The Boston Globe reported this past Saturday that Maine Governor Paul LePage has announced that his administration intends to reject the expansion of Medicaid provided for under the Affordable Health Care Act, and that existing coverage provided to more than 40,000 residents of Maine will be eliminated commencing at the end of this month. Among those affected will be the elderly poor, persons with disabilities, parents, and childless adults who have incomes well below the poverty line.
In a remarkable and important headline story ("A Message To Maine: No To Heath Billions"), the Globe's Jan Tracy reported that approximately 13% of the state's Medicaid population will lose coverage despite the fact that they are a part of the same group that the Obama administration sought to insure through the Medicaid extension that was a part of the Affordable Health Care Act.In a January 28, 2013 letter to the U.S. Department of Health and Human Services, LePage stated that Maine's previous Medicaid expansion prompted people "to drop their private insurance in favor of fee coverage at the expense of Mane taxpayers" and created "an addictive-like dependence on federal dollars."
LePage's comments ignored that fact that Medicaid is a means-tested government benefit program. Eligibility depends upon whether a person's income falls within a certain percentage of the federal poverty guidelines. In other words, only those people whom the state defines as "poor" can receive Medicaid benefits. By definition, those who are "poor" cannot afford to purchase private health insurance. Thus, LePage's rhetoric unfairly demonizes the working poor, the children of the working poor, and the disabled by likening them to addicts.
Maine is also the poorest state in New England. It has a low-wage economy - with a median income of $48,000 per annum - that Jan reports is dominated by tourism, fishing and lumber.
The Globe's reporter chronicled the plight of Louis Bourgoin, a sixty-nine year old retired shipyard worker who is currently undergoing treatment for cancer of the liver. Mr. Bourgoin told the reporter that he and his wife were about to lose thousands of dollars in Medicaid benefits beginning in March.
Tracy Jan quotes Bourgoin as saying, "The government doesn't care. It means we're just not going to eat very much." Katherine Bourgoin, his wife who is also 69 and a retired paper mill worker, said that she intended to forego cortisone shots and physical therapy for chronic back pain so that her husband might continue to receive chemotherapy to try to extend his life beyond the eighteen month period that a his physicians predict.
Jan also described the plight of Jennifer Webb, a 35 year old mother of three and her husband, a former Army sergeant. Mrs. Webb had just completed ankle surgery that will require physical therapy after she is able to walk again in a month's time. Her husband suffers from a traumatic brain injury and a post-traumatic stress disorder as a result of his having served two tours in Iraq. He had found a job installing metal roofs, but he was laid off one week before.
Ms. Webb said that she understood why the Tea Party's emphasized self-reliance. "My husband's one of those people," she is quoted as saying. "He's an extremely conservative Republican who comes from a hard-working family. We were raised to stand up on our own and do what you have to do to survive, which we're trying to do."
Jan also reported that earlier last week a telemarketer for a private insurance company called the Webbs. However, the sales person hung up after Mrs. Webb explained her family's financial plight and inquired about the costs of various plans.
In response to LePage's decision, Jan's quotes Sara Gagné-Holmes, the executive director of Maine Equal Justice Partners, "We're using stereotypes, rhetoric, and ideology to create public policy and that's always easier and resonates more than looking at the facts."
Governor LePage himself seems to have drawn the wrong lessons from his own hard-scrabble life. He grew up in a French-speaking family. At age eleven, after his father beat him and broke his nose, he ran away from home. Thereafter, he begged on the streets of Lewiston, and sought shelter wherever he could find it, including in horse stables and at a "strip joint" He survived by shining shoes, washing dishes at a café and by hauling boxes for a truck driver. He later worked at a rubber company, a meat-packing plant, and was a short order cook, and bartender.
As a young man, LePage applied to Husson College in Bangor, but was initially denied admission. He scored poorly on the verbal section of the SAT because English was his second language. LePage has acknowledged that Peter Snowe - the first husband of U.S. Senator Olympia Snowe - gave him a critical leg up after Snowe persuaded Husson to give LePage a written exam in French. The results of that examination allowed LePage to demonstrate his comprehension and he was subsequently admitted. He graduated from Husson College with a Bachelor's Degree, later earned a Master's Degree in Business Administration from the University of Maine (a public, tax-payer supported institution), and became a successful businessman.
LePage's politics and those of his Tea Party supporters epitomize an austere and insensitive version that Gunnar Myrdal described as the "American Creed" - a paradoxical set of beliefs in which those who describe themselves as "conservatives" seek to protect and defend a radical form of individualism that first emerged in 17th century England.
The central tenets of that ideology to which most Americans still subscribe, albeit in less extreme versions, evolved out of liberal political philosophy of John Locke. Locke believed that human beings were by nature motivated by the singular concerns of the self, that utilitarian calculations formed the true basis of moral decision-making, and that the desire to possess things - the acquisition of property - was the sine qua non of human aspirations. Locke also argued that the individual is the only concrete reality, that society is merely an aggregation of individuals, and that government is an artificial construct created solely by a contract among consenting parties.
David Hume, through his essays about the importance of money and trade, Adam Smith, with his emphasis upon the role of markets as self-regulating entities, and David Ricardo, with his concept of comparative advantage, completed the edifice of what has now become this country's political and economic orthodoxy.
The problem is that here in the United States, Locke's political philosophy - in stark contrast to the English experience - has been constructed upon a foundation that recognizes and envisions only solitary selves. Hence, a concept of the whole - the public interest - what we owe to one another as citizens - is largely missing from American public discourse.
Whether the issue today is universal medical coverage, poverty, antiquated labor laws that harm workers and benefit employers, access to education, the need to rebuild our economy or the need to repair decaying infrastructure and to invest in research and development, the impediments- which are the legacy of Locke's politics --remain: parochialism, special interests, and, all too often, an inability to see beyond the refrain of "What's in it for me?"
Among true believers today, this extreme version of anti-social individualism has been given free reign, unencumbered by the restraints, modifications and caveats to which it was subjected in England and in other European political systems. There the ties of the traditional society and medieval ideas that place an emphasis upon cooperation and the importance of community have not unraveled and they continue to inform and bind the political discourse.
As a result, in Europe, Locke's individualism was given nuance and context; whereas in America, in the context of the political tabula rasa of the New World and the seemingly limitless expanse of "free land" that could be claimed by hard work, the self has become the avatar.
Although the frontier was declared closed by the end of the 19th century and a new industrial economy emerged, the mythology of self-reliance still lingers. As Christopher Hitchens once observed, "I have always found it quaint and rather touching that there is a movement [Libertarians] in the US that thinks Americans are not yet selfish enough."
Why then do so many Americans still subscribe to an ideology that no longer provide answers - or any meaningful policy prescriptions- that can possibly begin to address this country's real political and economic problems?
Thomas Kuhn, in his epic work The Structure of Scientific Revolutions has provided a possible answer. Kuhn, a former historian of science at MIT, has described how the paradigms in which individuals live and work - what phenomenologists refer to as a "shared field of meaning" - continue to control the beliefs and behaviors of individuals long after the anomalies have overwhelmed the paradigm and long after the paradigms have ceased to explain what is actually happening in the real world. This holds true whether the issue at hand involves a scientific hypothesis or an economic theorem.
As individuals and societies hold fast to beliefs that no longer explain or inform social reality, fear, anxiety and anger often mount. The death- throes of these ideas is resisted with a ferocity that overwhelms civility and rational political discourse. This, at least in part, explains the rise of the Tea Party and the emergence of truculent ideologues such as Governor LePage.
The Governor of Maine and the countless millions of Americans who share his political philosophy refuse to live in an evidence-based world. Their refusal to extend the same helping hand to their neighbors that they once received is inexcusably mean-spirited, profoundly short-sighted, and antithetical to any concept of social justice.
Political cultures are governed by what the French often refer to as the "flux and reflux" - the ebb and flow of culture's life cycle as it is nurtured by competing ideas. When cultures exhaust their collective ideas and fail to find new explanations for their politics, they stagnate and ultimately cease to exist. That is the fate that befell the Soviet Union as its population no longer accepted the tenets of a Marxist-Leninist ideology that excluded large segments of the population from meaningful participation in the civic life of their society and did little to improve their standard of living.
In a similar vein, continued reliance upon the myths that the
Tea Party endorses - and that are more broadly held by supporters of the
GOP -- will provide little guidance for life in an ever more
interrelated and interdependent world of the 21st century. Unless a new
and more inclusive paradigm emerges, the American experiment will
increasingly flounder. We will all be the poorer as a result.
