All Together Now

                                   By Mike Koetting          April 24, 2018

This post wraps up, at least for now, my on-and-off again posts on what I consider the three most pressing issues facing us—inequality, the environment and the nature of work. Since I think these are the most important issues for our time, I am sure I will return to them. But before I jump to other topics, I wanted to make sure the connections among these three issues were spelled out, especially given the fragmentary way in which I have posted them.

To me, these are not separate issues that can be addressed independently. One of the many reprehensible things about current Republican positions is that they set these issues against each other—attacking environmental standards claiming it is necessary to create jobs, or suggesting that increasing inequality actually creates jobs.

I don’t deny that there are tensions among these goals, or indeed any set of goals. But preserving the environment is the North Star by which we must steer. Environmental degradation leads to a downward spiral where achieving all other goals becomes ever more difficult.

Lessening inequality is critical as a goal in its own right, but it is essential to adopting global policies that protect the environment: it is impossible to build sufficient support for protecting the environment if large populations feel such protections would be achieved at their expense. We see how this plays out in the United States. People at the bottom of the income distribution are sometimes skeptical of environmental causes because of concerns that regulations are a benefit to the upper class while their own needs are being neglected. The same dynamic holds world-wide. People of Brazil aren’t interested in stopping deforestation to protect the American environment as long as they feel we want to keep ours by preventing them from getting their share.

Restructuring our approach to jobs is necessary because the current capitalist system can clearly generate endless profits for the elite while cutting more and more people out of the labor market. Toss in the problem of absorbing the huge untapped work force in other countries—to repeat, they feel they are as entitled as US workers—and you’re looking not only at global unrest but endless temptations to increase long run environmental risks for short run gains in employment.

In short, these three priorities must be undertaken together.

A World of Three Zeros

Well after starting this series of posts, I read a book by Muhammad Yunus. He’s the founder of the microcredit movement, a Nobel laurate, and by any accounting a first-rate mind put in the direct service of making the lives of poor people better. The full title of the book is A World of Three Zeros—The New Economics of Zero Poverty, Zero Unemployment and Zero Net Carbon Emissions. You can see why this would resonate with me.


The core of his argument is that the capitalist framework is insufficient. Not that he is a socialist; he explicitly disavows socialism and greatly values the dynamic contributions that private business makes to human condition. Rather, he argues, the current understanding of capitalism is too narrow to encompass the human essence, based as it is on the assumption that Capitalist Man is motivated solely by personal gain-seeking, which he suggests it is only one aspect of humans:

Human beings are not moneymaking robots. They are multidimensional beings with both selfishness and selflessness…Traditional economic thinking…says that selflessness cannot be part of the business world….

Explicitly removing selflessness from business leads to the current malaise of capitalist societies. His solution is the development and spread of “socialbusinesses.”  By social businesses he means businesses that are not designed to be profit-maximizers, but meeting-human-needs maximizers.

Investors who provided capital to launch the businesses were able to get back their initial investments, but nothing more. After the invested amount was paid back to the investor, any profit earned by the companies was plowed back into the companies for improvement and expansion, so that more poor people could benefit.

I am less sanguine than Yunus that this construct by itself can result in the three zeros. (Remember, it is the sworn duty of this blog to make sure no “simple” solution goes unchallenged.)

First, I am worried about scale. There are almost 8 billion people in the world. That’s a lot of people and their number is growing and the environment isn’t. We need to move quickly. How can these social businesses get to realistic scale in time? I also wonder about the extent to which getting to scale winds up invoking organizational behaviors that are very similar to those found in “for profit” businesses.

Second, I am worried about the basic construct—what are the boundaries of “not for profit”? Consider the example of many American hospitals (often, now, health systems). While technically “not for profit”, I don’t think they are what Yunus has in mind. “Profit” is not something that is measured solely by the payout to investors; it can be marbled throughout to the participants in the enterprise. The idea of “selflessness” will have to extend not just to investors, but to all the participants as well who will have to agree to limits on their compensation.

Third, the transitions will be difficult, particularly in developed countries. The entire social order of these countries is geared to achievement of material rewards. These are valued not just for conspicuous consumption—however much there is of that—but because material rewards are necessary in order to educate your children, fully participate in cultural activities, and, indeed in some capitalist societies, to guarantee basics of housing and healthcare. It is not that there couldn’t be alternatives. But I do not think Yunus is realistic about the sacrifice necessary to get from here to there.

But It’s Still Worth Reading

My concerns notwithstanding, I strongly recommend this book because it does get so much right.

We have become sufficiently numb to the profundity of the problems of advanced capitalism that we find it hard to think about anything other than solutions around the edge. Likewise, for many reasons, we have come to accept the inevitability of some form of liberal capitalism as the driving economic paradigm of our world. Yunus suggests—really, kind of shouts it—that these are both wrong and potentially fatal to society.

It is hard to argue the fact that advanced capitalism increases inequalities, erodes the environment and severely stratifies the opportunity for meaningful work. The value of Yunus is that he reminds us that the problem is fundamental, not a result of particular times and circumstances. If we’re honest, there is really no reason why the current concept of capitalism will lead anywhere than what we see today—a bitterly divided world with lots of opportunities to become more so. It’s a bucket of cold water, but perhaps a useful shock to the system.

On the other hand, Yunus sees many reasons for optimism, which is another reason to read the book. One particularly hopeful note is around young people:

They do not regard “the system” as sacred….They judge the system by the results it produces, and on that basis they consider it flawed. On the other hand, they are not embracing any of the alternative ideologies once proposed as replacements for capitalism, such as socialism or communism. They view those systems as equally flawed. Instead, they are eagerly seeking a new approach…They are looking for ways to make themselves useful to the world.

Maybe that’s what all of us are looking for, a way to be useful. We surely appreciate the things that money gets us and we recognize that many capitalist constructs have moved the engines of progress forward. But as we look around, we realize that something is missing because our economic engine fundamentally exults the triumph of some people over the majority. This is a far cry from an economic engine that is explicitly designed to make everyone feel useful and, in the process, help everyone, and the planet, survive and thrive.


The title of today’s post, “All Together Now”, in addition to being a Beatles song, was borrowed from the title of a radio show that my friend Charlene Spretnak used to do around these and other issues. Another friend, Helene Dudley, encouraged me to read Muhammad Yunus. Thanks to bot

Author: mkbhhw

Mike Koetting’s career has been in health care policy and administration. But it has always been on the fringes of politics. His first job out of graduate school was conducting an evaluation of the Illinois Medicaid program for the Illinois Legislative Budget Office. In the following 40 years, he has been a health care provider, a researcher, a teacher, a regulator, a consultant and a payor. The biggest part of his career was 24 years as Vice President of Planning for the University of Chicago Medical Center. He retired from there in 2008, but in 2010 was asked to implement the ACA Medicaid expansion in Illinois, which kept him busy for another 5 years.

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