sacred things? Because if we believe it is, then the care of our health simply may not be appropriate as a commodity.

I suspect that most of the people who helped Obama employ his winning grassroots/netroots campaign strategy are not with him any more. It’s hard to speculate on the why’s and it could be a lot of things but, given that his sit-round-the-kitchen-table-and-discuss-with-your-friends-and-neighbors campaign approach was so successful (especially in states that use caucuses for their elections) it seems amazing to me that Obama did not kick off his drive for health care reform by extolling the same kinds of “house parties” that he did during the campaign. A comprehensive website about health care could have gone up quickly, complete with a downloadable kit that offered some specific, step-by-step ideas on how citizens could get together and discuss health care, beginning with the most basic issues and then expanding outward. I also suspect that, had Obama put forth this kind of effort, a sizable amount of folks would have come to conclusions about health care that are much less mass market-driven than the current set of Beltway political solutions in the various completed pieces of legislation. Because it’s important not to underestimate just how insistently these critiques of the mass-market I mentioned earlier have worked their way into the viewpoints of a significant number of Americans.

And those citizens could have become Obama’s peoples’ lobby, inserting themselves into the debate in a way that would have bolstered his hand as he jockeyed for position amid corporate-funded Congress-people, industry lobbyists, and a timid set of presidential advisors. Can you imagine what the debate might have looked like if such a strategy had been put into action 4-6 months before the Congressional debate even began?! Damn. The media would have almost been forced to cover the cross-country house parties. Such a missed opportunity.

But the esoteric thing about this whole debacle that I’m just perverse enough to be amused by is that the key to asserting health care as sacred and too important for commodification may be found in the judicious use of Internet marketing techniques that derive from the very commodity culture that inhibits a more person-focused health care system in the first place.

Oh, the paradox that is my country.

Teddy's gone

How many people have hit the keyboard to write about Ted Kennedy’s passing today? I don’t even want to hazard a guess and I’m sure another voice isn’t really necessary, but I still feel the need to write about it.

Outside my window, somewhere down the street, the cords to one of my neighbors’ flagpoles is blowing around, clanking insistently metal against metal over the light traffic noise. As someone raised in coastal New England, the sound of cords and lines banging against metal flagpoles (reminiscent of ships’ masts) brings up an enormous amount of associations for me. I won’t bore you with all of that, but I will tell you that one association that’s right in the front of my brain is the Kennedy family (ensconced for years in the cape Cod town of Hyannisport). The image, example, complexity, hubris, light, and dark of this clan has always had a strong influence on my little American subculture. And it’s all wrapped up in this dream, this sort of collective unconscious so many of us have (us white folk at least) of a certain type of great white father, like the Kennedy’s are a family full of Jimmy Stewarts or Gregory Pecks, if you get my meaning.

Elegance, wisdom, athleticism, ego, playfulness, humility, faith, appetite, command, humor, seriousness. A whole set of manly ideals to feast upon. A sense of unbridled potential that we can all get motivated by and try and emulate. And then the family has its corresponding set of superlative feminine dreamscapes, too, which exerted enormous influence over the Kennedy men.

With so many layers of meaning to the Kennedy’s and such fuel for the American imagination, I understand why the glowing eulogies have been pouring off many a keyboard today. Virtually every listserve I belong to has sent me a remembrance of some kind and they all fall prey to idealization (something Ted himself resisted when eulogizing his brother, Robert). But even with my deep New England affinities, I feel this fight in me to sober up and let Ted Kennedy and all he represents flow entirely across the movie screen that sits inside my head. Oh, that dangerous movie screen. How it fills me with longings that both augment and overpower certain realities.

A few of these realities, both good and distressing:

- Ted Kennedy honestly cared about his fellow citizens – this is rare in an elite politician

- He was a defining force in some of the best legislation passed by the government after WWII – Title IX, the disabilities act, children’s health, lowering the voting age, meals on wheels, sanctions against the Apartheid regime in South Africa – and he openly opposed some of the worst, including the authorization for the invasion of Iraq

- Although he cared and reached out to fellow citizens, he had an intrinsically top-down approach to democracy, which puts him squarely in the mainstream of U.S. Senators, both past and present – grassroots were not something he cultivated with any gusto

- He came to the Senate during a period (one that still arguably endures) in which the legislative branch of our government was atrophying and ceding its power (and, as a result, the people’s power) to multinational corporations, the military industrial complex, and the executive branch.

His work didn’t attempt to significantly change that unfortunate trajectory. For instance, he never really contributed to a power bloc or coalition that could have amassed real progressive power (even though he worked well across the aisle, individually). Essentially, Ted worked great from the inside, which, while impressive, is never a real game changer when it comes to power dynamics. Over time, he made his peace with the forces that control politicians, got in bed with his share of corporate interests, and worked within the narrow parameters of those interests much of the time

I found this comment by “Hugh” on a thread at FireDogLake yesterday and it reminded me that Kennedy took his share of contributions from health care firms and biotech in Massachusetts, which impacted his policy proposals:

“We should remember too that Kennedy's version of a healthcare plan had mandates and state exchanges and maintained the system of private insurers. There was a commitment to a public plan but with the details concerning it left up in the air. What Kennedy was proposing is essentially what we are seeing with Obamacare, with only perhaps a slightly greater emphasis given to the public option.”

- The dude liked to party. Hard. There’s no doubt it affected his work. He was saucy. Tales of his interest in young women (and a certain freedom with his hands) abound. The man had demons and appetites. And, as an elite person in this society, he was empowered to wrestle with them in ways that would send most of us to jail (let’s face it, if you or I had driven off that bridge on Chappaquidick, we would’ve been prosecuted on DUI, reckless endangerment, involuntary manslaughter, leaving the scene of an accident, etc.)

- He helped mitigate many of the abuses, the outrages that damage everyday citizens in a highly bureaucratic society that has institutionalized longstanding systems of power – these contributions are really quite significant, I think. Title IX, which tried to level the playing field for women in collegiate athletics, was a transformative piece of legislation and stars like Lisa Leslie, Mia Hamm, and numerous female Olympians would not exist in the same way without its implementation

- By his very presence, style, and being, he kept alive the idea that politics are connected to our daily lives, and that politics could be engaging, worth the trouble, and that rascals could be thoughtful, stalwart, and spirited…even with a crimson face and a drink in hand

I’m sad that Teddy’s gone. As a New Englander and an American, he was my rascal and I knew
at the end of the day he had a heart. Even so, he was a man. He wielded power better than can
be expected, but not superlatively. His decisions in the final days of his life are proof of it. To quote Hugh again:

There was a considerable amount of hubris in Kennedy seeking to change the rules for who would fill his seat. Kennedy’s cancer and its prognosis were known to him in May 2008. In other words, he had a year and a half to relinguish his office and for a special election to be held. He chose to hold on to it despite his general incapacity and despite the coming healthcare debate and his worsening condition. Now I am sure we can all understand why he would want to hold on but it was not a wise decision.

But still, Ted Kennedy got up and made the effort, every day. He could have
just been a lawyer and gone sailing and lived the good life all his days. Instead, he tried to do
something. That’s more than a lot of us can say.

And yet there's this darkness that nags at me, even beyond the sobering recognition of Teddy’s imperfections
(which we all share). It’s a feeling that, as good of a senator as he was, he just wasn’t good
enough to make a real dent in the fact that, in key ways, even with all the outcomes of all of the
various human rights movements, America is an uglier place, a less free place than it was when
Teddy entered the Senate. And I know it’s not fair to lay that at the doorstep of one man. But the
feeling is there, and it hurts.

So, now I’ve got my illusions lying here on the ground. And I guess that’s as it should be. I’m raising my glass tonight to Teddy as the credits roll in my mind.