If we want liberal governmental programs, we need more liberal political ideology in the USA

[andym]

Some of may wonder why the creation of single-payer health care was never "on the table" even last year during the primaries, when none of the major candidates proposed it. Some may wonder why it appears so difficult to even get a strong public option in health care reform.

A popular answer is that various corporate special interests have too much influence over even Democratic politicians. No doubt that this is correct. But it is not the whole story. The problem is also ideological and it is the current ideological state of affairs that give corporatists "room to operate."

Liberal ideology especially as it relates to the potential benevolent role of government has been in decline since at least the time of Reagan. The idea that the government is inefficient at best and at worst pathological to political and economic freedom must be defeated. The benevolent role of government acting in the public interest may seem obvious to many here, but it is not the prevailing ideology in the USA, especially in the South and Mountain West.

There are two ways to change to the tide: continually talk about successful examples of the positive role government plays (from Medicare to biomedical research, from the interstate highway system to the creation of the internet, etc) in the USA (and to a lesser extent around the world-- because Americans tend to discount foreign exemplars). And to enact as strong as possible legislation that shows the government is capable of efficiently executing new services--for example, a strong public option health insurance organization beating the pants off of private insurers in fair competition will do wonders for future liberal efforts to create even more effective programs like single-payer.

There are two other ideological problems that remain from the Reagan era. One is the idea that taxes should never be raised. Taxes are mandatory, and there are many who do not like to be told that they have to give someone else their money. Unfortunately, services whether private or governmental are not free, and must be paid for. The best that can be promoted here, is that a government program really can be the most efficient way to accomplish something like health care payments. The idea that the government provides the "best deal", the most bang for one's buck needs to take root. The only real way for this to happen is by example. When this is understood, a program like single-payer becomes a no-brainer to the American public.

The final problem is that government programs are seen as hierarchical and inflexible, which implies that individual freedom of choice and innovation are limited. Depending how a program is structured this is a potential problem, however, there are examples of government programs where decisions are made in ways that preserve competition and freedom. One good example is the funding of extramural biomedical research by the NIH. The government decides which general areas of research to fund, but has created a system where individual researchers are asked to create their own proposals. The proposals are then examined by panels of their peers (not the government) and then the panels' recommendations are funded by government employees who must to a large extent follow the recommendation. New programs should incorporate this kind of decentralization where possible.

If we are successful, the moderate Democrats currently in office will will either act more progressively, or will be replaced by Democrats who are more liberal. Most importantly, we will promote the creation of government programs that improve our lives.