I learn from virtually everything I read by Mike Konczal, and agree with much of it. But the essay he and Patrick Iber have written on Karl Polanyi, progressivism, and the 2016 Democratic nomination contest leaves me with more questions than answers.
Iber and Konczal aim to highlight a tension within the American left between a “social democratic” vision of how to address social problems and a “progressive but market-friendly” vision. They say Bernie Sanders, a social democrat, believes access to education and healthcare should be a right, available to all persons regardless of income or wealth, whereas Hillary Clinton, a market-friendly progressive, thinks education and healthcare should remain market commodities, with access hinging at least partly on a person’s ability to pay. Sanders, according to Iber and Konczal, “offers a straightforward defense of decommodification — the idea that some things do not belong in the marketplace — that is at odds with the kind of politics that the leadership of the Democratic Party has offered more or less since Carter.”
What does treating education or healthcare as a right imply for policy?
Though Sanders favors free college for everyone, that isn’t what he would provide. He proposes zero tuition (for in-state students at four-year public universities). But that wouldn’t cover room and board, which costs $10,000 a year or more for a typical student. Offering “free” college that doesn’t include room and board is a bit like offering “free” healthcare that covers the cost of surgery but requires patients to pay out of pocket for the hospital room. In the Sanders plan, low-income students, but not middle-income ones, “would be able to use federal, state, and college financial aid to cover room and board, books, and living expenses.” So for Sanders, like for Clinton, college education wouldn’t be genuinely decommodified.
That’s the case in Sweden too, which is why a large portion of young Swedes leave college with fairly large student loan debt despite paying zero tuition. Earlier in the life course, Swedes benefit from high-quality child care and preschool. But while public funds heavily subsidize the cost, parents do have to pay for this early education, up to 10% of household income. Is Sweden failing to treat education as a right?
How about healthcare? I share Sanders’ preference for a single-payer system, but that wouldn’t necessarily decouple access to healthcare from one’s income. Medicare pays, on average, only about two-thirds of elderly Americans’ total medical expenses, so “Medicare for all” arguably wouldn’t ensure everyone a right to what we think of as minimally adequate healthcare.
If we believe in a right to healthcare and education, shouldn’t the same be true for food and housing? If so, does that mean everyone should receive a basic food allowance? A housing allowance? What if providing a meaningful housing allowance to all Americans turns out to be extremely expensive? Wouldn’t we want to consider a policy that ensures housing for those least able to afford it but provides less help to those with higher incomes? That would be a “market-friendly” approach, in Iber and Konczal’s formulation, but it might also be the best one.
To me, labeling Bernie Sanders’ proposals “social democratic” and Hillary Clinton’s “market friendly” obscures more than it clarifies. And applying an overarching principle, such as universal right to access, doesn’t get us very far in figuring out the policy details for education (early, K-12, college), healthcare, food, housing, and more.