The   B u l l e t
Socialist Project • E-Bulletin No. 500 May 10, 2011

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Unionism, Austerity, and the Left:
An interview with Sam Gindin

Andony Melathopoulos (AM): Clearly these are not very good times for public sector unions, not only in Canada but worldwide. What characterizes the current situation? How does it differ from what unions have faced historically and how they could respond, not only in the 1990s, but during their formation in the 1960s?

Sam Gindin (SG): In the 1960s, there was an explosion of the public sector and also, an environment dominated by militancy. But militancy can only take you so far. You have to develop the capacity to challenge structural constraints, and that wasn’t on the agenda for labour. The result was its defeat, and, simultaneously, the strengthening of capital. At the time we didn’t see the scope of this defeat – our present moment has really shown its scale. One would think the current crisis resolutely delegitimizes capital and the financial system, creating an opening for the radicalization of labour. Instead, labour is weaker than before and capital stronger. This should be recognized as the product of a generational defeat of the labour movement, itself connected to the militant movements of the 1960s.

From Strength to Defeat

The crisis then is one stemming from the initial strength of labour and its collapse rather than as a crisis of international competition. Any gains made by the Left in the 1960s restructured production in such a way that is not without relation to present-day capital. Throughout the 1960s, the organized working-class in Europe and North America continued to pose a threat to capitalism, so much so that capital and the state spent a decade trying to figure out how to respond. Even the United States, the supposed core of the global capitalist economy, encountered its limits, such as inflation. So by the end of the 1970s, it became apparent the working-class must be broken, and it didn’t just happen overnight. It continued throughout the 1980s and 1990s, because you never know how far you can go, how many gains fought and won in the past can be lost.

Lenin said it many times: Trade unionism left to its own evolutionary drift settles for reformism, and eventually dissolves as an effective force for class self-defense. Only revolutionary theory can take working people  out of that vicious circle.

AM: You describe this period largely as a response by capital and capitalists. What about the politics of the Left through this period? Are they adequate? I mean, historically hasn’t the Left been able to politicize the most dynamic edges of capital reproduction in a way in which it seemed unable to do between 1960 and the present?

SG: That’s a good question. There are forms of resistance, but in the absence of emancipatory politics, they end up becoming part of the defeat. In 1976 we had a general strike in Canada. The question becomes, what happens if you have a general strike, everybody is intoxicated by their power, and the next day, nothing happens? There wasn’t a politicization, much less the onset of a revolution. The 1960s prove exemplary in regards to why the Left ought not exaggerate its power: cultural revolution and anti-war protests do not fundamentally challenge capitalism. While unions could have taken advantage of the moment of capitalist growth to ask for changes in working conditions and hours, they could not challenge capitalism. And while militancy creates a certain space for the Left to raise other questions, nobody was thinking about what unions are, what their inherent limitations are, or what kind of political organizations we need in the long-term. The Left took for granted the existence of a strong working-class rather than recognizing that its survival was tied to the fate of working-class politics.

So while the 1960s was a period of militancy, we shouldn’t exaggerate how far left it was. There was left activism, but there is a difference between being active against the war in Vietnam, and raising the question of socialism. Let me make it more radical. There is nothing spontaneous about workers becoming revolutionary. There is reason to think that they should collectively resist, and then there is reason to believe that they might form organizations for that resistance. But unions are sectionalist organizations, and have no instinct toward the revolutionary. At one historical moment they might be militant, they might inspire, they might raise standards, they might develop confidence, and in another moment in history they might be ineffective, their response might be toward conserving their own existence. It can easily become ‘necessary’ to reproduce an organization and the conditions that produce that organization. How you break this cycle is hardly objective.

I would characterize the moment right now not as one in which capitalism is legitimated by people thinking it’s fair and democratic or that it creates a beautiful world. This might have been so once in capitalism’s history. I think right now what reproduces capitalism in developed countries is that workers have actually achieved a lot, and the promise is that you can keep most of it if you do not protest. It’s a conservative orientation. This is symptomatic of a fatalistic view toward changing the world altogether. I don’t know that the Soviet Union’s existence really inspired people to another alternative when I was active, but its failure did evoke the belief that nothing else was possible. You didn’t have to believe in the Soviet Union, but when you saw that even those guys wanted to be capitalist, it was devastating. Fatalism allows for the lowering of expectations, for wanting to hang onto what has been achieved so far. This can’t be overcome by just talking to people, part of it is developing an understanding of the world, but to understand the world you have to feel like it can be changed. Not having organizations capable of expressing our frustrations, whether political organizations or unions, certainly contributes to this pessimism.

AM: Could you expand more on the connection between unions and politics? It seems in the present, union activity increasingly greases the wheels of the electoral success of the New Democratic Party (NDP, social democrats) and Liberal Party in Canada, or the Democratic Party in the U.S. At points in this conversation it seems that what you have in mind for an organized form of politics almost appears to be unions in themselves, yet you also suggest there are limits to how far a union movement can independently generate its own politics. What characterizes these limits?

SG: Unions can be involved in radical moments, but they certainly aren’t able to revolutionize the world in the absence of a Left. Unions today are not in the place to offer spaces for people to listen to more radical ideas, to push political parties or to join them, but are busy just defending themselves, handling grievances, busy competing with one another within industries. But even in their best moments, unions are only a fragment of a much larger, complicated world. The rank and file need to be linked to a Left.

A major issue here is that you have to understand class, a class built for the purposes of transforming society. That doesn’t happen spontaneously. Your experience as a worker doesn’t teach you that, it teaches you dependency. Class consciousness requires an organization beyond even the most radical union, whose interaction with workers is about understanding their position in society and their links to others. That is the kind of organization you need, and without it, workers look to the union to be merely instrumental in maintaining the world as is. They look to a party in the same way, instrumentally and pragmatically, especially if a party doesn’t even pretend to be radical. But even a party like the NDP, which in the short term will be of little help to the individual worker, doesn’t have ambitions to be a radicalizing factor for workers. You look at the party and wonder, how does a party change the world without a newspaper or a journal where they think through difficult things?

AM: To turn to the material base for class consciousness, there is a way in which organizing in the public sector, from the perspective of capital and its reproduction, limits its dynamism. As you pointed out, reducing public services were linked to regenerating the dynamic character of capital after the crisis of the 1970s. How can something that is increasingly unimportant to capital reproduction generate a progressive transformation from within it?

SG: Well, you certainly don’t want to get trapped into arguing for a larger state but you do want to argue for a fight for a more democratic state and workplace. Right now, that kind of strategy, in itself, is only a strategy for giving unions a way to start a struggle rather than passively saying they can’t do anything. It has some chance of building alliances and opening the door to begin thinking of issues in class terms, in terms of challenging who runs the workplace and questions about the priorities of the state. But, and this hasn’t happened yet, the next step is to honestly and soberly say to people, if they want this they have to become more radical.

This is also true in the private sector. You can’t win in auto manufacturing unless you say, ‘we have a whole different vision of what this productive capacity should be used for.’ So in each sector you have people making demands that can’t be realized unless they fight collectively. But even if they fight collectively, they can’t win if it’s just about militancy, so then you have to raise questions about capitalism. I don’t think any demands take you anywhere automatically, but some allow more than others. You begin to raise questions about who decides what’s valuable and what we think is valuable. You raise questions about production and consumption, and democratic planning – it raises a whole bunch of questions about what kind of economy we will have. To me class consciousness is when people know, and you can say to them honestly, ‘if you really challenge capitalism as a social system, there is going to be chaos and your living standards are going to fall, but it will be an investment in the future.’ When workers accept that then they are class conscious. When you tell them that when you get rid of capitalism everything will be better, that’s not class consciousness.

AM: There seem to be two issues for the Left to consider. The first are organizational problems in which the Left could, for example, create the means for workers to overcome the sectionalism of the union movement. The other is the issue of the Left being able to advance a utopian vision. But utopian impulses can misrecognize the potential of a given historical moment, and as you point out, organization can serve very instrumental ends. How would these two elements come together to make a reinvigorated Left?

SG: The question is, how do you build a movement that can begin to think in class terms to transform the conditions for unions, or in other words, how do you build a culture where socialists can influence rank and file workers without supposing that the line between political organizations and unions isn’t real and necessary? I think we need to begin by appreciating the limits of unions, but also the potential. On the other hand, one needs a Left beyond unions, a Left that raises questions that wouldn’t be addressed otherwise. The Greater Toronto Workers’ Assembly (GTWA) is trying to think about how we create a new layer of politics beyond ineffectual coalitions, but we are really struggling because, while we do not want to begin from a point of immediate rigid consensus, we are beginning to recognize how crucial it is to develop a cadre of workers and activists who both embody intellectual understanding and are active. This is especially difficult if you want to be honest about the obstacles we face as a movement, but the role of the Left is to challenge things, to reflect on our failures, to resist repeating the notion that the working-class are victims. The prime crisis for both labour and the Left today is the inability to rethink and reinvent our movements, our organizations. We end up reproducing archaic or inept modes of understanding and changing the world. So while I see some movements with good impulses, there aren’t many that would be organizationally capable of producing a critical cadre, recruiting from the rank and file, developing socialists, promoting education.

AM: There is a way in which, for example, socialism, or Marxism, are subjective aspects of capitalism. They emerge from capitalism but are reflexive and, in their best examples, comprehend its emergence historically. Of course some types of socialism are romantic, and understand their task to mount a resistance to modernity, but some might consider it a transformative process, and not from the outside, but through capitalism. With this in mind I want to bring the conversation back to something you said earlier about patterns of consumption eroding working-class capacities. I wonder how much of this is more a product of the degradation of left politics and its growing inability to politicize the changing character of capital?

SG: Resistance does come from within capitalism, but for me, Marxism is the attempt to look at capitalism from a perspective that can imagine overcoming it altogether. When I watch comrades jumping from the socialist ship, when they seemed at one point to recognize that capitalism would produce nothing but catastrophe, I wonder what about the world convinced them otherwise. I think many have been disillusioned by the failure to fight for bigger things, a failure which has marked the labour movement for well over a quarter century now. This does seem to suggest that Marxists aren’t immune to the cynical fatalism that there may be no going beyond capitalism. I wonder what caused this. Was it a degradation of the politics of the Left? Was it the increasing mindset that one is compensated through individual consumption, not through collective politics? I’m not exactly certain how things have gotten so bad, but it seems to me that without a Left that can keep alive some sort of utopian impulse, some refusal that things must be the way they are, and without organizations that can collectively raise these questions, only individual responses, however unsatisfactory, ‘make sense.’

Because for workers themselves it seems very hard to develop alternative perspectives. When it became evident that the working-class would cease to experience increases in standards of living, reflecting social mobility from being on the street or on the picket line, the reaction was not social rebellion or political upheaval. Workers weren’t radicalized – they responded to social problems by assuming the responsibility personally. Instead of understanding capitalism as systemically incapable of producing a world of equality or justice or extended freedom, a consciousness that would have to be politically contextualized and delivered, those demands were met by working longer hours, changing one’s family structure and how it behaves, and debt, all of which only further the kind of dependency produced under capitalism. If you are so busy working you can’t explore yourself intellectually or politically, the opportunities for a Left are slim.

AM: As you pointed out earlier one of the reasons why working-class neighborhoods surrounding the Greater Toronto Area (GTA) vote conservative is that there is a certain freedom that capital is generating that they do not want to lose. Wouldn’t a socialist politics have to engage that subjectivity and understand the ways in which it could advance politically? Without historical consciousness, how could you tell that the ways in which things are getting worse aren’t completely natural?

SG: Without a historical perspective, you would have to make sense of regression in other less effective ways. When times are bad I think people begin to get nostalgic for an imagined past. You get rid of a specific set of politicians and replace them, and for a while, you might have new hopes. That can keep you going for quite a while. You might even get quite militant, but the militancy is about returning to the past. The difficulty is to eventually convince people of the emptiness of a certain kind of life, without being patronizing. It’s enormously difficult, because you are not actually presenting them with a tangible alternative. The role of the Left, then, is to be able to take advantage of a moment to politicize people.

AM: Would you agree that the questions arising from this process will not provide political clarification without a ruthless critique? I mean hasn’t your experience been that many groups who already consider themselves anti-capitalist or working-class use these categories as a way to affirm their own practices, not to change them? Isn’t it true, as Adolph Reed wrote, that “the opposition must investigate its own complicity”? Put another way, what does it say about the Left in the present if the only way to have a conversation about capitalism with activists is to put critique to the side?

SG: The starting point for reinventing the Left is first, to appreciate the extent of our defeat, and second, to acknowledge that we were not in fact that strong and effective before that defeat, that our defeat was produced out of the limits of our analysis and structures. This means that aruthless critique of ourselves is fundamental. But this can’t mean a retreat from activism until we’ve fully clarified the ‘right’ response. Critique and discussions must not occur just by talking among ourselves; self-examination must occur alongside engagement in struggles. Otherwise we’re just talking to ourselves with no reality check.

The problem in bringing a wide range of people together in something like the GTWA is that the early focus is on developing working relationships and the fragility of those relationships means that any political discussions are very cautious and tentative – building bridges gets in the way of the critiques and discussions essential to building a new politics. I don’t know a way out of this dilemma other than trying to ensure that such caution is transitional and that at some point the ‘risks’ of the harder discussions must be put on the table. We haven’t gotten to that point yet in the GTWA. Some of these discussions have been forced on us where we plan events and have to get to the roots of why we don’t agree on certain specifics. But the difficult discussions have not really started. Some think it will be impossible to do so without fracturing the organization, that people are too embedded in their current activism, whether in the movements or unions, to seriously re-examine what we are doing. I think these pessimists are likely right, but the possibility that this may in fact work, or that we may learn something from the experience that leads to trying again in a more promising way, is good enough reason to work through the GTWA. I cannot think of an alternative way of working that is more hopeful. •

Sam Gindin is the Packer Chair in Social Justice, York University.

Andony Melathopoulos writes for the Platypus website, where this article first appeared (Issue 35, 1). This interview is a follow up to a teach-inlast November at York University.

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THE HYPOCRISY OF CAPITALISM is evident everywhere you look, but is particularly repugnant in its “normal” compensation disparities, with the executive class (not to mention the actual business owners) earning obscene multiples of an average working person’s pay. Capitalism in that manner exhibits the same indifference to inequality as its predecessor regime, feudalism, but justifies itself (especially in the American lore) through the spurious notion in practice that “anyone can make it if you work hard enough.”   Well, that ain’t much of a consolation for the enormous numbers who try faithfully, and still fall through the cracks (hint: the system is rigged). And guess what: Feudalism also had its ‘rags to riches” stories.

Meanwhile, Paul Ryan and the new crop of Randian moral cretins, notably the Republican (and often Democratic) governors blasting social defense mechanisms and public services in state after state, continue to rewrite the American social contract to the painful detriment of the masses. They can do so with something approaching impunity, for although the public is waking up to the sheer criminality and cynicism of these doctrines and beginning to spot the scaffolding of lies that props them up, popular organizations have yet a long way to go before they can really challenge the status quo. This week’s TOO MUCH newsletter packs a wealth of information and examples to help activists and citizens realize the full extent of the current usurpation. Invest a few minutes and divest yourself of the ignorance garroting this republic one twist at a time. —Patrice Greanville

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THE TIRELESS Cindy Sheehan has apparently joined the growing phalanx of prominent progressive doubters of the US government version of the killing of Osama bin Laden. The media have largely abandoned Cindy; she’s no longer front page news, as she frequently was when she rose to challenge George Bush’s wars.

Not that the mainstream media would ever give an authentic critic of the US imperial project a fair audience or a fair shake, but the fact remains that under Obama, most of the major outlets have tacitly made Cindy a non-person, and that, of course, includes a lot of liberal venues. Way to go boy and girls! That’s the American way to stamp out a pesky dissenter!

Cindy’s steady march to the left hasn’t helped, either. In a very short period of time this woman, wounded as deeply as only a parent can be by the loss of her child, has gone from superficially informed citizen to a formulated, dependable and ultra-lucid critic of the American capitalist system and its eternal wars. I’m using the word system, here, folks.  Cindy sees past the circus put forth by the transient occupants of the highest offices in the land, has little patience with the claptrap dished out by the commentariat,  and focuses with brave abandon on the rarely touched nature of the social arrangement so many apologists defend as “the American Way of Life.”  She recognizes that while high officials may imprint their style momentarily on world events, they cannot, will not, and do not determine the actual dynamic or trajectory of the American socioeconomic system.  It’s a lot bigger than them, and, besides, as politicians, they’re for the most part shills, not prime movers in the machinery of the system.

As media observers will surely agree, that kind of political clarity alone signifies automatic banishment from access to mass audiences in the United States. People in this country can gripe endlessly about the symptoms of the underlying disease , but never mention its root cause, the disease itself, capitalism.  If you do, the ax is sure to follow. What did the feudalists used to call it? Lese majesté?

Below, in an interview with (of all people) Drew Pinsky, the celebrity shrink interpreter, she sets forth her rationale for disbelieving the official accounts of Osama’s departure from this Earth. Check it out.—Patrice Greanville

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	The   B u l l e t
	Socialist Project • E-Bulletin No. 498 May 6, 2011

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‘What Matters Is What Works’: The State and the National Health Service in Scotland and Wales

Colin Leys

After forty years of ideological onslaught the very idea of ‘the state’ is close to joining others, such as ‘collective’ (not to mention ‘socialist,’ and even ‘left’), in the depository of Unclean Concepts. ‘State bad, private good’ may be a crude and simplistic slogan, but it is the very real starting-point of many politicians and most media commentators and BBC interviewers today, from John Humphrys down.

‘State’ is so often coupled with ‘nanny,’ ‘bureaucratic,’ ‘inefficient,’ ‘wasteful’ or some other negative adjective that this hardly raises an eyebrow. The state is never called ‘rational,’ ‘efficient,’ or even ‘democratic’ – even though commentators and interviewers like to stress the accountability of government (state) to parliament (also part of the state, and always called democratic) when criticizing extra-parliamentary forms of political action. A perfect illustration of this ideological schizophrenia was provided on television by Nick Robinson during the student demonstration outside Parliament last November. He contrasted what he saw as the illegitimate activity of the demonstrators outside with what he called ‘the democratic process’ going on inside – when what the students were objecting to was precisely the fact that the Lib Dems inside were doing something undemocratic – raising student fees after promising the electorate not to.

Wasteful Military?

Elements of the state that the corporate world likes and needs are usually treated as somehow not part of the state. The armed forces, the police, the judiciary, the monarchy and the Church of England are never described as part of the nanny state, or as being bureaucratic or inefficient. Even the notorious inefficiency of the Department of Defence’s procurement policies manages not to count, since the idea of privatizing it does not commend itself to the armed forces. The nanny, inefficient, wasteful, etc. state just means, in practice, those parts of the state (especially local authorities and quangos, but also central spending ministries such as the Department for Work and Pensions) which spend tax revenue on services for everyone – schools, social services, cultural services, and not least the National Health Service (NHS) – and which the right doesn’t like.

The effect is to narrow down our concept of the state to just these parts of it, and to make us at best indifferent toward them. We stop seeing them as the historic collective achievements they are, as expressions of what a mature society can accomplish through collective effort, as services of which we are all equally beneficiaries, and which we have a collective responsibility to protect and sustain. Instead we unconsciously absorb the message that they are by nature bureaucratic, inefficient, slow, monopolistic, etc. Every fault they exhibit tends to be accepted as evidence of an inherently defective institution. Above all we are conditioned to think that if they need improving, we ourselves can have no role to play in doing so – and that the only route to improvement is via privatization.

Yet the NHS itself provides a dramatic contradiction of this whole way of thinking. Unlike the English, the Scots and the Welsh have used their devolved powers to keep and develop the NHS as part of the state. We hardly ever hear about this. It is not something that the pro-market forces and commentariat in England like to acknowledge. It shows that people value the state as a bulwark of social protection and social solidarity, and see a state-provided health service as central to it. And where the political system has enough autonomy, and the voting system prevents unrepresentative minorities from determining election outcomes, they are able to get what they want.

The Scots and the Welsh have rejected the marketization of the NHS. The purchaser-provider split, which is at the root of the marketization project, has been revoked in both countries, and neither Foundation Trusts nor payment by results was introduced in either of them. Private finance initiative (PFI) was used in Scotland under the first Labour government in Holyrood, and one private treatment centre for NHS patients, but the use of PFI has since been scrapped by the Scottish National Party (SNP) and the treatment centre has been renationalized. Neither PFI nor private treatment centres have been used in Wales. The NHS in Scotland and Wales is once again planned and managed through a mix of central and local structures, as the NHS was in England before the 1990s.

Forward Looking NHS

But that doesn’t mean that the NHS in Scotland and Wales has reverted to the past. On the contrary, in both countries the NHS has been modernizing, but under the influence of very different mechanisms from those being adopted in England. Instead of fragmenting the NHS and opening it to commercial competition, Scotland and Wales have opted for democratic and accountable planning. There, the drivers of change are: a) the input of medical specialists and GPs on the Area and Local Health Boards where key policies are developed; b) the input of community health and social care/social work staff; and c) in Scotland, input from members of the local community, elected to the Boards since 2009 on a trial basis.

The restoration of full state responsibility for health services has led to further democratizing or redistributive measures, including the abolition of prescription charges, and the abolition of charges for personal care in Scotland, and their radical reduction in Wales. Equally significant, and contrary to the claims of marketizers in England, health services in Scotland and Wales have steadily improved, on various measures, including waiting times. Scotland’s have been among the lowest in the UK.

The contrast with England – where the NHS is being driven into decline and, increasingly, into chaos, in the service of privatization – is dramatic. If ‘what matters is what works,’ as Tony Blair liked to say (confident that the catch-phrase was enough to justify privatization), it is actually publicly-provided and democratically-managed health services that work, and the evidence for this is right here in the UK.

It will be very interesting and important to follow what further improvements are achieved in Scotland and Wales – and how what counts as an ‘improvement’ is defined when it is patients’ needs, rather than business values, that are the measure of it.

At the same time we should not expect improvements to run ahead of changes in other parts of the state in Scotland or Wales. The state was famously defined by the young Karl Marx as ‘the table of contents of civil society’: it registers the balance of social forces, and the level of democracy and solidarity and civic energy, that exist in the wider society. Thus far little creative thinking or experimentation has been done in any advanced capitalist country to expand the possibilities of democracy beyond the skin-deep variety consisting merely of periodic heavily-managed elections. Without more, the progress made with the NHS in Scotland and Wales is bound to run up against limits set by the wider context.

Yet the progress already made in the NHS in Scotland and Wales could itself encourage experimentation in other fields, from education to central government. And it offers a badly-needed antidote to ‘Anglo-Saxon’ ideology. At the very least, the ‘Celtic’ example shows that the state can be a democratic, rational, progressive state – if we want it to be. •

Colin Leys is an honorary professor of politics at Goldsmiths College London, and former Professor of Politics at Queen’s University in Kingston, Canada.

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Endnotes:

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Since I walked away as head of communications at a top health insurance company in May of 2008, I’ve worked tirelessly as an outspoken critic of corporate PR and the distortion and fear manufactured by America’s health insurance industry. It is a PR juggernaut that is bankrolled by millions of dollars, rivaling lobbying budgets and underwriting many “non-partisan” and “grassroots” organizations…”

Insurance Industry Up To Its Old Tricks

May 6th, 2011

Wendell Potter seems to be the only guy out there who understands what the Insurance industry is doing with the Health Care Reforms. He also seems to be the only guy who understands what the Republicans are trying to do to our health care system. I am sure there are others, but Potter seems to be the go to guy if you want the low down on the dirty business of health care lobbying. He should know, he was a PR man for the industry for a long time. Then he got religion, or maybe a decent offer, and joined the other side. It is a good thing too, the President is doing a crappy job explaining what he is doing with health care legislation. It seems that this industry, as with almost all industry, the controlling interests at the top are doing a pretty good job of blocking reform legislation and miss-informing the public as to what is really going on.

Domestic politics are a mess. We all know that. Many of us are about ready to simply shut the whole thing down and start over again with some kind of people’s democracy. Problem is, democracy takes eternal vigilance. You have to stay on top of the politicians or they will make deals with special interests that may not be to your benefit as a citizen. Recallable representation with a simple vote of the majority would help there, but that could easily be manipulated by moneyed interests the way the proposition process has been undermined by money here in California. Look at the Tea Party. It started as Astro-Turf, spending wealthy Koch Brothers seed money until it got enough middle aged white men to join in to create a movement. Democracy is dangerous without economic democracy to go along with the power to vote.

Under American capitalism, we the people are not supposed to have any say as to what goes on in the private sector, while the capitalists, through their lobbyists get to have all sorts of input in the governing bodies. Personally I think that sucks. I think the Germans and Scandinavians have a better idea there with workers on the board of directors of companies mandated by law. They think it is proper for workers to have a say on issues of their economic welfare. So do I. We need to get rid of this mentality that says let the rich get richer because they are the only ones familiar with handling money. Using that logic, pleasure should be left to the beautiful people in the entertainment business. And we might as well invite the Queen back, since royalty obviously are the only ones who know how to rule. We simply must get our hands dirty and learn how to run our world by and for the people. Or we will find that somebody else has the wealth, pleasure, and power.

There is a decent overview in the article “Worker representation on boards of directors: a study of competing roles”, in Industrial and Labor Relations Review.
http://www.highbeam.com/doc/1G1-11061499.html

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SPECIAL>>From Center for Media & Democracy’s PR Watch

GOP’s Medicare Plan Would Be a Windfall for Insurers

Submitted by Wendell Potter
Rep. Paul Ryan (R-Wisconsin)Rep. Paul Ryan’s plan to privatize Medicare would accelerate a trend started several years ago by corporate CEOs and their political allies to shift ever-increasing amounts of risk from Big Business and the government to workers and retirees.  If enacted, the Ryan plan would represent a windfall of unprecedented proportions for insurance corporations and other businesses.

For millions of average Americans, many of whom already are finding it impossible to save for retirement, it would represent financial calamity. The nation’s middle class would pay dearly for Ryan’s proposed shredding of the social safety net that Medicare currently provides.

Ryan, chairman of the House Budget Committee, wants to dismantle the Medicare program and replace it with a system of vouchers. Starting in 2022, the government would give the average 65-year-old Medicare beneficiary $8,000 a year to buy coverage from a private insurer. That’s the amount health care analysts estimate will be what Medicare will spend on every 65-year-old in 2022 if the government doesn’t turn it over to private insurance companies.

While that might sound fair on the surface, it would actually be a very bad deal for people who turn 65 that year, compared to those who turn 65 in 2021. That’s because commercial insurance plans are much more expensive, and operate far less efficiently, than the current Medicare program.

Insurers Spend Less on Medical Care, More on Executive Pay, Marketing

The amount of money commercial plans actually spend to pay medical claims has been declining rapidly over the past several years, while the amount they spend on administrative activities such as marketing and underwriting — and to pay executives and reward shareholders — has been increasing. That’s why Congress included a provision in last year’s health care reform law to require insurance firms to spend no more than 20 percent of their policyholders’ premiums on overhead. By contrast, the current Medicare program spends just 3 percent of its budget on administration.

The nonpartisan Congressional Budget Office (CBO) says the $8,000 voucher won’t be nearly enough for seniors to buy comparable coverage from private insurers and pay the additional out-of-pocket costs that those insurers would require them to pay. The amount the average 65-year-old would have to shell out to buy private insurance in 2022, according to the CBO, will actually be $20,510. Seniors would have to pay the difference — $12,510. If Medicare is not privatized, the difference would be $6,150.

Ryan Plan: Insurers’ Dream Come True

Here’s why this would be a dream-come-true for the insurance industry: The more health plan enrollees have to pay out of their own pockets, the less insurers have to pay for medical care. The money that insurers avoid paying out in claims goes straight to their bottom line — and into shareholders’ pockets.

Insurers have been shifting more and more of the cost of care to their policyholders over the past several years by enticing — or pushing — them into plans with ever increasing deductibles. This trend is part of what Yale professor Jacob S. Hacker called “the personal responsibility crusade” — making people more responsible for the management and financing of the major economic risks they face — in his 2006 book, “The Great Risk Shift.”

This crusade has been led by Republicans and insurance company executives who have been saying for years that the best way to control medical costs is for Americans to have more “skin in the game.” That’s an expression that former Aetna CEO Jack Rowe used often before he retired in 2005, the year he made $22.2 million. It was also a sound bite favored by the CEO I used to work for, CIGNA’s Ed Hanway, before he retired in 2009. Hanway’s total compensation that year was almost $111 million.

Author Wendell Potter, former head of PR for CIGNAThe problem is, most Americans have far less skin to put in the game than CEOs like Rowe and Hanway or even Rep. Ryan, who makes $174,000 as a member of Congress. The median household income in the United States was just $49,777 in 2009, which was down $335 from 2008.

That decline, by the way, was the continuation of another trend that began as the Clinton era was ending and the George W. Bush era was beginning. Median household income in the United States peaked in 1999 at $52,388 (adjusted for inflation). It fell more than $2,000 during the eight years of the Bush administration.

During that time, health costs rose dramatically. According to the Kaiser Family Foundation, the average annual health insurance premium for family coverage increased from $5,791 in 1999 to $13,770 in 2010. The average amount that workers contributed out of their own pockets for family coverage increased from $1,543 to $3,997.

Ryan’s Plan Will Throw the Elderly Back into Destitution

With household incomes declining, Americans have had far less money to put into retirement. According to a recent survey conducted by Opinion Research Corp. for America Saves and the American Savings Education Council, less than half of current workers are saving enough to have a “desirable standard of living in retirement.”

If workers are having this much difficulty saving for retirement, where in the world will they find the money to pay what Rep. Ryan would make them pay for Medicare coverage when they turn 65?

Ryan’s “blueprint” is one that will take America back to the pre-1965 days when senior citizens were losing their homes and their farms to pay for medical care. They were becoming destitute — and dying much earlier than they are today — because insurers would not sell them coverage because they were too much of a risk to insure, and there was no safety net for them.

That’s exactly the same place future senior citizens would find themselves if Ryan’s plan to privative Medicare ever becomes public policy.

http://www.prwatch.org/node/10643

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SPECIAL>>From Tucson Sentinel

Are insurers writing health reform regulations?
Columnist Wendell Potter says consumer advocates may be getting rolled
Posted May 5, 2011 |  Wendell Potter Center for Public Integrity

ONE OF THE REASONS I WAN TED TO RETURN TO JOURNALISM after a long career as an insurance company PR man was to keep an eye on the implementation of the new health reform law. Many journalists who covered the reform debate have moved on, and some consider the writing of regulations to implement the legislation boring and of little interest to the public.

But insurance company lobbyists know the media are not paying much attention. And so they are able to influence what the regulations actually look like—and how the law will be enforced—with little scrutiny, much less awareness.

At a January meeting of several hundred patient and consumer advocates in Washington, a top aide to Health and Human Services Secretary Kathleen Sebelius all but pleaded with those in the audience to bombard the Obama Administration with messages insisting that the law be implemented as Congress intended. Rest assured, he told them, that the insurance industry’s lobbyists were relentless in their demands that the regulations be written to give them the maximum slack.

One example: a section of the law expanding the rights of consumers to appeal adverse decisions made by their health plans.

“The Affordable Care Act will help support and protect consumers and end some of the worst insurance company abuses,” read an Obama administration fact sheet read from last summer.

The fact sheet went on to assure us that the new rules would guarantee consumer access to both internal and external appeals processes “that are clearly defined, impartial, and designed to ensure that, when health care is needed and covered, consumers get it.”

“In implementing this law, we have worked to end the worst insurance company abuses, preserve existing options and slow premium increases,” an administration official said. “Through it all, protecting consumers has been — and remains — our top priority.”

Regulations irk insurance companies

The rules, originally scheduled to go into effect July 1, 2011, were actually written by the National Association of [State] Insurance Commissioners (NAIC), which was tasked by Congress to develop several important regulations required by the law. If the law is implemented as the NAIC recommends, patients will be able to get an external appeal of a broad range of coverage denials, including denials that result from an insurer’s decision to rescind, or cancel, a patient’s policy—not just denials made on the basis of “medical necessity” as determined by the insurer.

The NAIC’s standards also say that insurers must provide consumers with clear information about their rights to both internal and external appeals and that the companies must expedite the appeals process in urgent or emergency situations.

Well, surprise, insurers don’t like being told what to do by regulators. So they’re pushing back hard. Consumer advocates who have been in meetings at the White House in recent weeks say they believe the administration is bending over backward to accommodate the insurers.

“We have reason to fear that the external appeal regs won’t be very consumer friendly,” said Stephen Finan, senior director of policy for the American Cancer Society Action Network.

Finan and representatives of several other consumer and patient rights organizations, including Consumers Union, the National Partnership for Women and Families and the American Diabetes Association, wrote officials in the Departments of Labor and Health and Human Services in late January pleading with them to “stand firm for consumers” in rejecting several of the insurance industry’s demands.

They expressed concern that the final regulations would allow insurers to stack the decks against patients by allowing health plans to deem a second-level internal appeal of a denial as meeting the requirement for an independent external appeal. They’re also worried that health plans will not be required to provide clear and understandable information to policyholders about their denial decisions, that the plans will not provide adequate translation of written communications into other languages (insurers are claiming this would be too burdensome), and that they will be able to take as long as 72 hours (instead of the recommended 24) to decide an urgent appeal.

Equally as frustrating for the consumer advocates is the administration’s indication that they will give the insurers until January 1, 2012, rather than July 1, 2011, to comply with the regulations.

Administration slows process

Consumer advocates say the administration has told them that the reason it is proposing to delay the effective date of the new rules for half a year is to accommodate the health plans’ enrollment cycles and marketing needs. Health plans do need adequate lead time to make changes to their systems and to prepare materials to inform their customers of new procedures, especially in multiple languages, so some of their push back is understandable. The new regulations also will add to the insurers’ administrative costs, and the new law limits how much they can spend on overhead.

But the consumer groups believe the administration itself has caused some of the problems by taking so long to finalize the regulations. The NAIC got its work done comparatively swiftly.

“There is a clear pattern of leaning toward the insurance industry more than consumers,” one of the patient advocates told me.

The consumer advocates, most of whom not so long ago were applauding the Democrats for getting reform enacted, even if it fell short of their original goals, are becoming increasingly discouraged, partly because there are so many more lobbyists for the insurers than for consumers. It’s hard to compete with them.

“We’re outnumbered 100 to 1,” said one of the consumer advocates.”

It’s clear,” he added, “that the insurers are willing to make life more difficult for patients” by trying to weaken and delay the consumer protections.

It’s also clear that, at least for now, the insurers seem to have the upper hand in dealing with the White House.

Reprinted by permission of The Center for Public Integrity.

News analyst Wendell Potter, a former insurance company executive, is the author of “Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans.”

http://www.tucsonsentinel.com/opinion/report/050511_potter_insurance/are-insurers-writing-health-reform-regulations

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