HEALTH CARE/Joan Retsinas

Revisiting the Wisdom of Charlie Wilson

When Charles Erwin Wilson, CEO of General Motors and President Eisenhower’s nominee for Secretary of Defense, came before the Senate Armed Services Committee, he allegedly said what is good for General Motors is good for the country. (The reporter misquoted Mr. Wilson, who suggested a more nuanced entanglement: General Motors was so large that its interests were inseparable from that of the government.)

The principle still holds among many Americans: leave the private sector to flourish, and “we the people” will flourish in concert. Our President has adopted this conceit; he sees government as a handmaiden to business, particularly his personal businesses.

Of course, we cannot have a robust nation without a robust private sector; yet the bottom line of Business can sometimes hurt “we the people.” A corporation weighs costs and revenue to decide its bottom line. It does not need to consider the “externalities.”

Here are a few examples.

Many working-age Americans are addicted to opiates. Public health officials, along with police officers, social workers, and employers, have raised the red flag: the nation faces an epidemic. Some states now restrict the easy prescriptions. Recently CVS announced that it would limit prescriptions, and the pharmaceutical association called for restraints.

Insurers face a dilemma. Opiates are more addictive than similar drugs, yet cost less. Looking at their bottom lines, some insurers have encouraged use of the opiates. In the long run, the insurers are acting against the public health; in the short run, they are maintaining profits.

The coal-mining industry in West Virginia is shrinking. In the wake, miners have been left redundant: those who once earned up to $80,000 annually are searching for jobs that pay $16 an hour. Families that enjoyed a middle class life are scrounging. One “externality” of mining has been contaminated land, lakes, and rivers – not easily cleaned, sometimes contaminated too far into the future for environmentalists to calculate. The tradeoff is depressing: do we save the Earth, while plunging families into poverty? Or do we keep the industry (which may face extinction within the next few decades) afloat, at the cost of the land?

The remaining mining owners, indeed the miners themselves, want short-term prosperity. Yet swathes of the state risk morphing into Superfund sites, dangerous to the health of anybody who wants to fish, swim, hike, even live there.

Obesity ranks high as a public health menace. Simply put, too many of us weigh too much. Walk through a mall, squish into airplane seats, or watch plump actors tout diabetes drugs on television to glimpse our girth. We know the villains, from sedentary lifestyles to fat-rich restaurant foods to a profusion of snacks (the lure of a “fourth meal,” late at night, was hatched in marketing departments.) Soda belongs on that list: a lot of calories; few nutrients.

Big Soda, eager to grow its market, wants to capture patrons early. If a child drinks soda with meals, he may drink soda as an adult. The school lunch program includes milk. Why not allow soda to be sold too? Or allow the machines in school hallways? Many children would reach for soda over water or milk, as would their parents.

Big Soda pays cash-strapped districts bonuses. The arguments, as well as the money, are alluring: Inviting Big Soda into the schools can’t hurt. The children probably drink it after school anyway. And schools can use the money to pay for sports.

In all three instances, the companies – insurers, mines, and soda – are behaving rationally. Their shareholders (which include pension funds and unions) expect no less. Charlie Wilson was correct: the interests of those companies are entwined with the country.

Our economy suffers when any major corporation fails (remember the debacle when our auto industry was sinking and Uncle Sam rode to the rescue with a bailout). We don’t want an insurer, a mining operation, or Big Soda to go into Chapter 11.

At the same time, we want to balance the public’s interest in corporate decisions. Uncle Sam needs a seat at the table, needs to accept some responsibility for the externalities of corporate governance, needs to speak for “we the people.”

That seat can be expensive: we can curb insurers, but we should also fund rehab. We can force mines to curb their poisonous outflows, to pay for environmental cleanup operations; but we should also rescue unemployed miners with subsidies for food, healthcare, and retraining. We can restrict soda sales in schools, but we should also fund schools so they don’t need Big Soda’s bribes.

We search for demons. On the far left, Americans want to curb the evil private sector for the good of the country. On the far right, Americans want to curb bungling government, to unfetter the efficient private sector, for the good of the country.

In truth, we need both: a robust private sector, and a robust public sector. They are entwined.

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

From The Progressive Populist, November 1, 2017

Populist.com