Privatization of Public Health is Against the Common Good
Pay any amount of attention to the news and one will learn of some new, fresh atrocity being forced upon the federal Department of Health and Human Services (HHS) or programs it encompasses like the Centers for Disease Control (CDC) or National Institutes of Health (NIH). While Robert F Kennedy Jr’s large scale firings of Public Servants, malicious funding cuts, and grant terminations are overt, these actions are in line with neoliberal policies from both American political parties. While former Speaker of the House, Newt Gingritch spoke of Medicare “withering on the vine” through funding cuts and restrictions and seniors then going to for-profit entities, Governor Andrew Cuomo exploited austerity politics during the Great Recession to use remarkably similar Gingritchian tactics to assault New York’s Department of Health – the impacts of which are still being felt and continue to be acted upon to this day. Regardless whether a Democratic or Republican party member, these politicians and their policies always, curiously, seem to utilize “public-private partnerships,” better known as contracting and, ultimately, complete privatization when neglected programs ultimately fail and are shuttered. RFKjr and President Trump have just leapfrogged the pantomime of “fiscal necessity” and went straight to shutting things down. By engaging in these actions, politicians hand over a common good, public health, to for-profit interests.
Aristotle describes the reason for the existence of the state as being for “the sake of good life” or the "supreme good." By Aristotle’s rationale, a principle purpose of government is the protection of its people and ensuring their quality of life so that they may engage in a life of self-improvement. While having a military probably jumps to mind for many people, protecting public health, certainly, falls under this umbrella. A reasonable claim cannot be made a government is ensuring a good life for everyone when children suffer by contracting measles or people in small towns once supported by the chemical industry develop kidney cancers after the drinking water and soil are poisoned with PFAS – by those same chemical plants. Both of these are examples of public health failures becoming more common. Certain Republicans, Libertarians, and to a lesser degree, Democrats will claim the government has no business in public health. While not their rhetorical intention, a semantic argument could be made they are correct. The government has no business in public health because the government is not a business and is not trying to extract a profit. The market-based rules that apply to businesses are not only inappropriate but, most importantly, public health is not a commodity or service. It is a common and social good.
No amount of mythical American rugged individualism is going to protect anyone from something like a virulent disease or environmental toxins. After all, John Wayne, the pinnacle of masculine American toughness, died from stomach cancer. The human body reacts to viruses, bacteria, genetic transcription errors, and poisons the same way regardless of someone’s income, ethnicity, or sexual orientation. However, the wealthy can pay to move away from environmental contaminants and they can pay for the best treatments when they fall ill. The Poor and Working Classes often cannot move, are forced to suffer, or go into perpetual, compounding debt in and effort to protect their or their family's health. Many may not even know they’ve been exposed to something or sick because they can’t afford healthy food, good housing, routine medical treatment, or to live in a good neighborhood free of carcinogens. In no way is this acceptable for any country that claims to support “life, liberty, and the pursuit of happiness.” People are dying. People are forced into terrible jobs and debt peonage. People are not happy.
The objective of politicians like Trump, RFKjr, or Andrew Cuomo is the cede a fundamental responsibility of government to capitalists in exchange for money and power. Quid pro quo. Ellen Meiskins Wood, in her book, The Origins of Capitalism: A Longer View, expertly and accessibly describes capitalism’s birth in England. She describes the process of enclosure where the common areas where peasants could graze livestock, grow crops, or hunt were fenced off, or enclosed, into private property. Broadly speaking, the spaces people once could sustain themselves and their families for generations was denied – resulting in their having to sell their lives to earn a wage just to survive. There’s more to it but this process has taken different forms but the end result is always the same – exploitation of the Poor and Working Class (if you have to work to survive, you are in the Working Class) for profit. The objective of the neoliberal project in regard to public health, is to enclose it so that it may be strip-mined in order to generate wealth for the 1%. We already know how effective the profit motive is when it comes to health care. Insurance companies raise rates and cut coverage. Hospitals staff at the lowest levels possible and cut community resources and programs while patients needlessly suffer waiting for care – just so some CEO can earn a multi-million dollar income. Our friends, family, and Fellow Workers are harmed and neglected just to fatten someone’s wallet. With the assaults on HHS, Trump and RFKjr are handing over our public health programs for prevention, testing, and research to the exploiting class. The work still needs to be done if the population is to be kept in a reasonably healthy state. The country needs healthy workers, after all, to have an economy that produces wealth. Capitalist, for-profit companies will be more than happy to take on the work – but only if they can extract value.
Profit must never enter consideration when public health is concerned. First and foremost, much of the labor being done by dedicated Public Servants is not profitable. The work is done because it must be done. The premise of surplus value is never considered – nor should it be. If the profit motive were involved, this type of important work may never be done – resulting in suffering and death. Perhaps the work could be exploited for wealth extraction wherein costs to the customer or consumer are increased, Labor is further exploited, or safety and quality are neglected. Then there is the inhuman dystopian option where access to information, research, or treatment is only accessible to those who could pay top dollar. All these scenarios are fundamentally immoral and intrinsically corrupt. Should research on a rare form of childhood cancer be stopped because there are not enough children dying from it to ensure a large enough market? Should information about the spread of a pandemic never be broadcast because there was no corporation willing to gather, analyze, and report the information because there was not an adequate return to shareholders? What if some oligarch, like Elon Musk, decided to sell a quack “cure” because it had a higher profit margin than an evidence-based treatment? Any action which ends or abandons the legitimate pursuit of public health for all for “profit health” for the few is a rancid betrayal of the social good and condemnation of the Poor and Working Class to illness, desperation, and death. Industry never does anything simply because it is the right thing to do.
Public health is a common good. The less people there are who are sick or suffering benefits everyone economically and otherwise. Whether considering asbestos or lead exposure regulations, vaccinations, or clean air, the United States has benefited, as a whole, because of scientific research, rules, and regulations which were developed to protect everyone – not just a select few and not in the pursuit of wealth. Much like our privacy and information (the “new oil”), our public health is a frontier neoliberal politicians and unscrupulous capitalists see as being ripe for additional exploitation. As the farce on which the American economy and the capitalist system are predicated upon – unbridled, unrestricted, and unlimited growth – encounters the reality of the natural world with its real, physical limits on material resources, the exploitative nature of the system will turn on us all if unchecked. We will further become targets as if we were Matrix-esque economic batteries only to be consumed and discarded when no longer materially benefiting the rich. Public health is not a commodity to be traded on the stock exchange or sold to the highest bidder. It is a social good and Robert F Kennedy Jr, Donald Trump, like-minded oligarchs, and politicians’ designs at enclosing it must be fought and stopped at every nefarious turn for the common good of us all.
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