I am often critical of conservatives for being ideologically committed to means rather than ends. For example, why does the average Republican support tax cuts? Maybe the college-educated ones will sputter something facetious about a goal ("to promote economic growth!") despite the paucity of supporting evidence.
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But for most of them, taxes must be cut because taxes are bad.
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There's no higher-level reasoning involved. We're not cutting taxes to accomplish anything; we have to cut taxes because we don't like taxes. This type of reasoning is largely responsible for the predicaments in which we so often find ourselves as a society. It makes no sense. We build dams to generate electricity or control flooding, not because we like dams. We pass laws to serve some specific purpose, not because "passing laws is a good thing."
I encourage everyone to bear this in mind before unsheathing the knives on Congress and the President for the alleged death of the "public option" in the healthcare debate. A very wise faculty member in my graduate program, someone whose academic interests had little to do with mine but who was a terrific mentor, taught me that goals are all that matter in public policy and we must be agnostics about methods. In this debate I am committed to a goal: giving every person in the country access to health insurance that is both affordable and useful. If this is achieved via a Euro-style single payer system run with an iron fist by the Federal government, I will be happy. If this is achieved via a co-op plan which caters heavily to the demands and interests of for-profit insurance companies, I will be happy. If this is achieved via an intricate system of lasers, mirrors, and rhythmic chanting, I will be happy.
It matters not how it gets done, only that it gets done. While I don't have a lot of faith in the Let's All Grab Our Ankles for Humana Plan, which is disturbingly similar to the failed 1994 effort at reform, I am willing to give it an opportunity to work. It has never been my position that everyone in the nation should get free healthcare from Uncle Sam. Instead I believe that we already have programs to cover the elderly and the destitute, so the goal is to find a way to provide affordable coverage to working people whose employers are among the growing ranks of shirkers who cut corners in ways that would have been unthinkable fifty years ago.
dbsmall says:
I share your perspective: the muddled masses pursue "means" rather than "ends". Sadly, it's not limited to one party or ideological club. It's that large-scale goals seem like fairy tales—it's often hard to see the path when all you have is a destination and no map. So the politicians provide a map, and the masses decide the map's the goal. Whether it's lowering taxes, or creating social programs, most folks aren't able to evaluate the appropriateness of the tool to the problem at hand.
To wit, I'm an above-average thinker. I am—honestly—not sure that a socialized healthcare program is a good idea. There's a fine dance there, between making sure that *everyone* has medical coverage, and between creating incentives for innovation and research.
I'm no free market guy, but the fact is that "outrageous profits" do serve a benefit.
"In this debate I am committed to a goal: giving every person in the country access to health insurance that is both affordable and useful."
If that's achievable (and I am unable to determine whether or not it is), then I support it, too. Affordable *and* useful.
Ignore the sleepwriting, below:
[Then the bitter cynic makes me feel that less population would be a good thing. I just don't think the heuristic for who lives/dies should be how much wealth the family's acquired.]
Shane says:
"We build dams to generate electricity or control flooding, not because we like dams."
Oh how I wish it were true. In fact, in this country at least, we very often build dams because we like building them, or sometimes just because we are afraid the other guy might build it first. (By "we" I mean mainly the Bureau of Reclamation and U.S. Army Corps of Engineers).
If you are ever so inclined check out Marc Reisner's Cadillac Desert.
Penny says:
This whole health care situation has completely decimated any remaining hope I had that any of our elected officials give even one half of one shit about us.
They care about keeping the people who donate the most money happy. Period.
I worked hard to get Obama elected, and he's abandoning me. I really do feel that way. I pray he's some kind of uber genius who has a brilliant master plan in place and everything is unfolding according to his blueprint and someday soon all shall be revealed and we'll all get health care and I won't have to spend hours and hours of my time on the phone with an infant who doesn't know shit from shinola and who has just told me that it was my "choice" to have the health plan I have that no longer covers routine mammograms and I end up in need of the services of a neurosurgeon to fix the aneurysm that I just blew when I informed Little Shit that it wasn't MY CHOICE for my company to be sold to WALMART LITE, where they figure two free teeth cleanings a year will keep the unwashed masses from noticing that their health plans just got completely stripped of anything beneficial.
And then Obama will buy me that pony I've been wanting since I was 4 years old.
Right?
Please?
God?
SeaTea says:
The problem as I see it is that in order to afford to cover the currently uninsured we need to realize sufficient savings to cover them. We don't have the money to just cover them out-of-pocket with our deficit spending as it is.
Getting an option that will allow us to get our per-capita health spending more in line with the rest of the industrialized world is the only way I can see us realizing enough savings to cover those people that we both want covered. Perhaps I'm missing something, but I don't see how broadening coverage under the existing for-profit system will accomplish any cost savings or reduce waste.
That's my concern about the surrender of the public option.
comrade x says:
History proves again and again that the people in power will not do shit for us plebians unless massive public pressure is put on them. The real enemies in the healthcare debate aren't the befuddled buffoons who scream and stamp their feet at these town hall meetings, its the lobbyists for the big drug companies. All they have to do to influence the outcome is toss money at the politicians. Unless the pro- single payer people conduct a campaign on a vast scale and seriously threaten to unseat the turncoats in the democratic party, we are going to see this shot down time after time.
On another note, what an excellent example of the Byzantine politics that take place in Washington these days. The teabaggers give the Obama administration the perfect out on public option, by saying the American people aren't " ready for it", despite the fact that poll after poll shows otherwise. This allows the administration to work a sweet deal for the drug and medical companies .
Wow! I get fucked and treated with condescension. Thanks, O- Team!
ladiesbane says:
Ed, please stop conflating health CARE and health INSURANCE. Most people can't afford either one — but if people could afford the former, they wouldn't need the latter. They are very different things.
Here in CA, the peepul, godblessem, seem to have voted for a whole bunch of things based on the "we like it, so we're going to vote it in" — without much thought about how it would be paid for, or how it would mesh with all the other crap they voted in last time. This is also how the Republicans thought voting for a huge expensive war could coexist with huge tax cuts. Whee! Reactive law changes, bread and circuses, "this is a democracy so I can have anything I want if the majority says so" — different parties, but all the same lump of short-sighted fools. Fifty million Elvis fans CAN be wrong.
Jeff says:
"It has never been my position that everyone in the nation should get free healthcare from Uncle Sam."
Why not? It's the only sensible position. Healthcare should not be privatised. Nothing that can save or destroy people's lives should be left to the free market, which has proven time and time again that it is too stupid to regulate itself or to operate in the best interests of the people.
Jason Harx says:
"lasers, mirrors, and rhythmic chanting"
I like this idea…I'm calling my congressman.
Keith says:
Health care for everyone should be the goal, and we should all collectively pay for it, and know that we are paying for it as a matter of what is in our own economic and social interest. Medicare for all makes the most sense. As long as the incentives are to deny care (as we see with health "insurance") then we'll continue to have large segments of our society left without adequate care. But somehow, the national conversation has only gone as far as "health insurance reform." I'm skeptical that approach will work.
Annoyed says:
dbsmall made me want to throw my computer across the room. Those are some of the biggest misconceptions and a huge reason we don't have any kind of universal health care. For profit health care has gotten us the worst health care system in the western world. We have the highest rates of medical mistakes. We have doctors that see so many patients they don't even have time to look up your history before you see them. The simplest things take an endless chain of expensive referrals. And we have the worst health outcomes of any developed country (this is irrespective of behavior- we actually rank about in the middle with healthy behaviors- so you can't blame those rates on poor people and smokers). There is no motivation for prevention. And there is no for profit research that is worth a shit. Most of the decent research is already government funded. The NIH and NSF fund university researchers with mediocre pay. Pharmaceutical companies research how to make more money. They only research diseases that everyone has, or that they can market to everybody (heartburn, depression, etc.) They market diseases in order to market drugs (osteoporosis was marketed to sell HRT to menopausal women, which then doubled cancer rates -nobody worried that much about the natural loss in bone density that comes with aging until there was a profit motive -and then more people died because of it). And the worst of it, is that they really spend the most money on advertising and reformulating drugs to extend the patents on them. It's sick. I've seen fuckers on fox talking about Obama ruining the best health care in the world. They've got their goddamn heads up their asses. And medical device companies are similar to the pharmaceutical companies. They make small changes so that hospitals can then advertise the newest equipment. For profit medicine is not about health. It is about us wasting our fucking money on crap.
And I kind of agree with you Ed, but that is also the reason we have the expensive mishmash we have now. Because somebody, from the AMA and unions 150 years ago to insurance companies today, has been fighting it. And all we end up with is this patchwork crap that doesn't benefit anybody.
Annoyed says:
And didn't Blue Cross/Blue Shield (the first medical and hospital insurance) start out as non-profits to help people who couldn't afford basic health care? My memory is fuzzy on that one but I think I am correct.
Because as ladiesbane is correct. But health care has always been and will always be to expensive when someone needs it, so we will always need insurance to spread the risk and pay for it collectively. So health care does pretty much equal insurance. You can't have the former without the latter without someone being denied care.
Annoyed says:
sorry for the typos. I'm pissed!
Aslan Maskhadov says:
Hey all you Obama supporters- this Commie wants to give you an official I TOLD YOU SO regarding Obama and the Dems. Remember, he never lied to you, the problem is most of you guys just imagined that he was preaching what you wanted to hear, when in fact his actual quotes and actions were the opposite.
Just to point out how pathetic the Democrats are, I want you to imagine real quick how much the Republicans would accomplish toward their evils ends if they had the White House and the same majority in the capitol. Now look at how easily Democrats take a dive with the same advantages.
jazzbumpa says:
Blue Cross IS a non-profit – at least here in Michigan. And guess what!!! It gets stuck with all the people* who the for-profit insurance Cos. drop because they're – you know – fucking SICK, and BCBS can't turn them down because they're a non-profit.
See how the system works?
I do care about how it gets done. How can you reasonably divorce method from results? Having a good plan and good execution gives you the Pittsburgh Steelers.
Having a bad plan gives you the Fucking Detroit Lions
Speaking of tax cuts – I firmly believe that cutting taxes over the last 45 years has been a significant root cause of our long term economic decline.
I've posted some economic data tonight that is not directly relevant to this discussion, but feel free to stop by and have a look, if you're interested. See here, and the previous few posts. My basic premise is that everything the Republicans touch turns to shit.
http://jazzbumpa.blogspot.com/2009/08/gdp-growth-1900-to-1960.html
_____________________________
* OK – the ones who can afford the premiums.
William says:
Why is health care the responsibility of an employer?
Annoyed says:
It isn't. Many are getting rid of it because it is too expensive. Or they are hiring contractors instead of full time employees so they don't have to pay for it. That is why the number of uninsured keeps rising. But it began as a way to keep employees healthy so they could work longer hours building dams and digging mines. Companies used to keep a doctor on staff. Then it became a way to keep out unions who also offered insurance. It is also a good way to compete for employees, and pay them less.
jazzbumpa says:
In addition to what Annoyed said, I think it goes back to the 50's. After the post WW II recession, the economy was growing reasonable well, and employers needed employees. I can't say for sure that offering health care was a way of paying them less (though the employee benefited from not having that equivalent income subject to direct taxation.) Even I don't have to be all cynical all the time.
Realistically, it was an incentive to work for an employer who offered health care. Competitive forces made it pretty close to universal.
Contrast Britain, which went Gov't controlled, universal, single payer in 1948, They were motivated by a moral imperative.