Thread by @darinbunch

Americans have a “Logic Deficit” when it comes to how the U.S. government *should* operate to both serve and benefit as many citizens as possible while protecting the country and providing the framework in which society functions.

A thread with two examples ...
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Myths about “how government works” are created because key aspects of U.S. government operations are viewed through the faulty lens of “This is how one thing works, so it must also apply to how all things work.” /2

This is illogical, obviously. Sometimes the differences are as subtle as comparing apples to oranges. Other times as glaring as comparing an ant to Shaquille O’Neal. All things are not equal. Thus, they shouldn’t be treated as equal. And, yet, this is how myths are created. /3

Politicians arm themselves with these myths, which are then amplified by the media, resulting in everyday Americans (of all education levels and political persuasions) accepting the myths as fact.

Here are two examples:
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As long as society agrees that no person in need of emergency medical care should be turned away (a cornerstone of American medicine), the country’s health-care system will *never* be a free-market system. Myth No. 1 is believing we should treat it as a free-market system. /5

Providing health care to anyone in need is fundamentally at odds with the core “free market” principle of competition. Scheduling surgery for a brain aneurysm is not the same as buying a car. The personal demand is exponentially higher, and the supply is exponentially less. /6

Thus, the argument that the market-driven private sector (rather than the government) should manage public-interest industries such as the health of our citizenry is a myth, for many reasons: /7

Can there be a mix of private-sector and government health care? Of course. It’s called “what we do now.” But it’s failing millions. The solution is to swing the system one of two directions: toward more private-sector or more government management. The latter is more logical: /8

First, the private sector is profit-driven. Allegiance is to owners and shareholders (and hopefully employees). Business decisions are based on maximizing profits. Conversely, reasonable people agree medical decisions should be based on an individual’s healing and well-being. /9

Also, in the market-driven private sector, businesses “have the right to refuse service.” Even if you argue that right is diminished in an increasingly PC world, it still exists. But “refusing service” is never an option for ethical present-day physicians. /10

If you go to the hospital with a broken arm and no insurance, you will be treated. You’ll most likely be sent home with a cast, pain meds and a huge medical bill you don’t understand, but you’ll be healthier than when you left. /11

How that ER bill can lead to debt and bankruptcy is a different discussion entirely, but it’s also another glaring flaw in our current health-care system that could be fixed by treating health care as a government-managed right rather than an employment-based benefit. /12

It won’t be easy to transition our existing health marketplace into a health-care system in which the “safety net” for all Americans is predominantly managed by govt. A private “premium care” market would likely emerge for those willing to pay for more personalized service. /13

But in such a public-private two-tiered system, those premium “customers” would know what they are paying for, while “patients” at large would also know what services would be available to *all* citizens, from ER visits to ongoing cancer treatment, and everything in between. /14

So this is how we get there. Health care doesn’t have to be an either/or proposition — the government can do its job (providing for the citizenry) and the private sector can do its job (creating a marketplace for those who prefer a higher level of service than govt provides). /15

OK, but how do we pay for a massively expanded government-managed health-care system that provides everything from basic care to advanced medical treatment for all Americans?

Ah, now we’ve arrived at our Second Example of political myths. /16

Myth No. 2: The U.S. government should manage federal finances like everyday Americans are expected to manage their own. Conventional wisdom leads you to believe this, but it is wholly incorrect. The government checkbook is not the same as your household’s Quicken register. /17

Even the ultra-wealthy are not atop of the economic food chain. But the federal government is. Individuals and businesses are indebted to whomever and wherever they spend their money. You have a limited supply. So you must bring in more money than you spend to stay afloat. /18

The U.S. government does not have your limitations. It can “make” more money, simply by wishing it so (via Congress, Treasury and Fed). In fact, decisions to pour more money into the economy make everyday Americans the beneficiaries in terms of additional spending power. /19

Of course there’s a check on such spending: Inflation. More spending power can drive up demand which can fuel competition that results in higher prices. When those higher prices outpace spending power, inflation is the signal that govt spending has become counterproductive. /20

But the U.S. economy is a long way from that extreme. Economists such as @wbmosler and @StephanieKelton argue that government spending is not only essential to economic growth but a moral imperative to provide Americans with necessary services to keep America strong. /21

And it’s not like the government is unwilling to make huge unfunded expenditures — politically expedient initiatives such as tax cuts and military spending seem to make it through Congress easier than programs that can be tagged (unfairly) as “entitlements for freeloaders.” /22

But we’re all freeloaders in some respect. Big biz get tax subsidies. Families get child subsidies. Poor get food subsidies. Vets get health-care subsidies. No one person *deserves* more than another — our Declaration of Independence spells out that “equality” quite nicely. /23

Pursuit of that “equality” is how we politically justify a health-care system that will benefit everyone. Economically, we simply create it, allowing the principles of Modern Monetary Theory (#MMT) to take over. Since the U.S. is creating the money, the “debt” is irrelevant. /24

Q: Does the political will exist to do something this logical (but beyond mainstream thinking) on the health and economic fronts? It will require dispelling these myths if elected officials want to make America even greater than it already is, and save us from ourselves.
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Obviously I have few followers on this account, so I’m guessing few, if any, will read this (very long) thread. But it would be nice if folks like @RBReich @GavinNewsom @AOC @BetoORourke and even @BarackObama and others gave it a glance, so I won’t have written it for nothing 😊