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?

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

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

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.