“I gather from some of the correspondence I’ve received about The Conscience of a Liberal — mainly, I think, from people who’ve heard me on the radio but haven’t yet read the book — that there’s some confusion over the book’s theory of modern American politics. Some people seem to think that I’m saying that racism and the other issues I classify as “weapons of mass distraction” are what movement conservatism is about. They aren’t.
I think Krugman is correct, however, I think he should have been more clear that this is the stated goal of a certain wing (perhaps the dominant wing) of the Republican party. There are other wings of the party which are genuinely focused on Biblical goals, some that just like to bomb and blow shit up, and others which are focused on keeping women and minorities down. It's one big happy family.
In any event, lest I repeat the same mistake, let me be clear: people are entitled to hold whatever political beliefs they please (of course, it would be nice if the opposition felt the same way, but whatever...). This is still
The reason why such candor is rare is the simple fact that to oppose the New Deal is to mark oneself as a heartless bastard, like Grover Norquist. Few pols are willing to go quite that far (in public, anyways) nor does their constituency want the public at large to be reminded how cruel, divisive and inhumane their political platform truly is (denying health care to poor children? Why, Reagan's ghost demands it! need another trillion to blow up a furren country? No problem!).
So they speak in code, (just as they used to do in terms of race) and this code-talking has served them well: not only does it hide the regressive ugliness of their agenda from the light of day, it also serves to make it difficult to argue against. This is the truth that lurks behind their perennial tax-cutting mania: not the noble goal of putting money back in the pockets of regular Americans, but a complete and total dismantling of government itself.
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26 comments:
Well written.
Why, thank you! (I assume you are referring to my scribblings, although your praise applies equally to Mr. Krugman's prose as well, I imagine).
If a more centrally planned economy and income redistribution are good things (ie. the New Deal, Great Society) and is what Krugman desires, why is it that just about every centrally planned economy in the last century has been discredited?
Why is it that even the Communist Chinese have reverted to a more capitalistic based economy?
Have either of you ever read about the disasters brought on by the New Deal (prolonging the great depression) and Great Society (increased births out of wedlock, increased poverty, increased crime rates, increased STD's), or do you just choose to ignore that data?
Do you have data to prove why this would be a positive step?
Which segments of the Republican party are focused on "keeping women and minorities down" and how do they go about doing so?
Can you share all this data for us?
One incident where a member of the Republican party have focused on keeping women down has been the attempt to remove the 19th amendment.
"I think the 19th Amendment, while it's not an evil in and of itself, is a symptom of something I don't approve of," she said at the time. "The 19th Amendment is around because men weren't doing their jobs, and I think that's sad. I believe the man should be the head of the family. The woman should be the heart of the family."
Granted, this is only one example of the fallacy of the "Big Tent" of the GOP. I'm sure given more than three minutes before work, I could find a few (thousand) more.
Cheers,
Marty
Pick up a book or two, such as 'Vision of the Anointed' by Thomas Sowell. It goes in depth about how liberal policies, while well intentioned, almost always have negative results.
Thanks for the example of Senator O'Connor. I'd love to see a couple more of the thousands of examples you have.
If you are going use examples, then it is your responsibility to site said examples in your arguments. Telling me to go "look it up" is not appropriate for discourse. What you are doing is quoting talking points and rhetoric--instead of sharing any useful information.
If you want to be taken seriously, I suggest you follow simple rules of debate and discourse.
Point taken. Unfortunately I don't carry the book with me at all times so I can’t type out the stats for you. However, I was kind enough to locate some stats and information found in various articles by Thomas Sowell and Walter Williams, two of the smartest and most insightful men in the country. And trust me when I say there is a lot more conclusive info out there; this was simply a quick Google search. Excuse me if this post is long, but it will be easier to reference some stats if they are in the thread and not just at the other end of a link. Also, if I remember correctly, you are involved with law enforcement and youngsters or something like that, so hopefully you can look at this information with an open mind and not through the "if a conservative says it it's wrong" prism that rules Nikkos entire life.
Preserving a Vision
Teenage pregnancy had been going down for years. So had venereal disease. Rates of infection for syphilis in 1960 was half of what it had been in 1950. There were similar trends in crime. The total number of murders in the United States in 1960 was lower than in 1950, 1940, or 1930 — even though the population was growing and two new states had been added. The murder rate, in proportion to population, in 1960 was half of what it had been in 1934.
Every one of these beneficial trends sharply reversed after liberal notions gained ascendancy during the 1960s. By 1974, the murder rate had doubled. Even liberal icon Sargent Shriver, head of the agency directing the "war on poverty," admitted that "venereal disease has skyrocketed" even though "we have had more clinics, more pills, and more sex education than ever in history."
Liberals looking back on the 1960s take special pride in their role on racial issues, for civil rights laws and the advancement of blacks out of poverty. Those riots that threatened to tear the country apart were race riots — and supposedly the liberals saved us all. But what do the facts show?
Both the Civil Rights Act of 1964 and the Voting Rights Act of 1965 had a higher percentage of Congressional Republicans voting for their enactment than the percentage of Congressional Democrats.
You can check it out in The Congressional Record.
As for black economic advances, the most dramatic reduction in poverty among blacks occurred between 1940 and 1960, when the black poverty rate was cut almost in half, without any major government programs of the Great Society kind that began in the 1960s.
This link has a snippet from a Williams article, and has a link to the original Washington Times article, but it’s behind uid/pwd.
What about the decline of the black family? In 1960, only 28 percent of black females between ages 15 and 44 were never married. Today, it's 56 percent. In 1940, the illegitimacy rate among blacks was 19 percent, in 1960, 22 percent, and today, it's 70 percent. Some argue the state of the black family is the result of the legacy of slavery, discrimination and poverty. That has to be nonsense. A study of 1880 family structure in Philadelphia shows three-quarters of black families were nuclear families, comprised of two parents and children. In New York City in 1925, 85 percent of kin-related black households had two parents. In fact, according to Herbert Gutman in "The Black Family in Slavery and Freedom: 1750-1925," "Five in six children under the age of 6 lived with both parents."
Therefore, if one argues what we see today is due to a legacy of slavery, discrimination and poverty, what's the explanation for stronger black families at a time much closer to slavery -- a time of much greater discrimination and of much greater poverty? I think a good part of the answer is that there were no welfare and Great Society programs.
First, William, I want to apologize for some early snark that crept into a previous post. I did not read this one completely before responding to this one. I am sorry for being snarky when I should have been scholarly.
However, if we are going to engage in honest debate, we need to drop the troll attitude. Making a snarky comment about Nikkos' attitude or about my willingness to be open minded isn't doing you any favors in creating discourse. It is, however, giving you a troll status. Likewise, an underhanded comment from me about not saying who I think you were is just as debilitating. Therefore, I will endeavor to stay calm and civil. I would appreciate the same treatment in return.
Both articles seem interesting--and I will give them a more thorough reading over the next few days.
However, I do have a few points that I find interesting. First, the snippet from the Sowell article seems to be pulling its statistics from thin air. TO be taken seriously, he has to got site a source.
In quoting how Republicans voted for the Civil Rights Act and the Voting rights act, "Both the Civil Rights Act of 1964 and the Voting Rights Act of 1965 had a higher percentage of Congressional Republicans voting for their enactment than the percentage of Congressional Democrats."
This is true. At the same time, this has more to do with the make up of the South than it does with Liberals. Hell, in the 50s even Eisenhower called himself a liberal. please take note of the in text citation.
In 1964 and 1965 southern democrats were opposed to desegregation. Commonly known as Dixiecrats, they attempted to filibuster the legislation. Those Dixiecrats are the reason why the numbers are skewed. What did those Dixiecrats do after the vote? Some switched parties--Strom Thurmond among them.
This article has a fairly decent summary of the event. This paragraph in particular:
In the mid 1960s, the Dixicrats switched from the Democratic to the Republican Party to assist Barry Goldwater in his unsuccessful bid for the presidency against Lyndon Johnson. They were, however, pivotal in the Southern strategy that won the White House for Richard M. Nixon in 1968. President Reagan, a Republican, is credited with bringing all factions of the Republican right-wing conservative movement together, steeped in the Dixiecrat states' rights tradition.
Strongly supports my argument: 1964-65 Southern Democrats skew the data that Williams eventually quotes. Those Democrats were Democrats because the Republican party was still heavily associated with Lincoln, the president who started the war of Northern Aggression.
As for this Point:
"Therefore, if one argues what we see today is due to a legacy of slavery, discrimination and poverty, what's the explanation for stronger black families at a time much closer to slavery -- a time of much greater discrimination and of much greater poverty? I think a good part of the answer is that there were no welfare and Great Society programs."
My argument would be that 1) Williams' citation of one book does not make his numbers perfect and 2) there are a number appear to be a study of African Americans in the north, not the south.
A quick google Scholar search regarding the Gutman book revealed what appears to be a rebuttal of his argument
This is only one article that had an abstract that I could read without paying for. Granted, it is no where near enough; however, given time I could find my texts on slavery and the economic impact. However, that'll be a long term debate, and right now I should be putting books away, not digging them up for a blog comment fest.
Secondly, in the data quoted by Williams (through Gutman), it appears he is using northern cities as his data center. There is a huge difference between Philadelphia circa 1920 and Birmingham 1920.
Furthermore, the cut off date for this data is 1925, fully 5 years before the great migrations of the 1930s. This migration, and the subsequent reaction by white communities lead to the Racial turmoil in this country. I believe the cut off date for Gutman's research skews more data than it illustrates.
My question to you is this:
Why would America push foward so many Great Society programs if the citizenry, and its legislators, did not believe it was necessary?
I also apologize for any errors in spelling, grammar or HTML rendering. Next time I will edit in a bigger window before hitting publish.
I just want to thank William for sticking around. i hope that you will continue to try and rationally change people's minds. It is to your credit that you argue rather than shout.
If a more centrally planned economy and income redistribution are good things (ie. the New Deal, Great Society) and is what Krugman desires, why is it that just about every centrally planned economy in the last century has been discredited?
Why is it that even the Communist Chinese have reverted to a more capitalistic based economy?
Have either of you ever read about the disasters brought on by the New Deal (prolonging the great depression) and Great Society (increased births out of wedlock, increased poverty, increased crime rates, increased STD's), or do you just choose to ignore that data?
Well, let's start at the beginning, as they say. Has just about every centrally planned economy in the last century been discredited? I really don't know. It depends on what you mean by centrally planned, I suppose. If you mean any economy that is to some degree regulated versus totally unregulated, then I'd have to say that the statement is false. Most European economies are credible, as is the United States economy. To be fair, they are not entirely centrally organized economies like in a "communist state." If we're just examining self-proclaimed communist economies, I would have to agree that they have been discredited, for the same reasons that the Chinese have been reverting to a capitalist society. Communist economies don't really work, primarily due to the fact that people are not rational economic actors. (This will come up as a point later.) This aside, we can return to the first point that "centrally planned" economies can be relatively successful, dependent on the degree of planning. While imperfections in the U.S. economy and society can be noted, I don't think anyone can reasonably claim that the economy has been a failure or discredited, despite the meddling or lack thereof on the part of the government/central economic planning entity. (And the U.S. economy is HIGHLY regulated. Just ask Wall Street what it thinks of the Fed.)
Jumping ahead to the New Deal, it has been said that it prolonged the Great Depression. Astounding, that. Is it true? No one can say, actually. It seems unlikely, though. It is more accurate to say that the New Deal did not shorten or end the depression, although it may have alleviated it's effects somewhat by providing work, money and food to the massive ranks of the unemployed. If it is true the program of local state and government action and volunteer efforts supported by Republican Herbert Hoover failed to stop the Great Depression, we can hardly turn about and use the same standard to indict the New Deal as prolonging it. No, in both cases, it is fairly easy to say that they didn't end it; this was moot because all economies started to recover largely due to the boost in industrial orders that coincided with the launch of WWII.
Just to note it, there really weren't any economies that recovered without some socialistic programs in action at the time of recovery from the worldwide depression, so it is impossible to compare a "New Deal" type economy to an non-"New Deal" economy in their recoveries from the depression. They were ALL New deal economies. Except for maybe the German Economy, which recovered first largely due to MASSIVE centralization of economic factors, principally ignoring foreign debt, conscripted service programs, and ordering lots and lots of war material. Oh, and seizing a lot of private property for income redistribution, primarily from Jewish Citizens. And that was the first economy to really recover. I guess centralized economies can be good...and very, very evil.
On to the Great Society, and the decline of civilization. I feel bad bringing it up, but let's review, even though we all know it: correlation does not imply causation. Yes, yes, we've all heard it before, but we all know it's not true. Otherwise, our beliefs would not be so secure. Then again, on review, our beliefs aren't actually secure at all. So that's okay then. I'm going to revisit the Great Society later, so for now, let us just ask the question: what is the mechanism by which the Great Society programs caused increased births out of wedlock, increased poverty, increased crime rates, and increased STD's. Did it erode moral and social mores? And if so, how? Did people lose sight of personal responsibility, or stop fearing God, or what? What is it about social assistance that seems so toxic that it could cause these trends? (Those are actual questions, by the way. Not snarky demands.)
William, I also have to point out that I don't ignore data. It's just that I am frequently forced to admit, I don't know what the data means. Later in these posts you will say, "But what do the facts show?" Answer: I don't know. Whenever I look at all the facts, I get dizzy. Anyone should. The ability to look at a few numbers and draw conclusions is a common one. The ability to look at any number of facts and draw valid conclusions...well, let's just say, it's a lot harder.
Teenage pregnancy had been going down for years. So had venereal disease. Rates of infection for syphilis in 1960 was half of what it had been in 1950. There were similar trends in crime. The total number of murders in the United States in 1960 was lower than in 1950, 1940, or 1930 — even though the population was growing and two new states had been added. The murder rate, in proportion to population, in 1960 was half of what it had been in 1934.
Every one of these beneficial trends sharply reversed after liberal notions gained ascendancy during the 1960s.
Hmmm. I have to say, finding any of these statistics had proven more difficult than I anticipated, even with library search databases. (Oh, EBSCOHost, you have failed me!) So, let's start by addressing just the logic here. We've already mentioned the correlation/causation fallacy. Is there anything to suggest that it is a fallacy in this case?
Well, yes and no. is there anything else going on here that can help explain these trends? A little, at least. Starting with venereal disease: what changed in the late 40's early 50's that might alter infection rates, especially in something like Syphilis? The answer is the establishment of certain medical protocols in the treatment of such diseases, most notably penicillin, which I believe became standard around 1947. If this was the root of limiting the spread of such diseases, it should have begun to decline significantly following the treatment's introduction, which agrees well with what William has said. As for crime, it tends to have a correlation with poverty, but this doesn't really hold up during the sixties, which were a period of substantial economic growth. Crime also correlates highly with a rather conservative aspect of government influence: prohibition. The 1956 Daniel Act and Controlled Substances Act of 1970 served to bracket the tumultuous '60's, and saw an explosion in the use of recreational drugs, particularly in the inner cities. Add in the element of the pill, approved for contraceptive use in 1961, and suddenly that whole era is looking a lot less simple. So, the question is, were liberal social policies the cause of increasing venereal disease, pregnancy rates, drug use, and crime, or was there a constellation of other factors at work?
To be fair to my argument, I think it is true to say it is easier to draw a link between a revolution in sexual mores due to the introduction of the oral contraceptive leading to more pregnancy and venereal disease than the introduction of significant welfare programs. (Women realize they can have sex without a significant risk of pregnancy, so they start having more sex. A significant number of them don't use the pill properly, leading to more pregnancies. The pill doesn't protect againt STDs, leading to more STD infections along with the extra sex. Contrast this with...Women realize they can not work, but still not starve due to government programs. They then become prostitutes, increasing pregnancy and STD rates. Now, to be fair, I can see a more complex scenario wherein the consequences of having a baby you can't pay for are mitigated by welfare, and this could compound the effects of the Pill, but i can't imagine it as an independent scenario.) Also, so we don't get off track, we're talking about "Liberals" as responsible or economic policies that contribute to problems like crime and teen pregnancy, not sexual liberation as a liberal policy.
So, again, correlation? Not causation. Liberal ideas like the Great Society had their shot in the late 60's, but then again, so did a lot of other social changes. To blame the negatives exclusively on the Great Society is disingenuous, especially after NOT giving the New Deal credit for all the positive changes in the intervening decades. (Not that I think the new Deal caused a decline in teen pregnancy, but that I think the case for that is just as bad.)
As for black economic advances, the most dramatic reduction in poverty among blacks occurred between 1940 and 1960, when the black poverty rate was cut almost in half, without any major government programs of the Great Society kind that began in the 1960s.
Well, yes, but this was in a period of incredible economic expansion following WWII. Everyone benefited, even minorities. I have no idea, however, if they benefited more or less than the general population. (Anyone?) To say that the general economy didn't benefit from a major government program, and that this didn't account for at least some of the benefits to the African American population, is likely false. The G.I. Bill funneled billions in training and support monies directly into the economy, as did continued if lessened war spending and loan repayments. These might not have been "welfare" programs, but the effect was similar. Income in the form of taxes was taken and redistributed, giving the economy a huge boost. It's till government spending, and it still had a social aspect. I'd say it has notable similarities to the Great Society, at least in philosophy.
As much as I'd like to go on, I have to end for now. Toodles.
PB-
Thanks for the comments. To start off with, I’m not a troll. I don’t care what anyone says, I’m here to engage in debate with people who I think are (usually) wrong. It’s not as much fun to debate with people you agree with. If you think I’m a troll, fine; I don’t care. You’re allowed to have your opinion. I will not drop my attitude with Nikkos (or Danny Douche, for that matter) because over the course of “debates” with them, they have proven themselves to be people who are unable to show respect to people who don’t toe their line (particularly Danny Douche). They can both be extremely hateful, venomous people.
As for Sowell and Williams, they are two of the most well respected scholars in the nation, both with impeccable credentials. You are not going to debunk their stats. If you’d like to try, good luck and I hope you don’t waste too much of your time.
As for your question: Why would America push foward so many Great Society programs if the citizenry, and its legislators, did not believe it was necessary?
Here, I believe, that you show some naivete towards the imperial federal government. What is the primary goal of just about every politician? --- power. How does a politician gain power over their constituents? --- by being in control of the services that said constituents rely on. It’s just as simple as that.
Surely, you’ve heard of pork spending and social programs referred to as vote-buying programs? Think about it – politicians set up programs to provide the citizenry with certain “entitlements” (calling them entitlements makes it even better because trying to take something away from someone when they’re entitled to it is even harder). Now, many people are getting “free” stuff by forcibly taking money from one small group and giving it to another larger group (the size of the groups is also important because the larger group getting the “free” stuff will continue to vote for the politicians who provide these entitlements). The more and more government programs that are created, more and more people fall under the grip of the imperial federal government – and it’s meant to be that way. Think about socialized medicine. Is there anything more important than your health? When the government controls your health, they will own you.
Seth-
Yes, by centrally planned economies, I was speaking of communist/socialist economies. I understand that the US economy is highly regulated, which is why I support the Fair Tax, which would bring many businesses back from overseas. But that’s another post altogether.
As for the New Deal stuff, all I can say is that after reading “FDR’s Folly” and “The Forgotten Man”, I’m convinced that the New Deal prolonged the Great Depression. And yes, I also agree that Hoover deserves some blame too. From burning food while people were starving to telling people how much they could charge for pressing laundry, the government was attempting to be omnipresent, which thanks to communism, we’ve seen does not work.
As for the Great Society, it made people dependent on others, and therefore, less dependent on themselves. Overall, personal responsibility started to go out the window and people started to feel that there were no consequences to their actions. Not a good thing.
I know this response does not match either of your responses in length or effort, and for that, I apologize. Or maybe I should apologize for the bastard who got me sick. Anyways, I’m no expert on any of these topics. However, I have read books, articles, lectures, speeches from people who are experts on these subjects. To me, what they say makes sense. A lot more sense than what I used to think years ago when I was a liberal.
Have a nice day.
Really Quickly:
William, while you may keep the venom up for Danny or Nikkos, if you truly want to engage in debate, do me a favor and drop the condescending negative attitude. I can be just as nasty as either of them--nastier probably given the chance--but that gets people no where.
I will fully and completely respond to your points while I am flying to San Diego. Given that I'm addressing the tone of your argument here, I won't bring it up in my follow up.
Cheers
Marty
PB-
There was no attitude or condescension directed at you.
Regarding the level of discourse in this comment thread and others, i might recommend that we all choose to lead by example. There are countless examples of moderators, bloggers and commenters of every political stripe being horrifically rude, demeaning, and disrespectful. The very nature of most modern media encourages this, because most blogs, shows etc. are geared towards a specific audience. As members of those audiences, we all tend to cheer when someone espousing an ideology we disagree with is taken down a notch with a vicious response. it is partisan, yes, but all too human. It is also obstructive to an actual discussion. For my part, I'm going to keep it civil. if anyone wants to attck my character, I will not dignify it with a response. I will just post their bilious words in this thread along with a reproduction of this resolution, and let viewers draw their own conclusions about who is the lesser person. With that said, can we all try to leave such things to the side?
"As for Sowell and Williams, they are two of the most well respected scholars in the nation, both with impeccable credentials. You are not going to debunk their stats. If you’d like to try, good luck and I hope you don’t waste too much of your time."
Well, I certainly haven't heard of them before, but that doesn't mean much. This aside, let's try and avoid anything that smacks of an appeal to authority, and focus more on the actual arguments. I will try and read up on these two scholars, but if you (William) have any ability to distill their concepts for us here, it would be a good start. And as for their stats...it might be impossible to debunk them, but let's not prejudge. After all, have YOU tried to debunk them? (You may have. I don't really know.)
"What is the primary goal of just about every politician? --- power. How does a politician gain power over their constituents? --- by being in control of the services that said constituents rely on. It’s just as simple as that. Surely, you’ve heard of pork spending and social programs referred to as vote-buying programs? "
Well, I won't argue with the idea that power is the goal of every politician, even though i think it drastically overstates the case. Since politics are generally regarded to be a system of utilizing and distributing power, I think we can let it stand. I suppose a more critical question is, to what degree is the pursuit of power limited to politicians? Are there other groups or circumstances where power of some stripe is the ultimate pursuit? Curiously, if I go beyond the cynical answer that everyone is pursuing power, I think a legitimate case can be made that the pursuit of power also lies at what many conservatives believe is the alternate (and more appropriate) model for regulating society: the free market. market systems are another power distribution system, and it is appropriately everyone's goal to try and amass as much personal power as possible in the form of the capacity to spend, i.e. spending power.
As for the politicians gaining power over their constituents by controlling services, that might be true in a system where elections don't take place, but I think that your latter statements about pork as purchasing support is far more accurate. Any politician who fails to secure needed services will not long be a politician. Any politician who threatens to remove services if not re-elected...well, they can only make good on their threat if they get re-elected, which seems unlikely since they just threatened the majority of their constituents. But are all instances of government provided services to be regarded as bribery of the electorate? After all, our taxes don't just go towards ugly liberal "entitlement programs," but towards things like the Department of Defense and local police departments. Even this is a form of income redistribution. The extremely wealthy, after all, can presumably afford to hire their own security guards, and in some cases, even their own private armies. By taking taxes and using them to fund entities like the armed forces, the government is protecting those of us who cannot afford to hire someone else to protect us and our property. So, the question is, if there are examples like this of income redistribution through provision of services, what is the character of "liberal" programs and services that make them not only distinctive from something like defense, but reprehensible?
"The more and more government programs that are created, more and more people fall under the grip of the imperial federal government – and it’s meant to be that way. Think about socialized medicine. Is there anything more important than your health? When the government controls your health, they will own you."
Well, I really do get what you're saying here. The more control the government takes, then the more the government as an entity can effect my life. This is certainly true, but does it matter? The government currently has the power to institute conscription, draft me, and send me off to Iraq to search more IEDs with my toes. They can arrest me, try me, and due to support from traditionally conservative circles, execute me. Given this extreme capability of my own government to end my life, why should them having additional power bother me? Well, because it would suck, presumably, and because those prior powers can be argued as necessary for the government to provide it's primary service of protecting me. (I have to disagree with your use of the term "The Imperial Presidency," though. It's clearly inflammatory, and prejudging the issue.)
So, let's clarify. We can agree that some government powers and services are necessary and appropriate, like the armed forces and justice system. We can also agree that some government powers and services are inappropriate, like it having the ability to tell me what to eat for dinner on Tuesdays, or what my religion should be. Your point seems to be that there are powers and services that fall between these extremes that should not be afforded to the government, because it would in the process either enslave us to the government, or simply grant more power than is justified.
So, disregarding the fact that the government already owns us to some degree due to necessary powers, let's look at your example of health care. I would agree that there is little more important than my health, and that if the government were to socialize medicine, it would grant the government more power over me, specifically in the arena of my bodily health. but before we just scream in horror and flee for the hills, let's look at the alternatives.
As it stands, there is virtually no service the government performs that couldn't also be performed by a private entity in a free marketplace. The only reason to require that one or the other perform these services is because one is presumably going to perform the job more optimally. In the case of defense, a mercenary army could certainly serve, but they would have little incentive to not switch sides if it benefited them. The government can instead supply a defense force which, while not subject to the efficiencies an open market can create, has a compensating benefit, that of being filled with soldiers with a sense of patriotism, loyalty, and esprit de corps.
So, for health care, what is the situation? My health is certainly important. What on earth would make it worth my while to trust this to the government rather than a free market system? For my money, the answer is twofold: I require health care, and the free market is a system that will specifically work against me regarding health insurance. The first point is simple. I cannot reasonably opt out of health insurance in a market system. As a semi-reasonable actor, I am aware that in the event of catastrophic disease or injury, I MUST have health insurance, otherwise I will almost certainly be bankrupted by the expense, and still might not be able to afford the treatment I require.
The second point is more subtle. In response to the first point, one can say, "Well, then just go to the best and cheapest insurance you can. Competition for your dollars as a consumer will drive down costs, and health care will be cheap and affordable." Ahh. it sounds tempting. But the insurance companies are rational actors too, and here we see a tricky aspect of where social requirements such as the basic needs of the citizenry intersect with the marketplace. The insurance companies certainly want my business, and are willing to compete for it. This is true only as long as they cannot identify whether I am at more or less of a risk to become ill when compared to the general population. All those handy actuarial tables and long questionnaires the insurance companies use are intended to do something very simple: weed out those most likely to cost money. The companies are in business to earn money, not provide a needed service. Any service provided by any company is secondary to the true goal in a free market, which is to transfer more funds into the firm than out of it. Since insurance companies increase their profits by limiting payments, we find ourselves in the conundrum as a society where our health care system is the most interested in soliciting the services of those that don't need it, and the least interested in consumers who do need it. This can be remedied by simply paying directly for services as needed, but this leave those who cannot afford services in the cold, and is generally seen as insufficient. We can instead require everyone be treated in emergency situations, but then we end up shifting costs back onto the insurance companies as health care providers raise general costs to compensate.
As it is now, my health is already owned. I am hostage to the good will or ignorance of companies who specialize in being hard nosed and well informed. The only way I can break free of being owned by the insurance companies is to either become wealthy enough to not require them, or to shift the responsibility for providing health care to the government. (To be fair, there are gray areas. If the government would offer free catastrophic care along with tax credits for regular health care, then the burden could be effectively split between the private and public sector, among many possibilities.) if I'm going to have my health in someone else's hands, isn't it better for me to have it in the hands that I can at least theoretically sway through the use of my vote, and a company I literally have NO influence over?
"As for the New Deal stuff, all I can say is that after reading “FDR’s Folly” and “The Forgotten Man”, I’m convinced that the New Deal prolonged the Great Depression. And yes, I also agree that Hoover deserves some blame too. From burning food while people were starving to telling people how much they could charge for pressing laundry, the government was attempting to be omnipresent, which thanks to communism, we’ve seen does not work. As for the Great Society, it made people dependent on others, and therefore, less dependent on themselves. Overall, personal responsibility started to go out the window and people started to feel that there were no consequences to their actions. Not a good thing."
Well, I can't critique the books until I read them, and with all the schoolwork I should be doing right now (but am instead doing this,) that won't be for a while. if you can summarize at all, great. otherwise I'll wait till I can get to them. To be a little more accurate, I don't think communism's failures really speaks to a flaw in big government in any obvious way. I'd say it more demonstrated that communism was vulnerable to totalitarian abuses, and that eliminating classes in society by disconnecting work from reward simply does not work. (Largely because people continue to seek rewards, but illicitly, leading to endemic corruption.) Communism failed because of other flaws than merely being big.
The great society, though? I don't think it in and of itself destroyed a concept of personal responsibility, especially in terms of programs like medicare and medicaid and education reform. the only program which really fits the profile of what you're talking about is welfare and the war on poverty, and I don't totally disagree. Wars on ideas seem to be an efficient way to, well, spend money. (Yes, I believe that applies to the war on drug abuse and the war on terror.) But an actual causal link between responsibility and personal perceptions and government aid...well, let's just tackle that another day. Sorry about how long this is.
Good night, and good luck.
By the way, please excuse all the typos and grammatical errors. I was tired last night.
First off, thanks for the response.
“The government currently has the power to institute conscription, draft me, and send me off to Iraq to search more IEDs with my toes. They can arrest me, try me, and due to support from traditionally conservative circles, execute me. Given this extreme capability of my own government to end my life, why should them having additional power bother me?”
Personally, it bothers me because I enjoy freedom. I want the government involved in my life as little as possible. I want them to do certain things, preferably those outlined in the Constitution, but besides that, I want them to be small, function efficiently and butt out. Maybe that’s not what everyone wants, but it’s the way our country was meant to be.
BTW, I did not use the term “Imperial Presidency.”
As for health care, choosing between the free market and government-run healthcare, I’ll take the free market every day of the week. I’ve challenged Nikkos and others to this (the only answer I’ve ever gotten is ‘I can’t name any’), but can you name a government agency (besides the military) that is run efficiently? If you can’t, why would you want them in charge of your health? On the other hand, can you name any actors in the free market who are efficient? I can. Just look at the fact that you can buy a computer for a couple hundred dollars, you can usually get cell phones for free, etc, etc, on down the line. Of course insurance companies will check to see who is more of a risk, it only makes sense. But what does that do? It brings us back to personal responsibility. If you want to pay less for insurance, you’re going to live a healthier life – perhaps you won’t smoke cigarettes, perhaps you won’t become a fatass, etc. The fact that insurance companies give cheaper rates to healthier people is a good thing because it encourages one to live a healthier lifestyle, without government intervention. At my work place, we had to fill out a form testifying to whether or not we smoke. If you don’t smoke, you get a discount on your insurance. Nice! If I was a smoker, I have the choice (personal responsibility) to (A) keep smoking and pay a higher rate or (B) quit smoking and pay a lower rate. Two choices, both choices for me to make, and no government. Fantastic!
“if I'm going to have my health in someone else's hands, isn't it better for me to have it in the hands that I can at least theoretically sway through the use of my vote, and a company I literally have NO influence over?”
But you have that theoretical vote through both the government and the free market. When you purchase a product in the free market, you are essentially voting for that company or product. In the free market, if there are enough people who can’t afford insurance, another company will come along to provide a service because, as you already stated, the “companies are in business to earn money.” If there is a market, someone will target it. Now, let’s take the same situation, but let’s look at the government solution. The government will increase taxes (therefore lowering the tax revenue) in order to create a new program (which will create a whole new generation dependent on the government) for the uninsured. Because the government is running the program (ie. no competition), the program will become a bureaucratic nightmare and begin to function inefficiently. To remedy this situation, a government agency will be formed in order to “get to the bottom” of the problem. It’s a never ending circle, and it’s not good. I believe that I, the consumer, have more power than I, the constituent. Have you ever written in to a company to complain about a product or service? I have. In my experience, what usually happens is that I’ll get a coupon or something free in the mail. Ever write to complain to your elected officials? I have. In my experience, you get a response written by a staffer that dances around the topic and doesn’t even give you a straight answer.
Yes, I agree, communism is certainly vulnerable to totalitarian abuses and that it failed because of more than just its size. As for the Great Society, we’ll just have to agree to disagree. I’m not saying that it was the first thing in the history of the USA that encouraged a lack of personal responsibility, but it was, IMO, one of the main contributors. I see a lack of responsibility in Medicare, Medicaid and education “reform” via the Great Society. It took responsibility out of the hands of the individual and into the state. For education “reform,” the Great Society threw a bunch of money at the problem, but did not care to measure results. No responsibility. Just a feel-good remedy.
I agree about wars on ideas. The war on drugs is silly. The war on terror, I think is a good idea, but I think it’s just not named correctly. It should be named to identify the enemy, Islamic terrorists or something similar.
I'm sorry. I don't write comments. I write essays. (We should start our own blog for this, really. too bad I'm so lazy.)
First, let me apologize for transmuting your comments on the "imperial federal government"into the "imperial presidency." No, you didn't use that term. That made me wince. Really sorry. (That said, I stick by the prejudging comment. Affix a negative modifier to anything in a debate, and it's dirty pool. Permitted, but still.)
"Personally, it bothers me because I enjoy freedom. I want the government involved in my life as little as possible. I want them to do certain things, preferably those outlined in the Constitution, but besides that, I want them to be small, function efficiently and butt out. Maybe that’s not what everyone wants, but it’s the way our country was meant to be."
Well, I'd agree with most of that, really. I also enjoy my freedom, and I would prefer the government intervene in my life as little as possible. Where we diverge is probably the limit on constitutional powers, and the size of government. Let me clarify that, though. I do not mean that I want government to take powers contrary to the constitution, and I will admit that it has, although mostly legally. We're probably disagreeing in terms of what the proper function of government is, so the list of "things they should do" that we would construct would likely differ in content and length. I also want it/them to function efficiently, but I have no real preference in size as long as it does function efficiently. (I will admit, there is a link between size and efficiency, where the larger the bureaucracy, the less efficient it becomes. This is true in the business world too, though. Why would the vaunted efficiencies of the free market permit this sort of waste? Likely because there are compensating benefits gained by being huge, if unwieldy. in the market, this is normally a function of purchasing power and economies of scale gained at the expense of personnel and management efficiencies. On the government side, i think it more is a matter of a trade off between efficiency and oversight, be that military intelligence, or the EPA. So size is not necessarily an absolute negative.) And as for how our country was meant to be? That is a point of endless contention, so I won't really explore it, but I have to ask, (and I hope you'll answer,) do you really think the founding fathers, if given all the info about the state of the world and our country today, would really honestly and truly not change anything about how they built the constitution? I'd bet dollars to donuts that they'd change a whole lotta stuff. I just can't guess how. (Well, I could, but I won't. Not yet, at least.)
"As for health care, choosing between the free market and government-run health care, I’ll take the free market every day of the week. I’ve challenged Nikkos and others to this (the only answer I’ve ever gotten is ‘I can’t name any’), but can you name a government agency (besides the military) that is run efficiently?"
I'm surprised you say the military is run efficiently. I certainly wouldn't agree, really, but that is based mostly on the incredibly huge defense budget and personal anecdotes from current and former military personnel. So, before we get into a yes-this-agency-I've-used-as-my-example-is-actually-efficient versus no-it-isn't, let me just reiterate my prior statement, and I will stress that while I think that it makes sense, I cannot prove it as a logical necessity: the larger the entity, the less efficient it becomes. (Interestingly, this is even true biologically. A single cell organism is far more energy efficient than a multicellular organism. It is also far more vulnerable in some ways, etc. But I digress.) So, sure. I'm going to say that the State Department is relatively efficient. Ideally, it should be. it is one of the oldest bureaucracies in D.C., and should have developed some rather efficient systems by now. Can i prove it? Hell no! I'd imagine you can't prove that it isn't efficient, either. That's at the crux of that sort of argument: how do you measure efficiency in government? How do you measure it in business? One option is value expenditure versus profits, but that would only be valid within a given industry or service, and doesn't compensate for economies of scale.
So, the useless counter challenge for me to make is, can you name a government agency that is provably inefficient beyond what should be expected of an organization of it's scale? I doubt it, but not because I think that this proves that government is completely efficient. I doubt it because when we talk about efficiency and government, we only have the illusion of understanding what the term means. I at least am hard pressed to come up with an actual definition that could be measured. (That said, I've spent, oh, 20 minutes thinking about it. There are likely better and smarter scholars than myself who have considered this issue. I'll keep investigating if you will.) Now, as for comparing this theoretical idea of efficiency that I personally can neither define or measure for government to that in the market: I have the same problem. I remember sitting in a meeting about five years ago where two gentlemen were introduced. They had each been working on the exact same project for about 2 months, and had not only never met one another, but had never heard of one another. The amount of work on their project that was duplicated was pretty substantial. And this was not some meeting of the Social Security Administration, this was a multi-billion Dollar multinational corporation. I only relate his to dispel a prevalent myth that business is perfectly efficient. It isn't. if computers were the only employee, perhaps. But modern corporations continue to employ us humans, even if it is to their discomfort and detriment. So, is there a measure of efficiency we can consistently apply to the marketplace? If Microsoft less efficient than Apple because Apple earns more profit per employee? Or is Apple less efficient because it earns less per person out of the potential world market? Is there a consistent means to measure this, and talk about it? if not, then again, we're saying the word efficiency, but we mean nothing by it. i think you, and most people, including me, tend to me something is efficient when we get more out of it than we anticipate given the input. That, though, is entirely subjective. Sure, free phones are great, and so are cheap computers. Are they examples of efficiency, though? Again, Apple has a nice profit margin, and they charge more for a PC than any IBM clone. Are they inefficient, or are we just using the term to offer approbation or condemnation? Okay, let's come back to the free market thing in a moment.
"Of course insurance companies will check to see who is more of a risk, it only makes sense. But what does that do? It brings us back to personal responsibility. If you want to pay less for insurance, you’re going to live a healthier life – perhaps you won’t smoke cigarettes, perhaps you won’t become a fatass, etc. The fact that insurance companies give cheaper rates to healthier people is a good thing because it encourages one to live a healthier lifestyle, without government intervention."
Well, of course it only makes sense. (This is us agreeing.) We all intuitively understand that any company is going to try to limit costs, and when we think about it, we realize that in insurance terms, this means that the companies are going to try and weed out bad risks. You say that this brings us back to personal responsibility. Is that completely true? Note I don't ask if it is true, but if it is completely true. It is, for this argument, one of two critical points to make. Let's start here though. Your statement has a very clear premise, but it is one that goes unstated: people are responsible for their own health. So, the real question is, is that premise true? If it isn't, then the logic of your statement, (rephrased: "If you want to pay less for insurance, you’re going to live a healthier life" can be equivalent to saying "in an open market, what people are required to pay is a function of the degree to which they have taken care of their health,") is seriously flawed.
For the most part, I agree. There is a reason that insurance companies have been moving towards models that reward consumers for regular health care through reduced premiums. Preventative care is far, far cheaper than remediative care, and it really does tie in with a philosophy of personal responsibility as a lifestyle choice. So, we can agree you're in good shape there. Let's move on to the uncomfortable extremes of this logic through a hypothetical scenario. I am, say, 40. I have never smoked, I eat well, and I both exercise regularly and drink minimally. I am as responsible as is possible for taking care of my greatest possession, my body.
I am suddenly diagnosed with Leukemia. Thankfully, I have relatives willing to donate marrow, and I'm very lucky. I recover. Shortly after this, I switch jobs, and thereby insurance carriers. As a preexisting condition, my Leukemia is not covered for the first year, which is not a concern, because I'm in remission.
Suddenly, though. I'm not in remission. It's back, and with a vengeance. I need medical care of an expensive variety, and lots of it, and even then, my survival is in doubt.
What would an ideal free market insurance company do in that circumstance? Would it have any free-market reason to step in and offer care earlier than contractually required? Certainly not. Not only would it not volunteer to pay out of humanitarian reasons, but it likely actively start looking for reasons to deny minor claims. Why?
Every day a payment is delayed is a day of interest payments on the account that money used for payments resides in. Every day delayed is a day of profit gained and loss forestalled. Every day delayed increases the likelihood the patient will die before they qualify for actual coverage and start to get really really expensive. Every day delay increases the businesses efficiency as a function of money taken in versus paid out.
So while everyone else is at the gym, I'm dying, spending every day fighting the insurance company so that my survivors don't have to deal with it once I'm gone, and so that maybe I have a better shot at surviving. Sure, the market can provide incentives to remain healthy before getting sick. It will never have an interest in caring for the helplessly ill. It can't. That's not it's job. That's not how the market works. (Of course, I suppose "good will" cases can be included in a marketing budget, but I'm unaware of any real marketplace theory or model that dictates this as a model or requirement for a company.)
Really, as unfair as this extreme example seems, it is still valid. we don't even really have to delve much to explore the trouble that children pose to a responsible society. My wife had cancer as a 14 month old. I don't think you or anyone else can claim that she was irresponsible in her lifestyle at that age. I mean, granted, she went clubbing frequently, and smoked like an old pirate, but all the articles for her age group indicated she was safe.
But kids are covered in their parents policies, you say! For a very small premium! This is true. Kids are a pretty good risk. Few die of cardiovascular disease, if at all. This is an example of the market at work in a positive way. Pick the company that will cover your kids as a consumer choice, and drive the cost of kid's coverage in the process. It's those pesky adults with their negative lifestyle choices that are the real issue.
There's a problem here, though. Kids with congenital problems grow up. Adults with diseases aren't always implicit in the causative factors for those diseases. So, I think a critical premise in the privatization argument is clearly false. The question is, what to do about it? Require coverage, thereby unbalancing the market? Cover the helpless through government? Shrug your shoulders, and say that it isn't society's problem? All those are answers, but not all are equal. If you as a conservative are going to argue that the market saves all, you must acknowledge this critical flaw. I don't claim that it is a substantial proportion of the population, but I do argue that it is relevant.
Additionally, there is the point of encouraging a healthier lifestyle. Let us say that one entity will reduce the required payment by 60 dollars a month if you exercise 4 times a month. Let us say that another entity will offer the exact same deal. Objectively, which one is the better offer to take? Who knows? They seem identical. Now, let's replace one entity with "your health insurance company" and the other with "your government." Does that change your answer? I would guess if we were to conduct a poll, it would change the answer when comparing similar groups, and that the most changes would be identified with "conservativeness." If this is that case, though, then the difference is entirely subjective, which is to say, it exists only in the minds of the observers. If the ultimate effect on the cash balance of a given American is identical offered the same deal through the government versus the marketplace, then there is no objective difference. None. Zip. Consult the law of identity. if someone offers me a free dollar, the dollar is the same no matter who offers. Any perceived difference is just psychology.
So, if the government can offer the exact same identical incentive as the market, what is that value in a statement like, "The fact that insurance companies give cheaper rates to healthier people is a good thing because it encourages one to live a healthier lifestyle, without government intervention." There is no required difference between a government provided incentive versus the market. the mere fact that you use bold type indicates that you consider the government intervention aspect to be a negative. i just ask, objectively, if we strip away the labels, what is the qualitative/quantitative difference between government versus market? Why is an insurance company interfering in how you live you life through offering incentives better than the government doing the same?
"Nice! If I was a smoker, I have the choice (personal responsibility) to (A) keep smoking and pay a higher rate or (B) quit smoking and pay a lower rate. Two choices, both choices for me to make, and no government. Fantastic!"
To reiterate: Why is having this choice under a government program versus a private program worse, when it is the exact same choice? Aaaand....moving on.
"In the free market, if there are enough people who can’t afford insurance, another company will come along to provide a service because, as you already stated, the “companies are in business to earn money.” If there is a market, someone will target it. Now, let’s take the same situation, but let’s look at the government solution. The government will increase taxes (therefore lowering the tax revenue) in order to create a new program (which will create a whole new generation dependent on the government) for the uninsured. Because the government is running the program (ie. no competition), the program will become a bureaucratic nightmare and begin to function inefficiently. To remedy this situation, a government agency will be formed in order to “get to the bottom” of the problem. It’s a never ending circle, and it’s not good. I believe that I, the consumer, have more power than I, the constituent. Have you ever written in to a company to complain about a product or service? I have. In my experience, what usually happens is that I’ll get a coupon or something free in the mail. Ever write to complain to your elected officials? I have. In my experience, you get a response written by a staffer that dances around the topic and doesn’t even give you a straight answer."
I have to retread ground some to cover the idea that "if there are enough people who can’t afford insurance, another company will come along to provide a service." This is absolutely true, but if and only if there is enough money to be earned in the process to recoup their costs. So, right off the bat, we can see that there are at least theoretical scenarios where either not enough people or not enough profits are available in that market to justify a company entering it. Yes, as I did say, companies are in the business to earn money, and I gather from you quoting me in that context that you agree. So, if that is the case, what are the odds that any company will reliably choose to insure a know risk, even if their health issues are clearly not attributable to their lifestyle. I think you would have to agree, likely zero to none.
The question is not whether companies can effective insure most people. They absolutely can. they cannot knowingly effectively insure everyone. The real question is, do we as a society want to allow any of our helpless members become victims of misfortune in the interest of reduced costs for the remainder of the population? do we even want to write off the poorer families who cannot afford any health services as undeserving? This is not a matter of a simple syllogism. It is a choice about what sort of society one wishes to live in: one that benefits each maximally as individuals, or each minimally as a society?
As for your government scenario, let's examine it. Need government raise taxes to pay for this theoretical health insurance? I'd say not. We can likely both agree there's plenty of fat to be cut from the budget. I'd happily reduce or alter the defense budget (but how is a whole different post) in order to free up some cash. Even if we didn't, and raised taxes, I'm confident that at least a few Ford or GM executives from the ever reliable private sector might be willing to testify that the cost to the economy through increased taxes would be compensated for through enhanced competitiveness on the part of American businesses no longer penalized by the necessity of providing health care to their employees.
And then there's this...
"Because the government is running the program (ie. no competition), the program will become a bureaucratic nightmare and begin to function inefficiently"
There as casual implied chain here: no competition leads to a complex bureaucracy and thereby to inefficiency. I was up in Wisconsin last year near Three Lakes, and I stopped off at the local grocery store, with no competition within less than 40 miles. Their prices were high, but no higher than in the heart of Chicago, an area rife with competition. They had a staff of, from what I could tell, one. Maybe more, when you account for additional shifts, but the place was open for only 5 hours a day, so I'm not sure. So, clearly, lack of competition does not lead to increased size and thereby to inefficiency. So if it is not the lack of competition that locally requires inefficiency, maybe it really is size, as suggested earlier. But then, there is a lower limit to the cumulative size of the private companies required to service the American population. By this I mean, isn't there a lower limit to personnel and costs to serve America, and if this is the case, wouldn't a single organization benefit more from economies of scale than a set of smaller companies? Is there anything definitively different about a government created business to do this, other than presumably that government business would not be permitted to deny coverage to the unfortunate? And, if you subscribe to my conception of a maximally fair society, isn't that a good thing?
As for never ending cycles, you don't need to look at government to find it. there are plenty of investigative committees formed in corporate America to explore to sources to waste to deserve mockery. There's a reason Dilbert is successful as a strip. Yes, it is funny and witty, but it is also keenly observant of the many inefficiencies and ridiculous policies present in corporate America, and that is a major reason that is has such a following. My god, get stuck with my father in an elevator and he will make your ears bleed with the idiocies encountered in the American banking community.
Finally, there's the idea that you as a consumer have more power than as a voter. This may be true, but I don't think a coupon is the best indicator of it. I tend to rely on the fact that an individual who relies on my positive input through voting will be more responsive than an organization that relies on my positive input through buying, but your point about staffers is taken. Perhaps in both cases we should consider the role of platitudes..."Thank you for your comments! Here's a 'signed' letter from the Senator!" versus "Thank you for your comments! Here is a coupon for three dollars off your next purchase!"
I can leave either one.
Finally..."For education “reform,” the Great Society threw a bunch of money at the problem, but did not care to measure results. No responsibility. Just a feel-good remedy."
Exactly. If we really want to evaluate the Great Society, we have to look at results. And, I'll say right now, they aren't glowing. (Although there were some measurements in education, but we'll get there later...) Rather than talking about causing a lack of personal responsibility, we need to talk about effects, and whether they are an example of what social engineering succeeds or fails at, rather than more nebulous topics. In closing, I'll apologize for the clear emotional content of this post, even as I assert that is is both relevant and necessary.
So, questions to consider:
What is efficiency in the market and in government? Are they the same?
Is the defense department efficient? How so? How are we defining it?
Why is government intervention in our lives better or worse than market intervention?
Why aren't government incentives for preventative health care equivalent to market incentives?
Does the free market really, actually cover everyone in terms of a social issue like health care?
Is everyone responsible for every aspect of their health?
Should everyone really have health care?
Peace out, yo. (Why can't this be a job?)
First off, thanks for the discussion. I appreciate the obvious time and effort you have put in. Hopefully my thoughts below aren’t too disconnected. I started taking notes on your comments, with plans to go back over them after I was finished. However, I must say it took a while, so I just tried to fill in the blanks…
Inefficiencies between government and free market – free market is not a monopoly so inefficiencies will be minimized or business will lose customers/profit. In government, inefficiencies lead to more inefficiencies through special “task forces” being setup to investigate why the inefficient practices are inefficient (see cat chasing tail).
I’m really not so sure that the Founding Fathers would change much in the Constitution. From reading much about the Founding Fathers, the processes, debates, rationale, etc that went into creating the foundations of our Republic, and comparing those events and ideas to todays world, and in particular our nation, I come to the conclusion, more and more, that the Founding Fathers were some of the most prescient individuals to found anything, let alone the most successful nation in the history of the world. Maybe change a couple things, but overall, the document holds up through the test of time. What do you think they would change?
Inefficient government agency: Dept. of Education. Compare the amount of money spent to the results achieved.
I well understand that large corporations are not completely efficient, sometimes being inefficient to the point of amazement, as I’ve worked for several multi-national corporations in various cities. However, the beauty of the free market (ie. competition) is that it requires them to be efficient enough that they don’t go out of business.
Oh, and btw, I agree that absolute efficiency is something that can probably never be achieved by humans on a consistent basis. Given the definition of “efficient” (performing or functioning in the best possible manner with the least waste of time and effort), there will always be lapses by someone (no sneezing, coughing or laughing! – you’re wasting time, etc).
I would say that cheap, quality goods are a sign of efficiency. Certainly not absolute efficiency, but efficiency to a certain extent.
As for the leukemia situation, I would say, if you knew you were sick and had the insurance coverage at your job, it was your decision to change jobs, knowing full well that you would be losing your insurance, which you also knew may be very handy. Again, that was a personal decision you made. You knew the risks and made a decision. Look to friends, family, charity, church groups, etc. However, I don’t think that I (or society in general) should be forced to pay for the results of your decisions.
And I agree that the market is not perfect or completely “fair.” But what is? Certainly not life. If it’s utopia you strive for, let me know where you find it.
When you speak of the hypothetical government vs. private insurance situation, let’s remember that it is a hypothetical. Chances are that almost every time, in a real life situation, the private company will be cheaper and better. Hypotheticals are great to talk about but have little value if they aren’t realistic when it really counts. If it does turn out to be the exact same rate and service (nearly impossible) then it affords the consumer a great option. Another advantage of the free market compared to government, typically, is that the free market is voluntary where government is not. For example, if HRC gets her way, every American would be forced to purchase health insurance. Show me in the Constitution where that can be found.
You say “To reiterate: Why is having this choice under a government program versus a private program worse, when it is the exact same choice? Aaaand....moving on.”
Again, I point to free market competition and the advantages it brings. The government is a monopoly. Monopolies do not have to adapt as quickly (or at all) to the new technology, trends, discoveries, etc. They have no competition, therefore, no incentive to keep up or even improve. Businesses in the free market have incentives, also known as profits, also known as customers.
Yes, I agree that government doesn’t have to raise taxes to pay for a particular program, but what are they going to do – slash existing programs? Not if they want to stay in office. There just aren’t enough politicians out there today that have the cajones to trim the fat. It’s a sad fact of life that raising taxes on people is relatively easy. Most people won’t notice or simply won’t care. It would be different if taxes were paid after you received your paycheck – this would result in a large revolt, I believe – but since taxes are taken out before you receive your paycheck, it simply does not receive the attention it should. It has been consistently shown that when taxes are cut (jfk, rwr, gwb) the tax revenue rises. The more money people have, the more they spend.
The Wisconsin vs. Chicago cost comparison. I would guess that one reason Chicago’s prices are high, despite competition has something to do with the tax rate. Also, comparing a federal bureaucracy to a local grocery store in WI with no competition within 40 miles (which indicates there probably aren’t many people in that area) is like comparing apples and pencils.
As for your questions at the end, I have listed some answers below. I believe the rest were answered above.
When I listed the military as something that may be efficient, I did so because my guess was that that would be an answer someone would give. I don’t think it’s totally efficient, but I do think it is just about as efficient as the government can get. I think they are wasteful in some areas and do some ridiculous things, but overall, I think the military gets the job done pretty well.
I do not think the free market covers everyone.
There will always be factors that can’t be controlled by the individual, so no, I don’t think that someone can be responsible for every aspect of their health.
Whether or not everyone should have healthcare – I don’t know. That is up to each individual.
"Inefficiencies between government and free market – free market is not a monopoly so inefficiencies will be minimized or business will lose customers/profit. In government, inefficiencies lead to more inefficiencies through special “task forces” being setup to investigate why the inefficient practices are inefficient (see cat chasing tail)."
Okay, agreed that in a free market competition should reduce inefficiency, but only provided the market isn't genuinely free. By this I mean, some government regulation is necessary to prevent to market moving towards monopolies that would eliminate beneficial competition. Government, though, need not be immediately inefficient, nor need it breed further inefficiency. I think that you are constructing a false logical statement, because you keep coming back to the inefficiency of government as a given. Are you assuming that because a market system can generate efficiency, that it is the only way to generate efficiency? If so, it is necessary to realize that as a statement, that is simply not true. Efficiency can result from proper management, for example. You mention the Department of Education as an example of an inefficient government agency, but it's administrative operating costs are about 2% of every dollar delivered to schools as funding. That's actually a very high efficiency if we're measuring an input/output ratio. 2 cents spent to deliver 98 cents in funding is good by any standard, I'd say. I'm not sure how to measure efficiency beyond this, in this case, especially since so much of the funding for education is local, not federal. As for comparing expenditure to results, well, the U.S. ranks 15th in the world in reading, and 18th in math. I would absolutely agree that at the district level there's a drastic need for school reform, and that this can include privatizing aspects of education. That, however, says nothing about the innate efficiency or lack thereof on the part of the federal government.
I agree that the availability of cheap quality goods can be a measure of efficiency, but it isn't one easily applied to the service industry. That is more a function of customer satisfaction, which is far more subjective.
"As for the leukemia situation, I would say, if you knew you were sick and had the insurance coverage at your job, it was your decision to change jobs, knowing full well that you would be losing your insurance, which you also knew may be very handy. Again, that was a personal decision you made. You knew the risks and made a decision. Look to friends, family, charity, church groups, etc. However, I don’t think that I (or society in general) should be forced to pay for the results of your decisions.
And I agree that the market is not perfect or completely “fair.” But what is? Certainly not life. If it’s utopia you strive for, let me know where you find it....Chances are that almost every time, in a real life situation, the private company will be cheaper and better."
Lemme just outline some premises as to why a free market would improve health care.
Premise 1: competition for consumers exists
Premise 2: consumers have choice in providers
Premise 3: there are multiple providers
Premise 4: consumers and providers do not coerce or mislead one another (voluntary participation)
Conclusion: Competition among providers for consumer choice will drive down costs and reward efficiency.
In instances where, say, premise four isn't met, then you don't get competition, and so there is no necessary reason for costs to be lowered.
I think that is reasonable. So, does the health insurance industry meet those criteria? No. In fact, no insurance industry where risks can be calculated can meet the criteria to function to drive down costs in a free market. Why? Because they don't meet criteria 1 or 2. There is not competition for all consumers, only for low risk consumers. High risk consumers not only are not competed for, but they also lack choice in providers. You even acknowledge this factor when you point out that the hypothetical person with leukemia was aware of the risk in leaving his job. There would be no risk if there were still competition for his role as a consumer. Awareness of his risk on both our parts implies we understand his altered status as a consumer.
Even if you choose to accept this pseudo-free market scenario as still better than the alternatives, you are also implicitly embracing the idea that it is appropriate that the consumer limit their income and profession based on a need for retaining coverage. How on earth is this idea of having a corporation limit your freedom to do things like take the job you want, earn what you can, and live where you please at all appealing or in line with any conception of freedom?
Basically, you are criticizing this hypothetical actor for trying to act like they are a real consumer in a real free market when they really aren't. Don't you see that this exposes a flaw in how this market is failing to function properly, as opposed to a flaw in how the consumer is behaving. Some services are not appropriately provided by a free market, and health care is one of them. Of course, I could be wrong. maybe I'm just failing to see it. Can you suggest a market model where those that need the service of health care the most receive it without resorting to blinding the insurance companies as to the health status of consumers? What is better about health care that omits the ill in the process of lowering costs for the healthy?
Then, you bring up alternative sources of aid. Family? Friends? Church? Certainly all could help, but for a chronic disease it is highly unlikely that local private sources could ever pay the bills generated. And if you're suggesting that it might be appropriate for a community to offer that sort of support, what makes it inappropriate on a broader scale? Plus, you say that you don't want to pay for my decisions. Well, I guess I can understand that. But aren't you already paying for other people? Isn't that what private insurance does? You pay a premium, the company collects it and uses it to pay for the care of others that is a part of the same plan, and keeps the difference as profit. If you get sick, you get other people paying for your care through their insurance. In any scenario, the healthy are paying for the care of the unhealthy. In the current U.S., we are paying through the nose when compared to the rest of the world for health care coverage that doesn't even cover everyone.
I guess it all comes down to your comment on utopia. I don't think I can find or build Utopia. I'm an pragmatic, cynical Atheist, after all. At the same time, I do think that it can be approximated, however crudely, and that the search for a better social and political structure was at the heart of what the founding fathers were striving for. I believe everyone has a right to a minimal level of health care, I know that it is possible to give everyone health care, and I'm aware that it comes with some negative costs. I would rather everyone pay a little more and be covered than a few pay less, but a small remainder not be covered at all.
It is true, life is not fair, and by fair, I mean, the world does not automatically provide what we need. But that's no argument against trying to build structures to provides for those needs ourselves. We lack a natural right to vote, or to free speech. These are rights we constructed because it seemed like a good idea. I would prefer to live in a world that chooses to add health care to that list of natural rights than one that does not. (Although, in worldwide terms, I already do when you consider the western nations that aren't the U.S. and most U.N. signatories.) If it comes down to this sort of philosophical difference, then we're just going to disagree. I prefer the ethics of my view, though. (I know that sounds insulting, but I mean it in the most neutral way possible. Sorry.)
"For example, if HRC gets her way, every American would be forced to purchase health insurance. Show me in the Constitution where that can be found."
Well, I don't really want to start defending HRC's plan, mostly because I don't like it, so I won't. I've already spoken as to why I think a free market system doesn't apply to a service like health care. Forced is certainly an ugly word, but it simply betrays how you already feel about it. You pay for health care now, I'd bet. Why the outrage? The problem isn't too many people being forced to have health coverage. The problem is too many people not being able to afford it. I'd rather be force to do something good for me than prevented to from doing the same, thank you very much. (Ideally, i'd have the means to do it on my own, of course.) An analysis of the risks makes all but the uber-wealthy pay for health coverage in some manner as it stands now. And as for where is says it in the Constitution, I believe it relates to Article One, Section 8 enumerating the powers of Congress: To make all laws which shall be necessary and proper for carrying into execution the foregoing powers, and all other powers vested by this Constitution in the government of the United States, or in any department or officer thereof. That, of course relates to to lay and collect taxes, duties, imposts and excises. to pay the debts and provide for the common defense and general welfare of the United States; but all duties, imposts and excises shall be uniform throughout the United States.
Interestingly, HRC's plan does have an interesting aspect: it prevents the government from becoming a monopoly. Basically, it creates the government as both an alternative and competition.
"There just aren’t enough politicians out there today that have the cajones to trim the fat. It’s a sad fact of life that raising taxes on people is relatively easy. Most people won’t notice or simply won’t care. It would be different if taxes were paid after you received your paycheck – this would result in a large revolt, I believe – but since taxes are taken out before you receive your paycheck, it simply does not receive the attention it should. It has been consistently shown that when taxes are cut (jfk, rwr, gwb) the tax revenue rises. The more money people have, the more they spend."
Agreed. It doesn't matter what the party is, it seems, or what they say; congress is on a permanent spending spree. Strangely, the "starve the beast" philosophy doesn't seem to work either. Then again, didn't Keynes theorize government deficit spending can spur the economy. Maybe pork is a good thing. I disagree that people don't notice or care about taxes. I know I do. I think you're right though when you say that they care less about incremental payments compared to lump sum payments. Then again, that says nothing about taxes. If people paid their heating bill, grocery bill, or phone bill only once a year, you would also see some outrage, so let us not confuse the outrage people would show with the presumed legitimacy or illegitimacy of a debt owed. People simply seem to be bad at thinking ahead in financial terms. After all, the government isn't the only entity to split payments into smaller sums.
And it HAS been consistently shown that when taxes are cut, tax revenues rise. Totally true, and completely misleading. What is normally implied here is the idea that if what you really want is more money for the government to spend on programs, what you should do is lower taxes so that the economy will be spurred by spending and investment and ultimately earn more money for the government to spend than otherwise if taxes had been left at their previous level, or even raised. Usually, supply side economics and the Laffer curve are also cited in the same conversation. Not only does this not take into consideration the fact that even if the tax rate were left exactly as it is, revenues would rise from the prior year due to inflation and general average economic growth. It is simply misleading, because it seems that while revenues do rise compared to prior years, they do not rise enough to compensate for revenue lost through lowered taxation over time. Yes, the economy is spurred, and this raises revenue at the lower tax rate, but not to a compensatory degree. What this means is while revenues increase from year to year, those increases would likely have been bigger if there had been no tax cuts. Not that I'm an economist. But some of these guys are:
"Federal revenue is lower today than it would have been without the tax cuts. There's really no dispute among economists about that," said Alan D. Viard, a former Bush White House economist now at the nonpartisan American Enterprise Institute. "It's logically possible" that a tax cut could spur sufficient economic growth to pay for itself, Viard said. "But there's no evidence that these tax cuts would come anywhere close to that."
Uh, actually, I think I'll just post a link to a handy list of prominent economists, many who worked for the Bush administration, commenting on how tax cuts aren't really self-financing (don't earn more money for the government than they lose.) Included are Greenspan and Bernanke.
Then, there's the Congressional Budget Office report, issued when both the White House and both houses of Congress were held by Republicans. It also confirms that tax cuts don't actually increase overall revenue. Now, with all that said, that doesn't mean that tax cuts are bad, but it does change how we perceive them and their effects, and it pretty much blows supply-side economics back into voodoo economics territory. If cuts primarily effect upper brackets of the progressive tax scheme, but result in less money for social programs that would benefit the lower income brackets, and there is no real trickle down effect through spurring the economy to the degree that the cuts are compensated for in terms of Federal and State revenue, then it is hardly worthwhile for the majority of the middle and lower classes to support.
"Also, comparing a federal bureaucracy to a local grocery store in WI with no competition within 40 miles (which indicates there probably aren’t many people in that area) is like comparing apples and pencils."
Actually, I think you are totally right. (that is one benefit of this format. WE're forced to be more rational and less emotional in our arguments.) But I think that the same realization of comparing totally different scenarios as inappropriate applies when comparing the Government to the Marketplace. They have totally different reasons for existence, functions in society, and feedback mechanisms. (Also, I realized that the Wisconsin store and Chicago stores have similar pricing due to similarities in population density versus number of stores and time required to get there. Chicago has more stores, but more people and congestion...)
"When I listed the military as something that may be efficient, I did so because my guess was that that would be an answer someone would give. I don’t think it’s totally efficient, but I do think it is just about as efficient as the government can get. I think they are wasteful in some areas and do some ridiculous things, but overall, I think the military gets the job done pretty well."
I agree most people would list the military as a government agency that does it's job well, but I assert that this isn't because of whether it does it's job efficiently when compared to a marketplace model, but because we accept that the market isn't an appropriate source for what we want the military to do. The market may lower costs, but it doesn't increase loyalty or patriotism. I'd say people almost intuitively understand that a mercenary force is not what we want, not because it wouldn't be cheaper, but because we understand that cost is not an appropriate measure of whether the military is doing it's job well. I just wonder, if you are capable of accepting that how we evaluate what the military does as independent of a market model because what the military does is too important to give low cost precedence over effectiveness, can you also accept that if someone like myself gives health care a similar priority, it is because we consider the importance of general health to outstrip cost-effectiveness concerns? And doesn't our concern for general health seem ethically distinct from that of raw cost concerns?
Okay, so I think that covers it. My main question is: why do you not consider general health important enough to divorce it from cost concerns and evaluate it purely on a social level? (I'm not sure if that is a good way to phrase that, but I think you know what I mean.)
I'm also going to restate some earlier questions from the post that I'm most curious about, and refine some not addressed.
Are you assuming that because a market system can generate efficiency, that it is the only way to generate efficiency?
Can you suggest a market model where those that need the service of health care the most receive it without resorting to blinding the insurance companies as to the health status of consumers?
What is better about health care that omits the ill in the process of lowering costs for the healthy?
If you are capable of accepting that how we evaluate what the military does as independent of a market model because what the military does is too important to give low cost precedence over effectiveness, can you also accept that if someone like myself gives health care a similar priority, it is because we consider the importance of general health to outstrip cost-effectiveness concerns?
And doesn't our concern for general health seem ethically distinct from that of raw cost concerns?
Why would anyone choose to not have health care as a responsible citizen?
Do you think in health, the free market covers most? Can you name a percentage? Why?
Do we, as citizens, have any social responsibilities, or are we instead completely independent actors?
Are my questions really, really annoying?
I apologize for any typos, grammatical errors, etc. I don't have time to go edit. I'm to busy eating my liberal brie and drinking my liberal champagne. (Actually, it's a cheddar and Shiraz, but still...)
By the way, I keep making you answer questions. I'm fine trying to return the favor.
Whups; forgot the link to all the economists who admit that tax cuts don't self-finance lost tax revenue through economic growth: http://logicizer.townhall.com/g/f48d2bf3-1c51-4592-aa46-191f089d752f
Also, there's this Congressional Budget Office analysis: http://www.cbo.gov/ftpdocs/69xx/doc6908/12-01-10PercentTaxCut.pdf
One other thing: the first link it a list of accurate quotes. it is also almost certainly a quote mine that omits the idea that most of those economists quoted would likely still support most tax cuts on the theory that economic growth trumps availability of funds to the government, and that deficit spending can also spur the economy.
While I see what you’re saying – that we shouldn’t necessarily assume that a government agency will be “inefficient” – I think that government has consistently proven itself to be inefficient in comparison to the free market, that at some point, reality sets in and one must accept the fact. I’m not saying we should get rid of all government, but because of its track record, I think the free market should be allowed to compete when possible.
And yes, when I speak of the free market and the government being “efficient” or “inefficient,” I’m speaking of the whole process and results. It doesn’t matter much, IMO, if an agency is run efficiently but the results achieved are not desirable.
I believe that there is still competition for people described in the leukemia example. They, obviously, will not get as good of rates due to their health situation, but surely there are places to get coverage. And when discussing healthcare, let’s not forget the great stresses that our legal system (namely trial lawyers) have put on the healthcare industry, but alas, that is yet another post for another time.
Yes, I would be paying for other people through insurance, but again, that is voluntary. When the government runs the program, it’s not voluntary.
I don’t believe that everyone has a “right” to healthcare. Overall, my default position is freedom and that everyone has a right to life, liberty and the pursuit of happiness. I think one should be able to live their life as long as they’re not harming or infringing on anyone else’s life. When it is stated that someone has a “right” to healthcare, you’re also saying that you have a “right” to someone else’s time, effort and work because someone must provide you with said healthcare.
Technically speaking, I do not believe that we have the “right” to vote either.
No offense taken about you preferring your view. I look at the healthcare situations in countries around the world and notice that many who live with socialized medicine come to the United States for healthcare, and that tells me something. I can’t even begin to count how many stories I’ve read of people from many European countries and Canada coming to the United States because of long waiting lines and poor care. There are trade-offs with both systems (as with everything in life), and I believe the non-socialized medicine is the best way to go, so we will probably agree to disagree on that.
As for people not having healthcare, the numbers usually are not given in the proper context:
Glenn Beck: “I've been looking at some numbers that of the 45 million uninsured, 9 1/2 million of those are not even citizens. 8.7 million earn over $75,000 a year. 8.3 million earn between $50,000 and $75,000 a year. And there's also, there's also about 40% are only uninsured for about six months as they are in between jobs.”
Mark Steyn: “Nobody really knows how many “uninsured” there are: Two different Census Bureau surveys conducted in the same year identify the number of uninsured as A) 45 million or B) 19 million. The first figure is the one you hear about, the second figure apparently entered the Witness Protection Program. Of those 45 million “uninsured Americans,” the Census Bureau itself says over 9 million aren’t Americans at all, but foreign nationals. They have various health care back-ups: If you’re an uninsured Canadian in Detroit, and you get an expensive chronic disease, you can go over the border to Windsor, Ontario, and re-embrace the delights of socialized health care; if you’re an uninsured Uzbek, it might be more complicated. Of the remaining 36 million, a 2005 Actuarial Research analysis for the Department of Health and Human Services says that another 9 million did, in fact, have health coverage through Medicare.
Where are we now? 27 million? So who are they? Bud and Mabel and a vast mountain of emaciated husks of twisted limbs and shriveled skin covered in boils and pustules? No, it’s a rotating population: People who had health insurance but changed jobs, people who are between jobs, young guys who feel they’re fit and healthy and at this stage of their lives would rather put a monthly health-insurance tab towards buying a home or starting a business or blowing it on booze ’n’ chicks.
That last category is the one to watch: Americans 18-34 account for 18 million of the army of the “uninsured.” Look, there’s a 22-year-old, and he doesn’t have health insurance! Oh, the horror and the shame! What an indictment of America!
Well, he doesn’t have life insurance, either, or homeowner’s insurance. He lives a life blessedly free of the tedious bet-hedging paperwork of middle age. He’s 22, and he thinks he’s immortal – and any day now Hillary will propose garnishing his wages for her new affordable mandatory life-insurance plan.
So, out of 45 million uninsured Americans, 9 million aren’t American, 9 million are insured, 18 million are young and healthy. And the rest of these poor helpless waifs trapped in Uninsured Hell waiting for Hillary to rescue them are, in fact, wealthier than the general population. According to the Census Bureau’s August 2006 report on “Income, Poverty and Health Insurance Coverage,” 37 percent of those without health insurance – that’s 17 million people – come from households earning more than $50,000. Nineteen percent – 8.7 million people – of those downtrodden paupers crushed by the brutal inequities of capitalism come from households earning more than $75,000.”
No, I’m not saying paying their income tax once a year. I’m saying if every month, when you get your paycheck, if you had to send in a check to the government (ie. return the money), people would start paying more attention to it and there would be some sort of revolt. Right now, many people couldn’t even tell you how much of their income is taken from the government because it’s just become habit that you will lose it because it’s already gone when you get your money. And of course, this is a generalization, because I know that there are people who pay attention, but certainly not the majority of people.
I do think general health is important. I just believe that opening up the market (and doing other things to, such as legal reform) is the best way to go here. There are examples of socialized medicine around the world. We should be able to look at them and learn.
Some people may not choose to have healthcare because they would like to spend their money elsewhere. Many young people do not choose to purchase healthcare.
I believe we have social responsibilities, but I believe that that list has probably become unnecessarily inflated recently due to many reasons, such as political correctness and demagoguery.
I agree that the market should compete when possible and appropriate.
"I believe that there is still competition for people described in the leukemia example. They, obviously, will not get as good of rates due to their health situation, but surely there are places to get coverage."
If that is true, then the insurance company would have to charge rates more than equivalent to the cost of care in order to make a profit. That would mean that those lucky Leukemia patients would be paying the insurance companies MORE than the cost of their treatment. Hardly a compelling deal as consumers. So. Okay. I'm going to have to throw down the gauntlet, here. Can you provide any scenario wherein an insurance company in the free market will take on a customer with a pre-existing condition and cover treatments for that condition (with profit as their motive) while charging rates less than the cost of care?
This should not pose a terrible problem, though, since we've already agreed that the free market cannot cover everyone in terms of health. What I'd like to make clear is that this inability includes the hypothetical leukemia sufferer.
Part of the reason I keep returning to this is that I seem to perceive as much as a bias towards the market as a panacea for societies ills on the part of conservatives as I do a bias towards the government as having a role in social construction. I believe it is imperative for each side to admit the deficiencies of their preferred system if there is ever going to be an actual pragmatic solution to some of our nation's ills. The fact that you can admit that the market is not a perfect actor to offer everyone health care is good, but your insistence that the hypothetical case would find coverage is, I think, irrational, and demonstrates that while you can say the market isn't perfect, you still believe it is to some degree.
"Yes, I would be paying for other people through insurance, but again, that is voluntary. When the government runs the program, it’s not voluntary."
Well, this doesn't bother me much. The only real difference for me personally is under the "voluntary" market system, I have more illusion of control. I guess I don't see a requirement to act like a responsible, rational adult as very burdensome. I think you are right, people won't like it, but I don't think they'll particularly enjoy being ill without insurance, either. The real difference seems to be psychological rather than a pragmatic.
"No offense taken about you preferring your view. I look at the health care situations in countries around the world and notice that many who live with socialized medicine come to the United States for healthcare, and that tells me something. I can’t even begin to count how many stories I’ve read of people from many European countries and Canada coming to the United States because of long waiting lines and poor care. There are trade-offs with both systems (as with everything in life), and I believe the non-socialized medicine is the best way to go, so we will probably agree to disagree on that."
Yeah, I've read some real horror stories, too. I've also heard some pretty good ones, as well. What's important to realize, though, is that the social versus market systems aren't the only options. France, for example, has the best health care system in the world, at least according to the World Health Organization, and it is socialized, it is true. But it is only socialized in that there are government provided funds for health insurance. Not only is there still private health care, in that doctors and hospitals are not government managed, but there are still private insurance companies that supplement the government provided insurance. The effect is a system that spends less of their GDP on health care than us (9.4% v. 13.9%,) has fewer deaths from cancer, lower infant mortality, better survival rates beyond 60, etc. etc. All this, and the absolute dollar value (in parity terms) they spend is about $2300 per person, compared to our roughly 4600 per person. (even after accounting for what would be required to properly fund their system, it is still cheaper than ours.) Now, these are apples and apples, but not strictly identical. We're fatter here, have more cardiovascular disease, etc. Still, though, it seems fair to say that on the surface their somewhat socialized system is running better than our mostly private system. Strangely, it's running cheaper too. Now, if we look at the U.K. or Canada, we don't see quite the same thing. There, tales of long waits and poorer care are generally legit, and that seems to be linked to government regulation of health care itself, rather than just the provision of insurance.
So, if we can demonstrate a system that is more efficient than our own but that is less privatized, what does that mean? Are you justified in your faith in a purely market system? I'd say not. I'd also say that the examples of more purely socialized systems that seem to have a lower standard of care put paid to an exclusively social health care system.
"As for people not having health care, the numbers usually are not given in the proper context."
Well, that's true. The 45 million is bandied about because it is an impressive number, even if it is misleading. What I find curious is the idea that only five million or ten million people without insurance is just fine. Is there a tolerable lower limit? You can say, and kinda already have said, yes, but you then need to realize you're in the minority. And speaking of context...
"According to the Census Bureau’s August 2006 report on “Income, Poverty and Health Insurance Coverage,” 37 percent of those without health insurance – that’s 17 million people – come from households earning more than $50,000. Nineteen percent – 8.7 million people – of those downtrodden paupers crushed by the brutal inequities of capitalism come from households earning more than $75,000.”
That is a fair bit o' cash for those households. Too bad that no information on how many people are in those households is included. Not that I really think that there's twelve kids to every family, but that to argue that we don't have enough context, but then to present numbers that imply something about the true state of affairs without making the actual context explicit seems...disingenuous. (That is more directed at Steyn than yourself, William.) I would bet that a fair number of those households can afford health insurance, but only by trimming the fat elsewhere. That, in fact, might be a better indicator of the problem. We as a society have no real savings, and tend to live from paycheck to paycheck, which makes affording insurance more of a challenge and the consequences of not having it more devastating.
I mean, right now I am paying about $650 a month for health insurance. That's money I'd love to be investing. (Although I'm about to switch over into an HSA. A much better deal.)
So, to recap, can you discuss what free market mechanisms would cover the hypothetical Leukemia patient? Can you talk about why the example of France is or isn't compelling? Is there a lower or upper number you personally would like to see in terms of numbers without access to health care?
Laters.
No, I cannot provide a scenario such as that.
In regards to buying insurance versus being forced to pay, the difference is that with purchasing insurance, everyone who may benefit is also contributing. That would not be the case with the government. Some people would be providing for everyone. That is not fair.
As for the remainder of your questions, I’m going to go with a quick no, no and no. This has been a nice discussion, but I don’t think it’s going to go much further from my side. I’ve said about as much as I’d like to and this Monday brings me a heavy workload whose importance supersedes this post.
Thanks again for the civil and most enjoyable exchange. Perhaps more will come in the future.
Well, then, farewell. I must admit, I've spent more time on this conversation that seems advisable, as well. I may only say, I hope that you, and i, and any audience members have been encouraged to examine our own assumptions in a constructive way. As Voltaire said, "Doubt is uncomfortable, certainty is ridiculous."
My only parting shot will be this: The unfairness of having to contribute to someone else's livelihood pales when compared to the barbarity of using that unfairness to permit and excuse suffering or injustice.
Thanks for the debate, and take care.
Seth-
You, sir, are a scholar and a gentleman and as such are always welcome here!
Thanks for your comments.
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