Carroll and Pagliuca in juxtaposition
To the editor,
I was struck that the January 3, 2011 Opinion Page of the Boston Globe had two essays immediately adjoining, James Carroll’s “Now the rich will get rich quicker” and Steve Pagliuca’s “The next big thing”. Carroll does a fine job of linking the issues around the decline of democracy related to the Supreme Court decision on campaign finance with tax breaks for the rich, the rise in poverty, the transformation of Americans into shoppers with borrowed money as an economic development strategy, and the growth of the military industrial complex and the need to go to war to keep the production of war machines going.
Healing the sick may be the opposite of war, but I think Pagliuca’s essay on growing the medical industrial complex is exactly an example of what is wrong with the American system. It is a perfect description of an economic system designed to make a very few people extremely wealthy while making health care unaffordable. If these are to be high profit, high wage businesses, it can only be paid for by more people paying more money for health care. In other words all of this is paid for by the consumers of health care. Over the last 60 years the percentage of the American economy in the health care business has grown from 5% to 17%, strangling the rest of the economy with its outrageous costs. If the price of insurance goes up 10% a year to keep the medical industrial complex growing at 8% a year while the rest of the economy contracts, it is absolutely clear that every penny Pagliuca and his cohorts make from the state investing in the medical industrial complex will come from the people who need health care, and fall further and further behind paying for it.
Yes, the medical industrial complex was deliberately expanded to provide some resilience in recessions as health care is still needed in a recession, and some sectors can not be offshored. The medical industrial complex buoys the economy of many communities around the country, the Providence and Boston metro areas as much as any, but it is a strategy that is dragging us down. Our economic development gurus tell us to have more, but its result is the same as with the military industrial complex. It starts to grow for the sake of growth and to enrich the wealthy, and it eats our communities. The result is first in cost, 37th in health care delivery and thousands of medically induced bankruptcies a year. The most unaffordable system in the world making the Steve Pagliuca’s extremely wealthy while bankrupting people who get sick every day. Investing more and more in this industry will create a few very wealthy men and a smattering of jobs, while at the same time it is costing jobs and lives by making health care more unaffordable. If it was not going to drive up the cost of health care, it would not attract the investment that makes a few men wealthy. It contributes to the greater and greater inequality in our economy.
Which is why the placing of these articles right next to each other was so interesting. Pagliuca offering us the traditional economic development wisdom, which the wealthy make sure becomes the policy of our government so it can fill their ample pockets, while it contributes directly to harming the economy and our communities, Carroll pointing out the problem. Thank you Boston Globe for making the contrast so clear.