Tuesday, August 18, 2009

Sick

In my conversations with conservative and libertarian friends, no matter what the issue, their position boils down to one issue: how are we going to pay for it?

When they ask that, of course, they already know the answer. And if it doesn’t involve philanthropists or the benevolent private sector, then it not only isn’t worth doing, but it’s a great travesty to our republic.

Of course, streamlining expenses is a good cause. I doubt anyone really thinks tax money deserves to be spent in the worst and most inefficient way possible. In that sense, the con/lib stand on taxes is as unassailable as their stands on patriotism, life, mom, apple pie and Chevrolet. Especially Chevrolet. How could anyone be against any of these?

But like every other con/lib attempt to co-op universal attitudes for their own dubious principles, it’s best to read between the lines.

More than one of my friends has suggested that a fix to the health care crisis is tax breaks. I’ve also heard that the government should set up a panel to monitor insurance companies but stay out of the marketplace, the idea being that this would eliminate price gouging without giving the government an unfair competitive advantage. Others say leave the system alone - not because it isn’t broken, but because the expense to fix it isn’t worth it. Still others allege that many, if not most, uninsured citizens simply CHOOSE to be that way. All of these people agree that health care reform would be a costly, massive endeavor.

But again…does anyone think that it won’t be? That isn’t the point of disagreement; the end result is the real bone of contention.

If conservatives and libertarians share one defining issue, it’s the idea of streamlined spending. Both groups approach this in differing but equally flawed ways. In recent years, conservatives have largely abandoned any practical application of sensible spending (see war, Iraq and cuts, tax), but still espouse the notion whenever convenient. Libertarians, on the other hand, are loyal to this principle to a fault, which comes off as completely uncaring toward their fellow humans (which surely is an unfortunate misrepresentation). Either way, health care reform is seen as an unworthy federal investment.

And why would it be? Insurance is out there, and it’s no one’s job but the consumer’s to ensure that the coverage is fair. If not, don’t buy into it. If you do, and are unsatisfied, it’s your fault. Caveat emptor. Of course, this idea of a free-market insurance mall is mostly in their imagination, and people never choose to be sick, but at least they’re talking about it.

What’s most often left out is the fate of those too poor/sick to afford insurance. Some people have to be dragged into this territory like a screaming child to the dentist. All the tax incentives and anti-government arguments in the world aren’t going to help cover the uninsured. Of course, that could be the point.

As they say, hard work makes you self-sufficient. If you are not self-sufficient, you are not working hard, and thus don’t deserve support from anyone. Don’t have health insurance? Get a job that offers it! Nothing’s free in this world, pal, and if you wind up so sick from neglect that you need costly ER care, well, maybe that’ll give you pause next time, huh?

Combine that with the popular neocon argument that tax cuts are the answer to every problem, and you begin to see the problem here. It isn’t that they have inadequate or necessarily incorrect positions; it’s that they have what they feel is the best solution for them. And if it doesn’t address the problems of the poor, well, too bad.

I say “what they feel” rather than “what is,” because a lot of these positions are based on simple misinformation and ignorance. Middle-class and poorer conservatives do not vote for their economic best interests and haven’t for at least 29 years. Instead, they cling to the Milk and Honey myth that they will eventually be obscenely wealthy. To that end, they support policies that will pave the way for a comfortable existence once they get there. Only thing is, that doesn’t ever happen for 99 percent of the population. And even if it happened for everyone, it’s not a good idea. A tax base cannot sustain itself with a regressive scale, nor can a population stay healthy when health care is a function of wealth.

Of course, such concerns don’t bother those who are concerned primarily with their own lot. And that’s understandable in an economic climate where most people are barely hanging on. But it’s the very policies they support that lead them to this situation, which would be poignant if it weren’t outright outrageous.

Convincing the anti-tax camp that a public option is worth our tax dollars is, to put diplomatically, an uphill climb. They’re already convinced that the government never gets any bang for its buck, and even if they could see a healthy citizenry for themselves, they would not be moved, because all they see is money. But even if the system ultimately saved taxpayer costs in the long run and fostered true competition, they’d still be against it just on principle. After all, it’s Obamacare. And no medicine yet can cure such terminal demagoguery.

16 comments:

E.J. said...

I had a recent conversation with a libertarian and told him how I couldn't afford health insurance during the several months I was unemployed. He told me that I could have had I made it a priority since I found enough money to pay my car note (it was paid off I told him). Bet you paid car insurance, he said. (it's illegal not to plus I needed it to look for work I said). Oh, he said, well you could've afforded it if it were a priority.

Ian McGibboney said...

Yeah, E.J., that's a great argument. The idea that if you own a car or so much as a TV, that your priorities are wrong and that you're just being a crybaby. I guess in their perfect world, people have health insurance but have empty apartments and refrigerators. Just goes to show that they think health insurance is just another commodity you can shop for at the grocery store. What a crock.

Speaking of car insurance, the compulsion of which is a great point, I recently read an editorial that suggested health insurance was meant to be like car insurance, in that it's meant to cover major expenses and accidents, but smaller, preventive measures come out of pocket. Immediately I thought, "But oil changes don't cost $1,000."

EVERYTHING is about money to these people. More specifically, their money.

Tom Alday said...

Health care is not a right. If people can't afford it or don't want it's not the job of the government to force them to have it.

Ian McGibboney said...

Well, Tom, doctors are bound both by oath and by law to provide care to those who need it. So in that sense, you're wrong.

I also have never known a single person who could get/afford health insurance, yet chose not to do so. I'd never even heard of the notion until conservatives needed a justification for not changing the health system.

I personally think health care belongs under the "promote the general welfare" aspect of the Constitution. But even if you don't think so, the idea that people should be left on their own (and possibly to die) over greed and anti-government beliefs is the most cold-hearted policy I can think of. Fortunately, you're just a loud, ignorant minority.

Tom Alday said...

It's not a right per the Constitution, no matter how you interpret the "general welfare" clause, no court has ruled in your favor, so think it all you want, you're wrong. The general welfare clause refers to infrastructure needs, like roads and such, not making sure people get some Tums when they got a tummy ache.

People suffer and die every day for a host of different reasons, it's not the governments job to be nanny and coddle everyone.

The government can't even run Cars for Clunkers efficiently, and you somehow think they can run Obamacare?

Ian McGibboney said...

Considering there were no roads when the Constitution was written, isn't it an interpretation to say that "general welfare" refers to roads? But fine. Infrastructure, I get it. So why does it refer only to real estate and not human needs? Because from my understanding, the Constitution does not outline a capitalist economic system. So it seems strange to me that the preamble would refer to property, but not social needs. It's a curious interpretation.

As for people suffering and dying every day...how many of them are in that shape specifically because of corporate health care? Because they couldn't afford preventive care, and now it's too late for anything but the ER? We pay for that already, and get nothing but misery for it. If we're going to pay for it one way or another, why not go the way that saves lives and raises our standard of living? Even a bean-counter such as yourself should know the answer to that.

As for Cash for Clunkers: how has that been a fiasco? It's boosted dealerships all over the country and gotten lots of unsellable cars off the road. Yes, it's not perfect, but up to this point the only criticism I've heard about it was from people who thought some of the cars should have been resold. Or is this just the latest fear-inducing example of government ruining everything, now that people realize that the Postal Service, highways, Medicare and Medicaid have failed to turn public sentiment against all things government?

E.J. said...

Health care is not a Constitutional right but it's in the interest of the country to control its costs. I'd rather pay less of my taxes towards subsidizing healthcare so more people can have it instead of the insane amount of money government now pays to hospitals to reimburse them for the care they provide to the uninsured and the underinsured who can never pay them back. The hospitals would go out of business otherwise, then NOBODY would have access to hospitals.

Hospitals and clinics are indeed part of our country's infrastructure. Revenue and productivity and national security are compromised without healthcare as sure as washed out roads would compromise our economy and our security. Look at the money lost and ripple effects of closing schools, etc. caused by a pretty mild swine flu outbreak earlier this year.

Tom Alday said...

As for people suffering and dying every day...how many of them are in that shape specifically because of corporate health care? Because they couldn't afford preventive care, and now it's too late for anything but the ER? We pay for that already, and get nothing but misery for it. If we're going to pay for it one way or another, why not go the way that saves lives and raises our standard of living? Even a bean-counter such as yourself should know the answer to that.

//Because "that way" will bankrupt the country. It's a business Ian, the operative word in the name insurance company is "company", their job is to make money. If you don't like the care they provide for the money you give them you go to a different company and get your insurance. If you can't afford it then boo hoo, some people can't afford food every night, is the government going to swoop in and shower everyone in America with free food?//

As for Cash for Clunkers: how has that been a fiasco? It's boosted dealerships all over the country and gotten lots of unsellable cars off the road. Yes, it's not perfect, but up to this point the only criticism I've heard about it was from people who thought some of the cars should have been resold. Or is this just the latest fear-inducing example of government ruining everything, now that people realize that the Postal Service, highways, Medicare and Medicaid have failed to turn public sentiment against all things government?

//CARS has been a disaster. It has taken perfectly usable cars off the road, cars that could have gone to the poor, teens and charities and it's destroyed them. Not to mention the horrible bureaucracy that has only paid 2% of dealers back, denied thousands of claims with no reason given and generally been a pain in the ass for most dealers. Oh and it was so horribly mismanaged that it ran out of money in 1 week.

As for supposed "fear inducing" I can't help but notice you partake in that activity yourself. If someone only read your blog as a source of info on health care you would think their were dead bodies lining the streets and rich, insurance fat cats riding around in top hats and monocles on the backs of the poor counting their ill gotten gains. As I said before, 93% of the US is insured and 85% or so like the insurance they have. The government can't even manage medicare and medicade properly and you think they can take on an additional 250 million or so people? What world do you live in where the US government has ever managed ANYTHING well? Why do you have so much faith in a governing body that constantly fails you?

I just have to laugh when the same people that just 3 or 4 years ago were bemoaning the horrible inefficiency of government for not being able to get armor for troops in Iraq now suddenly sees the government riding in on a white fucking horse saving everyone with their awesome efficiency and super cool rainbow powers. //

NOLA Progressive said...

Government is as efficient as it's operators.

Different operators different results. The difference is I have some semblance of control over my government. Sure sometimes it may not seems so, but the referendum is a significant control. I have no control over a corporation and it's board of directors. They only answer to the wealthiest of shareholders or in some cases are the wealthiests of share holders.

The country most certainly will not go bankrupt by making health care a right and providing to all in a cost efficient manner. In the long run it will force costs down and provide as of yet unseen surprpluses in the health care sector.

Also the notion that I can simply shop my health insurance around is absolutely absurd. The same prohibitive costs and exclusions apply across the country whether it be pre-existing condition denials or no portability. Also be very very wary of throwing poll numbers on all of this around lest you note the percentage of people who believe serious health care reform is necessary. There is a lack of congruency in those numbers that speaks volumes.

Oh back to the it would bankrupt the country business. Let me be simple. How ya figure?! There are numerous countries (actually all industrialized nations in the world beside us) who provide health care as a right, and quite a few of them are in better shape fiscally than we are.

If you want details about those fat cats with monacles and top hats listen to the reports of former insurance execs who left out of disgust and guilt. Listen to the stories of denial after denial resulting in tens of thousands of deaths a year.

I can not imagine a more callous and less proactive point of view than to state in essence "afford or don't but it's your problem."

This ridiculous notion of completely inept government that constantly fails us is tired and not respected as any type of realistic debate. Government is the vehicle by which our country comes together to provide any number of things for us all. We decide on what those may be. Corporations are no more efficient, less under the public microscope, and not nearly as acoountable.

Ian McGibboney said...

Tom, CARS ran out of money because Congress underestimated how popular it would be. Drivers are attracted to it because up to a $4,500 credit is a great deal for a car worth far below that. In the words of one local guy, the vehicles "ain't nice cars." If they were, owners can get far more for them at a used-car dealer or in a private sale. No one's forcing these vehicles off the road, but many of them need to be off the road. You, Tom, act as if Obama is making everyone sell their cars to junk yards.

As for health care, the very problem for millions of Americans is precisely that current business practices price them out of coverage right away. Their job shouldn't be strictly to make money; it's also to give people the services THEY PAY FOR so that they can stay alive. Even people lucky enough to have insurance (like me) often find themselves at the short stick of every bean-counting measure in the book when push comes to shove. And I think that's why a public option scares so many insurance apologists - because it would force these companies to adopt lower prices and actually compete. They don't want to do that. I couldn't care less. The fact that there's such a call for change doesn't speak well for these business you defend so vociferously, Tom.

And please cite that statistic that insists 93 percent of Americans are insured. I haven't even seen that on Fox News. I also don't believe the satisfaction rating, though even it is true, it doesn't mean people aren't necessarily looking for something better.

Incidentally, don't you work in the insurance industry, Tom? I seem to recall that you did the last time you trolled around here.

Finally, the government. Only a reactionary anti-government type like you would suggest nothing in the government works well. You do realize the military is the U.S. government, right? And roads? Your arguments should really take more than one second to debunk.

As for criticism, people derided Bush because he WAS incompetent. He even seemed to take pride in it. And I'd argue that there's a huge difference between troops not having enough armor and these stupid "socialism" and "I hate government" cries from people such as yourself.

Tom Alday said...

Oh hey, fyi on that Cash for Clunkers program

http://www.breitbart.com/article.php?id=D9A63RC81&show_article=1

But hey what do I know, it's great and dealers love it because it's so awesomely run by the same bureaucrats that want to run my health care.

Ian McGibboney said...

Even if the dealers never got that money, Tom, they still saw an uptick in sales they wouldn't have had otherwise. People got new cars, and old clunkers are off the streets.

But they WILL get the money. The government has to pay. The money's been dedicated; all that went wrong were a few bureaucratic kinks that were mostly a function of underestimating the program's popularity. A private company in the same situation probably would have folded its tent and left many high and dry.

It's going to take a lot more than some internal funding snafu to change my mind on health care reform.

Tom Alday said...

Nice to know "internal funding snafus" are no big deal to you. I bet if it was YOUR money you weren't getting as promised you would be a tad more pissed. Maybe if/when Obamacare passes and that "internal funding snafu" screws up your coverage you'll see the error of your ways. Oh wait I forgot, Obama and his magical powers will make internal funding snafus...and really, any governmental mismanagement of funds, a thing of the past. Because he's THAT AWESOME.

Ian McGibboney said...

Yes, Tom, I am not basing my entire stance on health care reform on one reimbursement issue on an unrelated program that isn't even an issue of incompetence, but one of overwhelming demand (something that a reformed health system would fully anticipate). Sorry. Irrational hatred of the federal government doesn't come to me as naturally as it does to you. I happen to think that government does a lot of things right, and that private companies can be just as prone to the same mistakes and bureaucratic incompetence. The difference is, with the government, there's more accountability.

Tom Alday said...

My hatred of governmental waste is anything but irrational. If you cared about anything other than ensuring Democrats stayed in power you would have the same distrust. But you're too inflexible and rigid in your stalwart defense of the same government you derided the last couple years. Now they're the best thing ever and despite the fact that they can't even manage a goddamn rebate program effectively they are SOMEHOW going to manage the health care of 300 million people. Why do you trust them so much when it's RIGHT IN FRONT OF YOUR EYES THAT THEY SUCK? You can put your trust in a governing body that has run every institution it's created into near bankruptcy, but I'll trust the private sector, you know those guys who aren't 1 step away from insolvency due to gross mismanagement.

Ian McGibboney said...

"But you're too inflexible and rigid in your stalwart defense of the same government you derided the last couple years. Now they're the best thing ever..."

Yes, Tom, far be it for me to view an entirely new administration differently than the last one, especially since the new one is a lot smarter and actually prefers expertise to cronyism in its political appointments.

I've never despised the government as an entity, even when it has been ruled by vicious morons. You know, you used to make fun of me during the Bush years for being paranoid about government leadership. Now, you can't say enough bad things about not only the leadership, but about the entire system. So which one of us has truly changed. Tom?

If I were you, I'd also think about your unabashed worship of the private sector. I see a lot of gross mismanagement that you apparently don't. If you want to make a case for private over public, fine. But you're as uncritical of the private sector as you (incorrectly) accuse me of being of the government, and that doesn't help your case at all.

Finally, the government would not be directly involved in health care any more than Blue Cross bureaucrats take your blood pressure. Stop the scare tactics.