Wednesday, September 9, 2009

Stuck on health-care reform

I don’t pretend to be an expert on politics or policy. But I sure nailed this health-care debate two months ago. To wit:

“Barack Obama knows he can’t sell reform to the American people as a matter of wealth redistribution.” Yet the ideological essence of health- care reform is redistributive. It is key to the Left’s idealized vision of the welfare state.

Government-run health care is the unfinished business of liberalism going back to the Truman Administration.

That’s the briar patch President Obama is in right now. He will address Congress tonight, making his last best push for health-care reform... but he will dare not argue that taxpayer-funded health care for everybody is a duty of government.

He knows he can’t sell that.

As for the Right... sure, the Right wants to destroy Obama just for the sake of destroying him. And they’re hitting him with all they’ve got. But that doesn’t mean conservatives are wrong to be suspicious of a “public option.”

Just listen to what “progressive” economist (and former conservative) Glenn Loury has to say about a public option. (“I know I’m not supposed to say this...”)

This 6½-minute video clip sums up the whole issue rather nicely:

11 comments:

A. Charles said...

I'm curious about your terminology.

Would you say that the ideological essence of national defense is redistributive?

Also, if "conservatives" aren't wrong to be suspicious of a public option because it's a possible prelude to single-payor, is a similar suspicion about government-run defense appropriate?

Undercover Black Man said...

Would you say that the ideological essence of national defense is redistributive?

No. "Redistributive" means taking from the richer and giving to the poorer as a moral good. Has nothing to do with national defense. Theoretically, all citizens benefit equally from a strong national defense, so there's nothing redistributive about it.

Also, if "conservatives" aren't wrong to be suspicious of a public option because it's a possible prelude to single-payor, is a similar suspicion about government-run defense appropriate?

Dating back to this country's founding, providing for the national defense is a universally acknowledged duty of the federal government. The same cannot be said of health care.

Any more questions?

A. Charles said...

"Redistributive" means taking from the richer and giving to the poorer as a moral good. Has nothing to do with national defense. Theoretically, all citizens benefit equally from a strong national defense, so there's nothing redistributive about it.

Why would you accept the theory that all citizens benefit equally from a strong national defense?

For the sake of discussion, let's say that I'm in a remote area in Nebraska, and I eat and drink only what I grow on my own land. Let's also say that if there were no restrictions on my ability to arm myself, I could well afford to defend myself from any threat I can imagine coming my way.

So I've got no reason to have the fears that folks in border or shoreline towns have. And no reason to think that I'm ground zero on anybody's missle target map. Those folks who live in such places have way more need for defense expenditures than me. My tax dollars are being used to fund people who are less self-sufficient than me.

Dating back to this country's founding, providing for the national defense is a universally acknowledged duty of the federal government.

So is promoting "the general welfare."

True, the constitution doesn't provide for health care. But it doesn't provide for a permanent, standing military force, either. It seems to me that both are included in the category of permissible specifics allowed by the general principle.

mint_tea said...

All through the election, I was under the illusion that Obama would turn out to be a legislative genius. The fight over the stimulus bill was the first unpleasant surprise - but at least there you could blame it on all those Blue Dog Dems from conservative states.

The mishandling of the healthcare debate, however, has been a huge disappointment. Obama may be very smart, but he's no Lyndon Johnson. But then again, if a genius like Bill Clinton failed so abysmally with healthcare reform, perhaps even Lyndon Johnson would not have been able to succeed today.

The Obama team has done a lousy job articulating their case to the American people. As you've asked, why do we need it and why now? Is the goal coverage for all, or to cut costs and benefits? Does it all have to be done at once?

They have to sell it. I hope they pick up their game.

Undercover Black Man said...

The Obama team has done a lousy job articulating their case to the American people.

They must believe that if they tried to articulate the ideological case -- that it's the duty of taxpayers to finance health care for all -- the people would reject it mightily.

So they're in a position of double-talking and euphemizing and looking like they're trying to pull a fast one.

Like with this Robert Reich video which you may have already seen today.

Reich is an avowed proponent of a "single-payer" system... meaning a government takeover of the health-care markets. He didn't mention that in the video.

Rand said...

If I may, I'd like to object to your definition of redistributive, or at least make a qualified objection to it. Redistributive usually implies that the aim, while still ultimately for the public good, has an element of decreasing inequality. That doesn't have to be the case with health care, you can instead pitch health care as a right (I probably wouldn't but I'm saying you could), or as a necessary charitable duty of society.

My own feelings on the health care debate are ambivalent, but if I were to favor it, probably I'd favor it as a charitable measure of society, obliged by our common humanity. That is to say, independent of how it affects the rich, or the gap between the rich and the poor, there is a minimal level of medical care, which if we as a society are able to provide we must.

In fact, such a principle already operates in our medical system, emergency room patients cannot be turned away, even if it is obvious they cannot pay, because of a human obligation binds society to make this charitable gesture of emergency care. At least one non-redistributive approach to justifying universal healthcare would just broaden this principle to healthcare as a whole.

ronnie brown said...

i gotta go with A. Charles on this point. I think government "promoting the general welfare" has become too cumbersome in a profit driven society. We are selfishly splitting hairs when we imply that national defense and universal health care are somehow working at cross purposes with each other...society has a vested interest in being protected and healthy.

mint_tea said...

Reich is an avowed proponent of a "single-payer" system... meaning a government takeover of the health-care markets. He didn't mention that in the video.

I hadn't seen that, however there's an old youtube floating around of Krugman admitting that the public option would kill private insurance as we know it. Prominent liberal blogger Kevin Drum has admitted this point as well.

So they're in a position of double-talking and euphemizing and looking like they're trying to pull a fast one.

That sounds about right. However, if Americans could be guaranteed a switch to the French or Swiss systems overnight, I think most people would be ecstatic. But their gut tells them the current efforts will not get them to a France or Switzerland, but instead just append more costs and bureaucracy to the Frankenstein monster that is American healthcare.

I caught the tail-end of a Townhall meeting on C-SPAN with Howard Dean and another Democratic Congressman answering questions. A questioner expressed her concern about the centralized record system in France, and how she was scared to death the U.S. would adopt such a centralized system.

Now you can argue about trade-offs between privacy and efficiency, but not once in his response did Howard Dean say "France has the best healthcare system in the world. Transferring medical records seamlessly between physicians is essential to saving costs and avoiding medical mistakes." Instead he said "that's valid point, we are certainly aware of privacy concerns, yadayadayada..." Gah.

aaroncrowe said...

Health care or not, I’m partisan to a president that can lower my taxes and fix what the housing market “greed” created… Just get the job market back up and avoid more scams…

Anonymous said...

There should be access to medical care for everyone in the world...

there should me non-emergency clinics that do not need appointments available to everyone anytime...illness is not just 8 to 5....
prices should be regulated on health supplies...Im pissed about paying 4 to 10 dallars a month just because Im female and have a period...the number of wamon in America alone should have drove the cost of femine items down...NOt Here Greed!

Anonymous said...

Obama is right, we have to start somwhere...I think most people who people apposed the plan are right up there with the Lazy...No one wants to work to make it work.

Rich people without health care pay cash, pour people die.

But what the rich people should remember, what if you become poor. optemistic, Let this country blow up in extreme violence and see how poor some rich people get.