Rational’s Not In It


On the new Medicare proposal from Paul Ryan and Ron Wyden, Digby writes:

One might have thought the prudent thing would be to wait and see how the health care reforms work before throwing the sickest population into the mix, but apparently we just “know” it’s the way to go.

That’s not to say that people won’t be able to “buy” what we know as Medicare with their “supported premium”, but because the spending will be capped for all, and almost assuredly subject to political exigencies, this is very likely to result in, at the very least, a more difficult system to navigate for the most ill and vulnerable adult citizens. My observation of the most elderly in the past few years is that they can’t competently pay their phone bills, so this should be interesting. I suppose some kindly insurance salesmen will come to the rescue.

What strikes me about this comment is how alien it is to mainstream discussions of health care reform — and public-private fusion plans in general. It’s rare that you hear a politician or a respectable wonk or a think tank spokesperson discuss these kinds of plans in terms that aren’t loaded-up with jargon, for one; but even if the conversation is being carried out with plain language, there’s rarely if ever a focus on how the actual plan would work for real human beings, rather than abstract Consumers.

The disconnect Digby’s pointing out here is born from a larger ideological blind-spot of this era’s political class: they cannot see the world without the language and logic of the market. The wide swathes of the population who may not be able — or may not want— to adopt the mindset of the holy Rational Consumer might as well not exist; they’re square circles. To say that people can be quite real and quite valuable while, at the same time, not really being Consumers? Imagine telling a Medieval monk that the world can’t be divided between saints and sinners. It just doesn’t register.

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