HEALTH CARE/Joan Retsinas

The Elephant at the Republican Convention

Memo to stalwarts at the Republican National Convention: You had an elephant in the room. Not cartoonist Thomas Nast’s pachyderm, the one he drew to represent solidity (in contrast to the donkey – more a jackass – that Republican Nast drew for the Democrats.) Nast’s 1874 logo has lasted; the Convention featured stylized versions of it.

This elephant – overlooked yet hovering — was Government. On the one hand, Government was the bete noire of the Convention. Government is too big, too avaricious, too inefficient. Its profligate ways have driven up the deficit, driven up taxes. The solution for America’s ills is to pare Government more than a few notches, to let the ordinary Joes and Janes (wealthy folk revere ordinary folk) live their lives unfettered by the feds. So droned the mantra.

On the other hand, an activist Government – the one that undergirds the wellbeing of the very unordinary Conventioneers — was the missing pachyderm. The conventioneers, even as they railed against their bete noire, were oblivious to its beneficent omnipresence.

Consider health. Without Government, we would all – rich, poor, Republican, Democrat – live in a filthier world. Thanks to federal regulations, everybody breathes air that is cleaner than it would otherwise be. Environmentalists might complain that the myriad of regulators are not zealous enough, but without Government’s oversight, we’d all be coughing. The Tea Partiers should search for blue skies in a city without air emission controls, maybe in Mexico or China. Ditto for water. Our streams, lakes, and rivers are not pristine. Superfund sites testify to the myopia of private industry – or maybe its callousness. Yet without government controls, some too late to be effective, and without reclamation efforts, we’d wallow in toxins.

Government is behind the safety of our transit. In the developing world people die on the road – poor roads coupled with unsafe vehicles coupled with untrained drivers. If we banished the highway safety regulations, automakers could scrap those annoying air bags, nix all those recalls, drop the pollution controls. We’d have cheaper cars, pay lower taxes.

And medications! The conventioneers keeping their blood pressure, their triglycerides, their cholesterol low with daily pills should pause: what role did government play in the research behind the development of the wonder drugs? Think “National Institutes of Health,” funded courtesy of taxpayers. Similarly, we take the safety of medications for granted, but without the Food and Drug Administration, we’d rely on the vigilance of private pharmaceutical firms.

As for Medicare –a mini bete noire – remember when Medicare didn’t cover prescription medications? And we left private insurers to devise solutions? The outcry from seniors spanned all parties, all income levels. President George Bush’s solution – one many of his Republican colleagues supported – added Part D, a prescription benefit to Medicare. Ironically, Part D’s costs hinge in part upon concessions give to private insurers – a concession urged by Republicans.

Indeed, Republicans should pause before pressing a voucher system to replace Medicare. Do they want one of the current hodgepodge of private plans for themselves? For their families? The Wall Street Journal, in a linguistic bow to the Olympics, has described the “hurdles” cost-cutting plans are now erecting (Anna Wilde Mathews, “Remember Managed Care? It’s Quietly Coming Back,” Aug. 2), like limited networks and required pre-authorizations to see specialists. (The Affordable Care Act, a.k.a. Obamacare, has ended the exemptions for pre-existing conditions.)

Finally, everybody at the Convention wanted to slash Medicaid. “An opportunity not a handout” was the mantra. Ironically, delegates and politicians who didn’t pull themselves up by their own bootstraps urged poor Americans to yank on those proverbial straps. But the putative boot-strappers live among the conventioneers — mowing their lawns, serving their meals, cleaning their toilets. Those needing “an opportunity, not a handout” need the handouts to live. Medicaid, food stamps and welfare are not fringe benefits. Again, to see a country where governments let people sink or swim on their own savvy, conventioneers should visit the developing world. No expensive, intrusive social welfare programs there.

The hallmark of a humane progressive country is a government that improves the lot of citizens. We all depend upon that government. Only the Republicans don’t know it. They don’t see that very real elephant.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email

From The Progressive Populist, October 1, 2012

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