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Published by: Crowdsourcing.org on Jul 20, 2012
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JULY 19, 2012
Posted bySteve Coll
About six years ago, Netflix offered an award of $1 million to anyone who couldmine its database of customer-provided
movie ratings and improve the system‟s
overall accuracy by more than ten per cent. Many people tried. In 2009, Netflixawarded the prize, in the form of stock, to one participant.David Bollier, writing for the Aspen Institute last year, cited the contest as alottery-like, high-reward example of crowdsourcing, which is one of the ways that
computers and connectivity are changing how work gets done. “People no longer need to work through organizational hierarchies to do important work,” he argued.“Because
they are connected electronically, they can undertake „small activities‟on their own, without authorization, and still have significant, often global impact.”
 The New America Foundation, the think tank where I have worked for the last fiveyears, was one of the places where scholars first fixed on the use of an individualmandate to buy health insurance as a way to address the economic and moralproblem of large numbers of Americans who lacked insurance, and therefore,health and economic security. These scholars were focussed in large part on theproblems of equity and access to health services. Yet a futuristic vision of work and mobility in post-industrial America also influenced them. And this expectationof a coming age of connectivity, mobility, and empowered individuals
comes more into reality each year
 —is a reason why the Supreme Court‟s decision
to uphold Obamacare will be transformational in ways that are hardly ever noted.The fact that most Americans of working age receive their health insurancethrough their employers
a system that has lately produced too many peoplewithout any insurance at all
is an accident of history and an anomaly amongindustrialized democracies. It reflects a twentieth century America of factories andassembly lines, some of them scaled up massively to fight the Second World War.The conventional wisdom at mid-
century held that “the best way to harness human
talent is through full-time, exclusive employment relationships where people arepaid for the amount of time t
hey spend at a common location,” wrote MichaelChui, a fellow at the McKinsey Global Institute. Employees should also “be
organized in stable hierarchies where they are evaluated primarily through the
 judgment of their superiors.”
 The story of how health insurance ended up as a common benefit of working in abig private or public-sector organization (and overtook the drive for otherinsurance schemes, such as a Medicare-like single-payer one) is long and tangled.By 2000, however, the system had produced a gap that no longer lookedsustainable, at least not to many Democrats
tens of millions of uninsuredAmericans, many of them poor, who died early for lack of preventive care andwhose visits to emergency rooms and other uncovered expenses imposed highcosts on everyone else. The individual mandate was chosen to address this problembecause it fostered a market-led approach in which insurance companies couldbenefit, which attracted Republicans like Mitt Romney, when he oversaw theenactment of such a plan while the governor of Massachusetts.The mandate idea was also responsive, however, to the collapse of the mid-century, employment-for-life corporate workplace. The new system would makehealth-care insurance portable, so that a father who wanted to work part-time to bewith his children, or a new entrepreneur who wanted to take a flyer on a new idea,could temporarily restructure their working lives without falling through the healthsafety net. (A single-payer system also would have been responsive to more mobilework, but it was seen as less politically viable.)Global economic forces have made this portability of insurance more and moreessential for reasons that have less to do with aspiration and creativity.The worldwide mobility of capital, factories, and information that is shorthanded
as “globalization” has meant that American factory workers, for example, have had
to compete with Chinese and Bangladeshi workers in ways they never had to in thenineteen-fifties. This integration
coupled with campaigns by business againstlabor unions, the normalization of temporary and contract workers, and otherfactors
seem to have suppressed American wages over the past two decades, inmany fields.
The same system unduly rewards those at the very top. Because Kobe Bryant‟s
 jersey is hugely popular in China, his wages exceed even those he could commandif he were only, at times, the best basketball player in America. And so we getmore inequality
the middle and the bottom of the work force slide graduallybackwards, and the very top separates and rises quickly.All of this is pretty well understood by now, and agreed upon, even if Republicansand Democrats (and the Tea Party and the Occupy Movement) have completely
different views about how much it matters and what should be done. We‟ll hear a
lot about these themes when Obama and Romney debate in the fall. The reason
Obama‟s attacks on Bain Capital, which in their tone and technical charges
involving Securities and Exchange Commission filings can sound likedemagoguery, are in fact legitimate is because
Bain‟s history is a proxy for the
larger debate about why inequality is increasing and who gets hurt.Economic insecurity is less often discussed than inequality. It is not the same. Forthe last couple of years, Jacob Hacker, a political scientist at Yale, has led a seriesof studies into economic volatility experienced by American families. Hacker andhis team have created an Economic Security Index, which measures, over time,what percentage of Americans lose at least a quarter of their available householdincome because of job losses, medical spending, or other shocks. The percentagehas risen substantially between 1986 and 2010, they have documented.This is where Obamacare matters. It will raise the number of insured individualsand families
by exactl
y how much, we‟ll see, but a lot. By doing so, it will make
American family life less volatile and insecure. Rising medical costs
more than aone-third increase in median costs
are a factor in household insecurity, althoughit less important than job loss. About a quarter to forty per cent of all personalbankruptcies are caused by the shock of unmet medical costs, according to a 2005Harvard University study.
Obamacare won‟t address this just by extending insurance to those who could not
obtain it. Over time, the new system would also have to reduce total health-carecosts as a percentage of household income and raise the number of people who live

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