About Last Night: The Shock Doctrine Reversed

By Al Giordano

After offering the soundbite heard ‘round the world - "We will rebuild, we will recover, and the United States of America will emerge stronger than before" - the President proceeded to make the case for three big domestic spending priorities: energy, health care, and education:

"The fact is, our economy did not fall into decline overnight.  Nor did all of our problems begin when the housing market collapsed or the stock market sank.  We have known for decades that our survival depends on finding new sources of energy.  Yet we import more oil today than ever before.  The cost of health care eats up more and more of our savings each year, yet we keep delaying reform.  Our children will compete for jobs in a global economy that too many of our schools do not prepare them for. "

Those who liked to complain in recent weeks that the $787 billion dollar Stimulus Package was "not enough" behaved as if it were the only spending that would be proposed ever again from here to eternity. Yet we've already seen, just one day after the signing of the Stimulus, the rollout of $75 billion toward saving family homes during this housing crisis. And we'll look in a moment at what Obama, according to his speech last night, has on the docket for the immediate future.

First, it's important to note what is really going on here: The Obama-Axelrod-Emanuel war room has taken Naomi Klein's Shock Doctrine - the observation that those in power use times of crisis to supplant the state with private sector capitalism - and turned it on its head. Instead, they're using the current economic crisis to bring back the New Deal (government stimulation of the economy and firmer regulation of the corporate sector) and the Great Society (domestic and social programs to create a safety net for American workers and the poor).

Obama basically admitted it last night:

"History reminds us that at every moment of economic upheaval and transformation, this nation has responded with bold action and big ideas.  In the midst of civil war, we laid railroad tracks from one coast to another that spurred commerce and industry.  From the turmoil of the Industrial Revolution came a system of public high schools that prepared our citizens for a new age.  In the wake of war and depression, the GI Bill sent a generation to college and created the largest middle-class in history.  And a twilight struggle for freedom led to a nation of highways, an American on the moon, and an explosion of technology that still shapes our world."

Regarding energy, the President said:

"But to truly transform our economy, protect our security, and save our planet from the ravages of climate change, we need to ultimately make clean, renewable energy the profitable kind of energy.  So I ask this Congress to send me legislation that places a market-based cap on carbon pollution and drives the production of more renewable energy in America.  And to support that innovation, we will invest fifteen billion dollars a year to develop technologies like wind power and solar power; advanced biofuels, clean coal, and more fuel-efficient cars and trucks built right here in America."

As part of that he cited a commitment to "a re-tooled, re-imagined auto industry that can compete and win.  Millions of jobs depend on it.  Scores of communities depend on it.  And I believe the nation that invented the automobile cannot walk away from it."

Regarding health care, the President boomed, "we can no longer afford to put health care reform on hold.":

 "Already, we have done more to advance the cause of health care reform in the last thirty days than we have in the last decade.  When it was days old, this Congress passed a law to provide and protect health insurance for eleven million American children whose parents work full-time.  Our recovery plan will invest in electronic health records and new technology that will reduce errors, bring down costs, ensure privacy, and save lives.  It will launch a new effort to conquer a disease that has touched the life of nearly every American by seeking a cure for cancer in our time.  And it makes the largest investment ever in preventive care, because that is one of the best ways to keep our people healthy and our costs under control. 

 "This budget builds on these reforms.  It includes an historic commitment to comprehensive health care reform - a down-payment on the principle that we must have quality, affordable health care for every American."

I didn't hear a single TV pundit last night or today pick up on what Obama is really up to here. It's in the bold type: "This budget builds on these reforms." He was talking about the budget he is about to propose. The next steps in creating national universal health care will come not in separate legislation which requires 60 out of 99 US Senate votes, but, rather, as part of the budget bill that, according to Congressional rules, needs simply a majority - 50 votes - to be passed and which cannot be subject to opposition filibuster.

That was exactly the point in the speech when Senate Republicans got those long unhappy looks on their faces. He had just ripped from them their only obstructionist power. They shifted nervously in their seats and scrunched their "holy crap" scowls. Skilled politicians all, they knew their goose had just been cooked. It was at that point in the speech that, after a couple of minutes of coming to grips with the new rules, they began to make a show of applause and standing ovations for the cameras. If you can't beat Obama, join him. It was a beautiful play to watch.

Regarding education, the President has just pledged that any American that wants to go to college or get vocational training will be able to do so:

"I know that the price of tuition is higher than ever, which is why if you are willing to volunteer in your neighborhood or give back to your community or serve your country, we will make sure that you can afford a higher education.  And to encourage a renewed spirit of national service for this and future generations, I ask this Congress to send me the bipartisan legislation that bears the name of Senator Orrin Hatch as well as an American who has never stopped asking what he can do for his country - Senator Edward Kennedy."

There was much more tucked into this speech: the coming regulation of financial industries and the "I get it" moment regarding the bankers and bosses were especially notable. And the pledge to cut the budget deficit in half - down to $533 billion - in his first term will also bring some interesting new moves in progressive taxation and finally in doing what Bill Clinton failed to do: "reform our defense budget so that we're not paying for Cold War-era weapons systems we don't use."

The only complaint I heard from anywhere on the left about Obama's first nationally televised speech to Congress regarded the President's revelation of the plan to withdraw all combat troops from Iraq in 19 months (that's down three from the 16-month plan announced in Iowa in 2007, but, really, it still ends the war before the 2010 elections, and what must be dismantled has just been through more than 70 months of escalation so it's a bomb not easily disarmed). If anyone wants to complain about that, good luck to ‘em. Nineteen months sounds damn good to most war-fatigued citizens and soldiers compared to what would have been had some others won the White House instead.

Last night, the President again proved the Chicken Littles wrong (I'm lookin' especially at Paul Krugman, and at those who almost religiously took the New York Timesman's words as economic Gospel, or at least as an excuse to cluck about falling skies). The Stimulus Package merely got the hard stuff through. It was the down payment. It's going to be very tough-to-impossible for the Republicans to get Senate unanimity against the energy and education spending bills to come. And by putting the first steps toward national health care into the budget, the President has just erased their ability to obstruct that, too.

All three of those big items will also add to the economic stimulus - creating and preserving jobs and giving those workers money to spend - as they simultaneously tackle the long overdue crises in energy, health care and education.

Update: And right on cue, word is out that the budget the White House proposes tomorrow will include a $634 billion dollar ten-year health care "reserve fund." Here's how that will work: First, pass the expenditure, then make the Republicans and other interests fight over how to spend it, rather than the ideological issue of whether to spend it.

Also: If you're not a regular reader of the comments section here, I highly recommend it. We've got a very interesting discussion about those who are trying to push Obama to reverse his campaign pledge against mandating that all Americans buy insurance company policies. I often add many of my own more detailed thoughts in the comments section, as I do on this thread.



Shock and (I hate to say this) awe

I know, I know, a horrible title to my comment, but at the same time, it feels right.

I am in awe. In awe of the political skill of this man, of his intelligence, and also of his determination to do what's right for the US and for the world (I'm in Canada, btw).

I must also admit that I'm in awe of your skills, Al. This post is a masterful one. I laughed out loud while fighting back the tears, when I read the part about health care and the budget. Wow.

keep it up, Al.

The End of the End of Liberalism.

Anyone worried about triangulation or bipartisanship from Obama would do well to review last night's speech.  This was the most unapologetically ambitious plan for domestic programs of my lifetime (which started at just about the time Theodore Lowi marked as the end of liberalism), and it was done with a rhetoric that marked the goals not as "liberal" but as American.

This is what I meant at a house party nearly two years ago when I described Barack Obama as "our Reagan."  Not that his policies were Reaganite, but that he could use rhetoric to shift policy the way Reagan did...only for a markedly more progressive vision of what government should do.  It got Republican congressmen to give standing ovations to the regulation of banks.  Hard to imagine that two or ten years ago.


I was also wondering what happened between their obstinate stance in not applauding nor giving standing ovations to the wild applause and giving standing ovations galore--I had thought they realized it would be in bad form if they kept doing that and that they were responding to Obama's brilliant rhetoric. 

I noticed the "Oh Sh#*$T" expressions and confusion when Obama had said that line about Health Care and the budget but I did not understand WHY??

Now I know why, thank you Al--brilliant analysis.

Something to say

Your take on the healthcare comments made by Obama are so helpful.  I appreciate the vote count info. and remembered how masterfully the votes were gathered to give him the nomination.  

I am in the process of supporting a young woman for alderwoman in my Ward. She has a Masters in public health and is wonderfully gifted in expressing herself. Many Obama supporters/volunteers are working for her election, challenging the status quo.

Thanks for having something to say.  I'll check everyday, anyway.


Obama makes it difficult for those seasoned politicians who only know how to play politics at the expense of the citizens.

Great post Al - thanks.  I was wondering if it didn't hurt though for Paul Krugman and the like to be Chicken Littles so as to make it appear that Obama was a centrist on the Stimulus Bill and thereby accommodating the Republicans who worry about adding to their self made trillion dollar deficit. 

Disagree on Krugman

Al, I think you have Krugman exactly wrong - he's not a Chicken Little, he's the most powerful progressive and independent economist in the nation.

As such, he's an incredibly powerful lever: he's succeeding wildly not in getting the Administration or Congress to agree with everything he says, but in pushing them all to the left. The guy is brilliant, committed, and (in my view) he's tactical. He's worth all the rest of the NYT op-ed morning zoo combined.

Look at healthcare: Obama's on the verge of a full mandate for 100% of American citizens. That's Krugman, baby - and it's a good deal. And you know, it fits the Obama "make me do it" Challenge to a glove. A tough Nobel-winng voice to the left of the President is a beautiful thing in these times. Politically, a little pressure from the left is also valuable thing for the President - and clearly a force he understands and is comfortable with.

On the speech: his most important since the Rev. Wright speech, in my view. I didn't agree with everything in it, but I loved the good wood he put on the GOP - I, too, saw them sagging and hound-dog in total defeat. And then we got Jindal...

Great post

See, Al, all you needed to inspire you to write was a speech from the Community Organizer-in-Chief.  Great catch on the budget, that went right over my head.

The moment when my husband and I looked at each other in wonder was when he made the budget sound so noble.

In the next few days, I will submit a budget to Congress. So often, we have come to view these documents as simply numbers on a page or laundry lists of programs. I see this document differently. I see it as a vision for America – as a blueprint for our future.

Only Obama could give me goosebumps talking about the federal budget that way.

Senate Finance Committee

Health care has been undergoing development among members and staff of the Senate Finance Committee. The former Chief of Staff for the committee's chair works in the White House. This is a tight effort and part of rolling out health care, yes, through the budget.

When scholars write books comparing the Obama health reform efforts to the ones in the Clinton administration, the comparision will be amazingly stark.


The staffer I referenced is Jim Messina.  Check this out:

Messina. . .and Baucus are such close friends that they describe it as a "father-son" relationship. Every two weeks, they meet for dinner and a glass of wine at Bistro Bis, an upscale restaurant in the Hotel George on Capitol Hill. http://www.washingtonpost.com/wp-dyn/content/story/2009/02/21/ST20090221...

Anyone who complains that Obama has too many insiders is not watching how important they are to getting the agenda DONE.


Tom W - I don't see any evidence that Krugman's whining has "pulled Obama to the left" at all on any matter.

On the question of mandates - and I'll explain why I oppose them vehemently in a second, and oppose them from the left - there's nothing "more left" about them. They're authoritarian in ways that, say, mandated Social Security is not. With Social Security, you pay in, you get back, the entire transaction is money.

While I want health insurance universally available to all who want it, that would involve mandatory signing over of the most personal physical and mental health information over to the State. There, simply put, are many people (your correspondent included) that will not do that, that will refuse to do that, that will go to prison if need be in an act of civil disobedience refusing to do that.

In a prohibitionist regime and a medical system in which "doctors" have certain rights to force institutionalization on patients under very laxly regulated conditions, there are many brilliant artists and others who, either because of their eccentricities that the medical establishment calls a disease, or because of their chemical preferences or self-medication, or their disdain for Western Medicine preferring instead alternative therapies that health insurance refuses to cover, will never ever opt in to such a system, and it would be fascistic to attempt to force us to do that.

I don't mind that we all pay our fair share to make sure everybody that wants Western Medicine health care can get it. But I'll be damned if I'm going to hand over one piece of personal data to the new computer system.

American doctors - with a minority who are exceptions - are fucking butchers. They get their hooks in you and they never let go. The courtrooms across the land are filled with malpractice cases that reveal medical "professionals" making people sicker in order to be able to collect more from the insurance system. Thank you very much, but I'll take my chances in Mexico and Cuba before I let those bastards get a hook in me. I've seen them destroy more lives than I've seen them heal.

During the campaign, the so-called "progressive" John Edwards briefly admitted what the pro-mandate lobby really wants: his original health care plan included a mandate not only that all people must opt-in to the system, but they all must report for regular medical checkups. From there, it's a slippery slope to piss tests and many other invasive procedures with criminal consequences. Only in an upside down Orwellian world would such mandates be seriously considered "to the left" or "progressive."

It remains to be seen if Obama - after withstanding the Clinton-Edwards attacks and sticking to his guns being against "mandates" on individuals to be inside the health care system - caves to the authoritarians on that one. If he does, he'll have a big fight on his hands because many of us that supported him did so in good part because of his courage against said mandates during the campaign.

The Krugman fight is worth having

What cheered me most about Al's post here was the crack about Krugman.

I hold Krugman in very high esteem.  I think he's an incredibly important, progressive voice.  One of the few progressives with such impeccable economic credentials.  And the guy is a terrific writer, able to make esoteric concepts understandable.

But many of us have been too deferential to him.  He is such a valuable voice that he rarely gets challenged from the left.  And this is not a healthy thing.

More importantly, I do not believe Krugman's alarmist tone helps move Obama anywhere.  Sometimes, it seems that Krugman thinks Obama has abandoned his principles.  These over-the-top pronouncements fit the world-view expressed at certain blogs, but they are, indeed, squarely "chicken-littlish."

I think Krugman would be even more persuasive if he simpy stuck to the merits of the policies.

Right on, Al!!

Especially about the "universal" health care mandates.  Obama being strongly against them was an early issue that swung me to his side.


The "universal" canard has been very insidious.  Most people don't seem to realize the huge difference between Universal and Single-Payer.  As you said, why the hell should we be forced to partake in a horribly flawed system?!?

Single-payer is the only solution.  You have it available at all times, and you can take it or leave it at will.  "Universal" is not like this at all!

If this proceeds, I'll be joining you in the jail cells (well, first in the streets and living rooms organizing against it, of course).

Krugman and mandates

I asked Krugman about the mandates when he was doing an online chat at another blog.  He supported Hillary's plan at the time against Obama's, and he used the whole "stepping stone" argument in his support of "universal" coverage.

Not sure that would even work that, and second, it totally ignores the massive privacy and health problems that would be caused by forcing every American to do whatever the Medical Industrial Complex forces down our throats, literally, as we step over those stones.

"Universal" coverage would be an absolute boon to the insurance and medical industries, and give basically no benefit to citizens.  We need to be eliminating the health insurance industry...not making it stronger and richer beyond its wildest dreams.


When it comes to healthcare, I believe a single-payer system is the best way to go. This would involve getting rid of the insurance companies altogether. Mandating that people buy insurance from these same companies goes in the opposite direction of single-payer and would seem to me to make it difficult or impossible to move to a single-payer system. That is the main reason why I oppose mandates.

It annoys me when certain liberals act like only a plan with mandates is "universal" and that anybody who opposes mandates is somehow against universal healthcare. Something that Hillary Clinton rather notoriously tried to claim during the primaries.

I see Obama's plan as making it easier to get to single-payer than a plan with mandates.

One of the arguments that supporters of mandates make is that they are necessary to force insurance companies to cover people with pre-existing conditions or who in some other way have very expensive health needs. I think this is the completely wrong way to go. If we want to provide something for everybody as a basic right, even people who cannot afford it, it needs to be provided by the government. That way, we can tax the rich more in order to subsidize coverage for the poor. So again, moving to a single-payer system would resolve the problem without need of forcing anyone to do anything (other than pay taxes, of course).

Most of the discussion about mandates seems to take place in a sort of bubble, where the only concern is what sounds good in theory, not what will actually work in the real world.

O/T: immigration raids

Those interested in immigration issues may find this story worth reading to see what direction Obama is going.

Homeland Security Secretary Janet Napolitano has ordered a review of a raid at a Bellingham, Wash., manufacturing plant that ended with the arrests of 28 illegal immigrants.

Homeland Security spokesman Sean Smith says Napolitano wants to know why the Tuesday raid happened and all background information, as she looks into the case.

President Barack Obama, who appointed Napolitano, has signaled for a shift in immigration policy that would rely less on work site enforcement, focusing instead on employers who hire illegal immigrants and overall immigration reform.

Smith says the raid at the Yamato Engine Specialists was the first work site action that U.S Immigration and Customs Enforcement has taken since Obama took office.


I think that the mandates might be something that they put in knowing that it will be taken out later as part of a "compromise" with the Republicans.

Krugman, Obama & Healthcare

Al, your feelings about American healthcare standards notwithstanding (and it's bad, very bad considering the wealth of the nation), universality is a crucial point. And frankly, I think the privacy ship sailed in this modern world long, long ago. Of course, there are databases on personal healthcare and yeah, they be used for bad things - just as there are databases on travel, credit card usage, law enforcement, civil justice, and on and on. Very few of us can afford to opt out of that if we want to stay in our communities and use the local docs or medical center.

There will be no mass opt-out from medical databases, in my view. And the ultimate goal is single payer, Laura P. is quite right - but single payer is a Federal mandate, a 100% entitlement program that we'll opt into with birth. And I'm totally for it - we need it, it's an important goal for a still-wealthy civilized society. (Further, it never seemed to me that Obama opposed a full mandate over a 95% mandate for libertarian reasons - I think he thought it cost too much and would be bad for business).

As for Krugman, he's not a whiner at all. He's a damned fine writer and I also credit him for his constant blogging, his regular turn in the trenches testing ideas and policies. He's to be admired. I think Jim is quite right about that. He's also right that Krugman shouldn't be treated as a liberal demigod - but I don't think he demands that either. He mixes it up well.

Mandate clarification

Tom W - I don't mind if everyone has to pay in to make health care accessible to all. What I will fight to the death is that no private insurance company or state medical system is going to get its hands on data about me. I've been off the grid for ten years. (I also have zero credit rating, pro or con, after having a bad one twelve and more years ago.) You can still get off the grid. It takes sacrifice, but there are millions of Americans that are presently in the same free conditions.

My take on Obama's opposition to mandates is two fold:

1. Political reality: He saw "mandates" used as a successful wedge to turn significant numbers of the public against the Hillary-care 93 plan (i.e. the Harry and Louise ad) and as part of that understands that there are millions of Americans for whom the personal goal is to stay off the grid. (As a rare Democrat who listened to born-again evangelicals - where a lot of those home-schoolers also shun the medical system - he is probably more aware of this constituency than most. He probably also understands that millions of artists, self-medicators, addicts (remember, this is the first president in a long time that recognizes that he himself is an addict... to nicotine) and alternative health and lifestyle practitioners and patients (there are even more than all of those than of the evangelical side of the equation, and they're part of his base) see this as a very personal issue.

If the "Obama must put mandates in" crowd has its way, sit back and watch the guerrilla warfare as so many of the very same "creative class" folks that gave life and unprecedented creativity to his campaign will turn against the health care proposal and put our creativity to work to stop it. And then the coalition falls apart on that issue. Period.

2. I do think that Obama's penchant for constitutional law and civil liberties makes him also sympathetic with us "off the grid" types from left to right in our aversion to being forced to have insurance. But even bigger than that is his political pragmatism in recognizing that while we may not have advocacy groups or lobbyists at our command, but get us riled up and we can open a big can of whoop ass on a million fronts at once. If he wants a health care coalition to include those of us that see the difference between "everybody has a right to affordable health insurance" (good!) and "therefore everybody must be mandated to have insurance" (bad!), he's not going to back down on the mandates matter.

As my performance artist friend Penny Arcade says: "Bohemia (one could substitute the word 'liberalism') is not the underground. The underground is where bohemia meets the criminal demimonde (or, alternately, 'the underclass')." For once we've got a President that has walked and organized among the underclass and the marginalized (as his two books explained) and therefore knows we exist, accepts that we exist, and doesn't try to wish us away or bulldoze us with imposed hegemony through policy.

Nice catch!

I didn't notice that line about health care being in the budget.


One thing I found striking about last night's speech was how different it was from a Dubya SOTU.  He would mock Dems and always have half the chamber booing or clapping.  Always divided.  Last night was different.  Repubs had no choice but to cheer even when they didn't want to.  His applause lines were written in such a way that they pretty much had to stand up and give him his due every 90 seconds.  I loved it.


No comment on Jindal.  Yikes.

Crossposted to DKos


Another objection to mandated insurance

Is that for the poor, it is likely to be third-class at best. Think of an insurance policy for people who have no leverage at all-not even the real leverage of leaving because it's mandatory. Car insurance is mandatory, but people can at least give up the car. Dirt cheap health insurance could be forced upon the sickest and poorest-just enough to get the barest bones of service, just for compliance sake. You can't give up the body.

Keep it simple-health insurance should be expanded Medicare, period. We are already paying the taxes, just allow us to use our benefits as we go instead of waiting until age 65. We can go to any provider that is legally licensed to practice, anywhere, anytime. Simplicity would keep the plan cheaper too-nobody trying to "administer" the mandate.

Food stamps is an example of how this works. You can go to any qualified grocery at anytime. Nobody tells you which foods to buy and eat. Instead you are informed, encouraged, to eat more nutritiously. Federal health dollars would go to any licensed physician who can legally practice for the vast majority of legitimate medical interventions. Some procedures would not be covered, just as restaurant food isn't covered, because the purpose would be to insure a broad level of health maintenance. With health, you would be encouraged by the agency to improve self-care, and have an easy way to get more information about the latest treatments.



@Tom W.

The only thing the government really needs to do for "universability" is to ensure that everyone has the *ability* to enter into the system and that it remains solvent, and that can be done through... taxes. Going the Krugman-Edwards-Clinton route (I think it's accurate to call it that because all three have endorsed this sort of system) would require three things:

1. Forking over billions of dollars to health insurance companies  in de-facto subsidies who are partially creating the health-care fiascos this country is going through.

2. Force the government to create a brand-spanking new bureacracy to enforce an insurance mandate on people (which, coupled with the ridiculous war on drugs we have already would absolutely clog our justice system).

3. Force people (like me) to buy health insurance that is simply unaffordable.

This doesn't even include the fact that a mandated system is almost certainly unconstitutional (the Fourth Amendment comes to mind).


"The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic.” JFK

About that budget...

You wrote what struck me last night. It hit me when Obama talked about having people going through the budget line by line and having already eliminated $2 trillion dollars over the next 10 years.

I didn't hear a single TV pundit last night or today pick up on what Obama is really up to here. It's in the bold type: "This budget builds on these reforms." He was talking about the budget he is about to propose. The next steps in creating national universal health care will come not in separate legislation which requires 60 out of 99 US Senate votes, but, rather, as part of the budget bill that, according to Congressional rules, needs simply a majority - 50 votes - to be passed and which cannot be subject to opposition filibuster.

I woke up thinking about it because I woke up to a NPR story about SecDef Gates making every Pentagon official sign a disclosure agreement about the budget discussions. Highly unusual the commenter said. Never been done before. The PR is that they want the officials in the room "to be free to discuss what can stay and what can go without leaks." The NPR guy threw away some line (dont hold me to it, I was sleepy) that defense and Iraq military contractors would be able to head off changes at the pass if leaks got out.

Spot on, Al...

I am SO glad we are having this discussion...I am also glad that my daughter (the one you met) is studying to be a naturopathic doctor! She feels the same way as you about most Western medicine.

True story...she got very sick a couple of months before we saw you last fall. Her illness was from a delayed reaction from steriods that were given to her when she was a teenager and suffering very badly from asthma...the asthma almost killed her 10 times when she was in high school.

Anyway, 20 years later those treatments made her very sick. But when we took her to the U-Mich hospital, the tests they did came back showing she was so healthy, the lab ran the tests twice because they thought the first tests were wrong!

So we really believe in alternative treatments and holistic medicine which the insurance companies are just now and very grudgingly starting to notice.

Our family had to pay $1,000s for other tests in a four-month period that did nothing to make her well. We paid a naturopathic healer in Detroit $250 and my daughter is better than ever. It cost a lot of money that everyone in the family scraped together, but we had CHOICES. What about people who have neither money nor choices?

The health care push from O is something we really will have to watch.

And Al, just like you did during the campaign, you are breaking things down and giving the historical and political background we need to organize and respond.

Thank you.

waterprise2 AKA Pam

Liberal with a Capital L!


Universal Insurance and Medical Records should be separate.


These should be two different issues, as I explain below.

(1) I dont have medical insurance, so when I go to a doctor and the nurse insists on a SSN, i lie. And I keep track of my lies. I have to pay my bill in full before I leave, so what difference does it make. I do this in anticipation of the medical database, which I've seen coming down the pike for years.

Why do I do this? I got a call from some medical survey firm on contract with the government a year after a breast tumor removal. She had my medical records. I had been automatically enrolled in a long-term breast cancer study by my doctor. Ms. Perky started right off the bat with personal questions I dont tell my friends. Do you do this? Do you do that? Have you ever done...? These were really personal questions about my sex frequency, drug use, mental state, job history, etc.

I hit the roof. And got myself off that study by saying I was returning to live in Switzerland. Another lie, but the only way I could do it.

(2) A good friend of mine lives in Alberta Canada. Alberta has universal health care, just like the rest of Canada. But each province has a different system and different enrollment policies. Alberta has the provincial kind and the Blue Cross add-on. All of this insurance continues with small (provincial) and bigger (Blue Cross) premiums until you hit 65. Then it’s free, in Alberta, including whatever level you were on with Blue Cross before you were 65.

Here’s where the medical records vs insurance issue comes in.

So I was up there visiting my friend after her mother died. Two things happened: (a) and (b), which I will explain.

(a) My friend wanted to get herself checked out to see if she had the cancer her mother had. So first we go to the new doctor. The only thing on her medical insurance card is blood type. That and her med. ins. number. The new doctor wants her medical records. It was a two-day rigamarole to get the previous doctors to release the records. She had to physically show up at the previous doctor offices and sign affidavits before the previous doctors would send them over to the Cancer Clinic. And -- get this -- the previous doctors popped out to verify physically that she was who she said she was, and confirm that she wanted the records to go to the Cancer Clinic.

(b) Then a relative in Ontario contracted what her mother had: some rare form of cancer. The Ontario doctors wanted to see the records. Remember the mother had died. My friend had to produce 1) a death certificate, 2) a release from the executor of the estate 3) fill out a form detailing where the records would be going and why, and 4) a form that proved she was a relative and approved this before any of this could happen.

Even though the mother’s records were now digital.

In Alberta, only the doctor is allowed to hold the records, and release them. Digital, analog, makes no difference. The custodian of records is the attending physician, with laws and fines. The fines against release of medical records, and the culture built up around privacy, are so draconian that no doctor will dick with it. Furthermore, they believe it should be that way.

My point:

Universal health care can be instituted easily. You know those graphs where people are shown like clothes-pins? Just statistics in a row? Well, universal health care can be extended to someone like that. Statistically. But there is no reason why the medical records need to be universal as well. I think this is a distinction that must be made.

The argument that you can't have good health care without all medical records existing in a common database is bogus. Insurance companies have wanted it so they can craft exceptions to coverage and care. Dont fall for it.

Alberta health care is superb from what I can see. They are in the forefront with stem cell research that saves lives that would perish here. They dont have a universal medical records database. Why should we?

I’m with you on this one, Al.


Great discussion

With deference and respect to those who call themselves liberals, this is why I no longer consider myself one. Liberals tend to see government as a means to shape society because it's for their own good.

In my opinion, the larger public health issue is the toxicity we encounter every day: processed foods grown on denuded land lacking in trace nutrients, a polluted environment (inside the home and out), and a sedentary lifestyle that keeps us disconnected from the natural world. Our medical system develops treatments for the symptoms that arise from this lifestyle.

Allowing more people to get insurance is a good thing -- these symptoms can be very severe, and require treatment. But forcing everyone to get private insurance would remove any incentive for the medical system to change. They would have a captive audience.


First the verdict and then the trial. I have no TV, Al, so I will now have to find the text somewhere {the whole text} to fully appreciate your exegesis. As to Krugman, he is a nice enough fellow but generally three weeks behind the accurate online trends at, say, Mike Shedlock, Automatic Earth, Financial Times. He's a weathervane that registers when the postcards from the edge are arriving at the general MSM mailbox, but there isn't very much fresh meat at his bailiwick. Maybe Carlos Slim elbowing into the Times has something to do with the creeping message management and panic suppression program at the Ed and Op Ed barrios in Times Town. Right now I am waiting for Krugman, since January 29, to acknowledge Willem Buiter's suggestions about the Good Bank {there will be no Bad Bank} and I predicted to friends that he would get to that by February 19, but he is on some other trajectory now. I'll go find the Obama text now {a text that Ilargi at The Automatic Earth has mocked} and see who is closer to the mark, Al or Ilargi. I remain not much of a fan of the general drift of the economic paths laid out by Geithner, Summers, Rubin and Bernanke and promoted by Obama, but the rest of the Obama concepts don't bother me. Like Al, I can't very well buy health insurance for a system I avoid like the plague, and unlike him, I do have very good credit. But I've stopped borrowing, too. I am not really sure how the economy will get fixed if the public has decided to avoid debt and avoid unnecessary expenditure, unemployment surges, stimuli fall short, banks hoard, monetary cycles enter downward deflationary spirals and maddeningly complicated derivitives drag all other credits, insurances and bonds into the event horizon beyond which lies -- what? BUT if the magic Obama Sauce can get that mojo workin' I'm all for it. Oh, anybody heard from Volcker? Is he alive?

So what do you do?

...turn 40-plus million uninsured peope away from emergency rooms because of the lifestyle choices or libertarian beliefs or privacy concerns of a small subset of that group?

Or treat them and pass that cost on to the rest of the already-insured, which includes a lot more than high income people?

The only fair way is universal healthcare, mandating Federal coverage as the minimum.

That is hardly the police state Trojan horse, folks - once you decide to procreate, or care for elderly parents, or work at a job that has health risks, man, healthcare coverage is not an option, creative class or not.

I agree, by the way, in the canny tactics that Al is talking about - Politico has more details tonight:


And it's clear universality is central to where they're going, that Obama has moved from his primary tactic to a bolder plan now that he's in powre. Maybe he always planned to, as Ezra Klein suggests. By the way, who among us believes that the penalties for not opting in will be severe? Pretty much no one - the point will be to get 90% of the uninsured to become insured through a mandate - though I'm sure the administration won't use that word - not to hunt down those who prefer to live off the grid.

Primate health care

The truth is we are all now mandated members of the health care system to an extent already, even if we don't have access to coverage — if we were born in a U.S. hospital. You can find your baby footprints on file if you look far and long enough ... we are now at the brink of standard practice being a DNA sample in the tissue bank of life.

That is a reality I resent to this day, since it's sort of like a forced baptism when you haven't even had a choice yet to decide on your religion, if any.

Obama's extreme expenditures to digitize medical records will accelerate this tendency in our society, even as it cuts costs and improves care ... making possible sci-fi services such as telemedicine, which promises to greatly expand care and greatly expand access to vast swaths of the underclass who seek such care -- for their children if not for themselves.

Technology, in the final analysis, is apolitical; it's simply a rock in the hand of a primate who is evolving with its tools; at one point, baby footprints were cutting edge — a means of categorizing the human race for ignoble and noble means equally.

But Einstein had it right, in the opposite of what he said, but meant. We must assure that our technology does not exceed our humanity. That is, in the end, what makes us human.

Mandated health care coverage, as opposed to opt-in, in terms of the care itself, is putting the technology, the bureaucracy, ahead of the human. Paying for keeping open a choice, via taxes or other means, regardless of whether we opt-in, is the humane way to go, to avoid, where true conviction exists, the rock in the primate's hand from being used against the primate.

And the truth is, that's how our system works right now, just with great inequaility. Those with no money still get care, greatly inferior and at great investment of time to find the access points, and with a price of moral degradation in the eyes of a stratified society, but they do, even if when it is too late, get to opt-in to the system. That creates a huge cost-shifting disparity, which is extremely expensive to that society, and is exploited in the system by those who benefit most from it — the very people who don't need to opt-in to the existing system because they have access to an exclusive strata of very expensive, high-level care by virtue of their income and position in life — hence the rise of boutique medicine, though it has really always existed.

That's a very inefficent system. It can be improved for the many, but not as a result of mandates — nor with the possibility of totally elimianting inequalities, which in their essence will continue to exist just the same, just as they do in France, even Germany, where universal care is the norm. The rich will always be able to opt out of the main system, even if mandates are imposed, and into the exclusive system — which is sure to become a huge market with the advent of universal care in this country.

If there are to be any mandates, they should be imposed on the health care providers, to assure if they follow the path of this exclusive care they also remain bound to provide care to the rest of us. And for those of us who chose to opt-out of getting that care from the system, that is our right; that is the humane path, so long as we do not use it as an excuse not to pay our fair share for assuring the system is there for others -- and for ourselves, or our children, should we one day trust that the primate has evolved enough to not use the stone against us.



No mandates was one of the reasons I supported Obama

There were many, but early on that was one of them.

I live in Massachusetts, where we have "universal health care" already - and mandates - through the Massachusetts Health Care Reform Law (signed into law by none other than Mitt Romney!). And mandates are a costly, bureaucratic blunder. Mandates increase the cost of insurance coverage. And at that place where people live, mandates = headaches. Before you can do anything (get a license, get a job, etc.), you have to prove you have health insurance. Tax penalties ensue if you cannot prove coverage and choose not to carry coverage. These penalties increase incrementally the longer you go without insurance. Conscientious Objection to the draft was probably easier. Just by dropping the mandate requirement the state would likely save about $1.5 billion per year.

And Al is right to be concerned about privacy. The Mass. law established a new bureaucracy called the "Health Connector" to assist consumers with their health insurance options, plans, and choices. This new agency can collect information on residents’ insurance status, income, and lifestyle as it makes its assessments. That's not really the specter of Big Brother, that is Big Brother.

Choice is always the best option. Besides, early data suggests that those who opt out of the mandate and suffer the tax penalties are only around 5%. Why bother with the expense of a mandate when the vast majority of uninsured people will opt in anyway? No, make health insurance accessible to those who want it, but don't punish those who don't (for whatever reasons they may have).

I didn't drive a car until I

I didn't drive a car until I was in my 30s because I could not afford the mandatory insurance. But I lived in a place where I could walk and bike. There was an alternative I could choose.

Mandatory purchase of overpriced insurance policies, with no caps on costs of drugs or services charged to or by the insurer, will just displace the burden from employers to employees.


Dkos comments section

Made the mistake of reading through the Dkos crosspost comments (have never commented there before).  Drawn out discussion about whether the Shock Doctrine analogy is accurate?  The main critic seems to have missed the "Reversed" in Al's title.  Then, hardly any debate on the provocative points Al made in his post.

Not to bring it here, but just appreciating how the comment section here is moderated.

There is another complaint I've been seeing quite a bit at some other places though, and that's the O-man's wishy-washy language regarding Social Security "fixes."  Some of this is a little troubling and I'm not willing yet to just chalk it up to chess playing, so we'll have to keep a close eye on that I think.  Otherwise, good stuff from Obama!

What is it about Krugman?

Here is my take on Krugman. He's a great economist. He has a good heart. It is a blessing that he writes on the op-ed page of the NY Times -- if only they had more of his caliber. However... Krugman just does not understand politics. For Krugman, you have a good idea, you implement it. Yes, but there's a lot of stuff in between the idea and the implementation, and that's called "politics." He doesn't get that part.


Digital Medical Records

I think the best balance between privacy and effeciency would be to have each doctor/hospital to house the records locally but provide a secure electronic method to transport those records when the need is present.  This would prevent from having a central database with it's associated security risk, but allow for the easy transmisson of information when it is necessary and authorized.

I did go read the transcript

I did go read the transcript and Al's observations were very useful especially his noticing how the budget would be used to slip some acts past Congress. It is really a shame that Obama had to take office just as the Ship of State went vertical. But he is very good at encouraging all of us to grab the largest possible bucket and bail like mad, anyway. I'd like to see a series of actions commence immediately that lead to some recovery of unjustly rewarded bonuses on Wall Street and stolen contract money in Iraq. The last eight years in Washington and other neocon and corporate outposts were so corrupt there has got to be an awful lot of real {not make work} investigative and prosecutorial activity that could pay for itself and even come out ahead in clawed back funds. The public relations value of that high tech stake burning would be an excellent return on the small effort needed to set that up. I say appoint Cuomo to a bench in Washington and let him start reeling in some Big Fish. That's what I am missing in all of this. So we are having a crisis? Great! Lets strike some terror in the hearts of the mighty. It's such a cleansing and redemptive atmospheric. Perhaps a darkened judge's chamber with flickering, thick Hollywood style torchiers mounted in steel straps tilted away from the walls to give the proceedings the true aura of chill. It doesn't get any better than that.


I was really hoping that we wouldn't have to debate mandates after the Democratic primaries ended...but here we are.

Mandating health insurance works quite well in Switzerland where insurance providers are not for profit.  In Massachusetts they have been a disaster.

This is a huge giveaway to the insurance industry which is why they are so supportive and contributed so heftily to the Clinton campaign.  Mandates undermine the incentive insurance companies have to lower costs by guaranteeing a pool of new consumers.  There are a whole host of other problems, including health care cost increases in Massachusetts of almost 35% more than the national average.

I'm including a link to a report by public citizen prepared by professors from Harvard Medical School.





@priscianus, I agree, but with a tad something else

Krugman wants Titan status. His nose got out-of-joint in 1992/3 when Clinton didn't make him a major medical czar in his admin. I'm not making this up. I'm gossiping. There are several articles you can find from the past where this animus was expressed.

Now he has the Nobel Prize. Now he's a Titan of the Times. But he wants to be an Obama admin savior. Everytime I see him on Olbermann and see the cock of his head and he opines, there's something about him. . .I dont buy it. I hear something completely beyond whatever he's talking about. (Maybe it's as you say: politics.) I thought it was just me and my pillowcase of visceral reactions. I have the same but for different reasons for that unctuous weasel Friedman.


Just give me affordable insurance!!!!

Look I appreciate civil liberties debates as much as anyone, but as one of the 47 million uninsured living in a state that claims it's got
universal health licked (no freaking way!), I can state the bottom line for most uninsured is getting access to AFFORDABLE health
insurance. Most of us DO want to the insurance but it's a choice between rent/mortgage vs health insurance and the roof over our
heads always wins.

I supported Obama b/c he GOT IT - most of us don't have it b/c we simply can't afford it, Al.

His philosophical fight against Clinton on mandates was she approached us as WE NEED FORCING to get insurance. That's the
BULLSHIT Line Romney and Patrick sell here in MASS which leaves us with a HMO plan costs $700 PER MONTH, ridiculous, that's
rent or mortgage payment territory $$$. Or get a plan with $5,000-10,000 deductible for $900 per quarter, basically catastrophic
insurance. NOT good choices so we choose NONE of the above.

Please STOP debating this shit out of single payer or European models, HUGE change vs incremental, left vs right, etc. JUST GIVE
US a way to OPT into AFFORDANCE health insurance before age 60, that's all I ask.


@Bill Conroy

It struck me after I wrote my post at 9:13 pm -- jesus, sometimes I never know what I think until I write it -- and then read this comment of yours: Obama's extreme expenditures to digitize medical records that there is another solution.

Why does Obama have to spend the dough? Make doctors digitize with a Fujitsu SnapScan, cheap and efficient. Xray cos. can use the bigger ones. After all, it's just a storage issue. Or is it?

It's who has control over the records. Decentralize that control, and you avoid the database disaster. Unless the purpose of this database is for something other than stated.

Digital records are a far, far, far different thing than a database. Digital records can be PDFs sent in life-threatening situations, and they remain accurate pictures with text of the exact record. Databases function at one remove. Someone has to input that shit.

My fear regarding mandated insurance

I have a chronic health condition that requires an expensive medication to treat. I can just see losing my job, being required to have health insurance, only being able to afford a policy that WONT cover my condition, and then watching a bunch of politicians pat themselves on the back that they have brought about "universal healthcare". No, that's "universal insurance".



Privacy Concerns

I'm frankly kind of shocked by the strong opinions some have against the digitization of medical records.  It will save billions of dollars in administrative costs, money that can be better spent on providing medical care for the underserved.

As for patient privacy, there is very strict legislation regarding medical record privacy.  The HIPAA statute lays out very clearly what can and can't be done with your medical information.  Having digitized medical records does not mean that big brother will be collecting information on you, or that anyone with access to a centralized database will be able to access your records.  Your digital medical records will have the same privacy protections as your archaic paper records currently do.  Digitized records will be retained per current statutes regarding the maintenance of medical reocrds and patient privacy.  They will not be able to be shared without your express consent.

The Solution

Tom W.

You write:

"The only fair way is universal healthcare, mandating Federal coverage as the minimum."

But this presupposes that the only realistic way to get universal health care in this country is to make sure that everyone (or as close to everyone as realistically possible) is covered by insurance. By and large the ones who don't have insurance are generally the ones who can't afford it, by mandating health insurance you're basically forcing people to buy something they really can't afford. 


Of course, that's the not the real problem in the United States (as far as health care is concerned). Do you know what the real problem is? The biggest problem in this country isn't that a lot of people are uninsured, the biggest problem in this country is that most of the insurance people have is both extremely expensive and doesn't cover a lot of necessary procedures, medicines, etc. You're "solution" to the problem puts an undue burdon on people who can't afford insurance and doesn't even do anything about the primary problem.


But then again, this all presumes that mandates would even be able to do what they are supposed to do, that's not even a given. People have cited mandated auto insurance as an example, but the number of uninsured drivers is still pretty damn high (hell, in my home state of New Mexico something close to half of the drivers are uninsured). So even buying into the logic that universal insurance is a good idea in theory (I don't) mandating insurance probably still doesn't guarantee that anywhere near "universal coverage".

"The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic.” JFK

voluntary vs mandatory health insurance

"Allowing more people to get insurance is a good thing -- these symptoms can be very severe, and require treatment. But forcing everyone to get private insurance would remove any incentive for the medical system to change. They would have a captive audience."

(comment by Erik, above)

I have appreciated the discussion of mandates.  I too see problems with mandates and as a veteran homeschooler I developed an appreciation for many of the libertarian views in this subculture (although our family is of the John Holt secular/liberal strand, we are definitely not evangelicals).

The quote above struck me also in its applicability to the schools--with their captive audience they have no incentive to change, which is a reason for the intransigence of many of our education problems.  Fortunately, there are options for avoiding compliance with compulsory attendance laws now in all 50 states, although there was a time when homeschooling families went to jail.  But the interesting analogy here is looking back at the history of what happened in the United States when compulsory education laws were being enacted around the turn of the century, and were resisted fiercely (although ultimately unsuccessfully) in many places.  A reading of that history, especially J.T. Gatto's book An Underground History of American Education, might be instructive in resisting mandates for health insurance.

I do believe that Obama understands the underclass and people with alternative lifestyles and am very hopeful he will hold firm to his stance against mandates.  I myself look forward to purchasing a plan as good as the members of Congress have, as at the moment my spouse and I have to purchase plans on the market.  My spouse because the non-profit Easter Seal center he works for can no longer afford to provide employee coverage, and for myself because I am working part-time.  We both have recently gotten basically catastrophic plans from Blue Cross with high deductibles and hope for continued good health so we don't need more coverage than that.

Thanks to Al for this blog and all the others I've been enjoying since I've found this site recently.

thoughts from abroad

In the German system (where I live) we have several competing 'not-for-profit' health insurances (gesetzliche Krankenkassen) and private for profit insurance companies. Unfortunately all of them have to some extent invested in shamanism (homeopathy and similar stuff not shown to be effective - and, Pam, anecdotal evidence does not consist proof). Well, maybe the placebo effect is worth the efforts:-) The 'not-for-profits' have premiums based on income and all nuclear family members are covered, the private ones have profits based on risk and every family member has to be insured separately. The inbuilt advantage of the privates for young healthy adults is slightly offset by not letting people with private insurance go back to the not-for-profits, if they are above a certain income level. The employer pays half the premiums, if you get unemployment or retirement benefits, these agencies pays half. If you are not in any of these systems, there is no mandate as far as I know. The homeless people usually do not have insurance, and their life expectancy is ca. 2 decades lower than the rest of the population (of course that has several reasons, but lousy medical care is one of them).

In total the system works reasonably, I think, although we have to fight runaway costs as well. The main reason is the pharmaceutical and medical equipment industry, who charge outrageous prices considerering the large numbers produced. Their lobbyists are way to powerful and even help drafting the laws openly.

Well, the point of this information is to say 'there are several ways to skin a rabbit', which can work. The important point in all of them is to make sure that you get efficient competition between drug manufacturers, between instrument makers, and maybe also between insurance providers. Furthermore the system needs to be simple and not waste money on enforcement, i.e. make it attractive and voluntary. Of course, a mandate without sufficient funding is neither. Since the mandate, once decided, will stay in place independent of the efficiency of funding, it is a dangerous mechanism. I expect that the 'Al category' of living intentionally off the grid would be less than 1 % in my country, and maybe a little more in the US?

One last point. We are currently also computerizing (and debating it) the health care information. The benefits of having all your medical records together for better diagnosis and treatment are huge (e.g. if you present with a rather low leukocyte level but know that it has been always low, you can stop the doctor from testing you for leukemia - if you know it has usually been much higher you take it serious). The potential disadvantage of insurance companies, government and employers snooping around is also huge. This could be avoided if the information stays with the patient, who decides whether he wants to give it to the physician. This would avoid inefficient transfers between physicians and snooping, because it would not become central (actually it should become central in an anonymous form, because it would give lots of medically useful information).

Wellness Care vs Illness Care...

Do people remember that one one big focus for O is "Wellness" care vs "Illness" care which is what is mostly available in America. By encouraging a paradigm shift to emphasizing healthier lifestyles and wellness care, health costs would be greatly reduced overall.

The First Family is a great role model for that (except of course for the occassional cigarette sneaked by the Prez--which shows how hard it is to break that habit)...and of course, the insurance and drug companies make huge profits from sick people, not so much from healthy people!

Case in point: as a former public school teacher, I can personally vouch for the fact that when art, music, and p.e. were stripped from the curriculum in order to have more time to "teach to the test" and "No Child Left Behind", not only do we have less healthy and more obese children, but lower test scores overall as well!

As my daughter and all practioners of naturopathic medicine will tell you, wellness must be a holistic endeavor; which is mostly was in America until the early part of the 20th century when the drug companies found out how much money they could make.


waterprise2 AKA Pam

Liberal with a Capital L!


Politics and Economics Don't Mix

"(T)hose in power use times of crisis to supplant the state with private sector capitalism."

When turned on its head, the state becomes tyrannical.  It's always done ostensibly to benefit the population, but it invariably backfires.  And because it has a mandate of state power, it becomes much more powerful than any private sector interest can.  It lords over us all.

Politics and economics don't mix.  Keynesian philosophy does nothing more than to drum up a means by which the state can insinuate itself into the affairs of its citizens.  The founders of the nation knew this and drafted the constitution accordingly.

George Bush's problem wasn't that he was too conservative.  It's that he most certainly was not.  Consider that, while it took Bush eight years and two wars to bleed the treasury, it took Obama et al. less than six weeks to treble the national debt.  His promise of withdrawal fro Iraq is laudable but hardly differs from the rhetoric of the Bush administration in the latter half of 2008.  Why don't we call what Obama's doing in Afghanistan what it is; a SURGE modeled on the arguably successful campaign undertaken by the Bush White House and opposed by Obama while in the Senate and, more tellingly, on the campaign trail.  Guantanamo is, as it should be, operating as it always has (and has recently been found to conform to the standards of the Geneva convention).

Even more potentially damaging to the government and the nation than the irrational, inordinate vitriol aimed at Bush (which discredited any substantive criticism) is the servile and fawning adulation of Obama.  It subtracts the skepticism and suspicion of the citizenry from their relationship to their leaders, which is the unique ingredient of the US Constitution that prevents the abuse of superintendent authority.

@ Rowland

Rowland - I'm sympathetic with some of what you say, but I am guessing from a completely opposite direction. For example, in the early 20th century, most of the Ukraine's population had rejected both State power and capitalism, forming a locally based and decentralized form of self-management through Workers Councils (the workers owned the factories and the farms). Nestor Makhno, one of the organizers, called it anarchism.

For that brief shining moment they successfully fought back both the capitalist exploiting White Guard from Poland and the nascent Soviet regime. Eventually, though, the Soviets crushed the Ukrainian experiment (which was more true to Marx than anything the Soviets ever attempted).

Fast forward to the fall of the Berlin Wall: Many diehard communists argued that it did not represent the failure of centralized state communism because the Soviets never truly practiced it. While the latter point has truth to it, that was still a losing argument. And, likewise, the argument that George W. Bush (or Bush, Sr., or Reagan) "weren't conservative enough" doesn't change the fact that the conservative free market ideology as we know it is widely recognized to have been be a harmful failure.

George Soros, the other day, speaking on the current economic crisis commented that the only thing he'd ever seen in his lifetime comparative to it was the fall of the Soviet. He's right. That's kind of what is happening right now, and I'm guessing that there's going to be some kind of fusion between statist and libertarian philosophy as the next phase of human governance, if we're lucky.

In this present age when the uber-state has emerged from the private sector - gigantic corporations that have more power than governments and merely use them as their police forces and to manage the contraband - some form of state power is necessary to beat back that form of absolute tyranny. (Free marketeers need to come to grips with the fact that their ideal system does not bring more freedom, but, to the contrary, an authoritarianism without a flag).

In any case, the people are fed up with the "free market" ideology and the canard that less government is better government. And unless and until some modern-day Nestor Makhno and friends can make a locally based anarcho-syndicalist federation emerge somewhere as a model (something that is a ways off, I think, mainly because the population has lost certain skills of self sufficiency on the local level - humans have literally devolved and been made softer by our own beloved technologies - and it will take generations, if ever, to rebuild those skills), the only lever that people can pull to reign in the autocratic private sector is that of government.

I distrust state power. But I distrust corporate power a lot more. With the former, communities and organizers at least have a shot at steering it from the ground level. The latter doesn't even have whiff of democracy in its DNA. 

Thus, the argument that the free marketeers would have succeeded if they had only been more conservative is as moot as the argument that the Soviets would have succeeded if they had only been more communist. Both could theoretically be true. But both have failed as experiments (mirroring the same mistakes of centralization and authoritarianism) and something new must be born.


2010 budget here:


No cuts in defense, shame.

Evolutionary Meliorism

Rowland, while I share your suspicions of state power, I must say that your discourse leaves out--as most abstract accounts of social and political life must--any consideration for human bodies, in other words, actual lives. To go on about the insinuation of the state into people's affairs vis a vis Keynesian philosophy leaves out the glaring fact that there is no entity with power--other than the individual herself and the government, again theoretically, of, for, and by the people--that can protect the people, i.e.: reduce their pain. To (theoretically) ignore this fact that people are hurting now, as in the past and future, is a convenient elision (an accounting trick) that, in a discussion about rights, ends up leaving out the real reason for even talking about rights. We do not live in theory; we live, and we indulge in theory. Thus, abstract arguments about rights that elide human suffering are pernicious in my view. The question becomes one of how to ameliorate that suffering that abounds around us and is visible if we deign to open our eyes.  No theoretical system, whether capitalist, communist, anarchist, or whatever, will truly rid the world of suffering. The question is then not so much what theoretical system is best, but what practices and policies will reduce the suffering of the most people most efficiently right now.

I have quoted the poet Thomas Hardy before at this site, but his words from 1922 are salient today. He writes:


And what is to-day, in allusions to the present author's pages, alleged to be "pessimism" is, in truth, only such "questionings" in the exploration of reality, and is the first step towards the soul's betterment, and the body's also.

If I may be forgiven for quoting my own old words, let me repeat what I printed in this relation more than twenty years ago, and wrote much earlier, in a poem entitled "In Tenebris": 

If way to the Better there be, it exacts a full look at the Worst: that is to say, by the exploration of reality, and its frank recognition stage by stage along the survey, with an eye to the best consummation possible: briefly, evolutionary meliorism.  But it is called pessimism nevertheless; under which word, expressed with condemnatory emphasis, it is regarded by many as some pernicious new thing (though so old as to underlie the Gospel scheme, and even to permeated the Greek drama); and the subject is charitably left to decent silence, as if further comment were needless.

Happily there are some who feel such Levitical passing-by to be, alas, by no means a permanent dismissal of the matter; that comment on where the world stands is very much the reverse of needless in these disordered years of our prematurely afflicted century: that amendment and not madness lies that way.  And looking down the future these few hold fast to the same: that whether the human and kindred animal races survive till the exhaustion or destruction of the globe, or whether these races perish and are succeeded by others before that conclusion comes, pain to all upon it, tongue or dumb, shall be kept down to a minimum by loving-kindness, operating through scientific knowledge, and actuated by the modicum of free will conjecturally possessed by organic life when the mighty necessitating forces - unconscious or other - that have "the balancings of the clouds", happen to be in equilibrium, which may or may not be often. (557-8)




In Tandem...

@ Sophie...thanks for your comments...

Homeopathic medicine is meant to work in conjunction with Western Medicine...it doesn't have to be an either/or...there are a lot of good things about both...

probably the best thing about homeopathic medicine is that is emphasizes prevention and lifestyle issues before one gets sick...

Western medicine is just now moving in that direction...


waterprise2 AKA Pam

Liberal with a Capital L!


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About Al Giordano


Publisher, Narco News.

Reporting on the United States at The Field.

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