Ideology, Immigration and Health Care
One reason contemporary national politics is so intransigent is that politicians refuse to deal with social issues as if they were social problems, which mean conditions the nation can address so that they will be changed. Rather, politicians prefer to think about social issues as ideological, which means subject only to the reassertion of what is right in principle rather than in terms of what can be changed. Moreover, the principles that are invoked are still the hoary ones of states rights and individual liberty when the nation is far beyond the point where states rights mean much of anything except the protection of ignorance, so that a state board of education can restrict the teaching of evolution, and where individual liberty is long past the point of having been redefined because individual liberty is no longer modeled on the idea of the frontiersman disappearing over the hill where he can move into a new town and take on a new identity. All of us carry national identity cards. They are called credit cards and driverís licenses and are pulled out in the face of any minor functionary at a department store or pharmacy so as to make a purchase. Liberty has to mean more than absence of any scrutiny; it has to do with government scrutiny about things that are not done in public, and even ďin publicĒ carries with it the difficult issue of whether e-mail communications are or should be private. That is a free speech matter.
A good example of the displacement of social problems into ideological ones was the issue of slavery before the Civil War. Yes, there were intellectual arguments in books such as ďA Sociology of the SouthĒ about whether slavery was not better than the wage slavery of the north, and whether a democracy could thrive if it were not supported by a vassal caste. Those arguments treated slavery as a social arrangement which could be either buttressed or abandoned and what dire prospects followed from the latter choice. That was a social problems argument. But for the most part, however much the defense of slavery was the real reason for the Civil War, in that Southerners were scared of losing the way their economy worked and could not abide the idea of treating slaves as anything other than inferior beings, the arguments for the war were put in the terms of an ideological debate about States Rights. Did a state have a right to secede from the Union?
The Constitution did not explicitly say states did not have such a right, however much the history of the Constitution indicates that states did not have that right, giving the willingness of the states that had already ratified it to impress laggard states into the Union, and so the Constitutional ratification process was to be considered a once and for all time process, a marriage without a divorce clause. But never mind; people can verbally argue whatever they want, get as heated as they care to, and that is the impasse we are at this week with regard to two issues that would seem to be social problems, immigration and health care, that have been or are going to be decided this week by the Supreme Court as matters of ideology. Oh, the shame of it.
There are a limited number of ways that social issues can be reformulated as social problems. All political issues involve invoking one form of conflict or another. There is conflict which is regarded as irreconcilable and so it is a war to the end. That was the idea behind the war on cancer and the war on poverty. It is also the war on immigrants, some wanting them to self deport and others wanting them not to be treated as irreconcilable, that applying at least to the children brought here by illegal aliens before they were of an age to be considered to have made the decision for themselves. It is also appropriate to speak of a Republican war on women even if Republicans donít want to eradicate women. They just want to put them back in the places they occupied on the Fifties.
A second kind of political formulation is to see an issue as a matter of conflict control rather than conflict intensification. That means giving each side its due and trying to reduce the tensions between the two sides. That is what a stop and frisk policy is about and the political question is whether the balance is too much in favor of the cops or the troublemakers. It is a matter for negotiation, as one would think the trade off between new taxes and less spending would be, except that Republicans donít want to trade one dollar in new taxes for even ten dollars in entitlement cuts. They declare war against entitlements, just as they declared war against unions, given that the Wisconsin unions were willing to give back pension and wage benefits so long as they could retain legal recognition as unions.
The third kind of political formulation is to see an issue as a matter of conflict resolution. You can get rid of the problem rather than eliminate it or compromise about it by finding a way to solve the problem so that it does indeed go away. Vaccinations and other public health measures did away with most childhood communicable diseases. Universal education leads to near universal literacy even if not to much else. Not many people these days seem to have confidence that you can resolve a conflict. People have to suffer austerity if an economy is to suffer but that is a reference to a Christian idea that suffering is good for the soul rather than to economic theory, which suggests that all people can prosper if the government invests when the consumers canít and the people with money wonít.
Now, consider the immigration and the health care issues that the Supreme Court has and will decide this week in terms of whether they can be formulated as social problems, and you realize that the Conservative side is just venting gas. Immigration, for one, can be considered a social problem if you put aside the issue of sovereignty and so who has the right, the Federal Government or the states, to control the borders, and ask instead what one is trying to do by controlling illegal immigration. Conservatives say that it is necessary to do so because the immigrants bring crime with them, they are unsettling labor markets and taking jobs away from American citizens, and so there has to be a war on immigrants. Liberals say that there is no reason to be all that harsh on the descent of immigrants across the border. It is just that the Rio Grande is easier to cross than the Atlantic and so we have to think of some easy way to manage the crossing of people who are not that different from waves of earlier immigrants who enriched our country but happen to have done so illegally. They are not bad people. What they did is not essentially criminal, even if it is a violation of the law. We need new immigrants and it does not matter that these immigrants are not well educated. Most of the earlier immigrants werenít all that well educated either. They might not become scientists and lawyers but their children or grandchildren did. So a policy of conflict resolution is possible. These people are the source of prosperity not decline even if, like all the other immigrant groups, the Jews and the Irish and the Italians and the American Blacks who moved north, they are for a while seen as agents of American decline.
What to do about all the illegal aliens already here? That is a problem in which there is a conflict of interests between employers who want to keep them here and those who want to keep them out, and the solution is ameliorating, which is to say, a matter of conflict control. Find some formula that will allow them to stay but that is harsh enough so that the population can feel the illegal immigrants have been punished for their misdeed. McCain and others were at one time committed to regularizing the illegal aliens through some redefinitions whereby illegal aliens would pay penalties and be under a kind of life long parole, but that came to naught.
There is something that makes it very clear, however, why those against the illegal aliens will never be satisfied by some conflict control measures, much less conflict resolution measures. It is the fact that net immigration across the border is now nil. There is no longer a runaway infection. We have solved the border problem. That may be the result of the fence or of the decline in the economy. But Conservatives donít want to claim that the fence program worked, even though they championed it and, in fact, it may not have worked. What bothers Conservatives is the fact of all those illegal aliens that are already here. Conservatives want them to self-deport. Why? I suggest all the usual racist reasons. They donít want those people to be considered as American as you and I; America has to be a place for real Americans. Controlling illegal immigration is not a means to some other public good, such as good jobs for ďrealĒ Americans; it is an end in itself in that these people donít belong here, and the answer to that is the old refrain that we are a nation of immigrants, and I donít know how to go much further than play that placard, though I have been in many debates in my academic life about the ins and outs of immigration. Yes, there is more crime in the first generation of immigration, but then it quiets down. And so on.
Health care can also be viewed in terms of social problems. If you want a war on cancer through better care for cancer patients, you need to fund it, and that means getting the population to fund it whether it is called a tax or a penalty or a direct government handout. If you want to mediate between patients and doctors while the patient makes his way, gradually, to the grave, then you have to supply enough money to allow the patient to move down a path that is gradual rather than precipitousóthough I am not sure there are not those of us who would not be glad to have it over with quickly. And if you want to emphasize wellness rather than illness, and so think of health care as a lifelong way to be comfortable in your health, then that costs money too. All these methods cost money and the insurance companies get a lionís share of it and still have great difficulty cutting unnecessary health care costs and could use the assistance of government in bending the curve of ever increasing health care costs. It is no wonder that, as the New York Times reports, many insurance companies are going to continue some of the policies forced on them by the Affordable Care Act even if it is found unconstitutional. These are more rational ways of administering the health care dollar.
Wait a minute. What are we arguing about? Whether the government can force you to eat broccoli? No. We are discussing inevitable developments in the health care system that will make health care leaner and more humane at the same time. It does not have to do with taking a fork in the road but in the maturation of an industry so that it is both effective and efficient. If that is the case, then why have insurance companies not endorsed Obama care? It gives them a lot of new clients as well as mechanisms for rationalization. I am reminded of the criticism of Rep. Gebhardtís plan for the American government to pay insurance premiums to insurance companies for all Americans. That was seen by Liberals as just too much of a giveaway to the insurance industry. Well, Obama wants to do just about that for all of those now uninsured. He just wants to control health insurance rates of profit by saying that eighty percent of their premiums have to go to patient care. He does not want to control the amount of additional money the insurance companies would make by enrolling so many new patients. Who could object to such a deal? Only ideologues so concerned about the appearance of autonomy from government control that they donít care if they are losing money by clinging to antiquated ideas. That is ideology for you. The Marxists thought that ideology was a way to serve economic interests. How naÔve a view that is. Ideology merely serves itself; it makes people feel righteous. And that makes it very difficult to discuss and makes American political discourse, at the moment, so unappetizing.