Plain Dumb Luck

In my perfect world, I’d have Michel Foucault’s old job: Professor of the History of Systems of Thought at the Collège de France. Here’s a bit of what I might want to teach.

Consider:

• The graduated income tax
• Immigration restrictions
• Eugenics
• Women’s suffrage
• Prohibition

All were strongly associated with the progressive/left ideology in the first decades of the last century. For good or ill: Today almost all of us find the graduated income tax untroubling, immigration restrictions right-wing, eugenics unconscionable, women’s suffrage morally obligatory, and prohibition a tragic mistake. (Except when it isn’t.) Lashed together for a time, these questions have had anything but a common fate ever since.

Take it from someone who has studied it: The history of ideas is a stone cold bitch.

The point here is not to condemn, or to praise, early twentieth-century lefties. It’s to note that when we look at readily identifiable, real-world ideologies from the outside, they often turn out to be highly contingent. They’re brought together by one political moment only to be separated by the next.

This is very different from how they look to a true believer. To those who hold an ideology, that ideology is entirely correct, and it springs from a deeper, even transcendent source. Or at least, so says almost everyone.

Almost everyone is probably wrong about this.[1]

It’s very satisfying, but still probably too easy, to say in light of this perceived relativism that relativism itself constitutes the true ideology, or at least the true response to all others’ ideologies. The problem, though, is that real-world problems don’t go away, and relativists still come up with solutions to them. Sweep away all systems, and the result is a system. You may even know all about the play of contingency — and still find a given ideology compelling. Ouch.

So where do these strutting certainties come from? And why are they so often dashed? The answer is in the raw material of politics itself. This material is not an abstract conception of right or wrong — is not a transcendent moral order — is not even human nature, in any biological or economic sense.

It is, as far as I can tell, plain dumb luck. As an example, consider the following fact: Employer-provided health insurance is tax deductible.

This means it’s often a good idea for employers on the margin to spend more on health care than on cash raises for their employees. Raises in cash get taxed. Raises by way of health insurance don’t get taxed, making them relatively more attractive to employers. Partly as a result of this, employer-provided insurance becomes the norm, with 90% market dominance.

That’s not because employers are especially good at providing the service. It’s because almost no one who already gets health insurance as part of a compensation package is ever going to seek insurance anywhere else. And, as already noted, there are tax advantages for employers who want to make health care a bit more expensive rather than giving a raise.

Markets coordinate the interests of buyers and sellers, but when you’re not a buyer or a seller — and here, that’s almost all of us — you shouldn’t be surprised when your interests are not coordinated, but brutally disregarded. That’s what markets do. They brutally disregard everything that’s extraneous in the pursuit of efficiency. (But for whom?) If employers provided your automobiles, they’d also be way too expensive, and they’d also totally suck, just like your health insurance.

And yet the system sprung up almost entirely by chance, and what wasn’t chance was the product of economic conditions that don’t exist anymore:

While its origins can be traced back to 1929, when a group of Dallas teachers contracted with a hospital to cover inpatient services for a fixed annual premium, the link between employment and private health insurance was strengthened by three key government decisions in the 1940s and 1950s. First, during World War II the War Labor Board ruled that wage and price controls did not apply to fringe benefits such as health insurance, leading many employers to institute ESI. Second, in the late 1940s the National Labor Relations Board ruled that health insurance and other employee benefit plans were subject to collective bargaining. Third, in 1954 the Internal Revenue Service decreed that health insurance premiums paid by employers were exempt from income taxation.

This is the backdrop for one of the most important issues in public policy today. In its own terms, it makes no sense whatsoever, and no sane person would ever have designed a health care system this way. Still, and despite it all, when people judge “the free market in health care,” overwhelmingly this is what they are judging. And you know what? They’re not wrong to find it wanting.

We could go on. Why do we still have greyhound races? They’re a veneer of respectability for video poker, in an age when it’s not at all clear which forms of gambling are okay and which are not. Why are there so few distilleries? Because of face-saving rules put up for the temperance movement at the end of Prohibition. If we’d synthesized aspirin a few years ago, and if Vioxx grew in a plant, the former would be illegal and the latter would be an over-the-counter drug. (Of course, growing in a plant didn’t help marijuana, which had the misfortune of being smoked by immigrants.) We seize defendants’ property and charge the property with a crime — just as our superstitious medieval ancestors did — because doing it that way is easier and makes more money for police departments.

This is what your ideology is made of. Mine too. And everyone else’s, if it makes you feel better. Have a nice day.

[1] The most important exception I can think of is Robert Nozick, who often confessed to varying degrees of certainty about different parts of his intellectual project. He also wondered why others didn’t do the same. Nozick was probably more right about this observation than he was about anything else he ever wrote.