Yet Another Unpublishable Letter to the International Herald Tribune

The fact that these letters are unpublishable is the problem. Today, the IHT needs the space for ads, and for “name” columnists. But the road back from where we are is a long and hard re-education, in a society where a verbose text is a standing joke, as is the text of the Affordable Care Act is for Justice “Nobody Expects the Spanish Inquisition” Scalia…during this week’s hearings, Scalia drew the usual ignorant laughter when he asked counsel if counsel expected one so august as he to actually read the law. But as Auden said, “all I have is a voice”. 

To undo the “folded lie” of the mess that is my family back home, or this mess. They are related because the personal is the political. It was taken for granted by Evanston Hospital that I’d pay a hundred dollars well baby care for them to stab my sleeping, beautiful little son in the heel and wake him up to get a blood sample by way of an unnecessary and invasive procedure. This procedure had been taken out of the doctor’s hands and made a low-level job by paramedicine, the Sixties and initially liberatory idea that doctors’ “low-level” functions could be used to “create jobs” for low level people who do not care about a child’s pain. 

The problem is that when the 1% talk about “creating jobs”, in health care or any other field, they mean “creating new entrepreneurial opportunities in as yet under-regulated markets so we can make money using our money”. The job creation nets to zero because they also destroy jobs, especially in education, for shits and giggles.

My eldest son in particular has been stabbed in the foot repeatedly ever since by a toxic, cancerous growth in unneeded markets. When he was a little kid, the only shops open on Sunday on Sherman were Hoos Drugs and a couple of restaurants. The proprietor of Hoos Drugs happened to like bluegrass music, so on Sunday, his shop resounded to the Cumberland Gap and Angel Band. Needless to say, Hoos is long gone, and the neighborhood of Northwestern University is overrun with pricey and pretentious retail outlets of the sort that appeal to the rich and not especially bright students of that school.

I had a little taste of the free market and McJob working a couple of days at an early Baskin and Robbin’s Ice Cream in a strip mall in Palatine in 1966 and this was valuable, for it was a taste of Adorno’s dialectic of the holiday fool taking innocent pleasure in the puppets (Muppets) who serve him, thinking they serve him with pleasure and not knowing the difference between the rictus and the smile.

My own compromise was to Step Up to Big Pay in the Exciting Field of Data Processing at a time when the need for actual skill had not been removed but this was to be part of the problem.

My father’s response, which contained self-interest and principle in equal measure, was to avoid infantry service in WWII, the brutal nightmare that’s created our world, honorably by training as a physician and serving in the medical corps. He sought escape from two systems, the system of cannon fodder and the unrestricted free market.

But the Beast will have his due. The free market will gnaw constantly on all structures outside of what Habermas calls “operational reason” and, my own experience in structured programming showed, it will destroy the sweetness of life and a common search for truth.

The Constitution of the United States is to me a beautiful thing which bends but does not break because it was written before men had been driven mad by the market…before Willy Loman. Our duly elected legislators can pass laws to provide for the general welfare and which regulate commerce because to the Founders, the abandonment of mercantilism did not imply laissez-faire. The Supreme Court isn’t elected and in Citizens United or the Affordable Care Act, should not be determining our lives.

Here is the unpublishable letter.

Adam Liptak, in “US justices greet health care rules with skepticism” (IHT 29 March 2012) quotes Michael A. Carvin, a lawyer for the private challengers, as saying “if being born is entering the market”, then “that literally means that they [presumably the government] can regulate every human activity from cradle to grave”.

Carvin fails to see the absurdity. In fact, far more of life in the USA, including health care, is part of the market than in the past, and this is the reason why many Americans cannot afford health care.

In the past doctors were often willing to waive fees, work pro bono, or receive payment in kind; my own father, a physician, was compensated in the 1950s with a week in a farmhouse. In addition, services were partitioned far less finely; whereas automation cannot seem to track patient data with any quality, it creates markets for various services deemed separate from core medical care, such as X-rays, because it’s easier to set up record-keeping for new ventures using computers. 

I was surprised, being examined in Hong Kong, that the physician had a portable X-ray device and knew how to use it. In an American hospital, there would have been far more pomp and ceremony for X-ray services represent an opportunity for medical entrepreneurs.

The right argues that the Affordable Care Act is on a “slippery slope” to the point where the Commerce clause could be applied to all activities. This of course ignores that laws have to be passed by Senators and Representatives answerable to voters in some degree. But the spectre of some sort of Communist government controlling our lives is absurd. In fact, free enterprise is in the saddle.

Too many activities today materially affect commerce because the public good has been privatized and brutalized, and used as an input to private greed. To now claim that the vast network of new commercial relationships cannot be regulated is both true, and tragic, because the creation of new commercial relationships has deliberately outpaced the ability of government to regulate it.

Marketing directly to children in order to get them to nag for a product was unknown prior to the Mad Men era. Dismantling public space including mere park benches lest homeless people use them for sleeping, and directing people with enough cash to afford a civil space to Starbuck’s, is also a novelty. The fact that many employees don’t think twice about having to invest in their employers’ firms by owning a computer and using it for work without compensation is novel.

Scalia and the right seek to monopolize the intellectual high ground vis a vis the Constitution, and act as if we don’t understand it when we reinterpret it to fit a world so changed since 1789 that a time traveler would go mad trying to make sense of 2012. They speak as if there’s a void in us that seeks only entitlements.

But I’d say that it shows more respect for the Constitution to fit it to radically new situations. Congress has the unquestionable power to regulate “commerce”, but in contrast to the 18th century, where the eleemosynary and rural could act independent of interstate commerce, we’re in a commercial from birth, a situation comedy of ever multiplying pseudo-opportunities to work and spend.

Congress could limit the scope of commerce by strengthening public education and allowing the desperately poor a social minimum; Congress could under the Constitution regulate Commerce by parting the waters and saying, “you shall not crucify the working man on a cross of gold”, like William Jennings Bryan. This is clearly authorized by the Constitution which contains no written commitment to unlimited free markets in any absurdity that has a name at all, such as derivatives of derivatives of reinsurance contracts of derivatives.

But this would violate an entrepreneurial expectation of the wealthy that they shall always have novel, and initially unregulated, markets in which to make a bundle before regulation starts. They have marketized health care to absurd and unsustainable levels. Their commerce defines life, and there is no slippery slope from detailed regulation of that commerce to Communism.


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