Marcus Licinius Crassus is a prominent figure in the history of the Roman Republic. Contemporary of Sulla, Cicero, and a little-known character by the name of Julius Caesar, Crassus was the wealthiest man in the Roman world. So wealthy that his vast riches alone earned him a spot on the First Triumvirate alongside Caesar and Pompey, who would later engulf the Republic in civil war over the matter of a salad recipe (I kid…).
Crassus began to amass his fortune in the aftermath of another civil war, when enemies of the state were proscribed, and their property seized and sold at auction. From here he branched out and discovered all sorts of nefarious ways to accumulate wealth.
One such method involved tracking down the owner of a property going up in flames. Arriving on the scene, Crassus would offer said owner a trifling amount for the presumably destroyed property. Once the owner agreed, Crassus would then bring forward his private fire brigade, put out the blaze, and take ownership of the slightly damaged property.
Talk about a dick move.
This predatory practice continued until Augustus rose to power and established a public firefighting force. Fire was a very real threat in the ancient world. It could very easily gut a city. Against that peril, the investment in public firefighting seemed well worthwhile, as it still does to this day.
I bring up Crassus and his fire brigades as a way of maybe shifting the conversation about public versus private enterprises.
Our country is historically suspicious of government-run anything. There is a belief that government programs are inefficient, and that, by virtue of capitalism, matters should be left to the markets and private industry.
In most cases, I agree. When it comes to selling computers and clothing, car insurance and houses, supply, demand and competition tend to make things better for the consumer. If someone gets lazy and starts building crap products, you or I can always go elsewhere. Likewise if someone starts charging too much for too little. This is because the profit a company takes is directly tied to the quality and/or price of their product or service.
But there are sectors where providing a service can have a negative impact on profit, or where profits can be enhanced by unscrupulous means. Crassus’ fire brigades are a prime example, and one reason why private firefighting companies are a very bad idea. I would say the same for law enforcement, the military, and search and rescue operations.
If you thought this would eventually come around to health care, congratulations, have a cookie.
Profit-driven healthcare is, in my opinion, a dangerous thing. It can work to a point, and with proper regulation. For example, the employer mandate stipulates that health care insurers must cover an employees receiving benefits through their employers regardless of pre-existing conditions. They can’t drop them the moment things get hairy.
If you happen to work for a small company, or strike out on your own, that protection is gone. An insurer can refuse to cover a pre-existing condition, or charge a premium so high you can’t afford it, or employ rescission to drop you when you need care the most.
As someone who knows several people who have struck out on their own, and who may do so one day himself, this terrifies me. It is an anchor around the neck of every entrepreneur in this country, an anchor that keeps people working for “the man” and that stifles innovation.
Furthermore, given the perilous state of the economy, this is an issue that concerns each and every one of us. You may get pretty decent benefits through your job today, but what if your employer decides they are no longer worth the expense? Or what if you get laid off, and haven’t found another job by the time your COBRA benefits expire (or can’t afford the COBRA premiums)?
If you want some real-world examples of this kind of stuff, I highly recommend perusing the excellent “View From Your Sickbed” accounts Andrew Sullivan has been collecting and posting. It’s easy to spout platitudes about the uninsured from 40,000 feet, it’s another matter when you see how this system could very easily turn on you, your family, or your friends.
I’m typically not a fan of government intrusion, but in some cases Adam Smith’s invisible hand is not enough to keep private industry honest, and in those instances I DO feel it is the government’s role – as an entity that can act without hyperactive profit motive – to step in and set rules. Or, if need be, enter the fray directly.
And I feel that is the case with health care, which, though we may not often think of it as such, is a very real factor in American competitiveness and, it could be argued, is a matter of national security.
Posted by Matt 
Posted by Matt 
Posted by Matt 
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