Everyone who has lived through the last few decades knows what has been going on. Every institution in American life, and many throughout the world, have been reorganized in the interests of raising profits.

Let us start with the corporations. They previously served several ends including public service and obligations to their employees, to their communities, and to their nations, as well as making profits. Not any more. Downsizing, speed-up, reliance on part-timers: whatever squeezed a bit more profit out took precedence over all other considerations.

In publishing, the push to organize everything in terms of profitability has meant a concentration on a few pieces of schlock and an increasing reluctance to go with quality. In news, it has meant the reduction of journalism (too expensive) and the increase in entertainment (which brings in ads). In universities, it has meant more money for bio-tech and less for the arts and humanities, more part-timers, fewer tenured positions. In pharmaceuticals, it has meant the patenting of pieces of the biosphere and the maintenance of artificially high drug prices. In the schools it has meant testing, teaching for the tests, and an orientation to training for jobs. In immigration it has meant the selling of human organs, of babies, and of massive population transfers, only technically “illegal.”

This process has a name: neo-liberal rationalization. Everything is organized for the bottom line. In any single industry, it has a specific character; taken as a whole one sees that all industries, all human endeavors, are being synchronized, coordinated with one another, not with any thought of the public good, but only with the thought of increasing profits or, as used to be said, surplus value. It is a mistake to say the process is one-sidedly negative. It has had good effects as well as bad. Among the good are cheaper air-prices (once) and increased technology (computerization). What is important however, is not whether it is good or bad, but that it is unreflective, automatic, thoughtless.
It would also not be wrong to call this process “totalitarian,” as long as one explains what one means. It is totalitarian in that it subjects every aspect of human life to the same logic: economic logic. In fact, universities are different from factories, which are different in turn from law firms, which are still different from newspapers or bookstores. Yet, in the neo-liberal epoch, all of these institutions are governed by the same criterion: economic efficiency aimed at profitability. Assimilating diverse practices, disciplines, and institutions to a single logic is what I mean here by totalitarian.

I say this because I want to ask a question. Why does anyone doubt that the health care reform is not part of this overall process of neo-liberal rationalization? Why does anyone doubt that it is an effort to organize health care according to an economic logic, the same logic that has organized universities, theatres, museums, art galleries, and bookstores, along with banks and corporations? This is not to say that it should not be supported, or that it will not bring some good things. It is to say that we should see it clearly for what it is, and develop a politics based on reality and not on dreams of a messianic presidency, which anyway have already given way to discouragement, disillusion, and above all de-politicization, which will lead to further neo-liberalism, if there is anything still left to privatize.


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