"The Price of a Civilization," a new book by Columbia University economist Jeffrey Sachs, has sparked a very public debate between Sachs and House Budget Chairman Paul Ryan, the Wisconsin Republican who has proposed privatizing Medicare and major cutbacks in other government programs.
In a review in the Wall Street Journal, Ryan contends that Sachs favors a "European model" in which the government plays a larger role and rejects the economic freedom that Ryan says sets America apart:
The freedom and independence of the American population can best be guaranteed by allowing the people to govern themselves through their elected representatives; by keeping limits on the size of government; and by encouraging each of us to take responsibility for our own well-being. We can best be aided by our families, communities, churches and local institutions—and by the government only as a last resort.
For, ultimately, Mr. Sachs's quarrel is with our founding principles of equality and liberty. Underlying the arguments in "The Price of Civilization" is a contention that the Constitution is too conducive to freedom, that it endorses an economic system too friendly to growth and the satisfaction of appetite, that it creates political institutions too inattentive to our national character.
Sachs, in a response excerpted by University of Oregon economist Mark Thoma, says Ryan (or his ghostwriter?) and his allies misunderstand American values and are swayed by a wealthy and powerful "corporatocracy":
Ryan ignores the extensive evidence in the book showing that Americans support the values of a mixed economy, not of Ryan's free-market libertarianism. Americans today by large majorities support public education, Medicare, Social Security, help for the indigent, stronger regulation of the banks, and higher taxation of the rich. ...
On issue after issue, Washington is presently bucking the public's values, rather than respecting them. A majority of the public wants to preserve social programs, but they are being cut anyway. A majority wants higher taxes on the rich, but they are being cut rather than raised. A majority wants to end the wars, but they continue anyway.
The reason is the following. America is losing its democracy as our politicians trade their votes for campaign contributions from the corporate lobbies. We have a corporatocracy rather than a democracy, and Ryan stands at the center of it. The Wall Street Journal, which commissioned Ryan's review of my book, is the leading print mouthpiece for the corporatocracy.
This debate - at the heart of who we are as a nation - was also briefly in focus at a recent Republican debate when some in the crowd cheered Ron Paul's suggestion that medical care could simply be refused to an uninsured man who shows up at a hospital when, as Wolf Blitzer put it, "something terrible happens" after the man previously decided to forgo buying health insurance - presumably after the Affordable Care Act's new health-insurance mandate was overruled by the Supreme Court or repealed by a new Republican Congress and president.
It was hardly a random reaction. In a Chicago Tribune op-ed last year opposing the mandate, libertarian law professor Richard Epstein made the case for such denials, suggesting that one alternative solution to the "free rider" problem would be to simply "let any emergency room ask for a credit card at the point of service."
Never mind the question of what happens to people who arrive unconscious after a heart attack or bleeding out after a car crash - would we all need to have credit-card chips embedded in our necks? Back in the 1980s, during Ronald Reagan's presidency, we required emergency rooms to treat everybody in such an emergency because we recognized that the alternative was unacceptable - that wasn't who we were as a society.
If Paul Ryan and Richard Epstein are right, maybe that is who we are today and were all along. Maybe the last 100 years of progressive reforms - from child-labor limits and food- and drug-safety laws to Social Security, Medicare and Medicaid - were just one huge wrong turn. (If you think this isn't a plausible conclusion, read Jeffrey Toobin's piece in the New Yorker on Supreme Court Justice Clarence Thomas.)
Clearly, this is a debate worth having.