The Healthcare Debate: Revenge of the Laissez-Faire Liberals
Let’s repeat, once again, what the current healthcare reform proposal is actually trying to do. Despite all the (deliberate) obfuscation, it’s really quite simple. Paul Krugman says it best:
“The essence is really quite simple: regulation of insurers, so that they can’t cherry-pick only the healthy, and subsidies, so that all Americans can afford insurance. Everything else is about making that core work. Individual mandates are a way to prevent gaming of the system by people who don’t sign up until they’re sick; employer mandates a way to hold down the on-budget costs by preventing a rush by employers to drop insurance; the public option a way to create effective competition and hold costs down further. But what it means for the individual will be that insurers can’t reject you, and if your income is relatively low, the government will help pay your premiums. That’s it. Any commentator who whines that he just doesn’t understand it is basically saying that he doesn’t want to understand it.”
Not so hard to understand, is it? But of course, much of the right-wing opposition is ideological. They can sniff that the government is trying to “interfere” with the private sector, to stop it doing various things. (I will let pass the irony of the people who are actually under a single-payer system- the elderly- being the most opposed to “big government” heathcare). This purely ideological opposition sounds like a throwback to the laissez-faire liberalism condemned by all popes from Leo XIII onwards, which viewed the free exchange between market participants as a tent of natural justice. But we know that the private market does not embody virtue. It is merely a means to an end, that of supporting the common good. If there is an egregious violation of the common good, as there is in the current health insurance system, then it is incumbent on the government to step in and fix the problem. This has been at the core of Catholic social teaching for over a century. But it seems to be lost in the current debate.
Here is the renowned economist, Jimmy Akin, weighing in on the problem:
“Any reasoned look at what is being proposed will lead to the conclusion that the long term effects of the program will be to increase costs (something bureaucracy does exceedingly well), increase taxes, lead to greater deficits, lead to health care rationing, drive private insurance out of the market, promote euthanasia, lead to more nanny state interventions in people’s lives, promote greater dependency on government, stifle the development of new medical treatments (just when we’re getting to the point that we might start seriously extending the human life), and basically kill a lot of people, both here in the U.S. and in other countries, which have been relying on American innovation since their own socialized medical systems put the squeeze on domestic innovation.”
Where does Akin get this stuff? It is clear that he simply dislikes government on ideological grounds, because none of his arguments make the slightest bit of sense. After all, governments are supposed to be inefficient, so they will be inefficient. Why then do single-payer systems manage to deliver comparable quality healthcare without leaving anyone behind, and do so at about half the cost of the US system? You can argue against single-payer systems on any number of grounds, but cost is certainly not one of them. And anyway, why is it that private insurance costs are increasing dramatically faster than public insurance costs? Why does Akin worry about paying for healthcare subsidies to the poor by increasing taxes on rich, as opposed to the current system of the poor being left behind and the middle class bearing the brunt of the cost in lower wages?
Rationing, he says. Does he not understand that the private insurance market is rather adept at rationing? Can he think of a single healthcare plan where the beneficiary can have all the healthcare they like covered under the plan? Oh yes, the current system does rationing very well. 47 million are rationed out completely. A further 25 million are underinsured, meaning they have to forsake healthcare based on cost. Rationing. And when insurance companies refuse coverage, dropping coverage, and denying claims — as they do in thecurrent system and which disproportionately affects the poor – then yes, that too is rationing. So what then is he talking about? Perhaps the misconception that single-payer systems ration extensively on quantity rather than cost? This is simply not true, but is beside the point, because the current proposals are nowhere close to single payer. I will merely point out that the best systems, the ones that mix public and private coverage, generally do very well on speedy access to healthcare – and without leaving anybody behind. Oh yes, and they probably kill a lot fewer people than the US system, as they grant universal healthcare and emphasize primarty care. In fact, the US scores pretty badly on life expectancy and mortality indices.
Of course, he brings up the euthanasia canard. Why? Because Sarah Palin made it up? In fact, I think it is far more likely that a life would be ended in a private system where cost is the bottom line, especially if the family cannot afford the princely sums that would be needed. In fact, the law quite frequently allows hospitals and healthcare providers to withdraw care from patients they deem too expensive to continue sustaining. And remember the example of Elizabeth Anscombe’s daughter, a stroke victim whose life was saved by the “socialist” British healthcare system after the American system would have pulled the plug.
Let’s get to the bottom line. If one accepts healthcare as a basic human right, as the Catholic Church does, then one has to accept that the current system is deeply immoral. One has to accept that any reform must begin by regulating the behavior of private insurers, whatever you think of a public option (and remember, the whole point of the public option is simply to control costs — once again, as with a market solution, a mere means to an end). What does this reform do? It puts in place a code of conduct for insurance companies, and allows those without insurance to access it through a health exchange, with the help of subsidies. In other words, it tries to level the playing field a little, to increase the bargaining power of the ordinary person. Remember the insight of Leo XIII– there was a law of natural justice greater than the law of the market, and the worker could be “the victim of force and injustice” if this was not respected. This is the reason behind the Church’s staunch support of unions — to make an unequal bargaining relationship more equal, to allow the outcome better accord with natural justice. I would contend the same is true in healthcare — just as unions bring workers together to protect them from exploitation, so do health exchanges and regulation of insurance companies give the uninsured greater leverage, making it more likely that natural justice (in this case, the right to healthcare) wins out over the market solution.
None of this makes any sense if you believe in the Reaganite mantra that government can only bring ill. But it makes perfect sense if you read it through the prism of Catholic social teaching.
You are right in saying that the current health care system is lacking. Many conservatices wouldn’t argue. There seems to be a lot, though, that you are not learning about the current healthcare bill. One important point is that the USCCB, which supports universal health care, would never support this bill because it will not state that no abortions will be covered under government health care. Another interesting point is that the government will, in fact, be taking liberites it has no right to take. It’s not just about providing health care to all. They want to come into your homes and tell you how to raise your children. Do you think I jest? Check this out: http://townhall.com/columnists/ChuckNorris/2009/08/11/dirty_secret_no_1_in_obamacare Think what you like of Chuck Norris, but he’s found something in the bill that no one else has brought up. And, the bill will, in effect, eliminate private health care insurance. So many are saying it won’t, and it doesn’t explicitly state that it will. BUT it DOES say that employers won’t be able to change the healthcare they currently use, and that employees may not make changes to their plans. Not to mention that it will make it much more economical for employers to drop their current care. And did you know that the new health care would “cover” such things as gender changes? As a moral, monogomous practicing Catholic, why should I have to foot the bill for all sorts of immoral behavior?
While I admire your regard for current Catholic social teaching, I don’t understand your readiness to back up the “left” on many issues, this one in particular. No, our current health care system is far from perfect, but Obama’s would be far, far worse.
Why do you use the figure 47 million as the number for those not having healthcare? That number has been broken down many times into its parts and is not an accurate reflection of those who are in need but cannot get health care insurance. Also, justice and charity requires us to help all, the USCCB may call it a ‘right’ but that does not mean the federal or state govenment should be the provider of that right. That is certainly the easy way out with no thought needed- thereby letting us off the hook-just have the government do it and we can check it off that we tried.
Another interesting point is that the government will, in fact, be taking liberites it has no right to take. It’s not just about providing health care to all. They want to come into your homes and tell you how to raise your children. Do you think I jest?
I don’t know if you jest, but I know that claim is a joke. The bill allows an expansion of the infant and maternal health home visitations that have been in law since the 19th century. This program is partially federally funded, administered by the states and carried out by radical, anti-family groups like Catholic Charities and Lutheran Social Services.
If you think this is so wrong, why don’t you first speak to your bishop and tell him the Church should get out of applying for these grants.
OBAMA IS NOT “THE LEFT.”
Chuck Norris’s children don’t need to be raised–they are born full-grown with black belts in karate.
Chuck Norris doesn’t need health care–only his enemies do.
any others?
It is rather simple. This plan reforms nothing, gives a whole bunch of concessions to all the special interest groups Obama promised to oppose, and funds abortion.
Very simple.
USCCB may call it a ‘right’…
Actually, Ann, it is the social teaching of the Church, a teaching that is owed clear religious assent, that says it is a right. In perusing some of the right-wing Catholic blogs (why I am such a masochoist?) I’ve noticed a lot of this stuff about the Christian call to private charity without government interference. My response is this: if this is truly the case, what is the point of Catholic social teaching since Leo XIII? WHy should we bother pushing for strong unions, living wages, and social safety if all that matters is private charity?
As I said in the post, the need to for the government to boost the power of the patient over the insurance company is akin to the justtification for unions. Of course, there are many ways to do it: (i) regulated private insurance; (ii) public insurance; (iii) keeping the current system but providing financial assistance to those in need. Of course, (iii) is financially untenable.
Krugman makes the mistake of asking question and he gets a response he does not expect.
Highly recommend the attached article by Camille Paglia. She, of course, is in favor of health care reform, but she correctly places the blame for the heated discourse where it belongs on the Democrats and Obama for attempting to hastily push through poorly explained and thought out legislation.
http://www.salon.com/opinion/paglia/2009/08/12/town_halls/index.html
She states:
“But who would have thought that the sober, deliberative Barack Obama would have nothing to propose but vague and slippery promises — or that he would so easily cede the leadership clout of the executive branch to a chaotic, rapacious, solipsistic Congress? House Speaker Nancy Pelosi, whom I used to admire for her smooth aplomb under pressure, has clearly gone off the deep end with her bizarre rants about legitimate town-hall protests by American citizens. She is doing grievous damage to the party and should immediately step down.
There is plenty of blame to go around. Obama’s aggressive endorsement of a healthcare plan that does not even exist yet, except in five competing, fluctuating drafts, makes Washington seem like Cloud Cuckoo Land. The president is promoting the most colossal, brazen bait-and-switch operation since the Bush administration snookered the country into invading Iraq with apocalyptic visions of mushroom clouds over American cities.
You can keep your doctor; you can keep your insurance, if you’re happy with it, Obama keeps assuring us in soothing, lullaby tones. Oh, really? And what if my doctor is not the one appointed by the new government medical boards for ruling on my access to tests and specialists? And what if my insurance company goes belly up because of undercutting by its government-bankrolled competitor? Face it: Virtually all nationalized health systems, neither nourished nor updated by profit-driven private investment, eventually lead to rationing.
I just don’t get it. Why the insane rush to pass a bill, any bill, in three weeks? And why such an abject failure by the Obama administration to present the issues to the public in a rational, detailed, informational way? The U.S. is gigantic; many of our states are bigger than whole European nations. The bureaucracy required to institute and manage a nationalized health system here would be Byzantine beyond belief and would vampirically absorb whatever savings Obama thinks could be made. And the transition period would be a nightmare of red tape and mammoth screw-ups, which we can ill afford with a faltering economy.”
She even has sympathy for Sarah Palin’s recent statements about Death Panels:
“As a libertarian and refugee from the authoritarian Roman Catholic church of my youth, I simply do not understand the drift of my party toward a soulless collectivism. This is in fact what Sarah Palin hit on in her shocking image of a “death panel” under Obamacare that would make irrevocable decisions about the disabled and elderly. When I first saw that phrase, headlined on the Drudge Report, I burst out laughing. It seemed so over the top! But on reflection, I realized that Palin’s shrewdly timed metaphor spoke directly to the electorate’s unease with the prospect of shadowy, unelected government figures controlling our lives. A death panel not only has the power of life and death but is itself a symptom of a Kafkaesque brave new world where authority has become remote, arbitrary and spectral. And as in the Spanish Inquisition, dissidence is heresy, persecuted and punished.”
Paglia is entertaining, but I don’t look to her for policy analysis.
I do find it interesting what leading CONSERVATIVE REPUBLICANS are saying about Palin:
Sen. Johnny Isakson (R-GA) said 8/11 that ex-AK Gov. Sarah Palin’s (R) charge that Obama’s health care plan would create a “death panel” was “nuts.”
Isakson, in an interview with Washington Post’s Klein, said: “I just had a phone call where someone said Sarah Palin’s web site had talked about the House bill having death panels on it where people would be euthanized. How someone could take an end of life directive or a living will as that is nuts. You’re putting the authority in the individual rather than the government. I don’t know how that got so mixed up.”
Klein: “The policy here as I understand it is that Medicare would cover a counseling session with your doctor on end-of-life options.”
Isakson: “Correct. And it’s a voluntary deal” (WashingtonPost.com, 8/11).
Meanwhile, Sen. Lisa Murkowski (R-AK) told an Anchorage crowd 8/11 that critics of health care reform aren’t helping the debate by throwing out highly charged assertions not based in fact.
Murkowski: “It does us no good to incite fear in people by saying that there’s these end-of-life provisions, these death panels. … Quite honestly, I’m so offended at that terminology because it absolutely isn’t [in the bill]. There is no reason to gin up fear in the American public by saying things that are not included in the bill” (Demer, Anchorage Daily News, 8/11).
Michael J. Iafrate – Maybe Obama is not “the left” – he’s so far off the charts that he makes the lefts look moderate.
Michael J. Iafrate – Maybe Obama is not “the left” – he’s so far off the charts that he makes the lefts look moderate.
Obama is so un-left he is barely a Democrat.