WHY AMERICA NEEDS A SHRINK
If America were an individual, she would long since have experienced an intervention where a trip to a competent psychiatrist would have been highly recommended.
Maybe our good friends France, Germany, and Great Britain could step in and gently make us confront our schizophrenia, pointing us toward the psychological help we need. I hear Russia is reasonable as far as hourly rates but Iran’s shock therapy might be just what the doctor ordered.
On one level, the debate in America over national health care is a political tussle. The mud wrestling, eye gouging, and hair pulling that is going on between the two sides can be seen in the context of many of our more contentious debates over issues like race, war and peace, or gay marriage.
But on another level - and I am not trying to be melodramatic - this is a fight over the soul of America. Perhaps all big political battles have this element lurking underneath the debate, but national health insurance, far more than any previous political scrum, holds the potential to change America in ways that even the most die hard proponents of the bill can’t imagine.
I have written often that change is what America is all about; that we stand still for nothing or nobody and that we either adapt to change and prosper or refuse to accept it and wither away. This process has always been affected by conservatism and it’s notion that there has to be some elements in our society that are worthy of handing down to the next generation, that change must be orderly, channeled, and that it fits in the framework laid out at our founding. In this way, the vast majority of Americans come to accept the change peacefully.
Why then the resistance to national health care? It isn’t just “tea baggers,” I would say to my liberal friends. There is genuine distress over this issue among at least 1/2 the population - probably more. Dismissing these concerns in a political context where opponents of reform are caricatured as (take your pick) racists, heartless monsters, or wildly out of touch “angry white men,” may be unavoidable, but I wonder if you realize that most opponents of national health care take issue with those cartoonish criticisms.
At bottom, most Americans really do see this issue as a question of what kind of country we should be. The latest Gallup poll reveals that there is great uneasiness over what the Democrats are trying to ram through:
More Americans now say it is not the federal government’s responsibility to make sure all Americans have healthcare coverage (50%) than say it is (47%). This is a first since Gallup began tracking this question, and a significant shift from as recently as three years ago, when two-thirds said ensuring healthcare coverage was the government’s responsibility.
Gallup has asked this question each November since 2001 as part of the Gallup Poll Social Series, and most recently in its Nov. 5-8 Health and Healthcare survey. There have been some fluctuations from year to year, but this year marks the first time in the history of this trend that less than half of Americans say ensuring healthcare coverage for all is the federal government’s responsibility.
The high point for the “government responsibility” viewpoint occurred in 2006, when 69% of Americans agreed. In 2008, this percentage fell to 54%, its previous low reading. This year, in the midst of robust debate on a potentially imminent healthcare reform law, the percentage of Americans agreeing that it is the government’s responsibility to make sure everyone has health insurance has fallen even further, by seven points, to 47%. Half of Americans now say this is not the government’s responsibility.
I would hazard a guess and say that all the while that national health care was an abstract idea, it enjoyed broad support. But now that we’re getting close to actually realizing that goal, people are getting cold feet. And the reason goes to the heart of defining what this country is all about.
Whither government in America, ask the people? How much should we allow it to do for us without losing something essential that makes us who we are? Are we really all that different of a people from everyone else on the planet? Is there an identifiable “American character” that sets us apart?
Our ancestors certainly thought so. Alexis de Tocqueville agreed. Indeed, it may be out of fashion to talk about the basis of our Constitution, but if we ever forget the idea that all power flows from the consent of the governed and not the other way around, we are doomed to suffer a significant loss of personal freedom simply because government can do pretty much whatever it chooses to do unless the people withhold their consent. There hasn’t been a lot of that these last 40 years and government’s ravenous appetite to do what all governments, once created, and regardless of who is in charge, seek to do - control - has gotten out of hand.
This despite the best of intentions of government’s major cheerleaders, and their belief that society can be perfected with the application of the principles of social science; seek out root causes of society’s problems and address them.
In their eagerness to improve the lot of the American citizen, a government has been created that stopped asking permission and now simply runs roughshod over the very idea of “consent of the governed.” Perhaps American society has become too complex for government to stop its manifest destiny to control, influence, and otherwise interfere in our lives. It certainly seems that way when looking at national health care. And those Gallup numbers reflect that notion. No one understands what’s in the bill. All they know is that, for the moment, it massively increases the role of government in people’s daily lives.
I liken it to the very first draft initiated by President Lincoln during the Civil War. The riots that took place in New York City and elsewhere, along with the general unease with the very idea of conscription demanded by Washington was a symptom of something much bigger; the idea that the national government, for the very first time in American history, could reach out and tap the ordinary citizen on the shoulder. Prior to that, the only contact that most people had with Washington was through the Post Office. The draft (and other Civil War era initiatives like nationalizing currency) went against the ideal people held in their imaginations of what kind of country America was.
I think those Gallup numbers reflect a similar unease. And here is where the real schizophrenia of the American people is demonstrated.
People actually want health care reform. They want a public option. They want health insurance to be cheaper and available to all. And they don’t think people should be denied insurance just because they have a pre-existing condition that insurance companies say makes them ineligible. Every poll taken confirms these facts. We talk a good game with regard to self-reliance, individual liberty, and being true to our Founding principles. But when it comes right down to it, the majority of us want government to relieve our burdens and make our lives easier.
It may make us less free, but many of us are willing to trade that freedom for a little security.
You can argue that we’re not losing anything by having government eventually taking over 1/6 of the American economy, but that is nonsense. We are about to hand government an enormous amount of power along with the ability to control our lives in ways that can only dimly be glimpsed at this point. If you think this a positive good, fine. But please do not insult our intelligence by claiming that national health care will be so much better because we will get rid of evil insurance companies, ride herd on Big Pharma, or stick it to those rich doctors and hospitals.
I imagine despite the unease that people feel over health care reform, we will eventually come around to accept it if it passes. And we will continue to fool ourselves that the version of America many of us hold in our heads that celebrates the freedom and individualism that marked roughly the first 150 years of the American experiment is still a viable model to define who we are.
But eventually, that disconnect between who we are and who we think we are will have to be confronted. What will replace it? I haven’t a clue.
Maybe we can ask Spain for a second opinion.
This is Rick Moran at his unjudgmental best.
I too have written that the health-care reform imbroglio is a fight for America’s soul. But once you blow torch away the political veneer, while acknowledging that the legislation that will end up on President Obama’s desk will be flawed, the result will be that America still does have a soul and that enough people with enough clout believe that being able to get decent care when you become sick or diseased is a right and now a privilege based on your wealth.
Comment by Shaun — 11/13/2009 @ 11:42 am
It would be helpful to know the demography of those for and against this so-called health care reform which in reality is a destruction of the health insurance industry. It could reveal who is willing to accept what will be the ultimate surrender of freedom and liberty for the sake of getting “free” health care. Perhaps most of this group includes people who want Obama “to buy my gas”, “pay for my mortgage” and look forward to personal stimulus stipends. I guess it would include those who are left ecstatic by BHO’s oratory. Nothing is for nothing, an axiom that is beyond those who have been blinded to the facts of life.
Comment by SmartyMarty — 11/13/2009 @ 12:28 pm
“America still does have a soul”
The soul that is in our Constitution and our laws and culture has been eroded and has been under attack by 1960s leftists who disparage the pillars of American traditions, values and freedoms. The Obama agenda
is rooted in the 1960s new left and is like acid poured on America’s soul.
“people with enough clout believe that being able to get decent care when you become sick or diseased is a right”
Such a belief is an oxymoron. No economic good is a ‘right’. Such blather
does injustice to the real issue and challenge, and is precisely why the blather polls better when its abstract than when its real and concrete. Economic goods have limits, and *ANY* government program that tries to ’solve’ the problem of market/cost-limited healthcare will REPLACE it with bureaucratic limits (the road to ‘death panels’ and QALY ratings is paved with good intentions).
If society should provide healthcare to the level society can afford rather than an individual can afford, state it that way. stating it as a ‘right’ is selling a promise that NO Government program can possibly keep. For example, if healthcare is a ‘right’ than what right does the Government have dictating those terms of care - in qualified plans?
What give Government the right to deny healthcare choices, including the choice NOT to take up health insurance? Why the heavy hand of Govt ready to fine and jail people for the ‘crime’ of not choosing what the Government dictates?
So in the end, they (the ObamaCare folks) are selling a lie. it has to be a lie, just based on iron laws of economics (it cant get fixed by renaming government-run healthcare into some euphemism, or hiding hundreds of billions of ‘doc fix’ costs in another bill). As people figure out that not only is it a lie - it has to be a lie - that support falls away.
After all, the old on Medicare are already on alert that they WILL will paying the price for ObamaCare through getting the screws applied. People have figured it out - Obama does not have a magic pixie dust solution to throw millions more into Government healthcare burden without it (a) costing a lot more (b) adding to the deficit (c) hurting those currently in Medicare etc. and (c) causing huge job-killing taxes, fees and regulation burdens on individuals and business. We know now that ALL of the above WILL happen.
But it’s worse than merely selling the lie and airbrushing limits. What’s worse than that even is that American rights and freedoms are being crushed left and right in this mad rush to turn more and more of the healthcare industry over to Government control. They are now asking Congress-critters “Say, is it Constitutional for the Federal Govt to force individuals to have health insurance?” Instead of the correct answer (”No, I guess not”) we now have videos of Congresscritters shrugging off Constitutionality … ah, and archiac scrap of paper barely of relevance to 21st century Governance.
That is the America-soul-killing thing.
As stated … “We are about to hand government an enormous amount of power along with the ability to control our lives in ways that can only dimly be glimpsed at this point.” … only glimpsed because this 2,000 page Godzilla of a bill is only the prelude to literally TENS OF THOUSANDS of pages of health care regulations that the DOZENS of bureaucracies will be writing up
We will ‘accept’ it, the way we ‘accept’ gridlock rush hour traffic, the common cold, bad TV sitcoms, and the existence of endemic corruption in politics. “It’s just the way it is” it will become an awful restriction on our freedom, an anchor on our economy, and a boon to much that is disreputable and base in politics (pandering, corruption, and self-interested taxpayer-raping-for-special-interests galore). But it will be like some ugly furniture that we cant seem to give away - and so it will stay.
… but it doesn’t HAVE to be that way. ObamaCare is NOT inevitable, even at this late hour. Only partisan blindness and this “idee fixe” of the Democrats that this is magic elixir for their majority (nope, its poison). Should the Dems pass it, Republicans will win back the House next year and the Senate and White House in 2012. And the Democrats will be discredited and tossed from power for another 10+ years. Perhaps they will realize that this Big Bad Bill is the wrong bill at the wrong time. Perhaps they will come back from the brink and do something appropriately incremental rather than a socialist rewrite of socialism… but who’m I kidding? Like the scorpion who stung the frog that carried him across the river and made them both drown - “It’s in their nature”.
Comment by Freedoms Truth — 11/13/2009 @ 12:41 pm
I can’t help but be struck by the similarity between the rhetoric against health care reform (”the ultimate surrender of freedom”) and the claims made against Medicare (”One day we will tell our grandchildren about a time when America was free”)
Rick has a point, in that we fantasize about ourselves being independent and free of government entanglements; yet when we actually suffer some calamity ( a flood, a layoff, a devastating illness) we are appreciative of the “Big Government” that gives us assistance.
Despite the appeal of a Jeffersonian “limited government” how in practice would such a thing work in a complex global age?
In short, it was the investment of Big Government that helped create that capitalist engine. You are reading these words over an Internet that Big Government created, your computer powered by electricity likely coming from a dam built by the Corps of Engineers, your job dependent on freight that comes through a publicly built harbor, where you commute on a federally built freeway, to an office park made possible by municipal sewers, storm drains, streets and power grid.
You probably got a flu shot courtesy of the public health agencies, and are protected by government fire departments, police department. Your company is protected by government patents and federal interstate commerce regulations, the food you eat is inspected and assured safe by government health regulators.
The idea that extending health insurance to those who are currently uncovered will result in a Soviet gulag is the most absurd paranoia and hyperbole. The idea that we currently live in a pure free market economy with no government control is also absurd.
The marketplace actually works better with a reasonable amount of government oversight and control- if you doubt this, show me one modern industrialized nation that does not have government regulation and a social welfare system.
Aside from Somalia, I can’t think of any.
Comment by Reason60 — 11/13/2009 @ 12:52 pm
Polls are very tricky things. When they’re nice and nebulous, and the thing being polled is “out of the blue” and is unlikely to be immediately implemented, people will say “sure, free lunches are nice, and/or I want to be a nice person and take care of people”, unless they have an ideological disposition against big government or high taxes - which, sadly, many people don’t have.
When the question gets more precise and becomes something like “how much are you willing to pay (either by taxes, a weaker economy, deficits, etc) to give a free lunch to someone else”, support drops.
Of course, all free-lunch questions are the latter, but it isn’t clear until people have been paying attention to the topic for awhile.
Comment by Foobarista — 11/13/2009 @ 1:20 pm
I doubt anyone disagrees that we all have a right to life (along with liberty and the pursuit of happiness). Of what value is that right without a commensurate right to appropriate healthcare necessary to maintain that life?
I doubt many would hold that we should demand proof of insurance before treating an accident victim, particularly one that has life-threatening injuries. Why is it so different when we encounter a person with a life-threatening condition like cancer?
If we have a right to something (life, healthcare, etc.), someone/something must presumably be responsible to see to it that we get that something we have a right to. Who/what has that responsibility? Does it make sense to say that we have a right to something, but we will have to depend on charity to obtain satisfaction of that right?
Just wondering….
Comment by Terrible Terry — 11/13/2009 @ 2:04 pm
SmartyMarty:
You never fail to let me down with your deep insights. Death of the health-insurance industry? When pigs fly.
Freedoms Truth:
At least you try to back up your assertions.
Providing decent health care to all Americans elevates that from merely being an “economic good” just as not being allowed to discriminate against someone based on their race or ethnicity when selling or renting a house elevates that from merely being an “economic good.”
The Constitution does not outlaw stupidity, however, so increasingly desperate Congressional Republicans are fully within their rights to argue that a key aspect of the health-care reform bill passed by the House and awaiting Senate approval is unconstitutional.
The Republicans’ argument, which we’ll be hearing a lot about in the coming days, goes something like this: The individual mandate, which will require people to have health insurance or be penalized, is not sanctioned by the Constitution.
The argument falls apart quickly when you consider that the individual mandate is a tax of a sort, which is constitutional. Then there’s mandatory auto insurance, which is constitutional, and my favorite — the Americans With Disability Act — which requires businesses to install handicapped ramps and such even though the Constitution does not address the issue of entryways.
Where your argument goes completely off the rails is when you term health care a “right” and “freedom.”
This isn’t about Washington taking over SmartyMarty’s precious widdle health-care industry. It’s about leveling the playing field. Period.
Comment by shaun — 11/13/2009 @ 2:21 pm
I look forward to not fearing the pursuit of happiness due to the possibility of losing my health insurance.
Comment by Chuck Tucson — 11/13/2009 @ 2:26 pm
The schizophrenia is easily explained by the fact that Americans want their *own* burdens to be lightened by the government, but that they refuse to lift a finger to pay for relief for *anyone else*.
Comment by Zandar — 11/13/2009 @ 2:58 pm
#7:
Excuse me, but it is the Left who has been using the phony “health care is a right” mantra. I am only exposing the contradiction between Socialized Medicine and that terminology. Socialized Medicine and “health care rights” are incompatible, inherently so.
One good example of this in action came from England- A woman was refused the right by the NHS to augment her approved treatment with certain life-saving drugs to treat her breast cancer - EVEN IF SHE PAID HER OWN WAY. You see, that would lead to dreaded inequality, and you can’t have that, can you? The restrictions on care is due to bureaucratic cost reasons - as explained here:
“Based solely on cost, Britain’s National Health Service has for years denied
the four best available drugs to kidney cancer patients in Britain, leaving as
many with the choice only of Interferon, to which as many as three-quarters
do not meaningfully respond,6 or essentially being left to die. In 2007, the
Times quoted a Birmingham oncologist saying of Nexavar: “Patients with
this cancer tend to die quite quickly but I know from my own patients who
were on the trial how well this drug works. They are still alive two years
later.”7
http://www.nationalcenter.org/ShatteredLives.pdf
All real rights are freedoms. Expressions of ‘right to ..’ especially in our Bill of Rights are rights of property, conscience and action that Government may not interfere with. They invariably limit Government action NOT our own liberty.
Your rights ends where the wallets of another begins.
So let’s be clear about what “Providing decent health care to all Americans ” … Are you a doctor? Are politicians doctors? No. So this is not about ‘providing’ care, its about funding care via redistribution of wealth. It’s “taking from the pockets of one group in order to give to another group”. Redistribution of wealth by force of Government dictat is the opposite of ‘rights’ and ‘freedoms’. It denies rights and denies freedoms. It also is INHERENTLY LIMITED by the economic sustenance of the society’s economy. It does NO GOOD to tax people to the point where the economy suffers, and leave less resources for the very care you are trying to secure.
Properly understood, the debate here is between socializing healthcare further, in the interest of providing healthcare ’security’ to those who might not have it, versus a more market-based system of greater choice, liberty and inequality. Given that Medicaid and Medicare has already sufficiently socialized the system to address most of those ‘in need’, it begs the question of why go with the folly of MANDATES, when it is crystal clear that this attack on our liberties buys us SO LITTLE in beneficial improvement in health-care security. We know now that the 45 million uninsured is largely mythological, that in reality the need gap is more like 10-15 million, excluding illegal aliens and those with sufficient means to take care of themselves.
Few Americans who are currently ‘in the cracks’ will have better healthcare due to this bill, and those that do could benefit from a simpler addressing of the ‘pre-existing conditions’ issues; meanwhile millions of Americans will have higher-cost health insurance, worse benefits, and other things taken away. For me personally, the House bill is a blow, as our family uses health savings accounts to manage medical expenses - they are limiting that reasonable and responsible program below what we use. So this bill worsens me personally (and will likely do even worse if/when we are forced into a govt-run program like millions of others) squeezing out folks like me to garner pennies. It’s a recipe for disaster on multiple levels.
Pretending that those against the destruction of health-care freedom are simply hard-hearted is wrong. It is also folly to pretend there is a free lunch involved in this ‘more security at high cost’ type program.
If ObamaCare was being sold HONESTLY it would be the “More Equality, Less Liberty, All-Inclusive Healthcare Government Insurance Program” … and it would get that 40% support of pro-socialists backing it up, with 60% of Americans aghast at the prospect.
Comment by Freedoms Truth — 11/13/2009 @ 3:01 pm
The issue with freedom is directly linked to population and technology.
In 1870, when an American got a 100 acre homestead. you could do just about anything you wanted. You work for yourself killing all the buffalo and turning the prairie into farmland and do as you pleased. You would have next to no contact with any government. You and your wife would have 8 kids, half of whom would die before 1. You would also die at about 30 because life was harsh but you were free, completely and totally free.
In 2009, you live in an single family home with about 5000 people living within that 100 acres. You can’t even shoot a gun because you would kill someone if you did but you have electricity, sewers, police and fire. You come in constant contact with government: speed limits, sales tax, gun licenses. You work for someone else making incredible stuff: airplanes, cars, phones, software. You will only have two kids because they will both grow to out live you and you will probably live to be 78 years old.
There is no way you can have 300 million people survive under the rules of the 1870s. Life has changed too much. I know that we have lost a lot of freedoms because of it but I have gained a lot of new freedoms that they never had. Overall I’ll take 2009. Bring on healthcare reform.
Comment by Ken — 11/13/2009 @ 3:09 pm
#7: On Constitutionality …
“The argument falls apart quickly when you consider that the individual mandate is a tax of a sort, which is constitutional.”
So Obama supports and the House just passed a tax on millions and millions of American citizens, making middle-class wages … fascinating.
The problem with your argument is that taxes are taxes on an economic activity … You are basically saying THE DEMOCRATS HAVE PASSED A TAX ON BEING ALIVE. It doesn’t compute.
“Then there’s mandatory auto insurance, which is constitutional,”
False analogy. That is required by STATES not the Federal Government.
” and my favorite — the Americans With Disability Act — which requires businesses to install handicapped ramps and such even though the Constitution does not address the issue of entryways.”
Well, that sure dances on the edge of constitutionality, but the Commerce clause is roped in via the fact that these are ‘public’ facilities. As of yet, commerical buildings not homes are required. Same with business mandates, I suppose.
But let’s get to individual mandate.
Let’s cut to chase of the Constitutionality question - what provision in the Constitution allows for the individual mandate?
Honestly, without the fig leaf of the commerce clause, and without the phony subterfuge of ‘it’s a tax’ (if you can tax being alive, then you have indeed turned the Constitution into TP), … there’s nothing there.
Comment by Freedoms Truth — 11/13/2009 @ 3:12 pm
@Freedom Truth: Here’s a recent post on the consitutional issue from Jack Balkin’s well-regarded Balkinization blog:
“Wednesday, November 11, 2009
The Constitutionality of the Individual Health Insurance Mandate
JB
Penn’s PENNumbra is hosting a debate between David Rivkin, Lee Casey, and myself on whether the individual mandate in President Obama’s health care plan is constitutional. The first round of the debate has been published. Rivkin and Casey think the individual mandate is unconstitutional, and you can read their arguments here. I believe that the individual mandate is constitutional and you can read my arguments here.
If you would like to read the actual language of the individual mandate in the House bill, (Section 501) it is here.
As you can see, it is a 2.5 percent tax on adjusted gross income, with various exemptions for people on Medicare, Medicaid, veterans, people living overseas, people who are too poor to pay the tax, and people who have religious objections.
Rivkin and Casey take the position that this tax is beyond Congress’s powers under the power to tax and spend for the general welfare and the power to regulate interstate commerce. I take the view that this is a fairly unremarkable exercise of Congress’s power to tax income for regulatory purposes, and that it is also within Congress’s power to regulate insurance markets under the Commerce Clause.
I do not regard this as even a close question after the New Deal. Thus, the debate between Rivkin, Casey, and myself has overtones of the debate about the constitutionality of the modern state created by the New Deal, and indeed, Rivkin and Casey’s constitutional argument relies on The Child Labor Tax Case, (Bailey v. Drexel Furniture Company), a Lochner-era precedent which struck down a Congressional attempt to ban child labor.”
Comment by Terrible Terry — 11/13/2009 @ 3:17 pm
The schizophrenia is easily explained by the fact that Americans want their *own* burdens to be lightened by the government, but that they refuse to lift a finger to pay for relief for *anyone else*.
Exactly so. Thank you for that moment of clarity.
Take a poll of Medicare recipients and see how many think Medicare infringes their freedom. Betcha can’t hit 10%. How many veterans think their benefits are an affront to freedom? Social Security recipients?
I got mine, screw you.
Are we going to let American citizens die for lack of medical care? That’s the core issue.
It’s so much easier — and so utterly dishonest — to camouflage this behind flag waving rhetoric. Because then it’s all an abstraction and not about letting an American child die of cancer because his parents can’t afford a marrow transplant.
Conservatives flee from the facts. Surely after all, it can’t be about actual human beings, actual Americans actually dying in agony so that Rick Moran can go on pontificating about liberty. No, no, it all has to be an abstraction.
This is the cowardice at the heart of conservatism.
Maybe you could step up, Rick, and cut through the crapola about liberty and tell us straight out:
1) Is it okay with you that working people, people who put in their 40 hours plus every week, can end up living in a box under a freeway when one of their kids get sick. Is that okay, yes or no?
2) Is it okay with you that Americans have to choose between feeding their kids and getting their kids inoculated, or choose between one of their kids getting insulin and another getting asthma medication? Is that okay with you, yes or no?
Can you just for once answer questions about real people with real problems?
Comment by michael reynolds — 11/13/2009 @ 3:33 pm
#11
“You would have next to no contact with any government.”
Many people had plenty of contact with Govt back in 19th century, that they didnt desire, that’s why they escaped to the US as immigrants.
“In 2009, you live in an single family home with about 5000 people living within that 100 acres.”
Only in Manhattan do you find 50/acre densities … come to Texas, you can get your own 100 acres outside of town for less than the price of a Manhattan condo.
” You can’t even shoot a gun”
Come to Texas. Concealed carry state.
“electricity, sewers, police and fire.”
And a gazillion other things provided via the free market, private-sector economy. Electricity provided in the US mostly by private sector utilities, and other ‘necessities’ like food, telecom, housing, are largely private, with Govt mainly involved via redistributing in some sectors.
Govt is over-involved in 2 sectors of the economy: Education and healthcare. Curiously, those are the two sectors of the economy that suffer from an inability to improve cost-effectiveness and cost-efficiencies, despite the obvious opportunities due to the information revolution.
” You come in constant contact with government: speed limits, sales tax, gun licenses.”
If that’s all the Govt did, it could live off of less than 1% of our GDP.
Point well taken that urban Government is more involved than rural Govt, but there too you have only another 1-2% of GDP for sewer, trash, parks, police, etc. That’s ’some’ Government (and local Govt too, the less intrusive kind), not the Leviathan Government like we have now that is consuming and spending 27% of a very huge $13 trillion GDP.
The Leviathan Government has nothing to do with our daily interactions with Govt in order to live peacably together. What that Leviathan Government is (aside from about 20% for DoD) is a massive amount of wealth distribution, from young to old, from taxpayers to welfare-takers, from consumers to farmers, from those who work to those-who-have-a-friend-in-Congress, etc.
The idea that ‘right-wing’ America is ‘anti-Government’ ergo doesnt want local police is just a red herring and sophistry. The REAL issue is this: Do we want the ‘limited but effective Government’ that sticks to the sewer/police/protect-the-border basics, or do we want the Leviathan Government that does that AND takes on managing industries (banks, GM), healthcare, energy, etc. AND redistributes wealth massively.
The real dividing line is not Government vs no Government (pace the Somalia Red Herring), it’s Redistributionist-Socialist Government vs Limited Government.
“Overall I’ll take 2009. Bring on healthcare reform.”
While we all will take today over yesterday, the false choice here is that implies support for Redistributionist-Socialist Government over the Limited Government vision.
The size of Federal Government relative to economy was smaller in 2008 than in 1945, and it was fairly even from 1960s through until 2 years ago… now it has spiked up and Federal Govt/ GDP is higher now than in 60 years. Is that the “future”? Inevitably Big Government?
Why bring on a 1945-era style of Government control - like ObamaLosicare - instead of something more modern, grounded in market-based choice, and leveraging modern technology? In reality, ObamaLosiCare is a THROWBACK to the mindset of the post WWII British socialists. The whole push to ’single payer’ is based on a mindset locked in paradigms that are out of date.
Didnt fall of USSR, and socialist economic basketcases warn us off that kind of path? If the future is Big Government, then the future will look much like the failed visions of Socialism Past.
Comment by Freedoms Truth — 11/13/2009 @ 3:36 pm
“Are we going to let American citizens die for lack of medical care? That’s the core issue. ”
Like they do under the British single-payer system …
http://www.nationalcenter.org/ShatteredLives.pdf
… once ObamaCare is implemented and we suffer a ‘lost decade’ of no growth due to Obama’s economic mismanagement, thereby forcing ‘needed cuts’ in the various programs? … You Betcha!
Comment by Freedoms Truth — 11/13/2009 @ 3:39 pm
I really don’t get it.
How can anyone defend our existing healthcare system that (a) is so expensive it’s not economically sustainable, on a national and personal level, (b) is so unfair that when a person gets sick they lose access, and (c) is so unfair that people unlucky enough to have a health problem can’t even get access? How can this even be called a “healthcare” system at all?
How can anyone defend a healthcare (or any other kind of) system that’s based on markets that are mostly non-competitive? What’s so All-American about a monopoly (or near-monopoly)?
How can anyone argue that, particularly in a fragmented system like ours, providing good healthcare is, in most cases, antithetical to profit maximizing? Or, that a profit-making organization should not maximize profits to whatever legal extent it can?
Sure, government involvement brings with it problems and thus has to be approached with caution. But it’s not like the alternative non-government option (such as the status quo discussed above) is without huge, even worse problems of its own.
Comment by Terrible Terry — 11/13/2009 @ 3:43 pm
“Is it okay with you that working people, people who put in their 40 hours plus every week, can end up living in a box under a freeway”
It is absolutely NOT OKAY that millions have lost jobs under Obama and will be losing homes as well due to the economic mis-management of Obama and his fellow Democrats.
It is absolutely NOT OKAY that in ObamaLosiCare they are proposing a tax on millions of Americans, and a tax on businesses too, that will destroy jobs and hurt many.
It is absolutely NOT OKAY that in the process of putting this bill together, they are going to be hurting the current recipients of Medicaid and Medicare by straining massively the budgets of both, thereby making it harder to help those truly in need.
It is absolutely NOT OKAY that those in favor of ObamalosiCare are using faux moral outrage instead of defending a very flawed bill that will harm millions and head us towards bankrupcy.
Comment by Freedoms Truth — 11/13/2009 @ 3:44 pm
“I really don’t get it.”
No you dont get it. You suffer from the logical fallacy of the False Choice.
It’s either Status Quo or ObamaLosiCare?
Wrong! Here’ a simple “third way” that could be bipartisan:
1. Allow insurance purchased from any of 50 states - lower cost through more choices
2. Medical tort reform - lower cost
3. Address pre-existing conditions with regulations requiring acceptance of people under such conditions in insurance (also form dropping coverage) and a Government program (based on tax on insurance itself) to pay into a catastrophic health insurance plan for pre-existing situation
4. Posted prices for all medical items - lower cost
5. Individual / small business pooling program to lower cost. We could also try … Tax breaks to equalize individual vs company provided healthcare
6. Expand health savings accounts so all health spending can be pre-tax. (related to #5)
7. Allow prescription drug importation
8. All Medicaid/Medicare recipients can get their govt subsidy via a voucher for same amount for insurance program of their choice
Understand - ANY system will have economic limits, and thus there will be imperfections. Do these things and see how it improves over the next 3 years.
This is how REAL REFORM would work.
If more/different is needed, iterate. Maybe this list needs tweaking,but the key - Fix what is broken without breaking what works - healthcare in the US is 85% okay and 15% broken and assuming it is the other way.
… the ‘idee fixe’ of going after ‘universal coverage’ (which will never happen) while ignoring that overall issue of cost, access and quality as a whole is folly.
ObamalosiCare is not REAL REFORM, it’s a Government takeover attempt. It will not make things better and is inferior to other alternatives.
“How can anyone defend a healthcare (or any other kind of) system that’s based on markets that are mostly non-competitive?”
Government over-regulation has made health sector markets non-competitive. Profit levels for insurance companies are less than 4%. Much of that Government regulation is indefensible, for example, silly mandates at various state levels that do nothing but make health insurance more expensive and less accessible. Often these are done for no reason other than some special interest got it in there - chiropractic care, acupunture, mental ‘welness’, etc. all drives up cost of health insurance. We should allow and have ‘bare bones insurance’ available, especially to young healthy individuals who cannot afford the premiums (and consitute a large portion of those opting out of health insurance entirely).
Comment by Freedoms Truth — 11/13/2009 @ 4:06 pm
Medical inflation (rising cost of health care) is due in large part to the intrusion of medicare and medicaid and the greed of the slip and fall lawyers. Eliminating the role of the consumer (patient) from the buying (utilization) process allows the provider (MD, etc) to milk the system, any system, to the hilt.
Medical Savings Accounts and tort reform would be a start to controlling this inflation.
Just as school vouchers have been successful where used, MSAs would bring the “free” market into play resulting in competitive fees, judicious utilization and elimination of bureaucratic waste and fraud. Insurance companies would return to the market
National health insurance would follow the same course as it does wherever you find it - disgusting. No wonder it’s appeal is dwindling.
Comment by SmartyMarty — 11/13/2009 @ 4:16 pm
“If you would like to read the actual language of the individual mandate in the House bill, (Section 501) it is here.
As you can see, it is a 2.5 percent tax on adjusted gross income,”
Let me clarify again - You are saying it is Constitutional because THE DEMOCRATS HAVE PASSED A TAX ON EVERY SINGLE AMERICAN WAGE-EARNER.
So much for that “I wont raise taxes on the middle class” campaign promise, eh?
And … it’s not just a mere add-on tax, its a behavior modification program wrapped in a tax.
“Rivkin and Casey take the position that this tax is beyond Congress’s powers under the power to tax and spend for the general welfare and the power to regulate interstate commerce.”
It’s seems obvious that this treads new ground in encroaching on personal choice and individual liberty. The power to tax is the power to destroy, and it is not clear that even the 16th Amendment grants unrestricted ability to dictate personal behavior via the income tax. Where does it end?
If its ‘unremarkable’ it is probably because we have gotten inured to such encroachments over the years.
Comment by Freedoms Truth — 11/13/2009 @ 4:19 pm
This is another pathetic Moran dodge.
Based on this theory, America has needed a shrink since 1776. If only we could have made peace with those Loyalists…
Here’s an idea: sometimes the people are right. Not to subscribe to populism, but it is a thought.
Comment by obamathered — 11/13/2009 @ 7:09 pm
You must know that there aren’t just two options to move forward given our current situation, right? We don’t have to select between your questions above and the reform being discussed. I know you have more nuance than that.
To answer your questions directly, no, neither of those situations are “okay” with me personally. But that is largely irrelevant to the topic at hand. Whether or not a situation is “okay” with someone is nearly meaningless when it comes to what the federal government can (or should) do.
Is it “okay” with you that Saddam had men and women raped, mutilated and tortured? If it isn’t, then clearly going to war in Iraq was the right thing to do? You see, there are usually many, many options to solve a particular problem. Boiling the situation down to Option A: “letting kids die in the street”, or Option B: “passing health care reform” is just silly.
Does the right to something imply that the federal government should provide it for you? Or does the right to something only imply that the federal government cannot prevent you from pursuing it?
If people have the right to health care, then certainly they have the right to a method of transportation to the nearest health care facility in non-emergency situations. After all, how can one pursue the right to life without the right to health care? And how can one pursue the right to health care without the right to access it?
Comment by sota — 11/13/2009 @ 7:35 pm
Freedom’s Truth:
Your evasion is noted and does not surprise.
Sota:
I posed those as threshold questions. I didn’t say or imply that the House bill was the only way forward. I wanted Republicans to take this out of abstract theorizing and talk about actual human consequences. Rick’s post was devoid of human consequence, so I re-introduced it.
Is the House bill the best thing going? Of course not. It’s the kind of stupid, half-assed thing we end up with when the bulk of the polity is lost in delusion and fantasy and resentment, playing politics rather than solving problems.
Does the right to something imply that the federal government should provide it for you? Or does the right to something only imply that the federal government cannot prevent you from pursuing it?
Your argument works as well against Medicare or VA benefits or Social Security as against insurance/health reform.
Does the right of old people to eat something other than dog food imply that the federal government should provide? Are you prepared to make the argument that we should do away with SS, Medicare and VA benefits? You’re trying to move back to the abstract, back to the theoretical.
But people aren’t theoretical, they’re real.
In every single country in the developed world — except ours — people have a right to medical care.
In none of those countries to people have a right to taxi fare to the doctor’s office.
Why is it that every other developed nation can do what we cannot?
Comment by michael reynolds — 11/13/2009 @ 9:57 pm
I understand the conservative’s argument about not wanting to pay a higher tax to help the uninsured, I get it. Personally I would rather spend my tax dollars on the 100 billion a year to help the uninsured versus the 100 billion a year to bomb villages in Helmund Province.We’ll end up going bankrupt in Afhganistan in an endless war, but God forbid spend that money on some working class stiff. There’s the soul of my country in full view. We got to have our priorities. Yep, drop bombs on Afhgan villages, and forget about healthcare for hard working Americans. Cut and dry, black and white. So for you folks that don’t want their tax dollars going to healthcare, I don’t want mine going to bomb making.
Beautifully built strawman you set up there. Oooh! Ooooh! Those meany conservatives!
How about giving the working class stiff a nice fat tax break so that he can purchase the insurance himself - make his own choices instead of bowing to your obviously superior judgment - and make him responsible for his own life?
True, you wouldn’t be able to control him so I see the downside for liberals. But if insuring the uninsured is really your goal, then it is cheaper to encourage people to buy health insurance than punish them for not purchasing government run plans.
ed.
Comment by Joe — 11/14/2009 @ 8:19 am
How about giving the working class stiff a nice fat tax break so that he can purchase the insurance himself - make his own choices instead of bowing to your obviously superior judgment - and make him responsible for his own life?
Because:
1) This does nothing to widen the pool of insured which is necessary if we’re to avoid the young and healthy staying out of the pool and then jumping in at the last minute. When people do that — acting in their own short-term economic interests — they avoid contributing to a system they later exploit.
2) Also, most “working class stiffs” don’t pay enough in tax to pay for health insurance with a tax break. So it would have to be an earned income tax credit — a handout. Welfare. Which Republicans would of course demagogue.
You don’t understand this issue, Rick. Which is why you talk in vague abstractions and offer ideological pabulum.
Comment by michael reynolds — 11/14/2009 @ 11:42 am
Doesn’t the government control nearly half of the medical expenditures via medicare/medicaid/VA/ADA/SSI/mirad levels of regulation anyway? Will taking over another quarter of that figure really change much? The fact is, we’ve reached the point of no return in government involvement in healthcare long ago, so we may as well own up to ourselves to make it work properly and fairly for all Americans and legal immigrants.
Comment by Surabaya Stew — 11/14/2009 @ 12:40 pm
Doesn’t the government control nearly half of the medical
Mt Reynolds, #24:
Your sophistry is noted and does not surprise.
Government malfeasance can and will in a number of ways lead to the situations you describe. Socialism has historically caused poverty and misery. Whether its a US version of NHS denying life-saving care to kids (as has happened in UK) via ‘care by postal code’ or whether Obama’s economic malfeasance/mistakes will lead to hard luck cases for people, the fact that you are unwilling to acknowledge the downside and limits to Government action suggests you are incapable of an honest discussion on this matter.
It is sophistry, and you know it, to assume that opposition to ObamaCare and other dreadful socialist schemes is solely motivated by insufficient concern for those in need.
I show my own concern by supporting private charity, and I suspect I may give more than you to charity. My concern is not lessened simply because I dont agree with wrecking the economy and the federal budget with over-reaching socialist schemes. These schemes hurt more than they help. It’s interesting, yet not surprising, that liberals want to play the moral superiority game with other people’s money, but not put their own money where their mouth is (surveys have shown that conservatives give more to charity than liberals).
Mr Reynolds, do you find it acceptable that conservatives give more to charity than liberals, and that liberals are less charitable than other Americans?
http://www.realclearpolitics.com/articles/2008/03/conservatives_more_liberal_giv.html
“People who reject the idea that “government has a responsibility to reduce income inequality” give an average of four times more than people who accept that proposition. “
Comment by Travis Monitor — 11/14/2009 @ 2:44 pm
“You don’t understand this issue, Rick. Which is why you talk in vague abstractions and offer ideological pabulum.”
ROFL … That’s the critique that should be lobbed at OBAMA.
The President has yet to honestly and directly address the concrete and real issues relating to government-run healthcare. All he offers is pablum, platitudes and patronizing feelgoodism.
Comment by Travis Monitor — 11/14/2009 @ 2:47 pm
#25: “Personally I would rather spend my tax dollars on the 100 billion a year to help the uninsured”
You are more than welcome to spend your personal funds as you personally wish.
Public spending accounts for between 45% and 56.1% of U.S. health care spending… so the Government already spends something over a trillion a year. So you are wanting to reduce it by 90%? or raise the ante?
Why not just means-test Medicare and you can add coverage for those ‘in need’ without raising Govt overall spending at all?
Comment by Travis Monitor — 11/14/2009 @ 3:05 pm
If you have ever had to deal with the health insurance industry as a patient/consumer…you would realize that we have already lost the battle. I have no fear of government coming between me and my doctor, or having the terms of my health care dictated to me…I have been experiencing it for years. The only difference I can see is that rather than some insurance company flunky I will have to deal with a government flunky. I have been getting my health insurance through my job with a Fortune 500 company for over a quarter of a century. I have raised 3 kids to adulthood and wandered through the maze of having the insurance company reject even the most basic procedures and treatments, and then engage in a telephone/USPS campaign to have things approved. It appears to be their default position, say no and then let the insured waste countless hours dealing with nonmedical people to get medical treatment. This coverage has never been cheap. Costs have gone up and coverage down, every year for as long as I can remember. I have been force to change doctors for my kids and myself because my employer changed insurance companies. There is nothing in this reform that frightens me. Death panels?…bring ‘em on!
Comment by Dee — 11/15/2009 @ 7:03 am