woman in white medical robe
Photo by Jeff Denlea on Pexels.com

 

 

 

 

 

Introduction:

 

I have just recently started reading Matthew Miller’s book The 2% SolutionThe book aims to provide solutions to social problems that both Democrats and Republicans could compromise on. As Miller put it “using conservative means for liberal social ends”. The work in this book is slightly dated due to being published in 2003. Despite the references to the bygone era of the Bush administration many of the problems detailed today still have not been solved. Reforms in the arenas of health care and education are to this day hotly contested issues.  Maybe if more people had read this modern political treatise written by a self-proclaimed “radical centrist” perhaps we would have more clarity on these issues today? Then again, this might be wishful thinking. It is highly likely that the apparatus of the state is too marred with vested interests to adequately administer educational and medical services. Regardless, it is a thought-provoking read.

I would have to agree with The Hill’s 2003 review of the book. One of the most notable chapters so far was Chapter 5: Universal  Coverage, American Style. Why? Because it details a rare instance of bipartisan compromise on the emotionally charged topic of healthcare. The chapter focuses on a discussion that Miller had with than members of the Ways and Means Committee Jim McCrery (R) and Jim Mc Dermott (D) back in the early 2000s. Diving into intricacies such as the utilization of vouchers, tax write-offs, and even a cash-out system for employees who receive insurance from a private enterprise (p.104).  Even entertaining the notion of allowing participants to choose between several state-approved health insurance carriers with their allocation of funds allocated for healthcare (p. 98-99). Kind of riff on the School Choice voucher system, only for health care.

 

These intriguing suggestions are not what I found to be the most surprising. Nor was it the civil and serious tone of the discourse. It was a comment made by McCrery about potential opposition to this proposal:

” The Union boss will not like it because we are essentially taking away one of the goodies that they claim to provide to their members” (p.107).

 

Pardon my ignorance, I wasn’t aware that the traditionally Democratic-leaning labor unions opposed government-funded healthcare! The majority of polled Democratic voters tend to perceive the decline in union membership as being negative. It is interesting to see that certain segments of the labor movement are not in lock-step with the DNC’s platform. I was thinking that the democratic-union coalition was impenetrable. However, this counter-initiative political position by unions is quite rational.  One of the largest labor unions in the state of Nevada is the Culinary Workers Union of Nevada, UNITE HERE Local 226. Many of the members present have excellent healthcare. Fear that if they were mandated to take a government healthcare plan they would experience a decline in the quality of care.  Putting aside my issues with the labor movement, I have to admit that is a valid concern. Union members even heckled Sen. Sanders ( a labor-friendly politician) demonstrating their concern with a universal system.

 

Bootleggers: 

 

Labor Unions that oppose government health care (E.g. Local 226 of Nevada)

 

Baptists: 

Organizations  (coalitions, think tanks) that advocate for fiscal responsibility ( E.g. National Taxpayers Union)

 

The Unlikely Bedfellows:

 

The concept of the Bootleggers and Baptists troupe is derived from a 1983 paper written by economist Bruce Yandle. Yandle observed that often you have seemingly opposing interests coming together on a certain issue. One group providing a “moral” justification for their policy position and the other side is mainly concerned with self-interest. The National Taxpayer’s Union is advocates of limited government and fiscal conservatism. They have been longstanding opponents of any kind of government involvement in health care. The organization even is willing to praise incremental alterations to the healthcare system to veer towards a more free-market approach. Typically all in the name of consumer choice and fiscal virtue signaling. Then again, if you were to look at America’s present deficit, NTU certainly has a point. The fact that they assume the moral highroad of proper economic stewardship, the organization falls into the category of the Baptists.

 

In terms of addressing the labor unions on this topic, it prudent not to paint with a broad brush. Not all unions oppose universal medicine. Particularly nursing unions and teacher’s unions generally support universal medicine initiatives. For the unions that do not endorse such measures, their rationale is quite salient. They are concerned about receiving healthcare that is inferior to their current plan. This is a valid concern. One that many individuals employed in private industries shares in common when faced with the prospect of handing over this service to the state. There is good reason to suspect that there is potential for the level of care to decline. There are countless examples of government mismanaging healthcare. For example, the Phoenix VA hospital controversy. Citing such examples is far from a conclusive indictment, but enough to raise reasonable concerns. Labeling union workshops such as local 226 the proverbial “bootleggers” is not a value judgment.  Rather, they fall into this category due to their justification being based on the benefit of the union members. Versus striding for a moralistic argument, like  NTU.

 

The irony is certainly rich. It is mind-boggling that unions and the conservative National Taxpayers Union could ever come together on an issue. Health care happens to be the quirky impetus for this usual alignment of political interests.

 

 

 

 

 

 

 

 

 

 

 

17 thoughts on “Bootleggers & Baptists Part VI: Unlikely Foes of Universal Medicine

  1. Excellent post. By the way, another factor potentially at play here — from a logistical or operational perspective — is the skillful use of parliamentary rules by “the Baptists” and “the bootleggers” … For more details about what I am alluding to here, check out this beautiful paper titled “A theory of loopholes” by Leo Katz and you will see what I mean!
    https://www.journals.uchicago.edu/doi/pdf/10.1086/649046?casa_token=9DN2IJKAqOIAAAAA:AClXxQJRjh_KCA-mn4vpqfgZTN3L2ugWz0cCEpB3-8-Mtmtv7073kHGNGdD4zUkgNWPB-XsRkCk

    Liked by 1 person

        1. Read it. The faculty meeting does provide some interesting insights to voting. It makes me wonder if times when extreme policies are proposed its a circuitous attempt of to stifle the more moderate variant of the same policy.

          Keeping within the theme of the paper is this ethically reprehensible? No. Due to the fact you are merely bringing another alternative to the table. Similar to making a suggestion. How others chose to act upon this suggestion is a whole other issue.

          However, Katz has a point. You can reliably predict the conservative sand moderate voters will form a coalition to defeat the radical measure. While this is not a hard and fast rule. It does explain the proclivity of voters to veer towards the center on issues.

          Liked by 1 person

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