WHAT IS AT STAKE IN THE 2000 CAMPAIGN?

In Salon.com, the Internet magazine, some thoughtful and well-known people were interviewed to give their impression of what's at stake in the upcoming presidential election. Of all the replies, this one seems to be making the most sense. It is from Robert Reich, Secretary of Labor under Clinton, who wrote "Locked in the Cabinet."

He says,

"What's at stake? Whether the nation is going to take its extraordinary prosperity and reinvest it in

people who haven't been on the rising escalator. Whether we'll put it into their education and their health, and thereby let them on board."

In saying this, he is trying to bridge the gap between the haves and the have-nots. This struggle between them has been going on since the Stone Age. Some people are better at providing for themselves, and though they live in abundance and security, many are unwilling to share their wealth with those who are unfortunate and disadvantaged. When asked to contribute to the poor, Scrooge asked weren't there workhouses and prisons? Most Americans adhere to the Judeo-Christian ethic, which says, "Love thy Neighbor", but in everyday life it's hard to consider the mass of humanity our neighbors. We have learned to mind our own business. The government and charities have been given the task of helping the poor. Donating to charities is voluntary. Paying taxes is involuntary.

And here is the difference between the liberals and conservatives--- for the most part the Democrats are in favor of entitlements to the disadvantaged, paid for by government taxes, while the Republicans would prefer to have the freedom to direct their charitable intentions wherever they want, and in amounts of their own choosing.

Here Reich points to an area where the haves and the have-nots have widely varying access to basic and specialized medical care.

"The biggest problem we have is the lack of universal health care -- the single largest missing item on America's unfinished social agenda. We haven't repealed the business cycle. When the economy softens, as it inevitably will, and unemployment rises once again, we'll be totally unprepared. We've ripped out the safety nets -- welfare, low-income housing, unemployment insurance (now available to only about a third of people who lose their jobs) -- and put almost

nothing in their place. This will be the first large domestic challenge faced by the new president."

I am sure most of us would want no American to be denied excellent medical care, just because they don't have the money to pay for it. Reich seems to be sure that if the voters realized the gravity of the situation to poor Americans, they would be willing to pay some extra taxes to bring about universal health care. This would probably involve a single-party payer, the government, which brings the specter of over-regulation to physicians and other medical-nursing workers.

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Reich goes on to say,

"I'll be very angry if George W. Bush is elected president with only a small portion of the adult population of the United States voting, and Bush's huge wad of campaign cash having blanketed the airwaves with mindless advertising. I'll be happiest if Bill Bradley is elected president, in part by a significant number of people who never bothered to vote before or haven't bothered for years, and a clear mandate for universal health care, better education for poor kids and an end to the

scandal of campaign finance."

He seems to be putting a lot of faith in Democrat Bill Bradley, who is making a case for universal health care, no matter the high cost. He feels the cost will be more than worth it, as health in and of itself is worth pursuing, and is for the common good. At this point, even many doctors feel ready to risk "socialized medicine" in order to return to higher standards of medical care which they learned in medical school.

Reich's current favorite idea is a controversial one: offering tax cuts to encourage corporations to treat their workers better. Reich first broached the concept in the wake of AT&T's announcement in January that it was firing some 40,000 workers; IBM, Boeing, Sears, GM and many other blue-chip companies had previously executed similar cutbacks. Lamenting these job losses in an Op-Ed article in the New York Times, Reich pointedly asked, "Do companies have obligations beyond the bottom line?" Reich argued they did and made his case by exploiting a favorite theme of Bob Dole and other Republicans: If entertainment companies are expected to forego the profits of lewd and violent programming in the name of social responsibility, "what_ about a corporation's duty to its employees and its community? The sudden loss of a paycheck can be more damaging to family values than a titillating screen performance."

Reich seems to be making a lot of sense. One can only wonder whether die-hard conservative-Republicans will continue to relentlessly oppose measures to level the playing field. One articulate conservative of my acquaintance has this metaphorical response. He says that leveling the playing field would be akin to bull-dozing mountains. He prefers the view of mountains-and-valleys to that of the level plain.

Dr Bloom is Clinical Associate Professor of Psychiatry, Wayne State University School of Medicine. He is a member of the American Academy of Psychoanalysis and on the editorial board of the Wayne County Medical Society. He welcomes comments at his email address---vbloom@comcast.net.