State-Corporate Healthcare: No “Right to Choose”

Those of us dwelling on the free market left, the strange breed that understand corporate domination as a protuberance of state power, are seen as paradoxical outliers within the American political catalog. We don’t fit very comfortably within a dialogue that regularly and mistakenly sets the interests of the powerful within our corporate economy against the powerful within the state.

The peculiar challenge for free market anarchism, then, is to explain not just how authentic interchange in goods, services and ideas benefits real, working people, but also to revisit the accepted account of business/government relations, contributing a revision that more accurately express those relations. The continuing debate surrounding healthcare reform offers a classic example of the pervasive cronyism — the state-corporate affinity — that is confused for the free market in the United States.

And in the face of all of their vehement debates, the rival sides in the current wrangle, Republicans and Democrats, without reservation indulge that system of anticompetitive corporate privilege and preferential treatment. Soon after the new healthcare law was passed in March, the attorneys general of states around the country filed claims in federal court to challenge many of the new provisions, among them the requirement that Americans buy health insurance or face fines.

Ruling on one such challenge, a federal court in Virginia held Monday, as reported by Bloomberg, that “the mandate on individuals in President Barack Obama’s health-care legislation goes beyond Congress’s [constitutional] powers to regulate interstate commerce.” Explaining his decision, U.S. District Judge Henry Hudson wrote that the central consideration is “an individual’s right to choose to participate,” that the “dispute is not simply about regulating the business of insurance.”

The most noteworthy feature of the court’s decision, at least for market anarchists, is that it exposes and thereby undermines the absurd false choice we’re conditioned to see in every political issue — the choice between endorsing state action on behalf of the common man and championing the free enterprise embodied by massive corporations.

That alternative and its assumptions about power are a sham, a pretense to dissemble the “public/private partnerships” of corporate liberalism that have long endured in the United States. In his critical reappraisal of the relationship between the state and powerful industries, Gabriel Kolko observes that the “motives and actions [of both the state and business] were designed to maintain or preserve a particular distribution or locus of power.” Kolko’s basic thesis is substantiated in the healthcare law, a corporatist chicanery that finds crusaders for the poor in the uncomfortable position of supporting a guaranteed market for greedy corporate mainstays in insurance.

That’s the progressive corporate state at its best; it has succeeded in deceiving the American Left into the belief that a comprehensive corporate holdup is the best way to provide health services to the poor. On the other side, it has coaxed the American Right into its customary, knee-jerk reaction, rising to the defense of Big Insurance and Big Pharma as paragons of some supposed “free market.”

As Kevin Carson demonstrates in his study, The Healthcare Crisis: A Crisis of Artificial Scarcity, the underlying problem precipitating America’s healthcare quandary is its considerable price, and not one of the apparent solutions coming out of the state-corporate elite confronts that problem.

Big hospitals and insurance companies, institutions with solidified links to the state, will do whatever they can to perpetuate the problem, to keep prices high. Accomplishing that goal requires them to construct a labyrinthine index of laws and regulations — from professional licensure, to drug patents, to special tax rules — that stave off the kind of competition that would swell supply and undo the state’s monopolies.

“[P]olitical decisions …” writes Kolko, “with few exceptions, preserve[] the type of distribution of power and decision-making that also insure[s] the power of regulated industries.” Judge Hudson’s opinion on the healthcare law throws into relief, even if not intentionally, the grievances of free market anarchists against the real welfare recipient in this country: Corporate-establishment Big Business. Voluntary, cooperative organizations are the way out of the price-controlled slough of the state-corporate economy, rectifying the misallocation of resources (read: Fraud) that defines the current paradigm.

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