Thursday, June 18, 2009

The rationing delusion - it's not just health care

I've spent most of my career covering business and finance, which means I've dealt with a lot of corporate executives in my time. And a whole lot of (gulp) investment bankers. And, to tell the truth, I've liked most of them very much. They're not out to trash the world, and they believe that their companies are doing good things (which, much of the time, they are).

So when my radical friends, or bloggers I like, attack corporations as rapacious monoliths out to dominate the globe, it makes me twitchy. Most corporate executives want to make the world a better place. I'm even willing to believe that at least some Monsanto executives want to make the world a better place - and genuinely believe they're doing it. (Whether or not they're actually doing it is another question, but one that can also fairly be asked of governments, radical activists, and in fact just about all of us. How to make the world a better place is a question to which there's no single, or simple, answer.)

But this much, I believe, is clear: the basic necessities of human life must not be controlled by any organization whose existence depends on making a profit.

The argument over health care is a case in point. Those who oppose government-run health insurance, and government research as to what treatments actually work, argue that we can't let the government decide what health care we get: that's rationing. But, as David Leonhardt pointed out in the New York Times the other day, private health insurers and providers ration health care constantly. The only difference is, they ration it on the basis of who can afford to pay for it and how profitable it is, instead of who needs it and whether or not it works.

It's the same with food. Let's say, just for the sake of argument, that Monsanto's GM seeds actually are better; that they can feed more people from the same amount of land than ordinary seeds. (Not that I believe it for a minute.) Even if it's true, though, allowing Monsanto to patent those seeds and control their distribution gives a single company the power to to ration our food supply. Not on the basis of who needs it, as many countries did in WWII, but on the basis of who can pay for it. (And, in Monsanto's case, who can keep paying for it, as the company carefully makes sure farmers can't save seed, but have to buy new for each planting.)

And here's one that we're not hearing so much about, but is possibly the most egregious of all: the privatization of water. By which I don't mean putting it in bottles and selling it, though that's bad enough. I mean privatization of the water supply. By the middle of this decade, the water supplies of 9% of the world's people were controlled by private companies, all of them hungry for more. (Milwaukee is currently considering turning over its water system to a for-profit company.) And what happens when a private company controls water access? Rationing again: those who can afford it get more, those who can't, get less - or even none at all. Meanwhile profits, instead of being reinvested, are siphoned off to the company's coffers.

It's hard to make fair rationing decisions, and however rational they may be, the people who don't get what they want, or what they believe they're entitled to, always feel disenfranchised. But what is so much better about rationing on the basis of ability to pay? And how is it that we - as a nation -
have somehow been bamboozled into accepting without question that rationing based on need, or usefulness, or any other rational criterion, is unwarranted government interference, while rationing on the basis of whether you've got enough money to pay is the wonderful free market at work?

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