Moving Past Neoliberalism Is a Policy Project

We aren’t political consultants, and we aren’t going to tell anyone how to win elections. But our political theory, nicknamed “deliverism,” is that Democrats, when in government, need to not only say popular things, but actually deliver good economic outcomes for voters. They did not do this for many years, and neither did the GOP, which is why Trump blasted through both party establishments. Deliverism is linked to the death of neoliberalism, because it’s an argument that Democrats could reverse their toxic image in many parts of the country by reversing policy choices on subjects like NAFTA, deregulation, and banking consolidation, which have helped hollow out the middle class for decades.

Deepak Bhargava, Shahrzad Shams, and Harry Hanbury, in a piece called “The Death of ‘Deliverism,’” recently argued otherwise, asserting that Democratic unpopularity shows that a narrow focus on policy to improve people’s lives is largely irrelevant to electoral outcomes. They point to a series of Democratic policies that, though enacted, did not help win votes.

It’s an intriguing thesis, and worth considering. If economic policy doesn’t really matter to voters, as many political scientists argue, then politics really should orient itself around cultural questions. That said, these authors use an odd basket of evidence, and in doing so, actually show the real political problem with improving the material lives of Americans. The problem is that most Democrats are so set on defending our policy legacy against right-wing attacks that they have no idea how voters experience the economy, or how our policies impact people.

Take the Affordable Care Act, which now seems to have a strong political anchor after years of political controversy. Bhargava, Shams, and Hanbury argue that the ACA is “Obama’s signature achievement” that improved people’s well-being. Yet, they say, there’s a paradox, as it “did virtually nothing to shift political allegiances.” If those who believe that helping people economically are right, they allege, then the ACA should have switched large segments of the voting electorate.

But is this a fair test? Let’s take a quick look at how Obamacare actually affected normal people. First, the goal of Obamacare was to insure more people, and it did. Roughly 85 percent of Americans had health insurance in 2008. Today, it’s about 90 percent. So 5 percent of the country has something they didn’t have before, and it’s quite possible to say that many lives were saved. Biden built on this by giving higher subsidies to individuals to purchase insurance if they don’t get it from an employer or qualify for a public plan.

What about the other 85 percent? Well, in 2009, the average medical cost for a family of four was $15,609. Today, it’s $30,260. That’s almost the cost of a new car in health care costs, every single year. In other words, 85 percent of potential voters have the same or a worse experience with health care today, versus 5 percent who gained insurance. It’s hard to call that a net economic improvement in the lives of most voters. (...)

There’s more. The typical Democratic talking point, that Obamacare prevented discrimination against pre-existing conditions, isn’t true. Since the ACA kicked in, the number of high-deductible health care plans has skyrocketed from 7 percent to 32 percent. That means if you have, say, diabetes, you get to pay $2,000 or more in cash every single year before your health insurance kicks in. That may be better for some people than the previous system, but is that nondiscrimination? No.

That’s before you get to the fact that routine drugs used in all hospitals are in chronic shortages, including many drugs used in the treatment of cancer. Hospital understaffing is at a point of crisis, with as many as 124,000 physicians needed by 2034, according to the Association of American Medical Colleges. Nurses are in such demand that those who travel to fill shortages can make as much as $10,000 a week. And mass hospital closures have left medical deserts in large swaths of America, with nearly 80 percent of rural counties left “medically underserved.”

It’s possible, even likely, that our health care system would have been worse without the ACA, and many wonks make this point. But our point is that how voters respond to Obamacare is not a basis for testing the political reaction to a program that improved the material life of Americans under Democrats. Because the fact is, health care as experienced by most people is more expensive and harder to obtain. If you can’t accurately understand how Americans experience our culture and economy, the very acts of seeking the care to live or die, then your judgment on political and policy arguments will be off. (...)

Medical costs are up and wages are not for one reason that is very easily understood by Americans: monopolies. [ed. emphasis added) Hospitals, doctor’s practices, health insurance, pharmaceuticals, ambulances, nursing homes, rehab facilities: Every part of our health care world is increasingly controlled by greedy bankers who kill people for money. Meanwhile, big corporations have consolidated over the last 40 years, pushing wages down for workers by tens of thousands of dollars a year. That’s an easy, true, and compelling story, and it’s the story that carried 19th-century progressive populists, and the New Dealers behind them. It brought together workers, farmers, and business upstarts who were being overrun by concentrated power. In the hands of Franklin Roosevelt, it was even seen as an antidote to fascism.

by Matt Stoller and David Dayen, The American Prospect |  Read more:

Image: Carolyn Kaster/AP