Someone mentioned the increase in gun sales as a possible reason for the reduction of crime (maybe if the reduction waspreceededby a notable, and well-publicized increase inshootingsof criminals). But my position was also misrepresented as "Obamahas brought hope to criminals." I never said that, but I understand how one on the "nature" side of the "nature/nurture" argument might make that mistake. What I said was: "if the drop in crime is particularly strong in black communities, I would suggest that it might have something to do with hope...and the fact that many blacks feel fully invested in the American Dream for the first time in 400 years. It's possible." Your comment would seem to imply that criminals are criminals even before they commit a crime...in other words that their criminality is innate rather than contextual. And of course, because crime statistics are higher among blacks, one might be forgiven for suspecting that the "criminals" remark would be most likely said by someone who believes that there is more innate criminality among blacks than whites. I have had countless conversations about the issue of increased crime in black neighborhoods, and one of the core differences in attitudes is that Liberals tend to believe the reason is that their context (history, current treatment and opportunities, cultural messages, etc.) are different. While conservatives more often believe that there is something different about black people themselves. That, in other words, if you took white babies and slipped them into black skins, they would perform better than the average black people. And if you took black babies and slipped them into white skins, they would perform worse than the average white people. This argument can't really be "answered"--people have been trying to answer the question of "does essence precede existence or existence precede essence?" for thousands of years. While the pendulum seems to be swinging toward a mixture of these factors, with environment making more difference between groups of human beings. What I will say is that it seems self-evident that one of the things that makes people honest is the belief that the system works in their favor. If you feel the deck is stacked, it is almost idiotic not to cheat. Young men want to see a way all the way to the top of the mountain. If that path is blocked, then in the classic words, they would often rather "rule in hell than serve in heaven."Obama'selection represents the first time in American history that the visual symbol of power in the world--the First Family--shifted. It is DIFFERENT, visually. Vastly.Disorientingly. A sign that, wow, one aspect of the battle for civil rights and equality is over. If you believe it's largely innate, of course, this is all just "coddling criminals." I get it. My belief? Almost anyone would commit crimes given sufficient motivation (who wouldn't steal bread to feed a starving child?) and one of the jobs of society is to prevent reasonable people from believing that they have no legal options to reduce the pain. Hope, then, that the system might actually be fair, that effort will be rewarded, is essential to keep people playing within the system. I don't believe in lazy people. I believe in people without goals they believe they can actually achieve. So they give up. All I have ever needed to motivate anyone is: 1) To help them clarify their goal. To admit that there is something they want. 2) To help them clarify the path to their goal. The easiest way to do this is to observe someone else who has accomplished it. To the degree that their actions and experiences match the student, their belief systems, mental syntax and use of physiology can be modeled to terrific effect. But as women have noted: seeing a woman accomplish something makes it "realer" to a little girl than watching a man do it. And watching a black man accomplish something only whites have done changes the entire game for many, many people. 3) To remove the emotional blocks that keep a person from believing that they can, or should, have this goal. I've counseled hundreds of people on issues of fitness, career, and relationship, and it is astounding the amount of damage we have around those issues...and how rapidly people can make progress if they can heal that damage. ## My comment aboutObama, then, could be interpreted as: "If the crime statistics have plummeted in black communities, it would be interesting to see if it has to do with increased hope, increased belief that honest effort will lead to positive results." The interpretation of my words might conceivably be interpreted as "giving hope to POTENTIAL criminals." To those who have wondered if the system is so corrupt that it makes no sense to "play by the rules." To those who think that whites are so evil that they will crush anyone of color "uppity" enough to aspire to greatness. Every single person I've ever had the opportunity to observe at length, of whatever race, gender, or political orientation, will break laws given the right set of circumstances, always with justification. It might be cheating on taxes or expense accounts. Speeding on the freeway. Running a stop sign.Underageddrinking. Pot smoking. Put people under more pressure, and more laws get broken. Whether one agrees with this or not, the real question is: 1) do you think that more blacks are intrinsically (genetically) criminal than whites? 2) if you think that the increased crime statistics are the result of social programming, do you think that blacks created their own social context? In which case...exactly where in the United States have blacks ever been isolated from whites long enough to create their own society? Ask any anthropologist: that takes generations, at least. And it never happened. The societies created by blacks in the U.S. were always hooked into the surrounding grid, controlled by laws they did not create, and policed and governed by people of the same ethnicity as those who had enslaved them. 3)In my mind, all of this stuff can be explained by universal human tendencies, without suggesting that blacks are inferior mentally or whites inferior morally. But the number of times I've had conversations with conservatives that headed toward "what's wrong with black people" is off the charts. And while about half the human race DOES seem to believe that our status in life is indicative of our basic intrinsic nature, it is interesting how seldom people will come right out and say this. But to the degree that this actually is a more pervasive attitude on the Right, it would be reasonable to suggest that THIS is the actual reason that the Right is having problems attracting minorities. And will continue to do so until this aspect of the debate is aired more honestly and openly. I just rememberOctavia'sDictum: "the most dangerous thing about human beings is that they are hierarchical, and tend to place themselves high on the hierarchy." And also that they tend to blame the victims for bleeding. ## Here's the question of the day: what law have you broken most often, and what was your justification? ## Because the health care debate is getting so passionate, I want to be very clear that I understand the arguments of the opposition to Nationalized health care. First, my positions. Everything I've ever accomplished in my life has been the result of observing people who are better than I am at something I wanted to learn. Modeling their actions and attitudes , and comparing them to my own. Where those actions do not conflict with my moral core, I change them. If every other industrialized country has some form of national health care, it seems asinine to suggest it "doesn't work". If their results are comparable to ours, that is a huge question mark. If they are paying LESS per capita to get BETTER results, that just screams at me. The choice seems pretty clear. But that choice isn't clear if I don't understand the arguments against it, so I wanted to enumerate them, as I understand them, and ask that those who are on the Right in this matter correct me if I am wrong. 1) The life expectancy and infant mortality statistics cannot be trusted. In essence, the American system provides better results. 2) The per-capita expenditure isn't being considered correctly. People in other countries are paying less, but getting less. 3) Americans are happier with their health care systems than are those in countries with nationalized care. 4) That the profit motive is the most important human motivation, such that a reduced profit will stop scientists and researchers from investigating and curing diseases. 5) People with free health care won't bother to take care of themselves, becoming an even worse drag on the system. 6) Socialized medicine will pull America down the road to a total socialist state. 7) It is unfair to ask the wealthy to shoulder the health burden of the poor. 8)Socialized medicine would reduce the amount of choice and freedom enjoyed by patients. 9) Emergency rooms provide adequate medical care for those without insurance. 10) Many if not most of those without insurance don't want it anyway. ## Is that pretty accurate? Have I left anything out?
Friday, July 24, 2009
Giving Hope to Criminals
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42 comments:
The Constitution defines the powers of the federal government. If a power is not specifically delegated to the federal government, it is reserved by people and/or the states. The power to control health care is not something that the Constitution delegates to the federal government. Thus, unless the Constitution is amended, federally mandated heath care is completely unconstitutional. In other words, it is an illegal use of government power.
This argument is only relevant to those that know what the Constitution is and who respect the concept of the rule of law. If you think that planting evidence in order to convict a criminal with a long rap sheet that the cops know to be guilty is acceptable, then the principle of ignoring the Constitution "for the greater good" is not a problem. To such people, the Constitution is merely an antiquated piece of paper. The number of us who think otherwise is relatively few these days though. Few Republicans, and even fewer Democrats do more than give lip service to the Constitution when legislation is being discussed.
Marco
My dubiousness is an amplified version of 6). Obama has said that he doesn't want the government to run health care, but afaik, he hasn't proposed any institutional structures to keep the government from doing so, and I'm not sure it's possible to control how the money is distributed and not have a large influence on what happens.
There are a lot of moral issues entangled with health care, most notably around abortion. It seems like an inconsistency that the people who were so angry at the Bush administration using its control of the money to limit access to abortion are so trusting of a system which would make it easier to decide what procedures are worth providing.
what law have you broken most often, and what was your justification?
Speeding laws. It seems safer to go the prevailing speed on the freeway than to be the only one strictly following the speed limit, and I've been told even cops don't enforce it if you're only a few miles an hour over the limit.
To such people, the Constitution is merely an antiquated piece of paper. The number of us who think otherwise is relatively few these days though. Few Republicans, and even fewer Democrats do more than give lip service to the Constitution when legislation is being discussed.
This is a religious debate at core, and I'm not going to jump into it too deeply, but I will say that I used to agree with you, before I saw George Bush shred the Constitution like toilet paper, with barely a peep from Republicans. Each side has Constitutional principles it likes, and Constitutional principles it dislikes. Dems don't like the 2nd; Republicans aren't wild about the 1st, 4th, 5th, and 6th.
I'll bite Steve. I think it's safe to say that I talk to a much higher percentage of conservatives than you do, so if you don't mind:
Arguments 1, 2, 3, 9, and 10 are things I have NEVER heard from a conservative. they are the kind of things that liberals say that conservatives say. It's a strawman game that both sides play. Ignore those.
What the conservatives I know actually say about your other points:
4) Funding for research- if it comes from the same pot and a politician has to make a choice between providing medicine and research, there are more sick people than scientists and altruists combined. They will budget for the short term potential gain in votes. Investors wouldn't.
5) Any system has the potential to be abused. The ADA and FMLA are both rampantly abused despite the best intentions. Government programs have a very poor record of recognizing when they have started to enable the behaviors that they were designed to prevent.
6) No comment- presented pretty much the way a conservative sees it.
7) Two aspects to this. Unfair for the rich to pay for the poor is usually argued either as: it is inefficient in any system- economical, workplace or training your dog to punish success and reward failure. You always get less of what you punish and more of what you reward (or, in this case, enable). The more libertarian version of the argument is that anything done by the government is done by coercion. The question is whether it is unfair for the rich to be FORCED to pay for the poor.
8) This is pretty much the same way I've heard it.
The two arguments you missed (three, if you count Marco's, which I completely spaced. Yay for the tenth amendment):
11) The government is notoriously inefficient at anything that it runs- Social Security, Medicare, even the post office (back when it was fully government run) the one legal monopoly in the United States were economic disasters that our grandchildren will be paying for.
12) Even if the government doesn't place a monopoly on health care, they have the regulatory power to crush any competition. Whatever choice promised will be an illusion.
13) This one is rarer, just remembered it: if it fails, it will fail in perpetuity. Very, very hard to get rid of a large government bureaucracy even when it is no longer needed.
With Marco's that's 14; but only 9 have I ever heard from actual people who describe themselves as conservatives.
Hope that helps, Steve.
Rory
Rory,
the government is notoriously inefficient at anything that it runs- Social Security, Medicare
I'll argue Social Security another day, but since Medicare is a prime example of the government doing this correclty, I'll bite here.
One: people on Medicare are happier with it and trust it a good bit more than do people with private insurance.
Here.
And here.
And here.
But these just document the reality that seniors are happier with medicare than everyone else is with private insurance. So, Two:
The assertion about inefficiency is also false, see here.
It's striking that the guy I linked above is a conservative who's trying to argue that Medicare's administrative efficiency isn't as great as claimed, and even he comes up with 5.2 percent overhead for Medicare vs 16.7 percent for private insurance.
Here's the question of the day: what law have you broken most often, and what was your justification?
Whichever one I felt like breaking at the time. The laws were written by people who didn't consult me, and I never agreed to any of them. Outside of a certain pragmatic respect for "I fought the law and the law won," I pretty much do what I think right.
Lynn:You certainly hit it on the head with respect to speeding. The safest speed you can drive at is the median speed of all drivers on a highway. This minimizes your overall relative velocity to the other cars and there by maximizes your reaction time if somebody does something unexpected.
Steve: I've dealt with this before, but try again on number 1. The obesity rate in the U.S. is the highest of any nation. It is estimated that obesity reduces life expectancy by 3 to 10 years depending upon the degree of obesity. Unless you can give an explanation on how private insurance causes obesity you can't use life expectancy to compare the efficiency of health care between nations because it is distorted by factors like obesity
I know this is not a response that you asked for, Steve, but the only one of the list that concerns me at all is #8. Lack of choice of options for healthcare I find scary. But, I am not a conservative.
BTW, I am not trying to be anonymous here, I just like the descriptive handle that I use from my blog address.
David Bellamy
Writing out my current understanding of health care, and contrasting it to your understanding of my understanding, would be a long, long write-up. I'll address just one point for now.
"1) The life expectancy and infant mortality statistics cannot be trusted. In essence, the American system provides better results."
As I see it:
The life expectancy statistics can be trusted, but don't cover two issues -- the crummy American lifestyle, and the crummy non-American quality of life of people rationed medical care.
First, American lifestyle. We're fat. Fat as pigs. Fat enough that people who used to be qualified as minor circus freaks are now commonplace. Fat enough that, in Heathrow airport two Mays ago, I knew I'd reached the terminal for my flight home when I was suddenly the thinnest guy in the area rather than a mildly puffy guy compared to other people. Fat enough that type I and type II diabetes are absolutely endemic, and racking up huge costs for medical care (one endocrinologist in the Wall Street Journal recently argued that if Americans just lost weight, that alone would improve medical costs substantially).
When you compare Americans to Europeans or Japanese, and we get about the same life expectancy despite spending more, what that does not show is how much worse our mortality rates would be without that extra spending compensating for the unfortunate number of us who are trying to eat ourselves into the grave and partially succeeding.
Second, quality of life: while England and Canada manage to lower their costs, they often also manage to lower their quality of care in ways that can either impair vitality or be outright deadly. If you don't provide heart surgery or joint surgery to an older person, they may live about as long, but they're likely to be living more as invalids than if you'd repaired their cardiovascular system or their skeleton. If you don't provide surgery for urinary incontinence (to take a recent instance from Quebec), people live just as long, but spend every night of their lives having to get up several times a night to go to the bathroom. If you have a national health service that's been demoralized by several generations of pure state control (as the UK's arguably has) you get "c diff" as a routine slang word because the rate of hospital-caused infections becomes infamously high and causes enough unnecessary deaths that the Guardian (!) had a long condemnation of NHS hospital care when I was there two years ago, and people in Scotland (a traditional Labour stronghold) were looking for ways to get private insurance.
So ..... if you want to lower American healthcare costs to match those of other countries whose life expectancy equals ours, I think that you'll find yourself needing to convince people to lose weight, or having to cut the quality of care, or doing both. The former is hard to do. The latter is not something I want to experience.
--Erich Schwarz
Your take on my take:
"4) That the profit motive is the most important human motivation, such that a reduced profit will stop scientists and researchers from investigating and curing diseases."
My actual take:
Capitalists who are deciding where to invest their scarce money want to invest in things that, on average when considering both failures and successes, bring in a decent profit compared to other opportunities they have for investing their money. If something isn't at least moderately profitable, they'll invest the money in Treasuries or gold and forget about buying big pharma stock or funding a biotech startup.
Moreover, it is just transcendentally difficult to get a successful profitable drug. The ratio of initially promising leads to final market successes is something like 100 to 1. Nobody knows how to make this ratio better (and if they did know, they'd have a tremendous selfish incentive to use that knowledge to become the Microsoft or Google of the drug world). To support the 99 failures, any one successful drug has to charge profits from some market.
Most existing markets in the world today, by law, make profits difficult or impossible. Pharmaceutical companies charge higher rates in America than Europe or Canada because America's the one real market they've got left. When that goes, their profit base basically goes too. And then that goes, their basis for supporting research in 99 failures to get 1 new protease inhibitor that blocks AIDS also goes.
Idealism is by no means nonexistent among the heads of big pharma companies, let alone among the scientists and physicians who work for them. But these guys live on planet Earth. They need to pay the bills. They would like, as would you, to do more than just subsist for busting their behinds at a difficult job. Many of them are trying to keep spouses or children supported and happy. Some of them even like making money for its own sake, while also wanting to invent the next penicillin.
Destroy the U.S. market and you will maim or destroy all that.
(And no, NIH-funded labs will not magically take up the slack. Yes, I myself work in an NIH-funded lab and have all my life; yes, I think we are all near-geniuses whose basic science is worth funding; but no, we are not a drop-in substitute for Merck.)
--Erich Schwarz
The people who argue that anything run by the government is inefficient are usually the first ones to want more spending on the military.
Which is run by the government.
It strikes me as odd that a socialized fighting force is ok to them but socialized healthcare is the end of the world.
"It strikes me as odd that a socialized fighting force is ok to them but socialized healthcare is the end of the world."
It would be odd if it was true. But it isn't.
There is actually a substantial capitalist aspect to the U.S. military. Private companies develop weapons systems and other products and services for military purposes and bid against one another in order to sell their products to the military. Civilian contractors work closely with the military on bases all over the world. These corporate employees service military equipment and train troops to use their products, doing so in order to earn a profit. This is hardly socialist. And, on the whole, countries with capitalist-driven defense sectors have produced much better military equipment than the countries which eschew economic competition (and choice).
Also, U.S. military members get more money for doing different things. Individuals with unusually dangerous jobs earn hazard pay, for example. Those who spend a lot of time in the air earn flight pay. GIs who are skilled in career fields in which there are shortages can earn re-enlistment bonuses. I earned hazard pay when I was a rocket fuel handler, and a re-enlistment bonus when I was in avionics. Such unequal, competitive pay is also not terribly socialist in nature.
Marco
By this exact logic, single payer health care isn't socialist either, because people working within the system will be paid different amounts based upon their skills.
The distinguishing factor here is that the government pays for it with our tax dollars. Both the military and single payer are socialist by this criteria. (Or conceivably neither are. I'm willing to come to terms on the definition.)
Staying with item 1) for the moment, having argued against life expectancy as a good measure of health care because it is to easily distorted by other issues than health care like weight and murder rates lets deal with the second sentence about U.S. health care is better than other countries. Lets look at a health care statistic that is clearly function of health care. One in which early detection is very important. Cancer survival rate. Which country has the highest cancer survival rate in the world, why the good old U.S.A
On the military and capitalism. In my relative youth, I work for the military industrial complex. In particular I worked on the anti-missile defense system during what was called the arms race between us and the soviet Union. It was discussed inside the project that the main reason for the project and part of the overall arms race strategy was to break the soviets economically by forcing them to spend more than they could afford on their military in order to keep up with us.
Let's move on to number 2 and use the the U.S. and England to make my point. If you look at the raw numbers the U.S. spends more than two and a half times as much as England per person on health care. But if you adjust this for wealth as measured by GDP England spends two and a half times as much as us per person. Now in truth neither of these is a really good measure of relative expenditures, but I am just making the point that to get that real economics of expenditures on health care between two countries you have to adjust for other economic factors.
To move on down the list
3) How happy people are with anything is hard to measure. It is also irrelevant to how good the care is unless all the people whose happiness you measure have lived under both systems and experienced various illnesses under both systems.
4) The question is not whether scientists or researchers would want to continue to investigating cures for disease. The question is will the people who pay the salaries of the scientists and researchers and buy them the equipment they need continue to be willing to pay the bills.
5) I haven't heard anyone who has argued by anyone, but if I did I wouldn't listen to anything else they said.
6) I would put it that socialized medicine is one more step down the road to a socialist state. When I look at Obama's policies and decisions two quotes keep running through my mind. "From each according to his abilities to each according to his needs." and "All pigs are equal, but some pigs are more equal." This belief that Obama is heading the country in the wrong direction on these issues is why I am a conservative. You disagreeing is why you are a liberal. We will never know who is right, because unlike in science fiction in the real world we never know the results of the road not taken.
7) As a believer in capitalism, I believe it is counter productive to ask the rich to shoulder the burden for everything. It is easy to make the argument for any one thing that is desirable, like better health care for the poor, that the rich should take this burden. But when you make this arguement first for ten, then for hundred good things you end with a socialist state and its my belief in the long run everyone will be worse off. Its my opinion, based on my read of history and human nature and again that's why I'm a conservative
8) Yep that's my opinion. Again, I have no way of proving it, but I am currently reading Canadian author R. J Sawyer's newest novel "WWW:Wake" and his description at the bottom of page 17 of how the Canadian health care system works would lead me towards that conclusion.
9) &10) These goes with 5) as non rational arguments that I don't see anyone worth discussing the issue with making.
I just want to ask if any of you watch Bill Maher.
He talks with political leaders and bloggers about this stuff.
Rory--
Not a single thing on my list was obtained from liberals. Some WERE, on the other hand, obtained from listening to Conservative talk shows or blogs...I can agree that perhaps I should consider those "points" to be evidence of flakiness, and listen only to the more reasonable Conservative points.
##
Regarding obesity: yes, I think that obesity is connected to education. If we're the only industrialized country without nationalized health care, and also the fattest, I wonder if those are connected. Most obese people I talk to have VERY little understanding of the exact practices that have led to their condition. Many seem to believe their bodies disobey the laws of physics. Others think it takes hours of exercise a day to reduce weight. These things are not true. The number of people who are obese is due to a social shift that disconnects physical effort from financial reward. We have to re-connect something that was just a natural consequence of laboring to survive...we simply succeeded in making our lives easy, and food relatively cheap. Recipe for disaster.
Apparently, conservatives who mention the obesity stats think that health care and overweight have no connection to each other. I think the opposite is true. I believe there is no aspect of obesity: diet, exercise, health, emotional issues...that cannot be addressed statistically by better, and universal health care.
Believing otherwise suggests that "some people just want to be fat" which is, in my mind, kind of stunningly unaware of the ways people deal with pain. There are better ways, and my entire teaching has been based on educating people to this. I may be wrong...but I am consistent.
Steve: Obesity and murder rates are just two EXAMPLES of factors that could distort the comparison of health care between nations strictly based upon life expectancy. Lets get away from the social debate and look at it as a physics problem. There are equations of motion that will predict the velocity of an object on impact based upon the objects mass and the height it was dropped from. You will find them in any good physics book. But drop two objects simultaneously from an airplane with the same total weight. Let one have a parachute set to open at the proper height to function. The velocity on impact of the two objects will be very different because the equations of motion assume essentially a vacuum and ignore the effects of atmosphere and shape. The first thing a good statistician learns is that an analysis that doesn't include all pertinent variables is a bad analysis. Coming up with reasons why other variables might not affect the conclusion is just a way of protecting a conclusion that is very important to you.
Your take on my take:
"6) Socialized medicine will pull America down the road to a total socialist state."
My take:
Socialized medicine doesn't pull anything anywhere. It just is, inherently, of its own immediate nature, a huge takeover of private activity by the federal government.
To the degree that the U.S. government requires, under pain of felony, that 16% of the entire private-sector economy be funded in a particular way, with health-insurance policies having to follow very specific mandates in order to remain lawful, with central taxation (enforced, in the final analysis, at gunpoint) used to subsidize the "public option", with the current defects in the partially-free healthcare market putatively remedied by yet more top-down taxation and regulation than we already substantially have ... it's going to mean more government control of one of the most basic and imporant areas of people's lives, not to mention of one of the few industries that Americans haven't already outsourced to China.
It's not a threat of more socialism, it's an absolute guarantee of more socialism.
And it will have both economic and psychological consequences. Imagine what effect it would have if we decided, for instance, that food was so central to American life that the federal government had to license, control, and manage every single farmer, rancher, restaurant, or food market in America directly, and that every single purchase of food had to be done via a government-approved "food insurance" policy. It'd be, by definition, a situation where you had to be on good terms with the current regime in Washington just to lawfully eat; where, even if you yourself weren't in trouble with the government, you had to endlessly care what Bush or Obama or Karl Rove or Rahm Emmanuel felt about you. It wouldn't be the psychological posture that freedom entails. And, in practice, you'd probably end up either rebelling or atrophying the psychic muscles associated with individual freedom.
I expect nationalization of health care to be the same: benevolent in theory, profoundly emasculating in practice -- both for economic and for psychological reasons. I don't know how much of that latter effect is expected by, or wanted by, the current advocates of single-payer (either in its honest form, or in the current form of single-payer-by-stealth). But I do think that those consequences will be real and serious.
Obama's promised, despite advocating a de facto complete takeover of the medical industry by the federal government, that somehow he and the Pelosi Democrats will nevertheless keep the federal government "out of health care decisions". I have no idea if he really believes this or is living up to the cliche of politicians ("Q. How do you tell if a politician is lying? A. His lips are moving.") But whether he's being consciously dishonest or not, I do think he's being grossly misleading. Maybe supporters of Obamacare are happy to see the federal government assume centralized control of all medical decisions by private citizens, but I'm not.
--Erich Schwarz
When I go to the doctor and he tells me Obama's instructed they remove one of my kidneys, I'm going to be crabby.
But I admit I don't see how we get from guaranteeing insurance to everyone, to that.
The same people who dislike universal health care dislike universal education. This is not unconnected.
Dan: I am actually for as universal education as we can get. But universal education in this country is handled by the states, not by one big federal education board. Neither of us would like it if the federal government took over education and a conservative administration mandated Intelligent Design be taught in all schools. I would love to see everybody in the country get good health care, but not via a medicare like federal health program. If it could be made affordable something along the lines of the school voucher program, where the government would pay for a qualifying individual's private health insurance would be an acceptable way to do this.
Marty,
I don't doubt your sincerity. But the perfect is the enemy of the good, and we've had something lousy for so long, I'm ready to try something new. If conservatives as a group, rather than you as an individual, were concerned about medical insurance, some conservative dominated state somewhere would have done something about it. Instead conservative states (and I imagine everyone's tired of hearing me make this point) are worse in this area than liberal states. (And most other areas, as well.)
Your take on my take:
"5) People with free health care won't bother to take care of themselves, becoming an even worse drag on the system."
My take:
Single-payer, nationalized health care won't make conscientious people stop taking care of themselves ... but it will make it harder for them to do so effectively, since they will lose most of the freedom they currently have to pick insurance policies which meet their needs or to choose their doctors.
Meanwhile, Obamacare will have no effect whatsoever on the poor health of people who don't currently manage their lifestyles well. Just as public schooling does essentially nothing to raise the academic performance of those subcultures disinclined to learning and study, public medicine will do essentially nothing to make people stop eating unhealthily or excessively, stop abusing alcohol or drugs, or start exercising.
--Erich Schwarz
"The same people who dislike universal health care dislike universal education."
"Universal" in what sense? In the sense that I would like to see everybody both medically well-cared for and well-educated? Why, you're simply wrong: I'd be quite happy to wake up and see that sort of "universal" situation.
My objections to Obamacare are that it strikes me as profoundly unlikely to leave most Americans better off either medically or economically than they are now. And while I would like to see the residue of Americans failing to get good medical care have a better shake than they're currently getting, I favor other means of doing so that strike me as being much more likely both to work and to leave the current system's benefits undamaged.
As for the actual state of public education: I have two close relatives who teach in SoCal public schools. I know that they try very hard to educate. I also know that the existing public school system, by and large, is not only not oriented towards educating the poor but actively works to prevent genuine education from happening. I know this, because every time I talk with either of these close relatives, I get to hear the horror stories of what being a public school teacher in a neo-Stalinist "public option" school system is actually like, not the left-wing daydream about what it is like.
"... we've had something lousy for so long, I'm ready to try something new."
That reminds me of the characters in a monster movie happily trooping down into the darkened basement with only one flickering flashlight between them while the soundtrack is playing soon-there-will-be-chainsaws music. Usually, these characters have pretty much the same insouciant rationale for their Hope-and-Change walk into the basement that's being offered here: "After all! what could go wrong?"
To which, even as a teenager watching these idiotic movies, my reply to the screen was, "Plenty, you suicidal jackass!" My current middle-aged self can only echo that younger self's dissident skepticism.
It's always possible to make a bad situation worse through what Jerry Pournelle calls "stupid but energetic" behavior. It's also pretty likely that you'll make a bad situation worse when you insist on changing a huge, complicated political system in one giant, drama-queeny, poorly reasoned, unexamined dramatic gesture.
(And it's particularly ominous when Obama and the Democratic Congress make it clear that they themselves have no intention of themselves living under the strictures that Obamacare will impose on the rest of us. "How could things get worse?", you ask? Clearly our enlightened Leftoid political masters think they could. Cue the chainsaws!)
If Obamacare is such a brilliant idea, let's see it debated in detail, not rushed through before its advocates have even bothered to read it. Better yet, let's try implementing its alleged magical mechanisms for cost control on Medicare and Medicaid -- the not insubstantial parts of the medical marketplace that the federal government already controls -- before reworking the entire system of medical care for the entire U.S. on the strange rationale that, even though we can't control costs for Medicare, we're magically going to be able to control costs for Medicare On Crystal Meth.
--Erich Schwarz
Your take on my take:
8)Socialized medicine would reduce the amount of choice and freedom enjoyed by patients."
My take:
For the majority of us who already have health insurance: yep.
--Erich Schwarz
"By this exact logic, single payer health care isn't socialist either, because people working within the system will be paid different amounts based upon their skills."
I don't think that you read my post. Only the second paragraph was about how GIs are paid. Much of my post described how major, competitive, profit-driven companies play a major role in making the U.S. military as effective, well-trained, and well-armed as it is.
In a in a single-payer setup, are there typically many major private medical companies - the medical equivalents of Lockheed Martin, Air Products, Raytheon, or Colt - earning substantial profits as major players in the health care system? Is competitive capitalism the basis for how a single-payer system works? Because that's how it does work with military contracts. In what countries that presently use single-payer health care is major involvement by private companies a major force in providing such services? If this does not take place, single-payer health care does not operate like the U.S. military.
Marco
Erich,
Where is the conservative plan to provide universal health care? How does it work?
It's clear that, contrary to your assertion, conservatives as a group don't want universal health care: they've never taken the vaguest step toward providing it. It's not the way Obama's attempting to provide health care that's upsetting them; it's the attempt itself.
Liberal states are richer, better educated, and healthier, than conservative states. God help us if liberals do for the U.S. what they did to all those rich liberal states.
Marco,
I read your entire post. Your argument is that the military uses government funds, does business with private companies, and pays people different amounts.
Of course, a public insurance option would do use government funds, do business with private companies, and pay people different amounts.
The dividing line between socialism and capitalism in these two cases is something of a mystery to me.
Dan: Here's my conservative plan for universal health care. The government forms a commission and determines a minimum acceptable health care services plan. Private insurance companies are mandated to make available the designated plan at a nominal profit level. The government pays for this plan for individuals who don't have other coverage on a sliding scale based upon income. Private Insurance companies can offer upgraded plans at what ever cost they choose. Individuals and companies choose the upgraded plans if they desire. If an individual would qualify for government aid on the minimum plan and chooses an upgraded plan they the same level of aid from the government as they would on the minimum plan.
Dan: a question, you assert that liberal states are richer and healthier than conservative ones. How did you reach this conclusion? Might other factors account for a states prosperity? I'm thinking population density and the commerce brought about by it has more to do with a state's well being than conservative or liberal policies. Maine is fairly liberal but this hasn't catapulted us ahead of New Hampshire, a far more conservative, and populous state than Maine, that also has a more robust economy. Just curious about how your conclusion was reached.
langdon
Langdon,
It first struck me after the 2000 elections. Something fascinating happened in that election: rich states voted for Gore. Poor states voted for Bush -- overwhelmingly, in both cases. I put together a spreadsheet and started comparing --
The 9 poorest states, by per capita GDP, went for Bush -- 15 of the 18 poorest states went for Bush.
By contrast, 10 of the 12 richest states went for Gore.
I updated the spreadsheet in 2004 and saw the same thing again; rich states voted for Kerry, poor states for Bush. Again, in 2008.
During the last nine years since this first came to my attention, I've tracked a variety of stats against this gap -- life expectancy is better in liberal states. The divorce rate is lower in liberal states. The crime rates are lower. The homicide rates are lower. (Theft rates are higher, interestingly, probably because there are more rich people to steal from.)
The thing is, though I've only been tracking this since 2000, the basic demographic split is old. The South has always been conservative and poor. The northeast has always been liberal and rich, at least since the industrialized north beat the rural south in the Civil War.
The same basic trend is observable outside the United States. With the striking exception of the oil states, rich countries are liberal, and conservative countries are poor.
I won't try to pull causation out of that; whether poverty causes conservatism or wealth causes liberalism, or vice versa, is irrelevant. I won't say that the correlation between wealth and liberalism is indisputable, because I've had people dispute it over the years ... but if it's not real, it's a hell of a coincidence that crosses states and countries and generations.
Marty,
That's not a bad plan. It's a shame bush didn't push something like that during the period when he completely controlled the country.
"Where is the conservative plan to provide universal health care? How does it work?"
I've already provided one link to a recent proposal about what to do: here it is again.
And here's another proposal by the Republican governor Bobby Jindal.
And here is a proposal for how to deal with the long-term debt problem by the Republican economist Greg Mankiw at Harvard.
There's no lack of Republicans offering sane ideas; the problem is that, in Obama's words, "I won". The Dems have the Presidency, a majority in the House of Representatives, and a filibuster-proof majority in the Senate. And they seem to be really, really, really convinced that their current Godzilla of a health care nationalization is the One And Only True Way.
So whatever whack nonsense they can pass, we'll all get.
--Erich Schwarz
Yep, Obama won, which is a problem for conservatives, but to quote somebody or other, elections have consequences.
I've heard a few decent ideas from conservatives. Where do you suppose they were during the Bush years?
"Obama won, which is a problem for conservatives..."
Obamacare bothers me because it strikes me as bad economics, dubious Constitutional politics, and ineffectual medical reform -- i.e., because it's a problem for people and not just conservatives.
--Erich Schwarz
Dan: It probably didn't happen during the Bush years because universal health care wasn't high on the conservative priority list. It is high on the liberal priority list. Now once its priority is raised the question is how is the best way to accomplish it. As you've acknowledge some conservatives have worthwhile suggestions in the area of implementation. Now in my opinion this is why the country needs both liberals and conservatives. The end result of the process will be better if both sides contribute. The problem is that so much rancor has arisen between the two groups that each side is unwilling to even consider the merits of the other sides ideas.
Marty,
Yeah, no question -- one of the things I like about Steve's blog is that liberals and conservatives talk to each other in a courteous way. (One of the things Steve likes about it, too, plainly.)
The question I have, and it's a broad question about conservatives as a group and not conservatives as individuals, is this: how far is the gap between universal health care being not a "not a priority" and "we're against it."
The general impression I have of conservatives is that they're against universal health care, on principle. When Party A is doing something Party B thinks shouldn't be done at all, it's hard to get an honest compromise with Party B -- Party B is going to (quite correctly, from B's viewpoint) do their best to sabotage the process in its entirety. And clearly this is where the national Republican Party is at this point. You've got national Republicans gloating that defeat on health care would be Obama's waterloo -- these aren't guys engaging in an honest way.
Dan: I can't speak for the national Republican party. I can only speak about myself and my Republican/Conservative friends and family. Most of them are like me. They agree with the Democrats\Liberals on some issues, but agree with the Republicans\Conservatives on more. So none of the Republicans\Conservatives I associate with like or would vote for Sarah Palin unless the Democrats came up with some one even more out there. I don't believe and sincerely hope she won't get the GOP nomination. When we discuss the issues amongst ourselves there are plenty of disagreements on issues. I suspect that part of the problem is that the most radical on both sides are
a) the most vocal
b) payed the most attention by the media.
As for health care, anyone else here noticed Massachusetts?
https://www.mahealthconnector.org/portal/site/connector/menuitem.d7b34e88a23468a2dbef6f47d7468a0c?fiShown=default
"...Our uninsured rate is now a remarkable 2.6%, according to a Massachusetts Division of Health Care Finance and Policy study conducted by the Urban Institute.
"The U.S. Census has determined that we have the lowest rate of uninsured residents in the nation..."
http://www.mass.gov/Eeohhs2/docs/dhcfp/r/pubs/08/hh_survey_08.ppt#409,4,Slide 4
http://www.census.gov/hhes/www/hlthins/hlthin07.html
Also, this from your earlier post:
"...If that's right, then it ties right into the idea that our reality maps warp easily (Birthers? 9/11 Truthers? Bodies disobeying the laws of physics? Lottery addicts? People who mistake sex for love?)..."
reminds me of this:
http://www.hereticalideas.com/2009/07/is-barack-obama-an-american-citizen/
(not the comments, though, just the article - keep reading through to the end!)
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