Giuliani's Unhealthy Triangulations
Here we go again. To make himself look less the one-issue, war-is-all candidate, Rudy Giuliani is about to unveil his health care plan. It’s war by other means—on Americans, as all these Republican-inspired “ownership society” schemes are—and on behalf of the insurance industry. The Wall Street Journal describes the plan as one that would “mark a significant change in how health insurance is paid in the U.S.,” suggesting a novel approach. It's nothing of the sort. From the June 7 Journal:
Mr. Giuliani, currently leading opinion polls for the 2008 Republican nomination, wants to move tens of millions of people from employer-based health insurance to the individual market as a way of giving people more coverage choices. It is an idea he alluded to in Tuesday's Republican debate in Manchester, N.H., and later expanded on in an interview. […]The principles Mr. Giuliani identified for health care mirror President Bush's call for an "ownership society" in which the power of the free market could eventually shore up health and retirement security programs alike. That concept proved a political failure when Mr. Bush used it in 2005 to argue for partial privatization of Social Security. But in the campaign to woo Republican primary voters, it could provide Mr. Giuliani with an issue to appeal to economic conservatives at a time when some social conservatives have misgivings about his support for abortion rights and gun control.
In other words it’s a purely political move using a failed idea to pander to that 30 percent of the electorate still supporting Bush—triangulation, Rudy style. How does this show Giuliani to be in any way independent, or even strategically imaginative, or fair (well: fairness was never his strong suit, not as a federal prosecutor and not as a mayor) is a mystery.
Kicking off employees from their employer-funded health care is, in any case, a matter of time. It’s where the American economy is heading, and not because it’s driven by the desire to give Americans more “choice.” Choice isn’t what Americans are looking for but quality and affordability, the two elements now missing from most plans. No plan will give them universal choice anyway, even less the sort of plan they have to shop for on their own, without the power of numbers. The Giuliani-Bush idea of an “ownership society” is driven by the business mentality now shedding every possible responsibility toward employees, turning employees into individual contractors across the board. Job security has long been history. Pensions are history. What’s the next-biggest cost employers can shed? Health benefits. So employer-based insurance will soon be history. It’s the natural progression of Wall Street’s all-against-all approach. Only shareholders matter. And no company has ever had to worry about shareholder benefits. Only profits. But the devaluation of employees’ worth, of employers’ responsibility toward employees, must be couched in terms acceptable to the electorate, in that language of campaigns and manipulation that make economic Darwinism sound like an offshoot of the Declaration of Independence (“choice,” “freedom,” “empowerment.”) So you get cynical summations like this from Giuliani: “It’s your health; you should own your own insurance,” as he said in Tuesday’s debate. “The reality is that we need a free market.”
In health care, that’s exactly what we don’t need. The free market is exactly what has turned Americans’ health care into a privilege, and Americans’ health into a crapshoot.