Starving public health - Letters

Washington Monthly, March, 2002 by Paul Jackson

Stephanie Mencimer ("Rich Man, Spore Man," December 2001) is tacitly critical of the Republican-led destruction of public health services, and the resultant increase in Americans without health insurance--changes that affect mainly working people and the poor; but she mainly appeals to enlightened self-interest, arguing that citizens must renovate the public health system because an epidemic will harm everyone. The first argument contains the class-based moral charge and vision of a genuine public health system that could mobilize currently disenfranchised working and poor people to return to the voting booth. The second looks to political centrists and an enlightened right to weigh in on the Democratic side and repair the system--not because all citizens deserve healthcare and government can tax the rich and give the leadership to provide it, but to protect themselves. In essence, a rationale for Democratic policies without old-fashioned Democratic appeals to social justice and class.

This appeal will fail. In modern stratified societies, epidemics do not affect rich and poor equally, as rich and poor know well. It is simply too easy to rig the present system to provide immunization services without constructing a comprehensive healthcare system, as the affluent know well. It should be no surprise, then, that the possibility of an epidemic has not slowed the Republican agenda one iota. On the contrary, their "stimulus" package was calculated not just to further enrich the wealthy but to starve federal government out of being able to afford projects such as she envisions.

PAUL JACKSON
New York, N.Y.