As I look at the healthcare debate the one thing, the one single theme that dominates the opposition to reform is not ideology or economics or politics. It’s corruption – the failure of political process and the negation of the public interest because of the propensity of those in positions of authority to seek personal gain through outright graft, cronyism, patronage, and the abuse of campaign financing. I am not saying that all of these practices are necessarily even illegal, but they are, nonetheless, part of a culture of corruption.

So how does our country stack up in terms of corruption? How concerned should we be that the public will is being thwarted by corrupt politicians, corporations, and media elites? A superb organization called Transparency International tracks public perceptions of corruption around the world. It publishes an annual survey called the Global Corruption Barometer, which, through surveys, attempts to measure the extent to which residents of various countries perceive six key sectors and institutions in their respective countries to be corrupt. For each sector or institution surveyed, responses were rated on a scale of 1 = not at all corrupt to 5 = extremely corrupt. In 2009, 73,000 people around the world were surveyed. The survey results are surprising resilient, without extremes (so even slight differences on the scale may be regarded as evidence of problems).

The survey may be downloaded here:
http://www.transparency.org/policy_research/surveys_indices/gcb/2009

The results ware indeed sobering if one focuses on the five of those sectors and institutions most pertinent to healthcare reform and other US political decisions: political parties, legislature/parliament (Congress in our case), business and the private sector, and the media.

(1.0=not at all corrupt, 5.0=extremely/completely corrupt)

POLITICAL PARTIES: Americans give their political parties a score of 4.0 out of 5.0, versus 3.7 average for European countries as rated by their own citizens, 3.9 for Asia-Pacific, 3.9 for the entire world, and 3.5 for Canada.

LEGISLATURE/PARLIAMENT: Americans give Congress a score of 3.9 out of 5, versus 3.4 for Europe, 3.8 for Asia-Pacific, 3.9 for the world, and 3.5 for Canada.

BUSINESS/PRIVATE SECTOR: Americans give their corporations a score of 3.7 out of 5, versus 3.4 for Europe, 3.5 for Asia-Pacific, 3.5 for the world, and 3.4 for Canada.

MEDIA: Americans give their media a score of 3.7 out of 5, versus 3.3 for Europe, 3.0 for Asia-Pacific, 3.2 for the world, and 3.1 for Canada.

In each case, American scores more closely resembled that of developing countries in places like Africa, Latin America and the ex-Soviet Union than that of virtually any of our comparably developed advanced industrial peers in Europe and Asia.

A separate question asked how citizens rated their governments efforts to fight corruption. Here the results were even more stunning:

73% of Americans rated government efforts to control corruption in their country to be ineffective, versus 56% in Europe, 62% in Asia-Pacific, 56% for the world, and 63% for Canada. This seems to be saying that 73% of Americans lack confidence in the fundamental effectiveness of their government to operate in a transparent and honest manner.

Let’s be clear about what this all means. Corrupt states are failed states. Their citizens feel they have little say in the policies that control their lives because those in positions of influence are not responsive to their needs or wishes. Their public institutions fail to serve the public interest. Corporate lobbyists set policy as a function of the bribery budgets of their clients and not as a result of informed debate. Urgent social problems are left unsolved because to resolve them would diminish the personal interests of the rulers. The cost of living or doing business spirals out of control because of the waste of resources required to pay off the corrupt. People are neglected. They suffer and die.

These findings hint at just how deep the rot runs in our country today, and gives us important clues as to why lies, deception, and demagoguery prevail in our struggle to reform healthcare.