Inadequate health care is but a symptom of a much larger crisis: the devaluation of justice and empathy in an orgy of greed.
Of all civilization’s constructs, wealth may exert the greatest influence. The means of producing what people need greatly influences the perception of wealth. Horses lost a good deal of value after the invention of steam and reciprocating engines. After the modern invention of credit, gold and silver became arcane investments in all but times of financial chaos. Virtual wealth, as measured by money, now sets a price on everything, even the priceless.
Capitalism developed during the ascendance of virtual wealth. It provided a means for acquiring virtual wealth that could be used for acquiring real wealth. The virtual requires a basis in fact, something for which it can act as a surrogate. Oil, wood, coal, gold, steel, food, labor, and all the rest of what actually supports us serves as the cannon fodder for capitalism. Converting real wealth into paper wealth evolved as the method of producing “wealth.” Virtual wealth furnishes the prize and therefore, the cost of production is measured in terms of dollars, not in terms of efficient use of resources. Profit is measured in terms of the difference between production costs and receipts. When wasting resources saves money, waste becomes part of the production process. Only regulations that require resource efficiency can change that environment.
Virtual wealth functions as a form of ephemeral barter. People who make money on wages can trade it for groceries. Virtual wealth permits extensive and sophisticated divisions of labor, which in turn, supports a complex set of market relationships often referred to as “The Free Market.”
“Free-for-all” might provide a more accurate label. An amalgamation of deceptions renders the market anything but free. But, that is another story. The point here is that the ease with which the supply of ephemeral wealth increases through the exploitation of resources fosters the illusion of unlimited growth. That unintended consequence of capitalism’s way of producing “wealth” will exhaust real wealth, which is not unlimited. We can print money until the end of time but we cannot eat it.
Digital production methods and a global economy, the ability to make almost anything anywhere and thus pit one labor market against another to keep lowering wages, has fostered another illusion, or fraud. Those countries exporting their production economies rely on a “service” industry to replace the wages lost by exporting manufacturing. They assume that the debts generated by any kind of service economy will support an endless supply of virtual wealth for use in bartering for real wealth, like housing.
There is nothing wrong with the theory but the practice is another matter. Limited real wealth cannot support a continually expanding service economy. The expanding wage debt will justify the endless printing of money, which will inflate the cost of real wealth while destroying it because, whatever the debt, the government will have to keep printing enough money to pay for the wages and to keep the economy going.
Since the exportation of the production economy in the service of corporate profits, huge increases of those employed in health care, finance, and information technology have arisen. Important as these services may be, they seldom produce real wealth. Often they have become bloated enough to produce bubble economies that burst—too much virtual wealth chasing too little real wealth on the basis of self-fulfilling prophecies. Wages remain stagnant while these inflationary trends continue so that, even with the expansion of service employment, people no longer have the necessary virtual wealth to pay the inflated price of real wealth. The illusion that we can convert to an “information” economy ignores how, without wisdom, information can be misused, let alone how useless it is without real wealth.
Information that increases the efficient use of real wealth has value. Unfortunately, in the context of present capitalism, information is seldom used for purposes of increasing efficient use of resources. The adaptation developing from the illusion of unlimited growth and the greed it inspires in the context of diminishing resources I refer to as the Victim Economy. Victims provide the source of profit—institutionalized extortion. Market economics has eroded the meaning of “extortion.” Maximizing profit has co-opted the ethics that once defined extortion.
The Victim Economy describes one of the unintended consequences of a means of production that ignores intrinsic values. People who grow corn develop a different set of values than those who market its uses. Food going directly to homes or farmer’s markets does not suffer the processing and packaging that goes with grocery stores. Farmers sell quality at the lowest cost. Grocery stores sell packaging and brands. Different modes of producing virtual wealth evolve different values.
Doctors once sold health care on the basis of reputation and cost. HMOs sell health care on the basis of profit margins for the middlemen in the insurance industry who control coverage and eligibility. Reputation and affordability mean little to them. Like the auto industry that prefers to make xx dollars on one SUV rather than xx dollars on ten little cars, HMOs want people who can afford to pay exorbitant prices and who will probably never get sick. Hence millions who need it most go without coverage. That strategy permits HMOs to hire fewer doctors but more “information” people to assign the task of limiting coverage and eligibility while charging exorbitant prices for “miracle” drugs. Extreme capitalism, like organized crime, finds extortion the most profitable means of producing virtual wealth.
Credit card companies now charge interest rate that were illegal for centuries. They want customers who cannot pay on time so that they can add fees and penalties to the cost of borrowing money. Those charges were once considered part of the interest rate and therefore subject to the interest limit. Only those who may never pay anything are denied a credit card. The rest of us pay for the defaults of others in higher prices.
Keeping all the people now employed in the finance industry busy required them to make loans to people who could not afford to pay them and to gamble on esoteric securities. As in all the examples noted (There are many more.), a good deal of deception helped to keep the bubbles going. Health care has led the bubble machine for decades and may well destroy the economy if not reformed. Health care, as a necessity, is a bubble that cannot burst but it can bleed us to death. The unreasonable cost (no other country pays so much for so little) of health care keeps labor and small business desperate. They become willing to make many concessions that net them nothing but stagnation while the middlemen who contribute nothing skim off the top.
The Victim Economy has other antecedents. The rise in virtual wealth and the deification of money as the engine of salvation—the ability to keep up with the bubbles—birthed the construct that managing money provided the means of governing almost anything, as if it had intrinsic value. I will not pursue that fallacy here. I only offer the observation that money must serve the efficient use of resources, which we must manage to survive, not destroy resources for paper values.
Those who control capital no longer have to put a gun to someone’s head to steal our money or labor. Manipulating the distribution of money provides a more efficient means of exploitation—an unintended consequence of managing money as the arbiter of wealth. Many of the exploitations, like interest rates, have been legalized and as a side effect many Ponzi schemes can be constructed to look legitimate. The extent to which the economy has become a victim economy raises the question of whether or not we can now produce anything but bubbles.
Another antecedent to the Victim Economy I refer to as the American Pathology: making it big as the transcendent value. The culture of celebrity and wealth idealizes material success: get rich or die trying. The drive to attain those goals appears to many as a justification for exploiting other people’s labor. The Victim Economy is also sanctified by the Religion of Money, which holds that money proves god’s love. If you cannot afford health insurance, God does not love you and government should not defy God—the philosophy of Ayn Rand.
Corruption is the greatest obstacle to a liberal democracy offering justice for all. We rush headlong into the ethical meltdown—institutionalized corruption like lobbying—that has kept so many Third World countries in the hands of despots. Conflicts of interest, if not now, will soon swamp our heritage and institutions. Everything is for sale when the prize is making it big. People in Congress who must vote on health care reform invest millions in HMOs who use health care as a means of extortion. The sweet deals industry receives from the agencies that are supposed to regulate them arise out of conflicts of interest.
The failure of capitalism to provide our children with a future did not (and will not when its time has finally come) occur because of evil people. The means of production created the values that evolved the Victim Economy as a means of adapting to the means of production—we are what we adapt to. Marx saw it first but failed to address the problem in any meaningful way.
Having eliminated most of the labor that once supported people, the machine economy accelerates the conversion of wealth into paper values that precipitate playing games for money, not efficient production. The success of that endeavor will leave us with nothing but money that will then have no value and stop circulating.
We could have the best health care at the most reasonable price in the world, but not if the degeneration of our values under the American Pathology and the Religion of Money continue to support a Victim Economy. A failure of empathy leads to a failure of civilization.
The reasons why congress has so much trouble resolving the health care crises go beyond partisan politics, which reveal the symptom but not the disease. A constellation of entrenched values, cited earlier, on one side and the systemic limitations on what is left of our economy after we exported the business of manufacturing evolved a social cosmology that is bipartisan. Both sides of the argument carefully avoid recognizing that costs will continue to rise under a privatized profit regime subsidized by taxpayers. There is no real competition under those circumstances and there are a great many vested interests in keeping the health care bubble going. Only a single-payer nonprofit regime can succeed but forty years of propaganda that government cannot do anything right and the vested interests in the bubble economy health care provides currently conspire to block that option.[1]
[1]A complete discussion of the concepts relied upon in this essay can be found in the book, Natural Selection’s Paradox: The Outlaw Gene, the Religion of Money, and the Origin of Evil by Carter Stroud.
