Hank Kalet

Contrary viewpoints — Part 2: More on Whole Foods

Michael Pollan, the great food writer, publicly stated his opposition to the boycott of Whole Foods. Not that he agrees with the company’s CEO, John Mackey on healthcare, he just believes that the good the company does in improving Americans’ diets is too important to jeopardize:

John Mackey’s views on health care, much as I disagree with them, will not prevent me from shopping at Whole Foods. I can understand why people would want to boycott, but it’s important to play out the hypothetical consequences of a successful boycott. Whole Foods is not perfect, however if they were to disappear, the cause of improving Americans’ health by building an alternative food system, based on more fresh food, pastured and humanely raised meats and sustainable agriculture, would suffer. I happen to believe health care reform has the potential to drive big changes in the food system, and to enlist the health care industry in the fight to reform agriculture. How? Because if health insurers can no longer pick and choose their clients, and throw sick people out, they will develop a much stronger interest in prevention, which is to say, in changing the way America feeds itself. When health insurers realize they will make thousands more in profits for every case of type II diabetes they can prevent, they will develop a strong interest in things like corn subsidies, local food systems, farmer’s markets, school lunch, public health campaigns about soda, etc. So Mackey is wrong on health care, but Whole Foods is often right about food, and their support for the farmers matters more to me than the political views of their founder. I haven’t examined the political views of all the retailers who feed me, but I can imagine having a lot of eating problems if I make them a litmus test.

There is something to this, I guess, though I think he’s missing the potential use of the Whole Foods question as an organizing focal point. But I respect his reasoning, given the difficulty of balancing his two beliefs.

Contrary viewpoints — Part 1 On Sen. Edward M. Kennedy

I have some links to pass along today, progressives/liberals taking a slightly different approach to some of the issues in the news:

Part 1 on Ted Kennedy, in which Doug Henwood, editor of the Left Business Observer, takes on the Kennedy myth and reminds us that deregulation was a very bipartisan affair

Henwood, in his blog, stands as the scold in the room, taking on Kennedy from the left in a way that was all too absent during the week’s coverage of his death. Kennedy was an interesting character — personal flaws, old-fashioned liberalism, etc., and the occasional contradiction. Kennedy — “soul” of the Democrats, friend of the common man, Liberal Lion (and yes I know I trafficked in some of this last week) — was also a significant player in the late-1970s push for deregulation.

Often, we talk about the Reagan years when discussion deregulation but the reality is that Carter and the Democrats got the ball rolling.

Once upon a time, working for an airline or driving a truck was a pretty good way to make a living without an advanced degree: union jobs with high pay and decent benefits. A major reason for that is that both industries were federally regulated, with competition kept to a minimum. Starting in the early 1970s, an odd coalition of right-wingers, mainstream economists, liberals, and consumer advocates (including Ralph Nader) began agitating for the deregulation of these industries. All agreed that competition would bring down prices and improve service.

Among the leading agitators was Teddy Kennedy. The right has been noting this in their memorials for “The Lion,” but not the weepy left.

Why was Kennedy such a passionate deregulator? Greg Tarpinian, former director of the Labor Research Association who went on to work for Baby Jimmy Hoffa, once speculated to me that it was because merchant capital always wants to reduce transport costs—the merchant in question being Teddy’s father,
Bootlegger Joe. Maybe.

In any case, Kennedy surrounded himself with aides who worked on drafting the deregulatory legislation. Many of them subsequently went on to work for Frank Lorenzo, the ghoulish executive who busted unions at Continental and Eastern airlines in the early 1980s. (Kennedy’s long-time ad agency also did PR work for Lorenzo.)

And what was the result of all this deregulation? Massive downward mobility for workers.

I’d forgotten this connection (not the Democrats’ role, just the Kennedy role) and I suspect — given Nader’s involvement — that the issues were actually the Teamsters, the antipathy that both the New Left and the Kennedy family had for Hoffa and his union, and the growing consumer advocacy movement.

The federal takeover of the Teamsters, I think, shows that they were right to be wary of the union’s power. But the focus on consumers to the exclusion of nearly all else was foolish, as history shows; the assumption that opening these industries to an unfettered market would lower prices and cause no pain was not based in reality. Someone ultimately had to pay the cost of those lowered prices — otherwise the lost revenue would have resulted in lost profit. And it was obvious that it wasn’t going to be the CEOs.

‘Yes, Virginia, the insurance companies do ration’

David Sirota caught something in today’s edition of The New York Times that backs up what those of us supporting single-payer healthcare have been saying for years: Private insurers ration care.

Here is a quotation from Cheryl Tidwell, 45, director of commercial sales training for Humana, the “country’s fourth-largtest insurer”:

“We believe there’s a better way to control costs by controlling utilization and getting people involved in their health care.”

Translation: We control costs by controlling access, by deciding what will be covered and what will not be. In a word: Rationing.

As Sirota points out, “we’re supposed to think that private for-profit health care companies don’t ration care, while government-run programs like Medicare do – but as the insurance industry admits right here for all to see, that’s just not the case.”

The obvious truth is that the health insurance industry works hard to “control utilization” – that is, it works hard to make sure that when you need a costly medical service, you are “controlled” (read: prevented) from getting it.

As I said in a recent post, anyone who thinks rationing will not be a part of a future healthcare system, whether administered publicly or privately, is fooling themselves. Triage is part of medicine — doctors make decisions every day based on need and effectiveness.

The difference is that private insurers make their decisions based on profit, while a public entity — at least in theory — would make its decisions based on the good of the patient and the good of society.

Free-marketers like to extol the virtues of the market, but the market — because it is profit-based — just doesn’t function well with these kinds of life-and-death questions. Insurance companies make their money, after all, by paying out less money than they take in — which creates a perverse disincentive. Remove the disincentive and maybe, just maybe, the healthcare system will start to behave in a more humane and rational manner.

Behind the 8 ball because of bailouts

Robert Johnson — not the blues singer — makes a compelling case that the failure of the Obama administration to stand up to the banks and Wall Streeters in the administration’s earliest months is costing him dearly now, as he tries to pass major healthcare legislation and could cost him greatly down the road.

He writes that the bailout of the financial sector, a bailout that lacked any strings, may have “made sense in isolation,” but lacked “an awareness of the historic context and opportunity” that called out for bolder action.

Free markets had profoundly failed. Government had been given another chance by the electorate that was inspired by candidate Obama. A chance to do some good
for the general interest and regain the reputation of a productive public sector after thirty years of disparagement. Yet by refusing to stand up to the oligarchs and set proper boundaries in defense of society, they fed the cynics and dissipated the magic that Obama had created for real change. The Administration seemed closer to Jamie (Dimon) and Goldman Sachs than to us. The lesson: if you fail to defend society once, people lose faith. The loss of faith carries a high price, and we’re paying that price now in the arena of healthcare reform.

The point is, Johnson says, that we are in times of “great danger”; the Obama administration needs to act decisively or risk losing the moment.

Today, the new US administration can disown responsibility for its inheritance; tomorrow, it will own it. Today, it can offer solutions; tomorrow it will have become the problem. Today, it is in control of events; tomorrow, events will take control of it. Doing too little is now far riskier than doing too much. If he fails to act decisively, the president risks being overwhelmed, like his predecessor. The costs to the US and the world of another failed presidency do not bear contemplating.

It is still early, of course, but we already are witnessing the seeds of a new narrative being born, with elections in Virginia and New Jersey that are turning on state issues being recast by the national media as referenda on the president. This is absurd, of course. The New Jersey vote will be about Gov. Jon Corzine and not about the president, who remains popular here.

But Obama’s decision to buy into the financial status quo — Summers, Geithner and Bernanke — and his raising of bipartisanship above policy on healthcare and the stimulus (not to mention his selling out of workers on card check and the auto bailout) are making it that much harder to generate the kind of change we thought we could believe in.

Whole Foods hit by protests

Protesters are targeting Whole Foods because of comments made by company CEO John Mackey made in an op-ed in the Walls Street Journal earlier this month.

At first, the protests seemed unlikely to have much effect, unlikely to shift the debate much. In fact, there was the very real possibility that they could backfire.

But Whole Foods now appears to be the poster company in the current healthcare debate and, especially because the company’s reputation (upscale progressivism) is belied by its aggressive anti-unionism, Mackey’s comments could be creating the kind of momentum that has been lacking on the left side of the discussion.

Here is what Mackey had to say:

Many promoters of health-care reform believe that people have an intrinsic ethical right to health care—to equal access to doctors, medicines and hospitals. While all of us empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter?

Health care is a service that we all need, but just like food and shelter it is best provided through voluntary and mutually beneficial market exchanges. A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That’s because there isn’t any. This “right” has never existed in America.

Someone should tell Mackey that the markets for food and shelter have massive flaws, that there are thousands — possibly millions — of hungry and homeless Americans and that food prices have been outpacing inflation for quite some time.

As World War II was winding down, Franklin Delano Roosevelt unveiled a new “Economic Bill of Rights” that included:

The right to a useful and remunerative job in the industries or shops or farms or mines of the nation;

The right to earn enough to provide adequate food and clothing and recreation;

The right of every farmer to raise and sell his products at a return which will give him and his family a decent living;

The right of every businessman, large and small, to trade in an atmosphere of freedom from unfair competition and domination by monopolies at home or abroad;

The right of every family to a decent home;

The right to adequate medical care and the opportunity to achieve and enjoy good health;

The right to adequate protection from the economic fears of old age, sickness, accident, and unemployment;

The right to a good education.

Roosevelt said “these rights spell security” and would help move the nation toward “new goals of human happiness and well-being.” William Greider, in his new book Come Home, America (excerpted in May 6 edition of The Nation), described Roosevelt’s “Bill of Rights” as setting the agenda for the three decades that followed.

One important condition government can provide is the platform of “essential needs” that will give everyone more security and therefore more confidence to explore new and different choices. We could dust off Roosevelt’s “second Bill of Rights” and address its unmet goals. FDR recognized in early 1944 that Americans were weary of the sacrifices imposed by World War II and so he announced a broadly conceived promise. After the war is won, he said, the country must construct a new set of meaningful “rights” for all, everything from health and education to work with remunerative wages. His vision of the future became the postwar political agenda of the Democrats, and in large measure the promises were kept.

Greider says we are at a point in history where we need to return to Roosevelt’s construct and expand upon it — to finish what FDR started.

Which brings me back to health care and the market. Roosevelt, basically, was saying was that there are some things in life that are too important to be left to the market. Health care is one of those things.

That’s why I believe we need a single-payer healthcare system, one in which the federal government — or some independent agency created by the feds — acts as the funder of all care, with doctors and hospitals remaining independent. Care would be up to medical personnel without interference from insurance companies.

I won’t pretend that such a change won’t have its difficulties — but the reorganization of the system would be an improvement on what we currently deal with. Critics of reform raise the specter of tax hikes and rationing, but we’re already paying through the nose and having our care rationed — but instead of a rationing by triage, with decisions made based on effectiveness and need, the insurance companies base their decisions on profit and profit alone.

Mackey’s belief in the market probably wouldn’t have triggered such disdain, however, had he not also blamed the victim in the healthcare fiasco. He said that “many of our health-care problems are self-inflicted,” blaming the rising costs on obesity and diseases that he says “are mostly preventable through proper diet, exercise, not smoking, minimal alcohol consumption and other healthy lifestyle choices.” Making better lifestyle choices would help stem rising prices.

There is nothing wrong with better choices, but the issue here isn’t McDonald’s hamburgers and Krispy Kreme donoughts. It’s access and cost and it is offensive to say that the people who are forced to use emergency rooms for primary care have brought it on themselves.

Hence, the protests, which are a direct response to the callousness of Mackey’s piece and a desire, a need, to put single-payer on the table.