In my last post on the Colorado Springs Experiment I wrote about the liberal/conservative divide over municipal services. Liberals, I suggested, failed to face the real economic costs of equal access to municipal services. Conservatives have rejected equality of services as a priority of municipal government. Here I’d like to approach the issues, especially the choices about how to run Colorado Springs, from the perspective of citizenship and capitalism. In the last part of the This American Life segment, the example of the landscaping employee who worked first for the city and then for a private contractor brought the two systems into stark relief.
Capitalism
The logic of capitalism says: get as much work as possible from the worker for as little pay as possible. We sometimes suggest that pay is tied to value, that employees are compensated in the market according to the value they add. In fact, though, at heart capitalism is exploitative – firms extract more value from their employees than they pay for. Otherwise, there would be no money for the firm’s profit. So, in this case, the private contractor pays the landscaper much less than the municipality did. But it also gets more work out of him by increasing the threat of being fired.
The logic of capitalism also says it is acceptable for services to go to those who can afford it. Capitalism depends on the market to distribute goods according to what people pay. It also depends on the market to distribute wealth. So there’s a kind of market justice to better goods and services going to the wealthy.
Citizenship
The logic of citizenship, in contrast, calls for the equal distribution of goods because it values each citizen equally regardless of individual characteristics. Everyone gets the same right to a trial by jury, one vote in each election, free speech, right to bear arms, etc. While the capitalist model seeks to maximize profit, the citizenship model seeks to maximize equality.
The employment model of citizenship is a bit trickier, mostly because it doesn’t exist in practice. Even government employment is enmeshed to some extent in the capitalist labor market to a greater or lesser degree.* But municipal employment in Colorado Springs reflected elements of a citizenship model. The landscaper recalled his surprise when he was (a) paid a much higher wage than in the private sector and (b) received a string of pre-determined raises.
Conclusion
I think the Colorado Springs example demonstrates the need to balance these two models in our society. The capitalist employment model, carried to its full logical conclusion, would spell disaster to democratic government. The wealth gap would spiral out of control entirely until we had a permanent wealth class and what little government remained would be dedicated entirely to serving their interests.
On the other hand, imposing the logic of the citizenship model on the economy would take us even beyond Marx (“From each according to his ability, to each according to his need”). We need the dynamics of capitalism and the profit incentive to keep our economy productive. But we also need to shield some aspects of society from the logic of market distribution. Sometimes we do this as a direct means of protecting our rights: I don’t hear any suggestions that people pay for their right to bear arms, for good reason. Sometimes we do this to promote democracy less directly: in establishing things like public education we sequester some of the product of our economic system to distribute goods to the next generation on an equal (or more equal) basis.
So the questions raised by Colorado Springs don’t have clear either/or answers. Privatizing everything isn’t the answer in a democratic society. But neither is providing everything through government in a capitalist society. From the federal government down to the local municipalities, we have to seek a positive balance between the systems in order to promote both greater prosperity and greater equality.
* Currently, certain classes of teachers (mostly those with tenure and less-transferable skills) are among the most shielded from the market.
† This is also, of course, partly the result of public sector union gains. Unions, as a fundamentally collective agency, are much more closely tied to the citizenship model than the capitalist model.
Jason,
I would love a walk through a thought experiment around how healthcare fits into these two models. I’ve always argued that Health & Healthcare as a sector is very different from the other sectors in our community. In my view, maximizing the health, happiness, and productivity of the citizens is part of the “Life, Liberty, & Pursuit of Happiness” that set up the goals of our republic & society. I, as a business owner & engineer appreciate the value & need for competition that drive innovation & efficiency. On the other hand, it would seem that a for-profit healthcare sector would set it’s fundamental capitalist goal at direct odds with the aforementioned goal of maximizing the health & well-being of the citizens in that healthy individuals consume less healthcare & therefore produce less profit. I can’t think of any other industry where the maximization of one primary goal (increasing your consumer’s health – this is the product sold) directly counteracts your other primary goal (make maximum profit by selling your product/service). Care to weigh in?
Grant-
Actually, you’ve just predicted the next three blog posts I have pending! I’ll let those roll out as the first response and then we can take our discussion from there. Frankly, though I identify the same problems you have, I’m still wrestling with my proposal for the optimal solution. As you’ll see, I favor a greater tilt toward the citizenship model for providing access to care, but we need to find a way to maintain opportunities for entrepreneurship, innovation, and increases in efficiency provided by the capitalist model. No small order.
Thanks, as always, for your insightful thoughts.
Jason,
I experienced the Socialized model while I was in Portugal, and YES, it had loads of problems. Did you have to wait a year or year and a half for non-life threatening surgeries sometimes? Yes! However, did you have a basic, comprehensive baseline? Yes! As I recall, from that starting point, you could buy all of the private insurance/service that you wanted. It seems like this would be the way to go – a Value-add above and beyond some basic care.
I fully appreciate and understand the intrinsic limits of any kind of nationalized system which aims to provide the greatest benefit to the greatest number of people, and the lowest financial burden of all. Study panels & best practices guidelines would surely have to be set up and maintained, and would bring with them problems. I also realize that if that were the case, there is a VERY real possibility (probably certainty) that my 6 yr old would have lost his left leg at the hip when he was 4 – that is the standard of care for children of his age with the diagnosis that he had. Instead, we were given the opportunity to push the entire field of pediatric limb saving surgery forward by Zeke being the first child ever of his age & size to have a prosthetic femur & knee installed. It was not cheap, and was not without problems – he just had his first replacement surgery 2 months shy of the 2 year anniversary of the install of the first prosthetic. As part of this process, he’s been part of a published study on the success/problems with this type of pediatric surgery. The surgeon is learning, as is the medical device manufacturer as we are pushing the limits of technology together.
I don’t know how this type of research, collaboration, and drive to push the boundaries of what’s possible would fit into the single payer model that I would prefer to see here, but I sure would like to get into the meat of a real discussion of how we could make this work for the citizens of the country.
– Grant
I should mention, that all of Zeke’s past & present medical care was provided by the outstanding Maryland State Children’s Health Insurance Program for which we qualified and for which I will eternally be grateful.
I think that I should also mention that we qualify for this benefit due the the drop in our personal income that came when I stepped away from my chosen profession to take a chance at starting up an independent business. I currently employ 4 people in addition to my own family that put money back into the local economy. I appreciate my State’s investment in me and my children as we grow to a point where we will be able to provide health insurance for ourselves and our employees. I am working hard to make sure that it ends up being a good investment in our state and our community.
– Grant
Thank you for sharing all of this, Grant. I am sorry you and your family had to go through it and am glad to hear that Zeke got the treatment he needed. That kind of boundary pushing definitely needs to have a place in the new system, even as coverage is expanded and we aim to cut costs overall. No small order.
My best wishes and prayers to you, your family, and Zeke.