Submerged State

Citizen Wealth Financial Justice Health Care

submergedstateNew Orleans   A frequent theme in the years leading up to the complicated and star crossed rollout of the Affordable Care Act or Obamacare among the pundits, editorial writers, and commentators tried to nick the President for his weak kneed efforts to “sell” the program to the American public.  Reading Cornell Professor Suzanne Mettler’s Submerged State:  How Invisible Government Policies Undermine American Democracy, you get a better idea of not only the entrenched interests that have to be conquered to achieve any changes but also the codependency of both parties and virtually all politicians in hiding the hands of government on the real levers leading to such critical confusion that democracy itself is endangered.  In short, it’s hard to sell a product that is almost deliberately designed to be obscure.

            Mettler takes her starting point at the Tea Party absurdity of people yelling at politicians that they hate Obamacare but wanted the federal government to keep its “hands off my Medicare,” seemingly not realizing that Medicare is of course a federal program.  She marshals extensive evidence, easily available, that the complexity of government programs is such that the vast majority of Americans are also unclear that Social Security is a government program as well, even though we have now had such a federal program since 1935, a full 46 years after Germany created the first government retirement scheme.  

If Mettler were writing her book now, she as likely would have combined the farcical Medicare point with Obama’s apology for his blanket promise that, “if you liked your current policy, you can keep it,” without spending the time and trouble to explain that he was specifically not talking about the total ripoff, though sometimes cheap, policies that some people had that are vastly inferior to the requirements of Obamacare.  In this case a man had to bite the dog as well, since Obama’s one-year extension allowing these fake policies another year of life given all of the rollout troubles, severely weakened the transition required under the Affordable Care Act to such a degree that a number of state insurance commissioners refused to go with the President’s change.  Mettler would have quickly pointed out that this stumble was due to an unwillingness to confront the “submerged state” represented by the insurance companies and call them out for selling crap in the name of real protection.  Needing their acquiescence and that of their hordes of lobbyists, the President was eating crow when he should have been spitting fire.

It’s hard to argue with Mettler.  If you conceal how things really work and what they really cost and who really benefits, because having the people understand how things really work might mean the deluge, then getting them to fully understand and act under a democracy is more and more daunting.  Her argument is a healthy antidote even to the “nudgers” and “default option” approval advocates among behavioral, libertarian paternalist economists, who mean well, but are also trying to “hide the hand that throws the rock” in their case for “peoples’ own good” perhaps, but for those of us still holding out hope for democracy, it’s another rock to push up the hill.