Structural change, indeed
by Tom Sullivan
Every now and again one drives onto a stretch of fresh pavement. Road noise drops many decibels. There is a satisfying "A-h-h-h" feeling to it. Because what you were driving on a second before was cracked and potholed and much, much louder.
That feeling is rarer these days. What with the financialization of every American experience, we are too busy extracting value from what's here to build new infrastructure or even maintain what our forebears built.
Jill Lepore watched Speaker Nancy Pelosi's impeachment announcement this week during a snowy train ride to Maine. She ponders how we got to this divided place where we've not only given up on building but, seemingly, on democracy itself.
"The train stopped under a stone bridge, a beautiful arch, it looked like a New Deal bridge, built by masons working for the W.P.A., now not much short of a century ago," Lepore thinks, looking out the window. "It stands in need of repair. It is a terrible thing to watch a nation and a people fall apart."
It was cold on the train. The heat was not working.
America's roads and bridges are a mess. The Eisenhower-era interstate highway system is in decay. (Yes, Republicans built things once, as did FDR before Ike.) Today, 47,000 bridges are “structurally deficient.” Repairs have slowed to a crawl.
A priest friend jokes, in America you are expected to have faith. Not faith in anything in particular, just faith. In a similar vein, politicians peddle abstractions like freedom. Not freedom for anything in particular. Just freedom.
Choice is like that, Sarah Jones observes. People want choice in health care, the health care industry insists. It's just that, having it, people don't use it. Research shows that by shopping around people could save as much as $2000 per year on what is one of many families' largest annual expenses. They don't. It's too much work and too complicated. That complication works for the industry, just not for patients.
The gap between what Americans say they want, and what they actually do, sets up a series of important questions for opponents and skeptics of Medicare for All. If it’s too difficult and too expensive for most people to exercise the choices they technically have, why is the private market so preferable to a government-run alternative? How much can the government really do to make private insurance less complicated and more affordable to use? And why should the government prioritize that project over one that guarantees an equal level of health-care coverage to everyone?While conservatives rail about government waste, fraud, and abuse, medical billing in the private sector might be considered all three, Elisabeth Rosenthal explains in the New York Times. The country's health care system (if that's what it is) is as decrepit as its roads and bridges. But we are too cold and shivering in our rail cars trying to get somewhere to think about it or to exercise our precious choices. We're just along for the ride, or being taken for one.
Opponents of Medicare for All should answer these questions. They haven’t ...