An exchange from email

Bruce wrote:
Mark -
    It is so perfect that I got your note when I did.  I had just heard that the gubmint wants to create an independent agency to watch the Securities and Exchange Commission to make sure they don't watch porn on their office computers.  Further, I was dealing with just one more example of official gubmint stupidity.  I was in a meeting trying to deal with a huge error in the  DOE mandates for water heater efficiencies in current round of Rural Development low income housing weatherizations.  I won't go into the details now, but the absolute arrogance of these government officials is truly astounding.  According to the manufacturer, the specified equipment cannot work where they are to be installed. The team I met with advised them of these facts and the manufacturer warned them.  Even so, the gubmint insists that contractors buy these water heaters because they have great efficiency "numbers."  Besides, they cost over $2,000 each and would be projected to save  $700 in their lifetime.  This kind of thinking is coming from a Federal agency that has lost its direction, costs us $29 billion per year, yet produces nothing but paperwork for other people.  The principle argument for the creation of the Department of Energy was to cut America's dependence on foreign oil.   I supported that goal when it was created and I support it today.  However, after spending hundreds of billions of dollars supporting the D.O.E. on this problem, the US now imports almost 4 times as much oil and produces 40% less oil than it did when the agency was created in 1977.  The D.O.E. was also charged with expanding nuclear power production.  The nuclear power generation capacity of the US has not improved at all in twenty-four years.  So, this agency continues to suck tax dollars while producing negative results. 

    The "Audit the Fed" movement precedes the "Tea Party Movement" by many years.  Texas Congressman, Ron Paul, is the force behind this and is a Libertarian not a Tea Partier.  I originally did not support this audit because I thought as you did, this was a stupid exercise.  Then one day I watched Michelle Smith, the Communications Director of the Federal Reserve, blithely state that she did not know what happened to the $12 Trillion the Fed just transferred out to foreign countries.  Then I got it.  These people don't even care that this is our money.  A reporter spotted the transfer in a widely distributed Federal Reserve publication.

    The whole idea of a Federal Reserve Bank audit is going to be very interesting.  If the Fed is indeed a part of the government as they insist, they cannot impede an audit if Congress orders it.  If they are not "government" as some conspiracy theories suggest, then they would have to admit it to avoid the audit.  Either way, the audit idea has some good followers.

     All this "Tea Party" stuff is apparently beginning to annoy certain liberals.  The AFL-CIO announced on their website that they will be infiltrating "Tea Party" functions with people charged with creating embarrassing "TV moments" for the evening news.  This should make for some interesting  television.  We've seen plenty of footage of SEIU members roughing up spectators at other events.  I even saw our President ridiculing the movement.  For me, I'd like serious facts and debate.  During the summer of 2008, debate was everywhere.  Now I'm seeing more put-downs and attacks than facts.


And Mark responded:
Bruce -
   The disagreement between us is not about the problem. We agree that government officials can be arbitrary and petty and irresponsible. What we disagree about is the solution. We have different ideas about what it will take to effectively address and resolve the conflict. [You will notice that I frame this question in terms of the field I feel most competent in. For more on the theory I refer you to Just Conflict.]

   You seem to see this as a conflict between us and them. They are the government and they take our money and throw it away if we are lucky and use it against us if we are not. I see this as a conflict between us and us. We are the government (of the people, for the people, by the people) and we have failed to construct the government we need.

   You seem to say that the government we have is too expensive so we must cut back what we give it. I am saying that the government we have is too inefficient so we must make it more accountable.

   You seem to say that the government is not efficient because it doesn’t have to respond to market principles as for profit corporations do. The market would fix it but the government is a monopoly. I see the market as being an appropriate force for shaping the structure and function of institutions but I don’t see it as a sufficient rein on power. The market is amoral. It will not construct social justice. [Glenn Beck recoils in horror at my choice of words.]

   Yes, I want to live in a just society and I see government as the only institution with sufficient clout to create a just society. I certainly don’t want a theocracy and institutional religion is dying a slow and painful death. The arena in which social policy is created is electoral politics. It is messy, but I don’t see an alternative. With the election of Barak Obama I have greater hope that the American electorate cares about broad social justice, not just narrow self-interest.

   We have genuine disagreements about what are the “best” strategies for restructuring our common life. What we don’t have is an agreement about what tools we use to evaluate good, better, best. We don’t have an agreement about the qualities we are trying to create.

   I have asked you before if you want to live in a society in which everyone has access to health-care. I didn’t hear your answer and maybe that wound is too fresh so let me ask this. Do you want to live in a society in which everyone has access to education?

   I am not asking whether we should fund vouchers or how you feel about charter schools. Those are strategies. I am asking if the goal is universal education. This is something we fought about in this country and we decided that having an educated populace was essential for a stable democracy.

   When we live together in a society which is knit together by    concern for the common welfare, the quality of life for all improves. The question is not whether we are knit together in a web of shared consequences but what we do to make that web strong and mutually accountable.

   In that regard am a deeply worried about the direction your thinking and your rhetoric is taking. You are a smart man but you are saying ill-considered things. When you say that, “the gubmint wants to create an independent agency to watch the Securities and Exchange Commission to make sure they don't watch porn on their office computers,” that is not a way of framing the issue that has any hope of leading to resolution. This formulation will not lead to greater accountability. That is a way of picking a fight.

   You end your piece with a lament that the left is now also devolving into put-downs and attacks. I share your concern. We are seeing more and more fighting in the public arena. We are becoming less and less civil. This lack of civility was once a hallmark of the fringes of society (the Wild West) and now is moving into the halls of Congress. I don’t think this is anything but backlash and I think we will move through and out of this period, but it is troubling nonetheless.

   Whenever a conflict arises we have a broad choice of strategies for how we will address it. We can, for example, choose to ignore it. One category of strategies are what we call fights. These are strategies in which we address the conflict by trying to make those we see as our opponents lose. We create an adversary and then we relate to them in a way designed to limit their power.

   We do this in sports all the time. We pick teams and then we try to score more points than they do. This is entertaining but at the end of the day we haven’t actually created anything.

   Electoral politics has devolved into petty partisan bickering. We are more focused on making them lose than we are on creating the qualities everyone needs. This is a sad and damaging situation. You are a player in this dangerous game. You are not creating a solution when you label the government the gubmint and you characterize a proposed check on the SEC as an attempt to limit porn. You are doing a Glenn Beck or a Rush Limbaugh. Some find them entertaining. But when people see them as informative they become dangerous.

   We will not construct greater social cohesion, stronger accountability, and fuller justice by fighting. We will do it by discovering our common needs and collaborating to meet them.

The Great Social Experiment Part 5

The path toward socialized medicine by New Zealand is quite different from the one the United States is taking. This is due in a great part to the very different traditions in the founding of the two nations. New Zealand is a part of the British Commonwealth and the long tradition of power, rights and benefits flowing from the government to the people is fundamental to that system. So, it was entirely natural for New Zealand to establish socialized systems for institutions such as health care, transportation and utilities.

The concept of rights and privileges flowing down from the government to the people is natural to someone who comes from a monarchy. Kiwis expect government to provide for them. Americans come from a very different idealogical foundation. It was the Americans who gathered the states together to create their own central government. It was the Americans who stated so eloquently in their founding documents that rights were inherent in humanity and government got power and authority from the people, not the other way around.

Nonetheless, the United States is embarking on the same path New Zealand has taken. It behooves us to examine the record of countries that have a long experience in government-backed health care. There are numerous arguments for lower costs and better health by centralizing health delivery systems. The question is, "Does it really work that way?" Given the Kiwis 37 year history, we can see how their system works after almost two generations.

From the standpoint of the locals I interviewed, the standard of care available to citizens is world class. The largest teaching hospital in the Southern Hemisphere is in Dunedin, NZ. As promised, people pay little for care. From a statistical standpoint the care New Zealanders get is nearly identical to what US citizens get. The number of doctors, nurses, hospital beds and so on per capita is very similar.

The real difference is in procedures performed. Knee replacements and heart surgeries are performed at a small fraction of the rate in the US. Indeed, from a world standpoint, the US is far ahead of the rest of the planet in the delivery of these services while spending in the US per capita is much the same. Generally, these procedures are more likely to be performed on aging people. From my interviews I learned that joint replacements are very difficult to get for aging Kiwis and just impossible for the elderly. In New Zealand, the wealthy can purchase private coverage and get the procedures they need. 22% of the population has private coverage. For the rest, these procedures just are not going to happen. We met a 55 year old bus driver whose mother has been waiting for knee replacement since she was 70; she is now 85 and no longer expects she will have the surgery.

The people of New Zealand approached their health care design with a lot of thought and planning. They distributed the administration to 21 district agencies since they do not have anything like our states or county governments. Local policy is made at the local level. Doctors and other providers are self-employed and compete for business within the districts. Nonetheless, costs have risen beyond the level of reason and services are rationed. The promise of universal health care has not been fulfilled. The people are now discouraged and believe their problems cannot be solved.

In our next post we will speculate on why this happened.