RSS Feed MenuTens of millions of Americans lack health insurance. Extending coverage to them has been a core goal of health reform proposals since the 1960s. President Richard Nixon offered a universal health plan in his first administration, but since then Republicans have hesitated to commit the nation to so costly an undertaking. Is it time to rethink? Should Republicans accept universal coverage as a goal? We posed this question to NewMajority’s contributors.
Eugene V. Debs — a “Democratic activist” who chooses as his pen name the name of an open socialist, and not one of today’s cuddly European socialists, either, but a socialist back in the days when socialist and Marxist were the same thing — tries to shame us Republicans into supporting nationalized healthcare: Why, it’s just us, Turkey, and Mexico without nationalized healthcare. “In every other advanced capitalist country” they’ve drank the Kool-Aid. Well, don’t I feel chagrined, not to be in the company of Cuba, Peru, the People’s Republic of China, Russia, Saudi Arabia, the Ukraine, and all those enlightened, prosperous countries with nationalized medical delivery systems. In Germany, the health delivery system was nationalized by Bismark. Spain implemented national health insurance under Franco, Austria adopted it under Nazi rule in 1939, as did the Italians in 1944. Makes you wonder what Mr. Debs has against the Turks, who are, in fact, one of my favorite people. As Mr. Debs eventually notes, “even a dictatorship like Singapore provides universal care.” Personally, I never thought that the fact that “even” a dictatorship did something was really a selling point for government action. Anyway, I suppose that Mr. Debs’ argument was used a lot during the revolution: There were the Tories, angrily denouncing their more adventuresome countrymen, “in every other advanced country they have a king.” So, case closed, I guess.
Now can we discuss this seriously?
Well, no, I guess not. Mr. Debs raises straw man after straw man: “Why even conservatives elsewhere embrace universal coverage.” Then we get some horror stories, only they’re not even real ones, just fictional. Sheez, Eugene, surely you can do better than that. I can come up with some horror stories of people denied care in just a few minutes. Of course, horror stories can be found in every country, and horror stories about people denied care in “universal coverage” nations abound. It is true that in countries such as France, Germany, and even the UK (I appreciate that Mr. Debs agrees that we ought to say “even” the UK, a subtle reminder of the failures of the NHS) most people are happy with their coverage — but of course shouldn’t he admit then that here in the good ole’ U.S.A. most people are happy with their care, too? To use his own phrase: Who are you going to believe Mr. Debs, “me or your lyin’ eyes.”?
And we’re told that if we really believed we shouldn’t endorse a government mandate of what Mr. Debs calls universal coverage, then we should repeal the law requiring hospitals to provide medical treatment to all comers in the E.R. Of course, that doesn’t follow, any more than opposing an expansion of Social Security or welfare or unemployment or workers’ compensation necessarily indicates a desire to abolish the whole system. (Holy moly, Democrats are opposing an increase in military budget – they must want to abolish the armed services! Are they crazy!) Mr. Debs also seems to take his anger about America’s emergency room policy out on me personally — that coverage isn’t good enough, so he’s mad, apparently, that I even brought it up. But if we are going to discuss universal coverage, that is part of the picture, isn’t it? Why don’t the liberals ever mention this? I mean, if some conservative says, “All Americans have coverage, Mr. Debs would jump in, wouldn’t he? “No,” he would say, “about 15% of Americans lack health insurance.” Well, isn’t the reality — the problem we are asked to deal with — that most Americans have very good insurance with which they are very satisfied, but a minority must rely on emergency room care? If we can’t even state what current U.S. policy is without a nasty, personal, rebuke from our resident socialist (or maybe just “Democratic activist”), how can we honestly discuss the problems with that system.
Meanwhile, the straw men keep coming – such as the one that anyone said that ER care was “consonant with real insurance.” Or the one that it is hypocritical to oppose a massive government scheme unless we are willing to have crummier insurance ourselves. I’m not sure I follow that, either.
And all this is necessary just to clear away the detritus. No wonder this debate never gets anywhere.
If we want to talk healthcare reform seriously, we need to lose all the self-righteousness, the nasty, smart-ass tone, the non-sequiturs and straw men. I am all in favor of expanding health coverage. I believe that we can have health insurance for basically all Americans, and that there are many ways to do it, but I think – as I said in response to the original question – that it is bad policy and bad politics for the GOP to suddenly endorse universal health coverage. I believe that one thing that makes the United States a superior place to live is that we have NOT followed our industrialized neighbors in their policies in this area. I believe that the more capitalistic, individualistic, lower tax atmosphere of the United States is good for America and good for the rest of the world, which benefits from our dynamism. I believe that the U.S. and its people have benefited from not having the type of system Mr. Debs wishes to impose on us, and I do not believe that the peoples of Europe have benefited from their efforts over the long term, once all factors are taken into account.
But then, why should Mr. Debs and I agree on this big picture? I’m a Republican interested in bringing my party back to power, and supportive of economic opportunity, limited government, and freedom. Democrats tend to be more interested in security and equality than in freedom and opportunity. Nothing inherently wrong with that — security and equality are pretty important to most people. But Mr. Debs is a self-identified Democratic activist, and given his chosen moniker, possibly a socialist/Marxist. He is almost certainly not interested in seeing Republicans retake power, and probably is not as concerned as I am about freedom, opportunity, and limited government.
All that said, now, Mr. Debs, would you like to seriously discuss nationalized healthcare and its alternatives? And if so, please let us begin by agreeing that it is OK to state what current policy is; and that “everybody else is doing it” is worthwhile knowing — it may lead us to ask why — but it is not, strictly speaking, an argument for us to do it.
To read other contributions to this symposium, click here.
NM Symposium Part 2: Universal Coverage: Right Goal, Wrong Principle? // Aug 25, 2009 at 12:19 pm
[...] Smith, Universal Coverage: We Need a Better Reason than “Everybody Else Does It” Eugene V. Debs tries to shame Republicans into supporting nationalized healthcare as conservatives [...]
debs // Aug 25, 2009 at 1:18 pm
It isn’t that ER “coverage isn’t good enough.” It’s that it isn’t coverage as any sentient person would understand the term–and as you surely understand the term with regard to comparing it to your comprehensive health insurance (which is why the personal reference is entirely relevant). It’s an apples to oranges comparison to hold up our ad hoc ER services for the uninsured with what countries from Canada to Taiwan to France to the Netherlands offer their entire citizenry–or what you and I have from our employers. If you don’t acknowledge that, you are either ignorant or cynical. I think you are cynical.
Nor is the point that most Americans, like most people in Canada in Western Europe, feel fine about their health insurance coverage. The point, rather is that: a) American health insurance, for those under 65, is slipping away–only 59% of Americans are now covered by private employers, a decline from 65% of just a few years ago. The system is unstable and fragmented; b) The European and Canadian political and intellectual classes–and the vast majority of their citizens–no matter what complaints they have with their own health care models, *never* think to themselves, “Gee, I think we ought to try the fragmented, incomplete U.S. model, under which 700,000 people underwent bankruptcy because of healthcare costs last year, and 15% lacked health insurance altogether (yes, yes, but their cancer is covered in the ER!!)”
One point about the UK, though: It’s not surprising that their health outcomes are somewhat worse than ours. But that has nothing to do with their delivery system, and a lot to do with the fact they *only spend 40% as much as the U.S. does on health care.* Yet, they cover everybody, and 10% of the population buys supplemental coverage and gets private hospital service, etc. In short, UK health care is a bargain and covers the entire population–and did keep Stephen Hawking alive. Imagine if they spent more (as they should, in fact). We spend more than everybody by a large margin, yet “ration” by income and wealth, as the two stores below, and countless others underscore. ( Oh–I forgot about all of that excellent, sustained cancer/cardio/diabetes care that the uninsured get from just their one visit to the ER. You can get a lot of chemotherapy from just an hour in an ER, right Mr. Smith? A lifetime’s worth, as it were, in your view. And there are so many oncologists lined up in waiting room waiting to take the cases of the uninsured? Isn’t that your experience with the ER, Mr. Smith?)
More later, if I can summon the energy to address this risible farrago of bad faith, misstatements, illogic, and a callousness that chills the soul. But, yes, you’re right about one thing, Mr. Smith: My argument had nothing to do with GOP political fortunes. I naively thought that the sheer peculiarity of American conservatives vis a vis other conservatives, let alone other advanced nations (and why you bring up countries like Cuba when I specifically limited my comparison to the OECD countries is, again, incoherent and irrelevant–nor is it relevant what the origins of these policies are. So, fine, Canada, Taiwan, the Netherlands, Sweden, and Switzerland derived their policies from entirely benign democratic procedures–happy now? What the hell is your point? Is this another of these idiotic “liberalism=fascism” axioms that your lesser lights have been trotting out?) might give people like you pause–but, no, you exult in your stupendous cruelty! You don’t want hypothetical arguments about poor people with ALS–they amuse you–you want the real thing! Those would be–what–even funnier? (Ok, see below). You may well “win” this fight, as you have every other fight against universal health insurance coverage in this country. Your pleasure in so doing is perverse.
Here–real stories, just like you requested. To be blunt: Not that you give a shit.
http://www.thenation.com/doc/20090427/michelman
http://www.guardian.co.uk/society/2009/aug/21/healthcare-provision-us-uk
debs // Aug 25, 2009 at 1:45 pm
Oh yeah, one more thing: You write, “I do not believe that the peoples of Europe have benefited from their efforts over the long term, once all factors are taken into account.”
How exactly have the Europeans (lets throw in the Canadians, the Japanese, and the Taiwanese, too) *not* benefited over the long term? Seriously: Their people are all covered. The health outcomes are roughly equal to ours (see the report below), in some measurable ways slightly better, in some measurable ways slightly worse, in some measurable ways, about the same. And they *all* spend less as a % of gdp–all of them, every single one, by at least one third, but often by around half. So no matter what fiscal issues they are dealing–and, yes, they are dealing with them–they are less pronounced than the ones we are dealing with in the United States. Oh, one more thing: In every one of these systems that I am aware of, the patient gets to choose his or her doctor. In fact, in the U.S., with the proliferation of HMO’s , that is often *not* the case, or, with PPO’s, not the case without a financial penalty (such as the one I pay with my health care).
So: What on earth are you talking about? You just assert this as if it’s blindingly obvious. Not only is it not blindingly obvious, it’s facially absurd. You don’t have any lucid argument to make whatsoever that would support this contention–zero, none. If you’ve got one–in the face of health care the equal to the United States, provided to all citizens, at a cheaper cost, and allowing patients to select their own provider (whether under single payer, e.g. Canada, France, or private insurance, e.g. Netherlands, Switzerland)–make it.
debs // Aug 25, 2009 at 1:51 pm
Apologies here is the report on international health outcomes I referenced above:
http://www.rwjf.org/files/research/qualityquickstrikeaug2009.pdf
debs // Aug 25, 2009 at 2:19 pm
And this: Our readers, regardless of ideology, should understand that your argument operated from bad faith almost from their very first word. I specifically compared American health insurance policy to that of the members of the Organization for Economic Cooperation and Development (OECD). Here they are:
The 30 member countries of OECD are:
Australia, Austria, Belgium, Canada, Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Japan, Korea, Luxembourg, Mexico, the Netherlands, New Zealand, Norway, Poland, Portugal, Slovak Republic, Spain, Sweden, Switzerland, Turkey, United Kingdom, United States.
And this is what you write:
“In every other advanced capitalist country” they’ve drank the Kool-Aid. Well, don’t I feel chagrined, not to be in the company of Cuba, Peru, the People’s Republic of China, Russia, Saudi Arabia, the Ukraine, and all those enlightened, prosperous countries with nationalized medical delivery systems.
Readers will observe that Cuba, Peru, the People’s Republic of China, Russia, Saudia Arabia, and the Ukraine are not part of the OECD. The OECD is composed of countries that might be called the closest to being peers of the United States. Mr Smith, thus it’s noteworthy that, of that group, we stand with two of its poorest members and least democratic members, Mexico and Turkey, in not providing health insurance to all of its citizens.
In short, from the first paragraph, your remarks were intellectually dishonest.
Brad Smith // Aug 25, 2009 at 3:08 pm
Struck a nerve here, I guess. Let’s respond to the outraged Mr. Debs’ comments more or less in the order they occur:
First Mr. Debs argues that no “sentient person” would understand ER care as healthcare? Wow, they must have really, really bad ERs in Washington. Again, I am just stating the reality of the situation. Look, if you want to say ER care is really inadequate and inefficient, I’m with you. I’d like to change that. Mr. Debs, however, seems determined to insist that ER care isn’t health care at all, which is just absurd. It’s not at all apples to oranges to hold up our system of last resort ER care with the systems of the Netherlands and others – it is exactly apples to apples. If it weren’t, how could Mr. Debs know that the other countries he mentions provide better care to their bottom 15%? That’s the point, Mr. Debs – to understand the issue and the politics of the issue, we need to look at how care is actually provided in the U.S. – not at what you would like to be the case, but at what is the case. Then we can assess rationally the nature of the problem, and consider what is to be done.
Mr. Debs then goes off again on how all the really cool places to live have national health care. As in his original post, he gives a whole list of countries – nice places to live – that have nationalized health care, and so concludes we should, too, with the implication that not doing this makes the U.S. a per se inferior place. I suggest that there are also lots of places that have nationalized health care that aren’t so nice to live, and he goes ballistic. Well, fair is fair – you can’t wrap yourself in the warm mantle of the French and ignore the hand-chopping Saudis. You can’t claim that this is somehow something that distinguishes OECD countries from the rest of the world, ignoring that lots of dictatorships and poor countries do it to, and that many OECD countries (including countries such as Spain, Germany, Austria, and Italy) before they were OECD countries. You can’t say that we must debate this on your terms, and suggesting any other analogy is somehow unfair or per se misses the point. That’s not the way debate works, Mr. Debs. In other words, let’s debate the plans on the merits, not on some theory that nationalized health care is essential to democracy, and that not having it limits one to being backwards and lacking, such as Mr. Debs views Mexico and Turkey.
Then Mr. Debs, who by this point is obviously really worked up, makes up some stuff, suggesting that I said that the ER is a good place to get cancer treatment. He puts this in the context of noting that countries with national health care aren’t thinking of abandoning it. But, as Michael Tanner of the Cato Institute notes, “Although no country with a national health care system is contemplating abandoning universal coverage, the broad and growing trend is to move away from centralized government control and to introduce more market-oriented features.”
Then Mr. Debs adds a paragraph of insults to conclude his first response.
But he’s still mad that anyone dare suggest that it is not morally superior to favor his vision for health reform in America, so he adds a second post. He says he thinks that countries with national health care are better off for having it. I, as I noted in my post, disagree. I suspect that those countries, by adopting nationalized health care rather than more market-oriented solutions, have probably sapped their economies, at a considerable cost. This is certainly up for debate, but I’ll put it this way: it’s not obvious to me that France, Germany, Italy, or England are better places to live than the U.S. In fact, I conclude the opposite. There is much, much that goes on here, including many subjective judgements about tradeoffs and more. I don’t try to debate that question because it would go far beyond what we can do here. I am just noting, once again, that the mere fact that other countries do it does not mean that they are superior. We need an American solution that hopefully gives us something even better. I’m sorry that Mr. Debs did not really understand my point, but I can see how he would not grasp that bigger point I was making as it wasn’t obvious from the post.
Then he writes one more post to accuse me of bad faith and being “intellectually dishonest,” again because I refuse to accept the validity of his argument that nationalized health care and being an advanced nation must go together, and that not having nationalized care must go with being in some lower class of nations.
Well, that wasn’t too hard. I’m still willing to have a serious debate on this, one Mr. Debs calms down.
Brad Smith // Aug 25, 2009 at 3:11 pm
I will add that I agree with Mr. Tanner’s ultimate conclusion:
“The answer then to America’s health care problems lies not in heading down the road to national health care but in learning from the experiences of other countries, which demonstrate the failure of centralized command and control and the benefits of increasing consumer incentives and choice.”
http://www.cato.org/pub_display.php?pub_id=9272
I would like to improve health care for the poorest Americans, and indeed for all Americans. I just don’t think that Mr. Debs has the right solution. I am sorry that that makes him think that I must be a bad person. But his invective won’t change my mind.
debs // Aug 25, 2009 at 3:58 pm
Let’s just try two points: First, I compared ER coverage, as you did, to health *insurance* coverage, not to health care, per se. Obviously, it is a form of health care. But it in no way compensates or substitutes for good health *insurance*. Do you deny that? If not, why do you even bring it up in the context of a discussion about providing universal health *insurance*? Emergency ER coverage has zero to do with that issue–precisely zero.
Second, regarding your peculiar remarks about Europe. You’ve moved the goal posts, as you now acknowledge, which I appreciate. In context, the discussion was about the health care/insurance policies in these countries, not about whether they are “better places to live.” As with most questions like that, I suppose it depends on who you are–anyplace is good for the Queen or the president to live, but, I suppose it depends whether you want a bigger house (Americans, on average, live in the biggest houses in the world) or a lot more vacation time (six weeks compared with two for most Americans) whether a middle class person, on average, would prefer to live in France or the U.S., to name just two variables–these are lifestyle choices. About the health care/insurance policy issue, you simply chose not to address my remarks about quality of care, cost, and flexibility, i.e. the ability to choose one’s own provider in these countries. That’s my issue. As a side note: loaded terms referencing how I wish to “impose” this or that policy on the country are witless and irrelevant. We are engaged in free and open debate, and we have a democratic polity and democratic political process–one, in fact, with so many chokeholds in its legislature (bi-cameralism, various committees, an extra constitutional filibuster, presidential veto) that it makes it almost impossible to pass any piece of major domestic legislation in the modern era. But nobody is “imposing” anything on anybody–which is rich anyway coming from a representative of the party of presidential power.
Finally, you equate this terrible system in Europe, by definition, with “nationalized” solution, rather than “market oriented” ones. As I and others have tirelessly pointed out, both Switzerland and the Netherlands rely entirely upon private insurance (as does Germany, but in a different kind of system), yet insure their populations (to within about 1% in the Netherlands and Switzerland). Repeat: these countries provide universal coverage via private insurance companies. This is not about the mechanism of insurance, as I wrote in my first post, it is about the principle of universal coverage. The mechanism is one that people of good faith can disagree about. The larger point is that in our peer nations–and please, enough with the Saudi Arabia/Cuba crap–it is axiomatic to insure everyone. To do anything else would be unthinkable. Then public policy decisions are democratically decided as to how best to do that. Nothing precludes doing so via private insurance, provided everyone is able to purchase it (that means subsidies will probably needed, as well as tight regulations of insurance companies to eliminate adverse selection). But there is no inherent necessary connection between “single payer”, an NHS kind of model, and universal coverage.
What baffles me, frankly, aside from the sheer political utility of defeating Democrats (which I do understand), is why Republicans and Conservatives don’t have their health policy people working on a free market universal program. If Swiss and Dutch conservatives can do this, why can’t American conservatives? I admit I am stunned by the response to David Frum’s query. And more than angry, I am depressed by it. Millions of our fellow citizens are suffering–medically and economically–because they lack what the rest of us have. It is not a material good that they can easily do without, like cars or a particularly nice living space–it can be, instead, the difference between a good life, and a precarious one, or even life and death itself. We all understand this, yet there seems to be so little social empathy in these precincts, and so little intellectual imagination–can Dutch conservatives really be that much more clever than American conservatives? I doubt it.
I think, Mr. Smith, contra your fears, that there will be plenty of freedom left over for all Americans even after the day that all of our countrymen and women have decent health insurance. Indeed, I think there will be more–without the chronic anxiety of worrying about their health care and how to pay for it, all Americans can exercise the freedom the founders wished for them with a great burden lifted from their shoulders.
But, if you’ve read the stories I’ve attached, you will understand that right now, many of our fellow Americans cannot do that. This is a wrong that reasoned, public policy can remedy. The point of discussing analogous countries, rather than impoverished autocracies, is to say that people similar to ourselves have done just that. Somehow, yes, I can’t help but think that if the legions of politicians opposing universal coverage who today, in fact, have their own health insurance provided by the government they so lambaste, were to lose it we would quickly see an solution to this problem.
Yes, that may sound simplistic, but it’s much easier to pontificate about this when your own coverage seem entirely secure and sufficient, isn’t it? To lack that coverage is really a situation that none of us would ever want ourselves or loved ones to be in, is that not so? So, why, therefore, do we not extend that margin of decency to all Americans? We’re not talking about nationalizing Walmart–we’re talking about a unique and uniquely necessary public good, unlike any other, one that every one us is desperately grateful we have–health insurance. (And no, selling insurance across state lines isn’t going to do it–it will just push insurance companies into whatever state sets itself up as a deregulated heaven, the way Delaware did for publicly traded corporations. Truly–no serious health care expert takes this idea seriously, yet conservatives on this list think of it as their main solution to the problem).
Brad Smith // Aug 25, 2009 at 5:24 pm
Reading this comment, it is pretty clear to me that you are not interested in discussing this in a manner that can lead to any serious agreement, primarily because, as you state above, you cannot conceive of good faith opposition. Some of that does go to different visions of life – Mr. Debs, being, I presume, a socialist (Eugene Debs was a socialist) believes that it is perfectly OK to coerce people to do lots of things (such as purchase insurance) that I don’t think that the state should do. Beyond that, there are questions of tradeoffs, and these tradeoffs go beyond health care in a way Mr. Debs seems to have a hard time understanding (for example, one could concede, arguendo, that the French or Swiss model delivers better health care results, but still believe that the other costs it imposes – lower economic growth, for example – make it on net a poor idea). So I will drop from this debate. I see no reason to have my motives and morality questioned repeatedly by someone who won’t do it under his own name.
Suffice to say, as I originally noted, the United States has a very good system. Most Americans are very happy with it. Whenever they have been presented with the trade-offs needed for near universal coverage (as Mr. Debs impliedly notes above, there really is no such thing as 100%, or truly “universal,” coverage), they have decided that it is not a worthy goal. I understand that this angers Mr. Debs very much, to the point, it appears, of considering the U.S. not worthy to stand among the civilized nations of the world (or only at the very bottom, with Turkey and Mexico, whom he apparently doesn’t think much of). For the rest of us, there are things short of adopting a universal coverage principle that can improve the system, and Republicans should continue to pursue those items. Those items do include selling insurance across state lines, but many other options as well, and many of those were discussed in my original post and others on this site.
ottovbvs // Aug 25, 2009 at 5:57 pm
…….How about everyone does it at half the price?
debs // Aug 25, 2009 at 7:23 pm
The trouble, yes, is one of values, but it is also one exacerbated because you make entirely unproven correlations that have no relevance to the debate, e.g. assuming that national health insurance has something to do with a a nation’s rate of gdp growth. I don’t think there is a serious economist in the world who believes that. If there is, s/he would have a hard time understanding why Norway has had higher growth than the U.S. of late, yet has national health insurance. You could pretty much say the same thing about every country in Western Europe at one time or another, and Japan, too, over the past 50 years. Sometimes it’s the other way around and we have more growth than these respective countries do–in short, one thing has nothing to do with the other. More apples and oranges–that’s simply not a serious intellectual remark, it’s pure dogma. In fact, in general there is no correlation between state spending and gdp–you may find this empirical data annoying as it disrupts your tidy nostrums of how the world *should* work, but it’s true anyway.
As for what Americans are presented with, they have been, as usual, presented with a deeply dishonest debate. And the people without health insurance, or who are underinsured–an even larger %–are not at all happy about it, even if their voices are often not heard in this debate. You seem to have abstract issues that deeply color how you believe their needs should be addressed i.e. don’t coerce them, as if the State doesn’t coerce us to do things everyday from paying taxes to stopping at traffic lights to getting dog licenses. There is no principled difference between those examples of state “coercion” and yet a hundred other things, and “coercing” us to own health insurance (if you insist on preferring that to the–horrors–of the more efficient single payer model), but until you tell me why you are opposed, on principle, to paying taxes, stopping at traffic lights and buying dog licenses, I won’t take this portentous libertarian claptrap very seriously.
You just don’t want to do it, Mr. Smith. That’s all this is about. You think it’s not worth an extra dime of your money to subsidize some people and/or to pay higher taxes yourself to make sure every American (or close to it) has health insurance. The stories I linked to here mean nothing to you–you found the idea of such stories to be faintly amusing. They happen to other people, apparently–your insurance is set for life, I guess. Yeah, I do think the “coercion” argument is a high toned intellectual dodge, if you want to know the truth. I think your argument is about a baser motivation, pure selfishness leavened by entitlement. You don’t want to pay the extra money–and you think you deserve what you have, and it’s just too damn bad others don’t have it, but that’s the way it goes. Yes, I’m stripping this down to a very elemental level. I’ve read your arguments, and, as it happens, I think they are so full of half truths, untruths, and flat out bullshit–like that selectively applied coercion argument, and the nonsense about linking health care policy to gdp growth and this completely diversionary silliness about the fascist origins of universal health care in a few countries (should we stop driving Volkswagen’s, too, Mr. Smith?)–that I have concluded that you are arguing in bad faith–I don’t think that about every conservative, but following your argument here, I have concluded that about your contributions to this discussion. And it started with the argument about “just show up at the ER”, which, as I pointed out, has nothing to do with having good health *insurance*. “Showing up at the ER” is, obviously, not at all a substitute for that (which you seemed to concede–in which case, why mention it? What relevance does it have to this discussion? You can’t have it both ways).
As I wrote above, you thought the idea of actual examples of people living in stress and fear because they were uninsured or underinsured was kind of amusing–you say, “Sheez, Eugene, [can't you come up with real horror stories]?” Hahahaha–yeah, those stories of Americans who can’t pay their doctor’s bills. Hilarious stuff–Daily Show material!! Those cancer and ALS victims who have no way to treat their illnesses in the richest nation in the world–I know, I must be killing you, Mr. Smith, telling you these stories about these walking dead among us. Hey, thanks for coming, I’ll be here all week! And, yes, I did find your glib reaction to the serious plight of millions of our fellow citizens deeply disturbing, and morally callous. If you find it unfair or outrageous to be accused of moral callousness, I suggest that in the future you not write in a way that can be fairly ascribed as morally callous. You’ve been hung by your own smug words.
And then you say–don’t throw in all this extraneous stuff. Let’s “debate the plans on the merits….” Ok, lets. So I do (allowing for the fact that we have no “plan” in the U.S., but hodgepodge of several different models, which is a large part of why are system is so irrational and so expensive). On one side–universal or near universal insurance, equal or better health outcomes to the U.S., choice of Dr., as opposed to U.S. HMO’s, and only 2/3rds to 1/2 the cost as a % of GDP compared to U.S. health care. The merits–fine, there they are. What’s your rebuttal, Mr. Smith? Something pompously inane about “coercion” and something economically illiterate about the relationship between national health care systems and economic growth. Perhaps because you realized you couldn’t actually address the issue of comparing the merits of the American health care “system” and the many excellent European systems *on* their merits, as you suggested. Thus, time to move the goalposts, again.
Finally, despite your principled libertarian scruples about coercion, I’m sure you happily accepted your government health care while serving at the FEC, but I wonder why. More statist intrusion, right? Why didn’t you turn it down–go out on the private market, cut the best price you could, a free contractual arrangement between two rational agents, a man and an insurance company? Why not, Mr. Smith? Seriously, why didn’t you turn down your public health insurance? The free market beckoned. I know your reputation as a major libertarian thinker–this was a perfect opportunity to live your principles!
Your right about one thing. In addition to trying to employ logic and facts, I was trying to shame you into supporting universal health care. But to paraphrase the great Austrian novelist Robert Musil, I’ve run into The Man Without Shame.
Oh–one more thing: The selling insurance across state lines idea. It’s a complete crock. It won’t help at all–unless you wanted to nationalize insurance regulation, which, I’m sure you would oppose (more statist intrusion!). That’s another problem with your analysis. You don’t actually understand the issues in the slightest, and it’s clear you haven’t researched them either–you just plug in whatever free market nostrum you have lying around. You’re not an empiricist, you’re a formalist who can’t recognize that your arguments don’t match up with the data–for to recognize that would mean that your tidy little system would fall apart. You may be a good lawyer, but you haven’t studied the facts of this case–that’s pretty damn obvious. Send Gratzer an email when you get a chance, and ask him for a reading list. In the meantime, you can start below–just to delay for a couple of hours the re-rationalizing of your preconceptions:
http://www.newamerica.net/files/Policy%20Paper%20Across%20State%20Lines%20Explained.pdf
Brad Smith // Aug 25, 2009 at 9:19 pm
Case closed.
Universal Coverage: We Need a Better Reason than “Everybody Else … | Today Headlines // Aug 26, 2009 at 1:37 am
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barker13 // Aug 26, 2009 at 4:08 pm
“Makes you wonder what Mr. Debs has against the Turks, who are, in fact, one of my favorite people.”
Hey! Me too! I love the frigg’n Turks! I just wish successive U.S. administrations hadn’t allowed relations between our two countries to deteriorate as much as they have.
(*SIGH*)
“Mr. Debs raises straw man after straw man…”
And all from the shelter of an anonymous identity.
(*SMIRK*) (Well, that’s Frum for you… he’s the one who allows it.) (*SHRUG*)
Outstanding rant, Bradley! Well done!
(*WINK*)
BILL
debs // Aug 26, 2009 at 6:37 pm
I don’t have anything against the Turks–that’s obviously a moronic way to frame what I wrote. I’ve been to Turkey, and Turkish democrats and trade unionists are some of the toughest, bravest people on earth, have served jail time during some the military coups in that country. In fact, I admire Turkey’s mostly secular democracy.
What is not worth emulating about Turkey or Mexico–two nation’s far poorer than our own–is that neither of them provide health insurance to all of their citizens. Of course, because those nations are relatively poor, they have something of an excuse. They are the only two such countries among the 30 members of the OECD. Oh, there are three nations in that group–the richest country on earth, the United States. What’s our excuse?
artark // Aug 27, 2009 at 12:33 am
How about, It’s the right thing to do.
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