There is a fundamental problem in the United States. I think it comes from the fact that we have been such a rich country for so long. When you are rich, you are afford to be delusional. But the poor have to face facts. And as the vast majority of Americans get poorer and poorer, we are forced to see that our leaders (the power elite) aren’t making much sense and are thus making our lives worse.

I have a friend who is currently facing a drunk driving charge (although he wasn’t driving, nor had been driving—not that it much matters in modern day America). His lawyer recommended that he start going to Alcoholics Anonymous (AA) meetings everyday and collecting signatures. It is said that this will impress the judge. And doubtless it is true. All over the country, judges sentence drug addicts to attend various kinds of twelve-step programs like AA. This is sad and strange. Rather than being illegal, such sentences are now de rigueur. They are, after all, “spiritual” programs, based on 19th century evangelical programs of spiritual redemption. But such programs might be acceptable if they worked. But, of course, they don’t. The little study that has been done on such programs has found that they are no better at keeping people sober than no program at all. What’s more, when people in AA relapse, the length of those relapses are much longer. (See, for example, Alcoholics Anonymous: Cult or Cure?)

This isn’t intended as a criticism of the twelve-step community. If the program works for any given person, it works for that person and that’s great. But public policy should be based on what works in general and so these programs should not be forced on unlucky people who find themselves in the criminal justice system. I’m sure future generations will look back on this practice with much confusion. It will be viewed the way we now view doctors of old who bleed patients to death in attempts to cure them. The point is that our society still practices a lot of hocus pocus even as we pat ourselves on the back for our enlightened attitudes. (That’s especially true with drugs where it isn’t at all clear that “treatment” is better than jail.)

The problem is much bigger than the criminal justice system. And another big example made news this week: healthcare. I’ve had many conversations with conservatives where they say that we ought to fix our broken healthcare insurance system with a single payer. This seems to be more common now that one of the big talking points against Obamacare is that it is complicated. I don’t mean to suggest that these conservatives would not pivot immediately if a single payer system were on offer. (Not at first, perhaps, but as soon as Fox News was done with them.)

On Wednesday, Physicians for a National Health Program issued a press release, ‘Medicare for All’ Would Cover Everyone, Save Billions in First Year: New Study. The new study is by University of Massachusetts, Amherst economics professor Gerald Friedman. And his results are so shocking that I’m skeptical. He claims that we would save $476 billion per year from getting rid of the inefficient private insurance system that spends roughly 20% of its income per year trying to refuse care. And it would save another $116 billion per year by driving down the costs of drugs. That’s over a half trillion dollars per year!

One thing that there is no doubt about: a single payer health insurance system would save the country lots of money. Yet when it came time in 1993 and 2009 for the liberals to discuss healthcare reform, a single payer system was effectively off the table. It was largely an issue with the mainstream press: everyone just knew that single payer was not a serious plan, even if it worked great in a number of other advanced countries. (Hell, even the United Kingdom’s government-run health system works better than ours!) And why is it that we can’t talk about single payer? It certainly has nothing to do with the merits. It is just that we here in America don’t do things that way.

And that brings us to forcing drug addicts into useless (Or even harmful!) programs. We don’t care about results. Here’s another example: after 9/11 the government made all kinds of changes to airline traffic. I don’t believe one made us any safer, but they did make travel much more difficult. We could have made changes that would have been helpful, but we chose to make changes that were ostentatious and useless. Because that’s what America is all about: we want to look like we are doing something. It’s all about optics. It’s like the Billy Crystal character Fernando would say, “It is better to look good than to feel good.” Except in the United States, it is the power elite who look “good” and the uninsured who don’t feel good. We don’t look mahvelous.

H/T: Crooks & Liars

Update (5 August 2013 7:51 am)

I asked Dean Baker if the savings Gerald Friedman calculated were about right. He said, “If you got costs down near Canada’s, it would actually be more.”