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“The 15% Solution,” Serialization, 30th Installment: Appendix V: On Poverty, Sin, Regulation, and Freedom

Note: The Preface and Chapters One through Twenty can be found here:

by Jonathan Westminster, Ph.D. aka Steven Jonas, MD, MPH
Featured Writer
Dandelion Salad
crossposted on TPJmagazine.us
October 14, 2012

A Simple Message for the Religious Right

Image by mariopiperni via Flickr

This is the thirtieth installment of the serialization of a book entitled The 15% Solution: A Political History of American Fascism, 2001-2022.  Herein you will find Appendix V.  This Appendix, purportedly written by the 20th century political analyst, (the fictional) “Dino Lewis” presents a discussion of the contrasting views of the right and the left on the correct role for government in regulating personal behavior, economic activity, and environmental health, safety and preservation, the relationship, if there is one, between poverty and “sin,” and the whole religious concept of “sin.” It is certainly fully relevant to the United States and what we might face in a future governed fully by the Republican Religious Right.

For readers coming into this serialization at this time, you should know that under the pseudonym Jonathan Westminster, the book is purportedly published in the year 2048 on the 25th Anniversary of the Restoration of Constitutional Democracy in the Re-United States. It was actually published in 1996 by the Thomas Jefferson Press, located in Port Jefferson, NY.  The copyright is held by the Press.  In early 2013 it will be republished under the name of the true author, Steven Jonas, with the title The 15% Solution: How the Republican Religious Right Took Control of the U.S., 1981-2022 – A Futuristic Novel, by Punto Press Publishers, New York, and Brewster, NY.

A commentator had this to say about the book: “I am in the middle of reading ‘The 15% Solution.’  For some reason I assumed it was a recent publication.  About 100 pages in I looked to see when it was published.  It was published in 1996.  That absolutely shocked me. What it was saying then is exactly what is happening now.  The race-baiting, anti-homosexual crap that takes one’s attention away from what is actually happening, and it was written about 15 years ago.  Even the 14th amendment controversy is discussed in this book, as well as so much more – ownership of the media, talk radio, etc.  This is truly frightening, and if the Dems do not wake up and fight, I fear there is much worse to come.”  Indeed!

And so, Appendix V.

Appendix V

On Poverty, Sin, Regulation, and Freedom

Dino Louis, 1991

Regulation and Ideology

A basic theme of the Declaration of Independence, to which I have con­sis­tently referred in my work, is that all men are created equal and en­dowed by their creator with certain un­alienable rights. This theme holds that the primary motivator of human behavior is the fulfillment of these rights. A second basic theme is that the role of government is “to secure these rights,” that is, to aid our citizens in that endeavour. Un­der the U.S. Constitution, the Federal gov­ern­ment has powers provided by the General Welfare clause, the interstate com­merce clause, and a vari­ety of other provisions which project it into specific eco­nomic activities.

The views of the Right Wing, Republican, Reli­gious, and Other to the con­trary notwithstanding, other Constitutional clauses, to say nothing of the Bill of Rights, specifically pre­clude the government from interfering with any person’s free­dom to make indi­vidual choices on such matters as speech and religion. It is thus clear that the Founding Fathers held that the role of gov­ern­ment is to protect freedom, liberty, and rights of personal conscience of each individual, while regulat­ing economic activ­ity for the benefit of all.

However, there is abroad in the land another line of think­ing on the prop­er role of government. It is not as clearly ar­ticulated as the one de­fined by the Declaration and the Consti­tution. Nevertheless, as stated by the Donald Wildmons and the Phyllis Schlafleys, the George H.W. Bushes and the Jesse Helmses, the Pat Buchanans and the Pat Robertsons, it is un­der­standable enough. This view holds that the primary role of gov­ernment is to deal with sin, as sin is defined by the holders of this posi­tion.

In this view, the role of government thus becomes to protect people from being exposed to “sinful things,” like homo‑erotic art or “dirty words” in popu­lar music, and punish them by criminal sanctions if they commit a sin, like taking a currently illegal mood‑altering recreational drug. It is up to the gov­ernment, of course, to determine just which personal behaviors are “sin­ful.” In practice, that determination varies over time. Its logic, if any, es­capes simple understanding. At the same time, the holders of this view of the role of government would have ours largely ignore the Constitution’s prescrip­tion for action in the economic realm.

This essay presents the case for the position that the values of personal free­dom and unalienable rights should be the principal motors of national poli­cy. This phi­losophy stands in direct opposition to the one that holds that the pre­vention of sin and punishment for it should be the principal motors of na­tional policy. Representing the two major ideological camps in the United States, they can be termed the Constitutionalist and the Religious Fundamentalist.

Interpretation of Our Founding Documents

The contrasting positions of the Constitutionalists and the Religious Fundamentalists on all questions of policy are epitomized by their answers to the two major domes­tic policy questions with which this country is currently, sometimes violently, wrestling:

1. How are economic benefits and burdens to be distributed among the peo­ple? (In other words, what is the role of gov­ernment, representing the people as a whole, in regulating economic behavior and in evening out economic inequality of economic opportunity?)

2. Just what is meant by the term “personal freedom”? (In other words, what is the role of government, if any, represent­ing the people as a whole, in control­ling the thought processes and regulating the personal behaviors of individu­als?)

The Right is fond of saying that one of their primary goals is to “end gov­ernment regulation,” to “get government off your back.” In fact, they are not against government regula­tion across the board. They may want to get gov­ern­ment off your back but they also want to get it into your mind and into your bedroom. Only the Libertarians take a reasonably con­sistent stand against government regulation of all kinds of hu­man activity (like the Reaganite/Bushists ignoring the Consti­tution on this question, but from the other end of the spec­trum). The Religious Fundamentalists are actually in favor of a great deal of government regulation of: freedom of choice in the outcome of pregnancy; prayer in school; sexual preference and conduct; artistic expres­sion; the use as well as the sale of rec­reational mood‑altering drugs.

Thus there is little disagreement on the question of wheth­er government should regulate human behavior. Rather, as noted above, the disagreement concerns only what should be regulated. The Constitutionalists favor active government regulation of economic behavior with minimal regulation of per­sonal behavior in matters of conscience. In contrast, the Religious Fundamentalists (and other Rightists as well) fa­vor a great deal of personal behavior regula­tion with limit­ed regu­la­tion of the econ­o­my (Brownstein). And that regulation focuses on pro­tecting wealth and the eco­nomic power of the already wealthy.

Thus, while the Religious Fundamentalists say they are against governmental regula­tion of economic activity, they are in fact against the regulation of only certain kinds of economic activity. For example, they are in favor of deregulation of, for example, capital investment policy, bank practices, transportation and energy policy, environmental pollution and destructive activities, industrial working conditions, micro and macro health and safety.

However, they are certainly for the regulation of, for example, the nation­al monetary system through the Federal Reserve Bank (to control their bugaboo of monetary inflation), the setting of interest rates by the Federal Reserve and the Treasury, the macro operations of the financial markets, the operations of trade unions (to decrease their power wherever possible), strikes by public employ­ees, secondary boycotts, the retention of seniority rights by striking workers, freely negotiated minority set‑asides and affirmative action programs, and taxation policy to further benefit the wealthy and the large corporations. As I have noted before, one prominent outcome of the Right‑Wing/Reaganite approach to Federal government regulation of the econ­o­my is the redistribution of wealth from the poor to the rich (Phillips).

But, the question must be asked, which approach embodies true American values? The Declaration of Independence (and the military action taken pursu­ant to it) established this nation and laid out the rationale for its independent existence. Its plain language can be taken as our guide to what American values are. The Declaration says that men “are endowed by their Creator with certain unalienable rights, that among these are life, liberty, and the pursuit of happiness,” and that “to secure these rights, Governments are instituted among men.” That’s the primary function of government: securing the rights to life, liberty and the pursuit of happiness.

Thus, pursuant to the Declaration, the function of government is not to make everybody happy, but to provide everybody with the opportunity to pur­sue happiness. Among other things, happiness requires a reasonable economic standard of living. Standard of living is the part of the state of mind and being which constitute happiness that government can reasonably address. There­fore, government’s function in relation to the pursuit of happiness is to be found primarily in the economic realm. That function focuses principally upon the achievement of a reasonably level economic playing field.

On the other hand, according to the Declaration it is not a function of Ameri­can government to tell people what to think, what to believe in, what to feel, what to like and dislike. Rather, it is to ensure people that they can make free choices in these various areas of human thought and endeavour, assuming that by doing so they are not actively harming anyone else. The Preamble to the Constitution, and the Bill of Rights, confirm this view. Constitutionalists are in tune with both the letter and the spirit of our founding documents. Despite their prattle about “patriotism,” the Right stands squarely opposed to both the letter and the spirit of our founding documents.

The Philosophical Basis of the Contrasting Views on Govern­ment Regulation

At the heart of the dispute on regulation of the economy and redistribution of the fruits of production is a question which has riven Western capitalist societies since the establish­ment of the Elizabethan Poor Laws in late 16th century Eng­land: Is poverty the fault of the poor or, worse yet, a sign of pun­ishment for sin, or is it primarily the product of social and economic factors beyond the control of the individual? The Religious Fundamentalists and their political allies, powerful forces in our society, firmly hold to the view that poverty is the fault of the poor. According to this view it is appropriate to attempt to help the poor through private charity. The latter recogniz­es the poor’s state of “less eligibility,” as the 19th century English Poor Law “reformers” put it. (The “less eligibility” concept is indeed based on the view that poverty is the fault of the poor. Since the poor are at fault for their poverty, they are “less eligible” to receive/benefit from a variety of the good things that life has to offer to those who are not poor and therefore not culpable.) However, this view holds, any gov­ernment regulation of and intervention in the economy, for the purpose of dealing with poverty, not based upon the view that the poor are either at fault for their poverty or being punished for some personal bad act, is in no way justifiable.

Furthermore, any government attempts to redistribute income and the fruits of production from the rich to the mid­dle class and the poor constitute an entirely inappropriate in­terference with the natural order of things (al­though, as point­ed out above, transfers of wealth upwards are just fine).

The progressive, Constitutionalist, view is that sin plays little, if any, role in determining social and economic standing. For most people, social and economic standing are much more related to opportunity, geography, training, education, social class of parents, race, available employment, and so forth. Likewise, Constitutionalists tend not to view personal behav­iors in terms of sin. Thus, government has a very limited role in “protecting people from temptation.” Likewise, engaging in such behaviors should be punished, in the Constitutionalists’ view, only when they result in palpable harm to others.

These contrasting views raise an interesting question: Why is it that many of those who would leave thought and personal behavior only loosely regulated by government generally favor regulation of the economy, while most of those who want an unregulated economy desire closely regulated thought and per­son­al behavior?

There is surely no simple answer to this question. But part of it is to be found in the will of the wealthy to have as little interference as possible in their eco­nomic lives. And the Right’s concomitant interest in limiting personal liberty can be found in part in an examination of the relationship between poverty and sin, as it is seen by those who hold that poverty is the fault of the poor.

Poverty and Sin

In the view of those who hold that poverty and sin are interconnected, there are two possible causes of poverty. One, a person is poor because he is weak, weakness is a sin, and poverty is a physical representation of his/her inade­qua­cy. Further, poverty is the punishment for the sin of weakness. A second explanation is that whether strong or weak, a person is or becomes poor through having sinned in some other area of life and is being econom­ically punished for that infraction.

Certainly the concept of sin is central to the thinking of many Right­ists. They cast so many domestic and foreign policy issues in moral terms, in the formulations of “right” and “wrong,” “good” and “bad.” To do the wrong thing is to sin; to do what’s right is only to free one of sin (rather than doing the right thing for its own sake). Just listen to William Bennett, Reagan’s Secretary of Education, Bush’s first “Drug Czar,” on the nature of the drug problem (Morley; Weinraub):

•”The drug crisis is a crisis of authority.”

•”Drugs obliterate morals, values, character, our relations with each other and our relation to God.”

•”Drug use, we say, is wrong.”

And who can forget that President Bush, having run through oil, jobs, and “naked aggression will not stand,” as reasons for engaging in the Gulf War, finally cast it as a moral crusade against “wrong” (1991).

The Regulation of Sin

Given that the problem is sin and sinning, one solution is punishment. This way of thinking, for example, underlies the Bush/Bennett “Drug War.” In this kind of thinking, fault and sinning are equated. Therefore, in dealing with economic issues, it becomes appropriate for the poor to be punished for being poor. An unregulated economy certainly accomplishes that desired out­come.

Another solution to the problem of sin and sinning is to protect the susceptibles from temptation. The Religious Fundamentalists regard thoughts and per­son­al behaviors like viewing pornography, having an abortion, or being homo­sex­ual, as sinful. History has shown clearly that for the most part such behav­iors will go unpunished, in this life at least, unless government does the pun­ishing.

Furthermore, many people will engage in such activities, if only given the opportunity to do so. Therefore, according to the Religious Fundamentalists, and their Rightist political allies, to protect society from these sins government should vigorously protect people against the temptation to engage in them. This is best accomplished, so the thinking goes, by curtailing or prohibiting the supply of the offending agent. If sin is indeed the enemy, its progenitors must ei­ther be ac­tive­ly protected against or banished.

Hence, from the Rightist perspective, government has only two regulato­ry functions: protecting people from, or punishing them for engaging in, sins of personal thoughts and behaviors. Both are related to the role of low economic status as a punishment for and reflection of a sinful state of being. Thus gov­ernment should do nothing to interfere with the punish­ment of the economical­ly sinful by the economy itself. However, govern­ment should actively punish those who are personally sinful, (as the Religious Fundamentalists define sin, of course: gambling and drinking alcoholic beverages are okay for most of them, sexual intercourse except for the purpose of reproduction is not). Government should also attempt to actively prevent any citizen from being exposed to the tempta­tion to sinful personal behav­ior.

The Clash of Philosophies

Sin and dealing with it is certainly the central focus of many religions in this country, especially the Religious Fundamentalist sects on the Right. Thus it is no acci­dent that separation of church and state, established and guaran­teed by our Constitution is a major right‑wing target. If the Religious Fundamentalists can breach this barrier, then they will indeed be able to employ fully the regulatory power of government to fight their battle against sin. Un­der Constitutionalism, the power of government is not to be used to fight theological battles.

Religious Fundamentalism and Constitutionalism thus reflect two strongly held, gut‑level positions, based on very different philosophies of life. They are not easily reconciled by rational argument. In the 19th century the princi­pal poli­cy question the country faced concerned one aspect of the Declara­tion and the Bill of Rights: Did they apply to Negro slaves?

Today the questions are even broader:

•What is the true meaning of the Declaration of Independence, the Pream­ble to the Constitution, and the Bill of Rights, spelling out as they do the pur­pose and functions of our government?

•Do the provisions of these documents apply to all the people of the land, regardless of social class, ethnicity, sexual identity, or ideology?

•What is the appropriate role for the government in dealing with pov­er­ty and personal freedom?

One must wonder if the current struggle over poverty and personal free­dom, sin and the role of government, is the slavery issue of the next centu­ry. In 1820, Thomas Jefferson described the debate on the Missouri Compromise and its implications for the future of the Union as a “firebell in the night” (Garrity and Gay), warning of future bloody conflict in the United States over the issue of slavery. Is the present debate over poverty and personal freedom that firebell for us? Has the firebell indeed rung? Do we face a Second American Civil War?

I hope that we do not. I believe that it is possible for us to resolve our differences peacefully. But to do this, I believe that some progressive overarching political philosophy is essential. And central to that philosophy would be the concept that sin and its punishment are not appropriate symbols of either the American dream or the American way.

Government Regulation of Economic Activity

Turning to the issue of government regulation of economic activity, it is vitally important to note that it is an activity pri­marily reactive to circum­stance. It is not a proactive Govern­ment function, as the Rightists would have us be­lieve. It is a response to the activities of groups or individuals who at­tempt to unbalance the economic playing field or take certain actions that, say, pollute the environment, thereby significantly en­dangering the health and safe­ty of others. In almost all cases, regulation of an economic activity is imple­mented for one of two reasons.

First, one or more of the groups affected by the activity feels that left un­reg­ulated, such activity would harm their in­terest(s). Second, it can be deter­mined by a responsible agency based on scientific and historical evidence that if left unregu­lated such activity would produce a negative outcome for some signifi­cant number of people.

For a case in point, consider a neighborhood next to a tox­ic waste disposal company’s plant. Regulation does not come first. The economic activity that in one way or another in­fringes on the rights or interests of others comes first. Regula­tion is then invoked to respond to that situation. Government regulation is thus often something to be desired or wished for. It would be much better and much cheaper for all concerned if individuals and corporations did not take actions infringing upon the rights and interests of others to the extent that gov­ernment is forced to step in. Unfortunately, many individuals and corpora­tions take such actions and regulation becomes necessary to protect the inter­ests of the negatively affected parties in an effective way.

Because of the nature of economic activity, for better or for worse some kind of regulation is often necessary. This is true in health services, in main­taining a safe environment, in industrial production, in financial activity, and so forth. To make the process of regulation the focus of attention rather than why it is needed distorts reality. It diverts attention from real problems. If such problems did not occur, there would be no need to regulate the activities which cause them. But life in the United States, at least at present, is not like that.

For example, take the health care industry. It operated in a generally unregulated state until the late 60’s. When left alone, it concentrated on acute care, ignored health promotion, built too many hospital beds, trained too many specialists, mal-distributed its resources, did not achieve reasonable standards of quality, and became very, very expensive. If hospitals when left to their own devices did not build too many beds, there would be no need to regulate hospi­tal bed construction. But they did build too many beds, as demonstrated, for example, in a classic study by the Institute of Medicine (1976). It happens that uncontrolled health care capital formation, of which hospital construction is a major part, has been a principal driver of health care costs (Bentkoven). Since direct government operation of the health care delivery system is not desirable in our country, the only alternative is regulation.

If chemical companies when left to their own devices did not dispose of hazardous wastes in ways that cause people to get sick, there would be no need to regulate hazardous waste disposal. But hazardous wastes are unsafely dumped, as attested to frequently in the media these days. If automobile com­panies built cars with engines that did not pollute air, there would be no need to regulate automobile exhaust emissions. If automobile companies on their own had put in all those safety devices which have made cars safer, there would have been no need to adopt national safety standards. But they did not volunteer to make their cars safer. Thus, regulation is a fact of life, necessary to achieving and maintaining balance between the various contending forces and interests in our society, and, as stated in the Preamble to the Constitution, to “promote the General Welfare.”

Now, in most cases the bad results produced by unregulated activity are no more the product of evil intent on the part of their creators than are the regula­tions the opponents of regulation find so odious. (The major exception to the “no evil intent” finding is probably the financial industry.) Both bad out­comes and regulation are brought about by enterprises which did not think about the consequences of their actions outside of their own spheres of activi­ty. Further, they did not take the concerns of others into account. But this should not be viewed as a question of morality. Nor should regulation.

Regulation is neither “good” nor “bad” on its own merits. It is what it is used for that determines its social utility, determines whether or not it is con­sistent with basic American values. Many Americans seem to have a reflex negative reaction when “government regulation” is mentioned in general terms. This appears to be a conditioned reflex carefully nurtured over the years by the Reaganite/Bushists and more generally by the Republicans. If only the govern­ment would stop interfering, they say, all our problems would be solved. It is those nasty and mean‑spirited bureaucrats who are the source of all our trou­bles, they say.

Never mind the real problems that they are trying to tackle. Never mind the fact that most of the problems arose before government regulation was developed to deal with them, that regulation came on the scene precisely be­cause there were problems that had to be dealt with. But don’t confuse them with facts. Just get rid of regulation, substitute the “free market” and all will be well.

But when it comes down to specifics, to events and problems occurring in people’s own neighborhoods and experience, many people sing a different tune. Think of such problems as:

•Toxic waste removal

•Solid waste disposal

•Nuclear electrical generating plant safety and waste disposal

•Nuclear weapons facilities waste disposal

•Ocean dumping

•Employee safety and health

•Health services quality

•Consumer product safety

•Consumer fraud protection

•Pure food and drug supply

•Safety in housing

•Security of bank deposits

•Fraud in financial and real property investment

•Preservation of price competition

•Transportation safety

In dealing with specific problems, the closer they are to home, literally and figuratively, the more most people want regulation, not its elimination.

Regulation and Freedom

Paradoxically, regulation is one of the mechanisms which we Americans have developed to keep our economy and society as free as it is. Regula­tion doesn’t mean control and doesn’t mean ownership. It means precisely what it says: regulation, that is: causing to operate in a smooth, predict­able manner. In our society, the ownership of productive enterprises is almost entirely in private hands. While this pattern of ownership has produced many benefits for the American people, it has also created cer­tain problems for us. These prob­lems result from many different economic activities that produce profits for those who undertake them and benefits in terms of the production of useful goods and services. At the same time it can produce certain harmful out­comes.

For example, the indiscriminate chopping down of trees anywhere they are found can produce profits for the lumber companies, jobs for the lum­berjacks, economic prosperity for the timber regions, and beautiful new wooden homes. At the same time, it can eventually result in the total elimination of the natural resource, loss of recreational opportunities, de­struction of wildlife, disappear­ance of natural beauty, the disappearance of other industries (e.g., salmon fishing), and ultimately the loss of jobs and the industry itself. Thus there are inter­ests to be balanced.

The Rightists tell us that the best way to balance interests is through the functioning of an entirely unregulated “free market.” They fondly hark back to the 19th century, a time of virtually unregulated economic activity and indus­tri­alization. During that time, the U.S. experienced unprecedent­ed economic growth. But from the early 19th century until the 1930s Great Depression, there was also an unending cycle of economic boom and bust. This cycle often produced very hard conditions for workers.

Too, when left alone, industry after industry wreaked havoc on its envi­ron­ment in the form of stinking rivers, foul air, and unsanitary living con­di­tions for many workers. Modern‑day parallels can be found in Eastern Europe where there was no countervailing regulatory power to rein in aggressive but narrowly focused and uncaring factory managers. In this country, these nega­tive outcomes, slowly lead to the enactment of measures designed to control them and correct obvious social and economic imbal­ances.

But regulation has never been aimed at doing away with the “free mar­ket.” If anything, regulation has attempted to preserve it. The impetus to limit the free market comes from within the economic system itself, in the form of the creation of monopolies. Most early government regulation in this country was aimed not at destroying the “free market” but at trying to preserve some sem­blance of it. For when left alone, industry after indus­try moves in the direc­tion of monopoly. In fact, it was none other than John D. Rockefeller who in the 19th century said (Martin): “The day of combination is here to stay. Indi­vidualism has gone, never to return.”

The trend to “combination” continues to this very day. The boom of consol­idation and takeover in many major industries that occurred during the Reagan era has been a major feature of the unregulated “free market.” Left to its own devices the “free market” actually moves inexorably to­wards fewer and fewer competitors. Where there were once many tens of U.S. automobile compa­nies, there are now only three. There are only seven major airlines still in existence. After GE bought RCA, there was only one large domestic pro­ducer of consumer electronics left. It is no coincidence that the Anti‑Trust Division of the Justice Department was gutted by the supposedly pro‑”free market” Reagan Administration.

Public regulation of private economic activity aims to level the playing field, ensure economic competition in price, quantity, and quality of goods and ser­vices, and prevent damage to the environment and the interests of workers and consumers. In one sense, monopoly is a form of private regu­lation of econom­ic activity, with the owners accountable to no one. Mo­nopoly, as Mr. Rockefeller told us, is the natural consequence of unregu­lated free market activity. In most cases, it benefits the owners much more than it does the consumers or the workers. The only true alternatives to a regulated economy, then, are private monopoly or public monopoly, that is government ownership of economic enterprises. We certainly don’t want the latter. So if we don’t want the former either, we must go with a regulated market.

A Progressive Model for the Regulation of Economic Activity

The Regulatory Process

None of this is to say that the present regulatory process is perfect. Far from it, in fact. Several major problems can be identified. Government regu­lation follows the only model available when it began: that used in private industry at the time. Private industry internal regulation focused principally on cost‑control and the prevention of theft of time and prod­uct. By and large, it did not focus on program outcomes. The monitoring of program structures and processes was used as its principal approach. Regulation focused on how things were done rather than what they are done for and how good the out­comes are. (Only recently has the Japanese approach to internal regulation, which does focus on the quality of the product, started to make its way into American industry.) The majority of U.S. government regulating has followed the earlier model.

However, a great deal of government regulation has as its objective the achievement of social utility and balance. It fac­es identified problems of sub­stance. Thus, in reality regula­tion is primarily concerned with pro­gram out­comes, even though most of it rules address program process. To solve the problems, to produce new results, government regulation should be reformed to focus on program outcomes.

Let us once again take as an example the health services industry. Most regulation in health services is designed to count things and people, pre­scribe minimum or maximum spaces, specify personnel qualifications, require mini­mum standards for materials, set reimbursement rates, define orga­nizational structures, and so on. But patients are interested in out­comes: do I get better, how fast, any complications?

And so, instead of focusing on process, health care regula­tions could begin by setting out health and health care pro­gram objectives. They could then offer a variety of mechanisms to guide and assist the providers in achiev­ing those objectives. Objectives could be stated in terms of im­proved access, more equitable distribution of services, more primary care, emphasis on pre­vention, reduced patient waiting time, improved provider‑patient communica­tion, re­duced costs, goal‑oriented research, needs‑based educational programs, and certainly, improved health status for the people.

Logically, therefore, government regulation of the health care industry should be changed to the extent possible from the private enterprise mode of program process regulation to program outcome regulations. While program process regulation can easily produce rigidity and limitations in options for change, program outcome regulation would allow for creativity, flexibility, and concentration on program‑solving. In this approach, desired goals and objec­tives are established and the regulatees are given broad latitude to choose among the available means of achieving them. An excellent example of this kind of regulation was the draft National Guidelines for Health Planning (USDHEW), issued in the last days of the Carter Administration [1980] and quickly rescinded by the Reagan Administration. It was a progressive and flexible form of planning, by objective.

Planning

Planning is the opposite side of the coin of regulation. There is a natural American aversion to planning, because it appears to interfere with per­sonal freedom. However, to retain our position as a leading power we must begin planning now to deal with capital investment, the crumbling infrastructure, and degradation/depredation of the environment. Environ­mental issues can be well used politically to illustrate the need to introduce serious planning and make it respectable. Local examples to which people relate personally should be used to sell the concept. And of course, the success of the Gulf War was repeated­ly laid to the extremely detailed plan­ning which went into the military opera­tions before they were actually carried out.

The Goals of Regulation

As pointed out above, the principal goal of regulation is to achieve social and economic balance in an otherwise free society. This approach to regu­lation of economic activity is based on the role of government as prescribed in the Pre­amble to the Constitution. Government regulation of economic activity should be used to the extent necessary to “insure domestic tranquil­ity,” to “promote the general Welfare” and as otherwise needed to achieve its goals. Regulation of the economy should be used as necessary to main­tain a level playing field, to assure safety, promote healthy competition, and conserve and redevelop both economic and natural resources.


References:

Bentkoven, J., et al, “Development of an Evaluation Methodology for Use in Assessing Data Available to the Certificate‑of‑Need and Health Planning Pro­gram,” Washington, D.C.: National Technical Information Service, 1982.

Brownstein, R., Selecting a President, Washington, DC: Public Citizen, 1980, pp. 94‑96, 99‑100.

Bush, G. H. W., “Address to the National Religious Broadcasters Convention,” Washington, DC: The White House, January 28, 1991.

Garrity, J.A. and Gay, P. (Eds): The Columbia History of the World. New York: Harper and Row, 1981; pp. 897, 898.

Institute of Medicine. A Policy Statement: Controlling the Supply of Hospital Beds. Washington, D.C.: National Academy of Sciences. October, 1976.

Martin, D., “The Singular Power of a Giant Called Exxon,” New York Times, May 9, 1982, Business p. 1.

Morley, J., “Contradictions of Cocaine Capitalism, The Nation, October 2, 1989.

Phillips, K., The Politics of Rich and Poor, New York: Random House, 1990.

USDHEW: U.S. Department of Health, Education, and Welfare, National Guidelines for Health

Planning (Draft). Washington, DC: Health Re­sources Adminis­tration, 1979.

Weinraub, B., “President Offers Strategy,” New York Times, September 6, 1989, pp. 1, B7.


The original hardcover and trade paperback editions (1996) of The 15% Solution are available on both Amazon.com and BarnesandNoble.com. The 2004 print-on-demand re-issue of the book from Xlibris, with a New Introduction dealing with the first four years of the real Republican Presidency that began in 2001, can be found at Xlibris.com (http://www2.xlibris.com/), as well as at Amazon.com and BarnesandNoble.com. There is a “Sub-Home Page” for this serialization at the lower right-hand corner of the Home Page of TPJmagazine (www.TPJmagazine.us). It contains a full archive of all the chapters as they are published over time. It also has such items as the Disclaimer, the cast of characters, the author’s bio., cover copy, and several (favorable) reviews. The serialization is also appearing on www.BuzzFlash.com, Dandelion Salad; The Greanville Post; and TheHarderStuff newsletter.

Jonathan Westminster and biography are based on a pseudonym.

Steven Jonas, MD, MPH is a Professor of Preventive Medicine at Stony Brook University (NY) and author/co-author/editor of 30 books. In addition to being a columnist for Truthout/BuzzFlash (http://www.truth-out.org/, http://www.buzzflash.com), Dr. Jonas is also Managing Editor and a Contributing Author for TPJmagazine; a Featured Writer for Dandelion Salad; a Senior Columnist for The Greanville POST; a Contributor to Op-Ed News.com; a Contributor to TheHarderStuff newsletter; and a Contributor to The Planetary Movement.

see

The 15% Solution: A Political History of American Fascism, 2001-2022 Preface

The 15% Solution

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  1. […] “The 15% Solution,” Serialization, 30th Installment: Appendix V: On Poverty, Sin, Regulation, an… […]

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