In the coming battle, the right, having abandoned welfare capitalism and faith-based institutions, is likely to unite behind the libertarian voucher policy, while the Democrats will be split three ways among neoliberals, who are inclined to unite with the right in favor of vouchers; social democrats, who favor an expansion of universal middle-class programs; and what Mike Konczal calls “pity-charity” liberals who want to cut spending on the middle class to fund bigger means-tested programs for the poor. Far from being a victory for progressives, the Supreme Court’s decision in the Affordable Care Act opens the door to the voucherization of Social Security and Medicare, by means of individual mandates to purchase private retirement and healthcare goods and services.
To make matters worse, voucherization promises an endless stream of guaranteed profits to the CEOs and shareholders of private for-profit companies that would replace the public Social Security and Medicare administrations and extract income from Americans forced by “individual mandates” to purchase private health insurance, invest in private stock market accounts, and buy private annuities. The need to pay middlemen with high salaries would drive up the costs of retirement and healthcare, while the recycling of monopoly profits into campaign contributions would deter Congress from regulating prices in the new, voucherized welfare state.
With the right united and the left divided, and big money favoring the privatization of America’s welfare state, the prospects for an expansion of universal tax-based middle-class social insurance in the U.S. are not good. Which is a tragedy for America, because universal public social insurance is by far the most efficient and least corrupt way to design a modern economic safety net.