Money Does Not Care

And Those Who Follow It Don’t Either



Paul Krugman wrote an editorial Hurray For Health Care, in the New York Times lauding the effort of Obama on health:

“Now, the “Affordable Health Care Act” — known to its foes as Obamacare, and to the cognoscenti as ObamaRomneycare — isn’t easy to love, since it’s very much a compromise, dictated by the perceived political need to change existing coverage and challenge entrenched interests as little as possible. But the perfect is the enemy of the good; for all its imperfections, this reform would do an enormous amount of good. And one indicator of just how good it is comes from the apparent inability of its opponents to make an honest case against it. “

Yes, maybe, but another interpretation is possible, and it’s much more sinister. Indeed the “entrenched interest” is a code word for the extractive, exploitative right wing. Krugman just said the “Affordable Health Care Act” was about challenging the “entrenched interests”, that is, the health care lobby, as little as possible. So the opponents cannot make a honest case against it because, deep inside, they are delighted by it. As simple as that.

Krugman situates the problem:

The fact is that individual health insurance, as currently constituted, just doesn’t work. If insurers are left free to deny coverage at will — as they are in, say, California — they offer cheap policies to the young and healthy (and try to yank coverage if you get sick) but refuse to cover anyone likely to need expensive care. Yet simply requiring that insurers cover people with pre-existing conditions, as in New York, doesn’t work either: premiums are sky-high because only the sick buy insurance.

The solution — originally proposed, believe it or not, by analysts at the ultra-right-wing Heritage Foundation — is a three-legged stool of regulation and subsidies. As in New York, insurers are required to cover everyone; in return, everyone is required to buy insurance, so that healthy as well as sick people are in the risk pool. Finally, subsidies make those mandated insurance purchases affordable for lower-income families.”

Well that should  look good on paper, for the naive idiots who, apparently, Krugman believes his readers are.

“Affordability” indeed depends upon the health care plutocracy seeing the light and showing some restraint. Because nothing forbids it to keep on squeezing those who can pay, until everybody is poor and needs subsidies, themselves obtained through taxes or borrowing from the rich against interest. In other words, nothing prevents the runaway plutocratic train to keep on rolling ever faster. This is the likeliest economic development, which, believe it or not, neither Krugman, nor the president or his advisers seem to have prepared for.

But I must admit that the “analysts” at the “Heritage Foundation” are plenty smart enough to have foreseen what will happen. Namely their plutocratic sponsors will get richer, and thus the rewards will come their way some more.

Can philosophy help? Sure. The philosophical method is about big thinking, not getting bogged down in the details and debris, as ants are wont to do, per their nature. Notice that Obama uses the adjective “affordable“. Health care is like a hotel, as far as Obama and company are concerned. And the question is: “Is it affordable?”

I will use the following neologism, which, I hope audaciously, will be forgiven: Obaromcare.

Obaromcare was suggested by the “ultra right wing Heritage Foundation” because it is perfect for that branch of plutocracy that feeds off health care. Any vampire feeds off fresh blood, and Obaromcare brings 50 million new victims to suck dry… The subsidy thing changes nothing as it simply means more resources will be siphoned off the middle class, through taxes.

That the “Heritage Foundation” brought the idea should have been a hint to the clueless. Maybe the president and the honorable Paul Krugman should refresh their critical abilities by reading Homer, and learn to beware of the Greeks and the gifts they bear. That was the lesson of the Trojan Horse. Greek boys used to learn that kind of things, 28 centuries ago. Now big boys are going around, steering the world, and they take the world’s most expensive plane, Air Force One, to go watch a baseball game, in Ohio. If that’s not a collapse of the idea of civilization, what is?

Obaromcare will not be the first time in the history of civilization when the public is forced to serve the private, while claiming it’s a public service to do so. It’s actually very much an heritage of the oldest plutocratic tradition.

Philosophically speaking, Obaromcare is close to the definition of the most abject plutocracy. It’s a desperate attempt to give a veneer of respectability to the plutocratic notion that profit primes care. All other developed countries know that, care, per se, is a fundamental notion living in another dimension than profit. This is the essential point.

Will Obaromcare work? First one has to settle what “working” means. The present system works splendidly for the for profit health care industry. What Obaromcare will do, for sure, is to make the present system bigger, not change its nature.

So, for the average people and the larger economy, Obaromcare will probably not work, because profit is at the center of it all, and nothing will stand in its way anymore than it does today. Obaromcare may have already increased national health spending.

In other developed countries, the will to care is what masters the search for profit. In any case, the numbers are talking louder than propaganda: the cost of health care in the USA is ascending at a completely unsustainable pace.

Obama could have made a reform that would have worked, if he had put the private plans in competition with MEDICARE FOR ALL: opening the existing Medicare, by far the largest health plan in the USA, and public, for people more than 65. The idea was to allow anyone to pay for Medicare. Just by economy of scale, Medicare would have been cheaper, while making a profit… for the public (by opposition of making a profit by whom Krugman himself calls “entrenched interests”, the plutocrats).

But Obama did not boost the existing public plan, Medicare. Medicare has efficiencies of size (it’s by far the largest health plan in the USA), but it is handicapped by not having the full negotiating capabilities of negotiating for lower costs that its peers in other countries have. One would have expected a democratic president to give full negotiating capability to Medicare. But that did not happen.

As usual, all Obama did, with health care, as he did with the banks, or with the military-industrial complex, or with the energy or transportation policies, was to follow the money, and bleat.

It would seem that neither Obama, nor Krugman, their kind, or entourage, understand that the economy is more than a one dimensional object. It is true that the search for profit is one of the dimension of the economy. But it is not the only one. Caring is another, and it is what health care is all about.

Chancellor Bismarck understood this perfectly well in the 1860s, when he created a national health care system for Prussia. That universal health coverage was extended after 1871 to the entire “Second Reich“. That system was so good that, after Loraine and Alsace got reintegrated inside France in 1918, they kept the Bismarck system (and have it to some extent, to this day).

The conflation of the notion of economy and the obsession with profit, shows up in the Obama’s administration naïve approach to whatever, including in its approach to space exploration: it believes, with some extreme right wing politicians, that the search for profits will render space easily accessible. According to this plutophiles, the economy responds only to profit, so augment the opportunity for profit, augment activity.

So the Obama administration has been heaping vast amounts of taxpayer money and property towards Elon Musk, a non American born immigrant based in the Silicon Valley, who, stupidly, believes that his primitive technology (already used by the Nazis 70 years ago) will open up space to his conniving mind.

That general drift is reminiscent of Solyndra, a solar company founded by friends (and financiers) of Obama in the Silicon Valley. The White House sank 550 million dollars of taxpayer money in Solyndra, although that was clearly none of its business. But it was the business of Silicon valley financiers Obama goees visit with his big plane every few weeks. Then the president goes from mansion to mansion, and is introduced to hordes of plutocrats and their broods, who have paid of the order of the median family income in the USA to do so. A four year old can give $40,000 to Obama, but then Obama gives 500 millions to her daddy’s “investment”. Hey, it’s all the same money, freshly laundered taxpayer money.  

The space technology ignorant Musk got in just one contract 1.6 billion from NASA. And many other supports, such as untold secret transfer of technology, that is, of public American property, to a white South African. Some famous astronauts (ex-senator and first american in space Glenn, Cernan, etc.) are furious about it.

On the side, the Obama administration supports Musk, with taxpayer money, for making electric cars for the rich. Musk has got to have good musk: Obama never misses a photo opportunity with him. Musk: smells good. General situation: smells bad.

Basically the same scheme is repeated for Obaromcare health care, as with Solyndra, or Musk, on a much grander scale. Public money for the privates, unlimited. In a few years people like Krugman will say:  We could have never guessed. We just did exactly what the “ultra conservative Heritage Foundation” told us to do. What could go wrong?

None of the 36  countries which have better health care systems than the USA have followed the money to build their health care system. For the very good reason given above: money does not care.  

Once care has been made the master motivation of its own house, health care, care can dictate lots of behaviors which enhance care and that the search for profit cannot dictate.

For example most forms of advertizing by private health care companies is unlawful in Europe (and European authorities are suggesting to crack down on more subtle forms of lobbying). In the USA, lobbying and advertizing has become more costly than research and development, explaining, at least partly, why the development of new drugs and cures has stagnated in recent years.

Here is the classification of health care systems from the World Health Organization:

1         France

2         Italy

3         San Marino

4         Andorra

5         Malta

6         Singapore

7         Spain

8         Oman

9         Austria

10        Japan

11        Norway

12        Portugal

13        Monaco

14        Greece

15        Iceland

16        Luxembourg

17        Netherlands

18        United  Kingdom

19        Ireland

20        Switzerland

21        Belgium

22        Colombia

23        Sweden

24        Cyprus

25        Germany

26        Saudi Arabia

27        United  Arab  Emirates

28        Israel

29        Morocco

30        Canada

31        Finland

32        Australia

33        Chile

34        Denmark

35        Dominica

36        Costa Rica

37        United States of America

So we saw that the motivational space of an economy has at least two neurological dimensions: profit, and care.

Are there others? Sure. Any motivation of human beings will be a factor in house-management (“eco-nomy”). Sex, of course is one, and so are many obsessions. And Will to Power and plain old Curiosity are also important. And so is also the Will to Vice (for a demonstration of that, have a close look at Afghanistan). In particular, pathological lying.

Obama and Krugman pretend to think that Wall Street is a hospital. Is that a medical condition, or something even worse?


Patrice Ayme

P/S: (I immediately sent a comment to Kruman’s sycophantic utterances, but the censorship system at the New York Times put me at the end of the line, and a barrage of sycophants at the front. It seems they censored me completely, not to give the idea the great liberals who lead us just follow the money. Of course, the NYT is a private outfit. but, when it reveals itself less honest than Murdoch’s Wall Street Journal, it’s not a good sign that so many people on the left proclaim it be respectable! Maybe they should meditate some that many followers of Hitler were from the left, and that Hitler’s “ultra conservative” re-foundation was designed to appeal to them, and PC them into it.)

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11 Responses to “Money Does Not Care”

  1. Geo Says:

    Everything you say here needs saying and you are to be commended again for reminding present day humanity of it’s decadent predicament.

    My guess is that Prof. Krugman himself would acknowledge the greater part of what you say here, in private, if not much more. In fact, a few years ago he might have penned a somewhat similar essay, were certain circumstances otherwise than they have been.

    But the ‘facts on the ground’ (don’t you hate those phrases?) or political reality (in this election year) is that they have this healthcare imbroglio before the Supreme Court fairly immediately, and thus Prof. K’s essay is a dancing ‘two-step’ of realpolitik in the service of avoiding any ‘defeat.’ They expertly maneuver public perception between Scylla and Charybdis, and prompt to choose the ‘lesser of two evils.’ However true that may or may not be I have to confess myself very heavily inclined to favor President Obama over what appears to be on offer as an alternative. For all your pungent and apt criticisms of his policies, it has been in no small part the contribution of your essays on past couplings of theocracy to plutocracy which have added significantly to my convictions on this issue.

    Once again, my thanks for your eloquent persistence in trying to advise those blinded in one way by misfortune and in another by fortune itself.

    • Patrice Ayme Says:

      Dear Geo: thank you for thanking me and putting Krugman’s (or Obama’s?) conundrum so eloquently. “Conundrum” is a pseudo Latin word, the sort which was supposed the height of humor when it was invented in Oxford, centuries ago. It means an obscure riddle, typically made up about nothing.
      Obama got himself into this mess, by lack of intellectual honesty. Now Krugman is following him there, for the reasons you say. Although my spouse, after reading him, said:”No way. Krugman got paid to write that!”

      Obama is a leader, so is Krugman. So Obama tripled the troops in Afghanistan. I don’t think one man should have this sort of powers, especially one that ignorant. People would say:that’s what a president does. However, a president, or a Krugman, does much more than that, They form public opinion. That is why the New York Time, not to disrupt Krugman’s vibrant homage to the “ultra conservative Heritage Foundation”, did not publish my comment. It would have been among the first, and they prefer to put first lamentable sycophants such as “Winning Progressive”… Now singing HEIL! to the heritage Foundation…

      We have seen this sort of mental mess before: looking at Germany in the 1920s and 1930s is highly instructive. And not just Germany. In 1919, Keynes ranted against France. In 1944, though, he had discovered, a bit late, that Wall $treet was the problem… That’s how Arendt, a genuine combatant against Nazism at the risk of her life was, simultaneously in Heidegger’s bed (literally). Heidegger was a very influential Nazi. Heidegger broke any hope of unified resistance of universities, and was at the forefront of a group of very young, very respected intellectuals who brashly supported Nazism; an example of these enthusiastic youth was Teichmuller, a gifted young mathematician… who dies later, as he deserved, fighting on the Eastern Front.

      I agree that it will be better to vote Obama than Romney, and Sanctorum Santorum does not have any of the excuses that the Inquisition had. But if that means loving in a frenzy what Obama did, no. The fact anyone has to admit that Obama did nearly nothing good as president, except if, as Krugman says explicitly, you are from the Heritage Foundation… And then Obama is a dream come true.

  2. Old Geezer Says:

    Americans pay exactly DOUBLE what the French pay and, as your ranking list points out, don’t get as good care. I think the problem is…


    The French (and most other countries with national health care) insist that insurance companies and hospitals be regulated and be non-profit. And of course they insist that EVERYBODY be enrolled.

    My wife and I belong to Kaiser Permanente here in California. Based upon our premiums, and we are older than the median Americans, the ENTIRE USA could be insured for an aggregate sum which is LESS that what American currently pay. And there are 50 million who are not covered.

    But the Supremes will probably nix the whole idea of compulsory insurance. No matter that all employees have been paying FICA since 1937.

    But unless you get the healthy young people to pay into the system, it will not work.

    • Patrice Ayme Says:

      Dear Old Geezer: Agreed. In other places, health care contribution is a tax. One cannot escape it. Rightly so. However a tax is paid to the res-publica, the thing-public, not the thing-private. “Private” is what makes Obaromcare unconstitutional.

      If care is the master motivation of health care, as its name indicates, care can dictate lots of things that the search for profit cannot dictate. For example most forms of advertizing by private health care companies is often unlawful in Europe (and they are trying to crack down on more subtle forms of lobbying). In the USA, lobbying and advertizing has become more costly than research and development, explaining, at least partly, why drug development has stagnated in recent years.

      Interestingly, health care is not an issue on the raging presidential campaign (which was just suspended because of racially motivated terrorism by a single (?) killer of Jewish little girls and colored paratroops, among others).

  3. Dominique Deux Says:

    Dear Geezer, a word from France… you write “The French (and most other countries with national health care) insist that insurance companies and hospitals be regulated and be non-profit.”. Unearned praise can be as embarrassing as unearned scorn of the surrendering primate variety. Actually insurance companies and hospitals are regulated, as I hope they are even in the US; but they are allowed to make profit, when they are privately owned and operated. The French system ideally mixes private and public providers, both for care and for insurance, thus lessening the need for public investment while keeping a cap on private gorging through competition with the public actors. AND (unlike the three-legged Heritage Foundation system Patrice describes) the “third leg”, actually a sucker tentacle, is missing – no provision for public subsidy exists, contrary to the widely held misconception in Republican circles that the French are kept healthy by the Treasury (and thus would be better dead).

    Of course such a rosy view is open to much deterioration at the hands of money-driven elected officials of the kind who have been plundering us for decades. The private sector has been coddled, so-called “public-private partnerships” have proven to be shameless financial swindles and atrociously ineffective to boot (badly-built facilities have been empty for years, but the private investors keep charging the would-be public operators for the rent), health personnel is squeezed drier than a lemon, and French health care has been on a steep decline, only stemmed by vigorous public resistance (us being “reform-adverse” as the WSJ keeps bleating).

    But at least we know it can be improved – by getting back to the basics, and first giving the boot to our current bunch of blood-sucking idiots at the top.

    • Patrice Ayme Says:

      I read and approve what Dominique Deux said. I actually have a cousin who heads and owns a large private clinic in France. He complains quite a bit, and says private clinics like his can do a better jobs than many public hospitals, at less cost. However, nobody can compete with the state of the art CHU (Centre Hospitalier Universitaire, the (public) university hospitals).

      Anyway I am going on a total tangent there. As Dominique says, there is often a total lack of knowledge in the USA about how a system like the French one works. Too bad, because that could help the USA a lot, and also decrease the ridiculous hostility often directed by the USA towards the EU.

      Although the bleating of the Wall Street Journal or its associated Fox News is irritating, even more so the manipulations of the New York Times. They were careful to put my (scathing) comment at the end of the line for the comments on Krugman’s editorial singing the praises of the Heritage Foundation, although I should have been among the very first (I reacted immediately from the Twitter alert, and the date stamps were clear).

      Sometimes, the NYT censor me outright, and my comments never appear. At least Murdoch’s WSJ publishes me in three seconds… So I don’t call him Murderoch anymore, I have half forgiven the creature for Iraq… Now he goes around claiming that jobs for everybody is what matters most…

    • Old Geezer Says:

      Dear Dominique Deux:

      Thanks for setting me straight. Sadly, although insurance companies here in USA are regulated in theory, in practice they own the regulators and hence make all the profit they desire. Regulation is done at the state level, so there are 50 sets of rules, none of which favor the patient.

      Perhaps someday we will get it right, but the “ObamaCare” measure (which I doubt ANYBODY really understands) will likely be shot down by the Supremes. As PA correctly notes, it is probably unconstitutional to force private insurance on the public.


  4. Lenny, Australia Says:

    Thank you, Patrice

    I really enjoy reading your essays and get challenged every time.

    • Patrice Ayme Says:

      Thanks Lenny!
      I self challenge too, as the logic leads me sometimes where I do not myself expect. Especially as I check the facts I use, and they are sometimes different from what I expect in the details to the point that it modifies the main discourse (although it also happens that I shake my head about some of the distortion of the real facts, especially when reading “history” in Wikipedia!) It’s good to know it interests others.

      All the more as I do not enjoy having to be scathing with people such as Krugman or Obama. But people do what they do, and one has to judge their acts, not the affection one has, or used to have, for them. Just as I was relaxing about Obama, he is back for further outrage… And the worse is that he is often not present in the subjects where he should be, as he is busy being outrageous where he should not be.

  5. Paul Handover Says:

    Patrice, The sense of pain you feel comes over very powerfully. And in so many ways it would be so easy to abandon hope. But mankind also has a remarkable ability to change. As the saying goes, ‘we always do the right thing, after we have exhausted every other option!’ Interesting times! Thank you, again, for your thoughtful comments. Paul

  6. Sherryn Groch Says:

    Sherryn Groch Mar 22, 12:26 am
    Cheers Patrice. I loved your blog. So informative and clearly expressed. I’ll definitely be visiting again to read more.
    Haha This is why I shouldn’t post quickly between essays. It does terrible terrible things to my grammar.
    Thanks for following and for that info

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