I've just started reading Uninsured in America (by Susan Starr Sered and Rushika Fernandopulle, Univ. of Ca. Press, 2005), and I'm concerned. While the book is a much needed look at the working poor, and it promises to provide me with facts and stories I'll be quoting at cocktail parties for months to come, I'm worried that it won't make a lick of practical difference.
The point of the book seems to be to chronicle how working hard and playing by the rules is often not enough to let individuals and families meet crushing health care costs, and to shine a light on the often devastating consequences. It's a good reason to write a book. The potential problem lies in the presentation. Like most liberals, I already believe that if you work hard and exercise some minimal level of good judgment in managing your life affairs, a wealthy and powerful nation should be able to see to it that the necessities for health and happiness are available to you.
If this book is to make a direct change, then, it has to be aimed at the other side: people who believe (wrongly) that we do take care of our own; people who believe that because they are making it through, anyone can; and people who just don't give a shit as long as the market is humming. And by page 26, I've begun to worry that this book won't make a dent in that crowd.
My concern centers around the authors' apparent unwillingness to scrutinize their own opinions and assumptions.
Here's an example of an unnecessary over-simplification that detracts from an essentially valid point [from page 26, emphasis mine]:
In recent decades, a fundamental paradox inherent in the [American] dream has surfaced ever more clearly: although both employers and workers may share the vision of the American dream and may even share a belief that it can best be achieved when all pitch in for a common goal, the reality is that the means to attain that dream comes from one finite pot—company revenues. Gains on the part of workers come at the expense of profits for employers; labor compensation (wages, benefits, and other costs) makes up a large percentage of company expenses. Thus, as health care costs have soared over the past decades, many employers have come to see providing health insurance to employees as a burden.
Sure, if at the end of each quarter you took the total revenues and divvied them up amongst operating costs, covering capital outlay, worker pay and benefits, executive compensation, etc., then everyone is fighting over the same pieces of pie. But that's not how companies work. Companies often spend borrowed money. What's good for one area of the company may be bad for others in the short run but lead to overall improvement for all involved, and the inverse may be true as well. Does this mean that the authors are wrong? Not necessarily. It's true that employers can increase profits by shortchanging employees, but that's hardly an inherent paradox.
An analogy: A parent could trim his monthly budget by cutting his kids back to one meal a day—does that mean there's a paradox at the heart of the parent-child relationship? Of course not. If you saw someone treating his children this way, you would say that that particular relationship was sick, improper. You would say that the members of that family need help, and perhaps that the father ought to be punished. You'd say that he should be monitored in the future. You might want to make sure that there's system in place to deal with this kind of neglect. But is this reason to be suspicious of all parent-child relationships? No.
Why does this matter? Because it weakens the point the authors are trying to make in this section. Instead of saying that we live in society that has allowed large companies to shirk their social responsibilities, instead of pointing out bad actors and bad actions, Sered and Fernandopulle alledge that the American dream is built on an inescapable contradiction. I don't happen to agree, and I wonder why they would have taken a stance that is far more broad and absolute than necessary to make their point. I wonder why they would take a swipe at the foundational ideals of American capitalism without more than a few paragraphs to support the argument.
I suspect it's because the book is written for those who already agree with the authors. That's a shame, because the stories in the book deserve a wider audience.
So that's a harsh indictment of a book for only having read 25 or so pages. I'll be back in the comments over the next few days to update, focus, and, if it's called for, apologize.