Democratic Forest Trusts (PDF)in Watson, Alan; Dean, Liese; Sproull, Janet, comps. 2006. Science and stewardship to protect and sustain wilderness values: Eighth World Wilderness Congress Symposium; 2005 September 30-October 6; Anchorage, AK.Democratic trusts with leadership elected by citizen-members promise to solve many of the problems afflicting both traditional government and corporate ownership of forestlands. This article explores these issues in some depth.Complexity and the Dream of Human Control of Eco-Systems (PDF)in Watson, Alan; Dean, Liese; Sproull, Janet, comps. 2006. Science and stewardship to protect and sustain wilderness values: Eighth World Wilderness Congress Symposium; 2005 September 30-October 6; Anchorage, AK.The title captures it. I then explore the kinds of institutions compatible with both nature and the modern world that are implied from this analysis.Rethinking the Obvious: Modernity and Living Respectfully With Nature (PDF)The Trumpeter: Journal of Ecosophy, Winter, 1997.Modernity is usually considered a wrong turn in terms of respect for and sustaining the environment. I argue the reality is more complex, for modernity has freed us from personal dependence on agriculture, ended the economic value of children, radically reduced the likelihood of large scale wat, and shifted much production to intellectual rather than material capital. This partially decouples society from nature, which gives us important opportunities as well as problems.Towards an Ecocentric Political Economy (PDF)The Trumpeter, Fall, 1996.This paper begins my effort at showing how liberal modernity can be harmonized with an ecocentric perspective on our relationship with the natural world. It is a corrective to much “free market environmental” literature that sacrifices Nature to money as well as to anti-liberal attacks by well-meaning but economically naïve environmentalists.Unexpected Harmonies: Self-Organization in Liberal Modernity and Ecology (PDF)The Trumpeter, Journal of Ecosophy, 10:1, Winter 1993This is my initial paper exploring how what I term ‘evolutionary liberal’ thought can be an important means by which society and nature can be brought into greater harmony. The other Trumpeter papers build on it.Deep Ecology and Liberalism: The Greener Implications of Evolutionary Liberalism (PDF)Review of Politics, Fall, 1996.Liberal thought and deep ecology are usually regarded as mutually exclusive. But the “evolutionary” tradition offers a way to integrate the two through commonalties in the work of David Hume, Michael Polanyi, Arne Naess, and Aldo Leopold, providing a stronger foundation for liberalism while strengthening the case for an ecocentric ethic.(Related subjects: Ecology)Saving Western Towns: A Jeffersonian Green Proposal (PDF)in Writers on the Range, Karl Hess and John Baden, eds., University Press of Colorado, 1998.Developmental pressures in the rural and small town West involve three groups: long term residents, new arrivals, and environmentalists. Today their interests often conflict. This conflict is in part the outcome of institutions which prevent harmonizing competing interests. The concept of developmental trusts, both for rural regions and for small communities offers a means whereby these interests can be harmonized for the benefit of all concerned.(Related subjects: Politics)Social Ecology, Deep Ecology, and Liberalism (PDF)Critical Review, 6: 2-3, 1992.Murray Bookchin is considered a leading radical environmental theorist. However, his analysis is incapable of leading humankind towards a more respectful and sustainable relationship with the natural world. Criticisms of Bookchin from both the deep ecology and evolutionary liberal perspective complement one another, pointing the way towards a better understanding of how modernity relates to the environment.The paper as a whole offers an early discussion of issues that are more clearly addressed in later papers, particularly Deep Ecology and Liberalism (1996) and the three Trumpeter articles in 1997, 1996, and 1993. However, there are other ideas in the article which have not been developed more thoroughly elsewhere.
I am amazed that I have heard so little as to why the purely private option no longer works for medical insurance and never will again. The reason lies in the very logic of capitalism and the market. While right wingers have made the national debate pretty mindless over health care, as over everything else, I will do my little bit today to add some rationality.
Insurance works on the principle that a certain number of people in a population will need help, that number is predictable, but we have no idea who among the population will be the ones affected. Therefore we pool our resources to cover everyone’s risk, a few paying less than they will need, most paying more (because they will need nothing) and everyone being safe from the financial impact of that particular disaster. It is very simple logic, and works for car insurance, home insurance, and many other kinds of insurance.
It does not work for medical insurance.
The reason is simple. With the growth of scientific knowledge the pools keep getting sliced smaller and smaller. We can tell who is likely to need insurance the most, and if they are excluded from a pool. We can offer lower competitive rates to those included than can a company that does not exclude those most likely to need help. Very simple.
We see a version of this issue with auto insurance. Rates go up as we accumulate points in moving violations because we are more likely to need insurance. But unlike health insurance, we can alter our behavior so that rates go down. Or as we get older, rates go down, at least until a certain point. Here the variability of insurance rates is probably beneficial. In health insurance it is mostly a disaster.
The result is that some medical insurance that to those statistically needing it least, can be good. Others are priced out, or can get it only if they have a job that provides it. As a result in America people keep crappy jobs because of the insurance, avoid starting their own businesses because they do not want to put their families at risk,and at a rapidly rising rate, go into bankruptcy over medical bills: 62 percent of all bankruptcies in 2007 were due to medical debts, around 46 percent in 2001 and only 8 percent in 1981. The LA Times has a good summary and some heart wrenching examples.
To make matters even worse, profit-minded insurance companies are
dropping the needy as soon as they can figure out a means to do so. As Businessweek reported, the author of a recent Harvard based report published in the Journal of American Medicine said:
“For middle-class Americans, health insurance offers little protection.
Most of us have policies with so many loopholes, co-payments, and
deductibles that illness can put you in the poorhouse,” said lead
author Himmelstein. “Unless you’re Warren Buffett, your family is just
one serious illness away from bankruptcy.
“
All the pompous free market talk about the “miracle of the market” is so much blather because those emitting such sounds do not understand WHY a ‘free market’ works in some cases for insurance and not in others. They treat it like a magickal phrase. I am reminded of the behavior of members of a cargo cult.
All this assumes the insurance companies are honest. Now Congressional investigators have discovered they are not. I am not surprised. Corporations are designed to act like rational sociopaths, and it is small wonder that human sociopaths have an edge in rising ti the tops, men and women who cheerfully bilk people when they are the most vulnerable, to feather their already overly large beds.
Single payer is far and away the most logical form by which health insurance can be provided because it returns us to insuring the entire pool, all of us. Anyone who has taken much time to look at how it has been applied elsewhere knows that compared to the American model, by every measure of price, coverage, and overall quality that includes the population as a whole, it has proven superior.
posted June 30, 2009 at 3:10 pm
Healthcare reform proposed by the Federal Government may actually eliminate affordable medical insurance from the private sector entirely.
While publicly funded healthcare may seem to create affordable medical insurance for more Americans, it may actually create a bigger problem.
posted June 30, 2009 at 3:19 pm
(Much of what happens these days puts me in mind of cargo cults. “If we keep spending, prosperity will return…”)
posted June 30, 2009 at 3:51 pm
There’s also the issue of elasticity of demand. With normal goods, one can simply decide not to purchase. The same is not true of health care. Dying is not a viable economic choice. As a result, those companies involved in providing or facilitating health care can charge as much, often even more, than the market will bear.
posted June 30, 2009 at 3:57 pm
Partly so, Thomas, but a lot of people are deferring health care and check ups. Deferral is often rational from an individal perspective given today’s realities, but it irrational from a social one because prevention is usually cheaper than cure or amelioration.
In addition, an issue I did not bring up, health insurance is locally often quite monopolistic or oligopolistic, and apparently becoming more so. This sad fact strengthens Thomas’s point.
see
http://www.marketwatch.com/story/study-confirms-health-monopoly-fears
posted June 30, 2009 at 6:55 pm
Many people defer preventive care because they can’t afford it. Even with a copay, it’s too expensive for some folks to be able to pay for the doctor and the medical tests involved. When I had my first preventive colonoscopy, it cost me over $500 out of pocket. And I had good health insurance. But for a secretary making $33000 a year, $500 is a great deal of money.
Now, since I was laid off last year, I have no health insurance. I’ve been deferring doctor visits and bloodwork until the doctor wouldn’t refill my meds anymore.
In the meantime, private insurance companies are making record profits.
posted June 30, 2009 at 10:32 pm
Gus, I lived in South Korea. I was an English teacher there. I thought I had testicular cancer and had to access the government health care via my employer. It was awesome: cheap and thorough. I didn’t even need any appointments or referrals.
I dunno. Americans are suckers for capitalism. I’m starting to think that I’m a Communist/Marxist. I do enjoy benefits of marketed technologies, but at what cost to necessities?
posted June 30, 2009 at 10:41 pm
I agree something needs to be done. The existing system does not work but the government has proved to be incompetent at EVERYTHING, even those things that government is supposed to be good at. It looks like a no win situation to me. Where’s Captain Kirk when we need him.
posted July 1, 2009 at 10:05 am
A Public Option is not going to run private insurance out of business, but it will provide a new competitive model that is sadly lacking. As long as there is a standard that everyone can access, market pressures will drive out those insurers that don’t offer something better, but any private group that can surpass the public offering will do just fine. Those who have money to burn for superior insurance will still be able to get it, but the rest of us who have nothing now will have a badly needed safety net.
I’ve been uninsured since I finished school, except for 2 yrs when my employer offered coverage. It was cancelled because it was too expensive, and my boss couldn’t afford to keep it up. I spend a significant portion of my income to keep my kid covered, but if I get sick or injured myself, I’m completely screwed.
I have no sympathy for greedy insurance companies that line their pockets at the expense of the needy & the vulnerable. If they go out of business, it is a sign that justice still exists in the world.
posted July 1, 2009 at 11:39 am
As a Canadian who only has lived in a single payer system, I wonder if the US has the kind of societal consensus necessary to make the tough decisions that a single payer system must. American society seems polarized on many issues that are central in a single payer system – contraception, abortion, “futile” care, assisted reproduction, etc.
posted July 1, 2009 at 12:20 pm
Good and valid observations of government bureaucracy aside (just for the moment), the vast majority of people simply do not understand how insurance works. Gus made a good start in explaining it. It bears repeating often (though I’ll refrain).
The crux of the problem is profit. A for-profit insurance approach will, by definition, fail to cover some people. How many is based on how profitable each carrier tries to be.
It actually doesn’t matter how health care cost is covered. What matters is whether those covering it are trying to make a profit. Health care reform should start with the decision to make it not-for-profit, and elevate it to the same level of national mandate as national defense.
posted July 1, 2009 at 1:00 pm
South Korea is not a communist/marxist nation. Actually I don’t think there are any real communist countries left. China clearly is not really communist, and the healthcare system there is sorely lacking.
Since communism/marxism has proven to fail into simple feudalism, it will probably be as unable to provide decent health insurance as the Corporate feudalism which masquerades as capitalism in America today. The countries which have the best healthcare systems as evidenced by low infant mortality rates, long lifespans, and low levels of untreated epidemic and endemic diseases seem to be the ones with capitalist-based highly democratic semi-socialist governments.
I don’t trust governments to do anything right, but I trust Corporations even less. At least government as practiced now in America is somewhat transparent and must eventually answer to the folks who elect the politicians. Corporations are entities which are legally created to shield their directors from liability for their actions, and whose goals are specifically the merciless creation of maximum profits. Either capitalism or communism, when not regulated by a self-interested and self-serving electorate, will fall quickly into feudalism, in which a few overlords hold control over most property, and everyone else winds up serving them.
No matter the name of the governing system, the core of getting good healthcare will be weeding the parasites and predators out of the system.
Sadly, it seems many of our politicians have their hands in the pockets of the parasites and predators.
Thermal
New Age Cowboy said;
June 30, 2009 10:32 PM
Gus, I lived in South Korea. I was an English teacher there. I thought I had testicular cancer and had to access the government health care via my employer. It was awesome: cheap and thorough. I didn’t even need any appointments or referrals.
I dunno. Americans are suckers for capitalism. I’m starting to think that I’m a Communist/Marxist. I do enjoy benefits of marketed technologies, but at what cost to necessities?
posted July 21, 2009 at 4:17 am
Franklin,
I do agree with you, but you have to remember that insurance companies are there to make money, they will suck every little penny out of your pocket of you give them the chance
posted July 21, 2009 at 10:53 am
Franco is right – as health insurance demonstrates. What keeps it from happening with autos and such is genuine competition and genuinely big pools.
I notice that even the libertarians that occasionally comment on this blog have done nothing to challenge the logic of this post! Nor have they in other venues where I’ve challenged them. Ignoring an argument you can’t defeat is the best approach if purity trumps truth.
As to conservative opponents – they abandoned any concern with truth a long time ago.
posted March 18, 2010 at 11:39 pm
What a good question… ANd I also agree with your statement above
Find cheap auto insurance Texas
posted October 8, 2010 at 5:12 pm
This is why I made a choice not to sell health insurance. After specializing in property and casualty for 10 years, I thought I had a good grasp of how companies worked…
That is, until I took it upon myself to learn about health insurance. Learning the “ins” and “outs” of major medical kept leading to the following words: ARE YOU KIDDING ME?
Now that the dust is settling, let’s see how the industry reacts to the new mandates. It does not look good for private health insurance.
posted April 1, 2011 at 11:16 am
It is unfortunate that people prolong health care and check ups because of the inherent costs associated with these services. Maybe there will be a day when the majority can afford such coverage and care… sigh…