In theory, making policy should be determined solely by need, but obviously that presents a wealth of problems. For one thing who decides what the most pressing needs are? For another, how is it going to be decided which needs get priority? In America today there are pressing needs to reform the health care system, the educational system and a veritable cornucopia of other problems facing the country, yet ten million dollars a day is being spent on an unnecessary war halfway around the globe. Policy decisions clearly are not objectively based on pressing need.
Political ideology must always be taken into account when considering needs upon which policy is based. The traditional liberal democratic ideal holds that needs will be met based upon the greatest subsequent demand. The entire free enterprise system of economics is based on this idea, of course. Capitalism sprang forth from the collapse of the feudal system and was immediately embraced on the assumption that the greatest needs would be met because profit was the motive behind the seller. Since each individual would be faced with meeting his own needs, he in turn would provide products that met the loudest demand. This theory is held dear in political decision making as well.
Just as no businessman in his right mind would set up a shop to sell air conditioners to consumers in the northernmost reaches of the arctic, surely no politician in his right mind would try to sell his constituents a patently unnecessary idea. Political conservatism typically goes hand in hand with economic conservatism. Although even the most leftist of liberals in America reject the idea that free enterprise isn’t the epitome of economic policy, it is the conservatives who cling most desperately to the belief that needs will be met as they arise of out demand. If there is a political outcry for a certain necessity that can be met by the government, then it will be met. But only if that need cannot first be met by private enterprise.
The truly liberal tradition holds out the promise that all needs will eventually be fulfilled if only to stem the tide of rebellion. That fear is not the driving force, of course. This tradition considers true need as a value that must be met. If poor people are unable to afford high cost brand name medicine, for example, then companies will step up to offer lower cost generic equivalents. If the economic policies of the government result in stagnation of wages-for instance, the refusal to raise the minimum wage after almost a decade-the miracle of free enterprise will come to their rescue in the form of a national chain such as Wal-Mart deciding to drop the prices even of low cost generic medications. This is the liberal tradition of needs being met in action. Because a free enterprise system cannot succeed without a steady population of consumers, then demand will always result in supply being offered by a profit-minded institution. Since this is a time-honored method of doing things that has been proven effective over and over again, governmental policy has created a legitimate claim to taking a laissez-faire approach.
Consider the same situation in a non-free enterprise country. If a large proportion of the populace were unable to afford medication but there was no profit to be made by meeting that need, then the government would either be force to change policy and forcibly lower prices or else take a wait and see attitude. Essentially this public policy in the form of consumer demand. When enough of the population espouses a need, the liberal democratic tradition asserts that it will be met simply by virtue that someone else will have a second need that can be met by supplying the first need.
Another theory is an offshoot of the classical liberal tradition, suggesting the needs are not automatically met by the idea of supply and demand. Pluralist tradition notes that many policy decisions that meet needs are only arrived at by virtue of public demand. In other words, the system can’t always be depended upon to come to the rescue; sometimes activism is called for to achieve policy changes. Essentially, the pluralist view maintains needs themselves as a transformative device. When a need is felt by a large enough segment of the population, it will be transformed into political action. And it is only that action that will result in substantive policymaking decisions.
Using pharmaceuticals as an example, assume that drug prices in America continued rising to the point of being unaffordable for a large segment of the population. Further assume that the profit margin was too thin for generic prices to drop any further or for Wal-Mart or any other national chain to make the drugs affordable. At this point-with the lack of any other option-it might be assumed that the demand for cheaper drugs which can’t organically be met by a supply system based on maintaining a certain level of profitability could conceivably be transformed into political action that demanded the ability to purchase drugs at a cheaper rate from Canada. Current government policy in America stand in defiance of the political activism already calling for that. But if the number of activists grew large enough and powerful enough it is conceivable that public policy could be changed. This is an example of pluralist theory in action.
Of course, buried within that hypothetical situation is also a real life example of neopluralist theory in action. The fact is that today there is a tremendous segment of the American population-dominated by seniors on a fixed income-who cannot afford their medication. There is currently a real need for policy reform in some manner to either reduce the cost of brand name drugs or to reform the process by which less expensive generics are made available. When looked at from the traditional liberalist tradition, there should already have been a free enterprise miracle that stepped in to meet that pressure and growing need. Wal-Mart lowering the price on generic drugs is of no benefit at all to the person in desperate need of heart medication that is available only in high-priced brand name form.
And yet the pluralist mode has failed to change policy as well. The outcry is growing for a change in policy that would result in allowing for the purchase of cheaper drugs from Canada, but rather than responding to that political activism positively, legislation has been moving toward tightening rules. The neopluralist tradition looks at needs from the supply and demand point of view and inserts a curveball. Yes, needs will be met, but it will only be after the needs of those in power and with influence are met. Free enterprise, unfortunately, doesn’t stop at the halls of Congress. In fact, the free enterprise system is welcomed into Congress by doormen and led straight to the offices of the most powerful members.
Congress makes the legislation that determines the greatest needs for which policy is established. Currently vis-à-vis the war over affordable pharmaceuticals there are two sides: patients needing medication and pharmaceutical companies desiring to maintain their high profits. The war between the two is being fought on the battlefield of influence. There are obviously strains of pluralism at work; needs transformed into political action have resulted in lobbyists calling for afford-able medication or access to Canadian drugs. Pharmaceutical companies respond in kind with their own lobbyists demanding the exact opposite. Where the neopluralism raises its ugly head is in the fact that policy under this system is essentially for sale to the highest bidder. In a perfect liberal tradition, the greatest need would clearly be for those who will either go without food or go without medication. Apparently, however, America seems to be operating much closer to a neopluralist system.
The neopluralist theory of claims-making rests on the assumption that the claim for a need will be determined by influence. But it still doesn’t suggest that influence won’t make a valid case for need. For instance, the decision on whether or to lessen the burden faced by those who can’t afford medication is influence by the argument from the US pharmaceutical companies that Canadian drugs might not be as safe since the US Food and Drug Administration has no way of overseeing them. Regardless of one’s opinion of the true merit of that argument of the reasoning behind it, it does contain value. The neopluralist tradition is far from admirable to be sure, but at least it does consider the possibility that actual needs will be met.
But is that necessarily the case? Could policy decision made by governments-even democratic governments-actually take place within a system in which real needs are not met? The Marxist traditions considers the very idea of demand always being met by supply in one way or another as the great falsehood. Policy is made by those who stand to gain the most from the very decisions they make. Only the most optimistically naïve would believe any differently. If policy is made by the Congress, it’s a sure bet that the policy decisions aren’t going to be obstacles to their getting what they want. Rarely do those in power in any system of government purposely hurt themselves in order to benefit the poor or oppressed.
The Marxist view of meeting needs is one in which the elite struggles continually to create an illusory need for the masses in order to create policy that works to the benefit of the true needs; that is, of course, their own. Consider the war on terror. Following the tragedies of 9/11 the government did everything in its power to facilitate the pervasive sense of fear among the American people. The fact that only two cities were targeted and that few people ended up dead than die from smoking-related incidents in any given year was conveniently overlooked. To be sure, in the days following the tragedy there truly was a paranoia that America could find itself under attack at any given moment. And the federal government quickly jumped on that opening to create an entire system of policy.
The Marxist tradition would look at that in terms of creating a false consciousness. Every single policy decision since 9/11 has been related to security issues and the fear of terrorism. Civil rights have been restricted and gargantuan sums of money have been budgeted for security reasons. The Marxist view would state that the invasion of Iraq is an example of how policy was shaped to distract from actual needs by creating of a false needs. The American public supported the invasion of a country that had never attacked American soil, that had proven themselves incapable of beating Iran in a long war, and that had no ties whatever to 9/11. Meanwhile, a host of domestic concerns that daily affect the lives life millions of American have gone unmet. To the Marxist, America in the early days of the new millennium is a perfect example of how policy is not decided based on actual need but rather by created and false need.
The cornerstone of the Marxist theory on policy decisions is that people support policy that is contrary to their own best interests. This may be why Marxism has had such a hard time winning over its critics; most people don’t like to be told they don’t know what’s good for them. Unfortunately, it appears to be all too true in many cases. Despite the fact that many people cannot afford health care or pay for medication there is still a deeply harbored suspicion about socialized health care in this country, despite the fact that the US remains the lone holdout among developed countries not to embrace some sort of universal health care system. Is it in the best interest of Americans to pay $40 for an aspirin inside a hospital, or to pay $500 a month in health care insurance? Do Americans willingly accept and support policies that are completely oppositional to their own well-being?
The evidence suggests that just as the liberal, pluralist and neopluralist theories all have a stake in policy making in the American system, so does the Marxist. It is true that millions of Americans fervently support and even fight for policies that are not in their best interests. Witness the overwhelming support of wars in Korea, Vietnam and Iraq. And it is true that very often policy decisions that move to the top of the public consciousness are not those that directly affect the most pressing needs of the majority. Witness the outcry over immigration reform, which is basically a localized subject. But it is also true that in the free enterprise system a great many needs are met when demand rises to a high enough level. In another system, there may not even be access to lower price generic drugs, for instance.
Equally true is the fact that the democratic system in America is still strongly enough in place that a need that is transformed into political action can result in policy changes. For almost two century there was a desperate and quite obvious need in this country for an enormous segment of its population to be treated equally. The demand was certainly there and the ability to supply that demand was there, yet it went virtually unmet. Then it transformed into powerful enough political action that it resulted in almost the ultimate policy changing device in America: an act of Congress. In this case it was known as the Civil Rights Act. It is also true that the elite still maintain the balance of power in America and that policy will continued to be shaped by the influence of those who have the most money and access to politicians. Policy is usually-but by no means always-shaped by need in America, but the bigger problem may be that all too often the needs that shape policy are not decided on what is the most pressing demand, but on who can pay the most to advertise their demand.
