During the next week President Barack Obama intends to visit the United States. Here are just a few of the principal problems facing him and the country, and in each case accompanied by a few thoughts of my own that the President might find helpful in his attempt to begin to find solutions.
1) Homeland security, or what to do about suicide bombers. For the only real threat to our security is from those who don’t care if they live or die, and in particular who most prefer to die when their death will bring harm to us.
The solution? If there is one, perhaps less monies spent on aircraft carriers and more on efforts to stop the supply of bomb carriers at the source. In any case that would be my advice to the President.
2) Poverty. Up until now our war on poverty has pretty much failed. Better than what we have done, beginning with President Johnson’s War on Poverty, would be that this President provide greater school, job, and life opportunities to those who are without. Extending equality of opportunity to more and more Americans is still the best way out of poverty.
3) Immigration, in particular what to do about the tens of millions of mostly Mexicans, but others also, who are here doing for the most part useful work, but without legal status, and consequently living under the threat of deportation to their countries of origin.
The President needs to find a way of our fully accepting their presence among us, no different from his predecessors’ acceptance into our midst the millions of Germans and Irish who came to our shores, mostly without permission, in the second half of the 19th. century.
4) Education. We’ve already done the easy thing, got everyone into school. And we were first among the developed nations of the world to do so. The result is that today we have most of our young people attending, for some nine months or more during the year, free public schools, three quarters of whom will remain until graduation from High School. And we accomplished all this well over one generation ago.
However, our problem and now Barack’s problem, is that free and compulsory schooling through high school is not the same thing as learning. For too many of our children attending school doesn’t mean becoming proficient in the knowledge and skills they will need to land a well-paying job.
This is most especially true for the poor and otherwise disadvantaged children of our largest inner cities. Does Barack realize that schooling and learning are not the same thing? And that the way out of the dilemma is to think less about school and school reforms, and more about learning and about students and their teachers.
5) Income gaps between Americans. Whereas income disparities have always been with us they do seem today to be particularly large. The top 1% of our population earn nearly 40% of our national income. The bottom fifth less than 5% and in order to do so often have to hold down two full time jobs that which enables them only barely to meet minimum living costs.
The easy answer to this one has always been to redistribute the nation’s wealth, or create and/or expand government programs that will take from those who have more in order to give to those who have less. And only the government has the power and authority to do this.
On the face of it this makes perfect sense and one wonders why it is not done more than it is. One wonders why in a democracy where the majority rules the minority still have such a large portion of the country’s wealth. Is it that the majority is showing admirable restraint, or is it something else?
While candidate Barack did promise to remove George Bush’s tax cuts for the rich, and thereby have more to redistribute to the poor president Barack probably understands things somewhat differently. He surely knows that government revenues, for redistribution, or for anything else, will surely grow more from increases in our GNP than from additional and higher taxes.
6) Health care. Why has this now become the responsibility of government? Well, probably because like so many other social goods and services, it was neglected by private individuals, and now, for whatever reason, there are just too many without access to appropriate medical care.
The health care problem probably reduces to the high cost of available care that only very few of us can meet on our own. In other words the medical services industry has grown much faster than our ability to pay for it.
The huge amount of now available diagnostic equipment and procedures, the great number and enormous variety of available surgical interventions, the vast quantities of drugs and medicines coming from the pharmaceutical companies, the cast of characters, the doctors and especially the growing number of specialists, all this comes at a cost we cannot afford.
But at the same time there are few or none of us who want to do without the extraordinary benefits of modern medical science. Hence the problem and dilemma.
So the way to go now, when our health care is no longer in the hands of a single and affordable family doctor doing family visits, as was the case when I was growing up in the 1930s and 40s, is with a system of health insurance. For only if everyone pays a little something will both the many who need routine checkups and preventive care, as well as the few who need exceptional and usually expensive care, be able to have it.
Our question, and the question confronting the President, is how will the health insurance be paid for?
When something is just there for the taking, and when it doesn’t cost anything, such as doctors’ visits and medicines, people will abuse their use of these benefits and services, and there won’t be enough for everyone, and the resulting scarcity will drive up the cost.
This is true of air and water and land. In the past people by their indiscriminate use of these priceless resources brought about the deterioration of all three, and their excessive usage/abuse only ceased when they had, in part, to pay the cost. No longer a right to limitless resources, but a privilege to use as long as they were well cared for, such as, for example, the Hudson River and Boston Harbor.
This all seems to make perfect sense, common sense, that with which our President appears to be well supplied. So yes everyone should have access to health care, but that access should be limited in accordance with supply and cost, and to the extent they are able, they should pay for it. There should be all sorts of devices, co-pays, deductibles, awards for not overusing the service, all kinds of things that will keep down the costs of the insurance.
In this situation, when people are monitoring carefully their own use of a right or entitlement (better to speak of privileges, and of opportunities), be it air, water, land, or health care, most any health insurance payment system would work. A government single payer system, or private insurers, or as at present a combination of both.
And in any case in both systems the insurance costs will be met out of the productive areas of our economy, directly by the wealth producers by the taxes they pay, or indirectly by the wealth users or government organizations by the tax revenues they receive.
Ultimately the solution to our health care problem, as well as the solutions to the other problems mentioned above, does fall back on the entrepreneurial spirit and productivity of the private sector, which after all is the only source of our material wealth. Does our President know this? I hope so.
