Wednesday, March 24, 2010

Questions Answered

I received the following questions in response to my suggestion last week that lack of health insurance reform is uncivilized and immoral. I cannot attribute the questions to anyone as they were posted anonymously. Anyone with answer of their own are welcome to dive in on either side (or neither) of the debate.
1) Your claim that in "civilized nations where citizens have a right to health care one doesn't see begging posters like the one photographed on a Key West street. There is no need" a cursory search in Google reveals the contrary.

In Britain, homelessness estimated at 400K (source: Crisis.org)
In France 200K (Source: FEANTSA)
In Germany 590K (Source: share Int'l)
...and so on. If pictures are what's needed, there are plenty. There is no need? Please. I won't "jump the canyon" and throw the compassion card here....

2)To your summary of national funding networks to support the programs, I would love to know how they work in reality. I'm willing to learn - but it's almost impossible to cut through the partisan talking points and get to an objective comparison.

The core (and only) point I am making is concern over giving additional personal property and civil liberties to a central government. Period.

I would rather see the focus on how to make the system more responsive and efficient (is that the track record of our central gov't?) instead of how to "eat the rich" to pay for another gov't program.

Discuss the successes of Social Security, Medicare and various welfare programs in your reply. Don't just ignore these inconvenient topics and hurl epithets.

3)To your point that cutting spending on the military would finance this new entitlement program, I'll agree this would be a viable source of funding if we act fast. The Defense budget represents 24% of total gov't expenditures (source: usgovernmentspending.com). This percentage is has steadily dropped over time and the social safety net we're apparently sorely deficient on in this country represents 56% of gov't expenditures and is historically the fastest growing portion of the budget.

4) How do you specifically propose we provide jobs and grow opportunity for future generations if we increase penalties for companies to grow and provide jobs? I'm all in favor of a fairer tax code - one that eliminates the "social engineering" programs buried in the current mess we've got... but populists will have none of it (e.g. a flat tax, nat'l sales tax, etc.) as it's not "progressive" enough despite the fact that currently 1% of the population pays 40% of the taxes in this country.

How do you prevent companies from escaping the pain of the new U.S. economic system and going to friendlier climes? Taking jobs and capital with them. How?

Include in your reply the fact that the vast majority of jobs in this country are with small private companies, not large "poster child" corporations - and how are they to survive and add jobs with these "increas(ed) taxes on corporations and unearned income."

Do we really think "tax freedom" day comes too early in this country?

5) The religious intonations of the replies to my posts are disgusting and irrelevant. The insinuation of personal greediness and callousness speak better than I can on the shallowness of thinking on the posters part.

Apologies for
being redundant, but my point is not opposition to helping the needy, it's doing it via a "command economy" I'm afraid of. If the "civilized" nations of Canada, Switzerland, Germany, etc. have such a wonderful system, why aren't Americans expatriating en masse to those locations? Why not?

March 21, 2010 10:23 AM

1) Homelessness is not the issue under discussion. Every country has a proportion of people without homes. In fact the welfare states of western Europe have extensive support for people without homes and people in proximate danger of losing their homes. Unemployment benefits are more generous, mental health care is better, though not necessarily as good as one might wish. Poverty is generally less stigmatized as a moral failing than it is in the US. Nevertheless Britain, like key West has it's own population of vagrants, that is to say people who are homeless by choice, as a lifestyle. No one goes bankrupt to pay for medical care. That is a huge difference between the US and Europe. You may argue that there are fewer than the numbers quoted by progressives like me, but the fact remains that people are crippled by medical costs in the US; in Europe they aren't.

2) As far as insurance reform goes I would prefer to see Medicare extended to all with an option to buy private insurance for those that wish to and can afford it. For instance private insurance in the UK removes the wait for non emergency surgery, it pays for private rooms and so forth. However basic care is extensive and free. The drawbacks to national health care systems are real and are due to lack of money rather than generic "bureaucratic incompetence." A friend of mine diagnosed with adult onset diabetes had her co-pays waived as she was diagnosed with a chronic illness. that is to say with a medically proven need the system stepped in to actually help her rather than hinder her access to care. My stepmother, a lifelong smoker was diagnosed with terminal cancer of the jaw and throat. She lived in a remote community in the Highlands of Scotland and undoubtedly her care was intimate and personalized because she was in a remote community. But get this: she had round the clock at home nursing and doctor home visits as she lay dying. It cost her not a penny. Her family could face the prospect of her imminent death without having to worry about the bills. Does that sound uncivilized to you?

National Health care services are costly and they do suffer from lack of money and care is not uniformly excellent. However here in the US a visit to a hospital will reveal the same issues-long lines, botched treatments, crumbling infrastructure and other problems related to particular medical systems and facilities. Just because care if provided by for profit provider doesn't mean patients get better treatment than shareholders. The difference is we pay far more per capita for services that cost infinitely more to provide.

On the subject of Medicare, let me just say that people who have access to it and use it love it. Remember those seniors bitching about wanting to keep government hands off their Medicare? Talk to a Veteran and you will find a large preponderance who strongly approve of the level of service at the VA. And you will also find those that have received poor services. Just like in the private sector. Funding for these services has been subtracted by successive administrations to pay for General fund needs. The fact remains that left alone, Social Security is well funded into the foreseeable future. The problem is that it is the object of scurrilous attacks to impoverish and render more fearful working Americans. Without secure access to health care and pensions Americans are vulnerable to the depredations of corporate America and they like to keep us malleable. Europeans, guaranteed their services are protesting loudly the costs of bailing out the corporations; we aren't. That would just be a by-product of a strong social network in my opinion.

4) The tax code is impossible. I would support a flat tax perhaps set at more than one rate or set to kick in at a rate high enough to allow low income families sufficient tax-free income to live. Particularly I think corporate taxes should be flat rate taxes with no loopholes. the problem with the flat rate tax is it cuts off funding for charities but perhaps that is an issue that could be considered separately (one could check a box on the tax return to set aside a millage of one's taxes for charities or something like that). A loophole free tax code would level the playing field to some extent for small business.

I think the most important issue to consider is the oft quoted figure that consumer spending funds 70% of economic activity in the US and without a living wage consumers will not be there to fund anything. It is, you might say, the Henry Ford principle of paying workers enough to buy the product. The other thing that tends to be forgotten in the debate over taxes is that American consumers are the customers that have created extraordinary wealth in this country. Microsoft would be as nothing without the home market. I would envision some form of protectionism (hated word!) to force (hated word!) corporations to consider the value of the home market. If John Deere moves production overseas then John Deere products re-imported to the US (from Canada or Europe or elsewhere) suffers the same import tax as China or anyplace else. Protectionism is decried as a terrible thing but I have watched globalisation wreck productive well paid jobs in the US.

5) If opponents of health care reform stuck to the issue instead of shouting "faggot" and "nigger" and "socialist" at proponents perhaps the rhetoric would cool down. The Republican Party has not brought anything to the table in the move towards reform. All they have ever said is they want to start again. If you don't want to be tarred as a selfish, callow bigot you might do well to speak out LOUDLY against those on your side of the aisle who use those tactics. It's time to understand that we on the left aren't going to let the bully tactics of the right go unanswered.

While you ask why Americans aren't emigrating to countries with health care worth having the answer is complex. One, emigration ( as those of us who have done it) is intimidating and difficult especially to a country with a foreign language. Foreign countries don't want emigrants any more than we do and we are a nation unlike any other built on immigrants! Americans aren't taught foreign languages, rarely travel and are brainwashed to think this is the best country in the world. How many of your neighbors do you know have the money to buy a ticket to London? Or would know how to cope when they got there? Besides which, health care isn't the primary issue in everybody's life- not until they get ill. Then you find out how messed up our system really is but then you're ill and leaving your family and friends to live elsewhere is impossible wouldn't you say?

On top of all those practical issues is the fact, amply illustrated by your own questions, viz, question number two where you yourself say:

I would love to know how they work in reality. I'm willing to learn - but it's almost impossible to cut through the partisan talking points and get to an objective comparison

If someone as interested and involved as yourself can't sort truth versus fiction what chance does the average Joe have? Especially when lies and disinformation are the stock in trade of the Republican opposition? Republicans aren't discussing issues, they are throwing insults and calling the President illegitimate and a socialist and I don't know what. How about your side steps up and discusses reform rationally and presents a plan that can be compared to the Democrat plan? I guess we will see what Republicans can offer up that is constructive, not destructive. That would be change I could believe in.

8 comments:

Anonymous said...

Anonymous here;

I appreciate the thoughtful and passionate response to these rantings. We would likely find we agree on many objectives in this discussion, our differences being in the means to an end.

In the past day or so, I have read much on the details of the plan as it appears to be emerging from the braintrust that we refer to as congress, and while there are many elements I can never support (e.g. forcing citizens to purchase something they may not want or need), there are elements which I am intrigued by (e.g. physician limits on equity participation in hospitals - conflict of interest), and some I feel don't go far enough (national competition for insurance companies, pricing disclosures, etc.).

I disagree with public funding for "discretionary" medical procedures - the obvious ones like trims, tucks, lifts, and "fills"... but even pregnancy (which is preventable last I heard) - why should I pay the bill because my neighbor wants another bundle of joy? Do we really feel the human race is in danger of extinction that we need to subsidize the creation of more "miracles?"

A benchmark for any economic promulgation out of central gov't should be "does this grow the economic pie for everyone" - or does it merely "facilitate one constituent eating someone elses piece - thus leaving less pie for everyone."

No one is "too big to fail" and the responsibility for good and bad decisions should be borne by the decision maker (be it business (sorry Goldman Sachs) -or- personal (smoke 2 packs a day and expect neighbor to pay for cancer treatment)) - if not, we give up accountability and we end up with anarchy.

And to the point that the sacrifice is small on each individuals part (in terms of property - and privacy (Oh, the wonders of a marriage between our medical records and the Patriot Act?) - in the hands of a power that has demonstrated to care barely a wit about the individual consitituent, but moreso about its feeding perpetuation. Oft quoted by Franklin - "People willing to trade their freedom for temporary security deserve neither and will lose both."

Conchscooter said...

Likewise I don't think this plan is perfect, but the big point you are missing is that without reform the playing field was not even. You couldn't just go out and buy health insurance. Many people who recognized their repsonsibility to take car eof themselves were denied access to inurance by the insurance companies.
To pick on people for getting pregnant or smoking is a dangerous path to follow. Taking car eof new member sof society with propre pre-natal and post natal car eis common sense for the common good. Everyone in our advertising filled world has abad habit and choosing which bad habits to cover will end being a lot more obtrusive than requiring everyone to get car insurance and health insurance.
As to the patriot act- we've all noticed that president Obama has done nothing to repeal it. perhaps that should be the next campaign?

The Anonymous said...

The anonymous here:

The concept of insurance, as I've come to understand it, is to spread the cost of unforseen, unavoidable, and unpreventable loss (be it property or personal) over a larger pool of participants, with the actuarial belief that the individual costs are offset by the "group" benefits (e.g. healthier, more productive participants, etc.).

Where this breaks down is covering the costs of things which are discretionary, predictable, and avoidable. Then it becomes an individual "taking" to satisfy a "want" (the "want" of another child, to indulge in vices, tummy tucks and boob jobs, etc.).

While no one would rationally crash their car into a tree, or wish a chronic disease upon themselves or others - and insurance works in these cases, many people would enjoy a new Triumph or whiter teeth - if provided and paid for by others - and insurance won't work in these cases... it's a "taking".

Do we think the central gov't is going to be less intrusive in personal choice when they're managing the checkbook? Haven't we already heard the distant thunder (e.g. Bloomberg's NYC) of the encroaching nanny-state? - which will be further "justified" by central gov't funding (side note: ignore the sound of printing presses churning out trillions of devalued dollars which will lower the std of living for those least able to escape inflation).

... and On: The Obama regime now clearly owns two wars and the Patriot Act - as evidenced by Congresses ablity to enact this "reform" package, they clearly have the ability to extricate the citizenry from these gov't wrought afflictions. It's time for "the party of fairness and justice" (quoting the 3/26 essay) to be just that.

Oh, one more thing... why did Congress, Executive and Judiciary exempt themselves from this wonderful health care system we citizenry have been given?

Conchscooter said...

Inevitably I expect to see the intrusion of the "nanny state" as the English call it. For instance in countries where they have single payer they also have helmet laws 9which I loathe!) on the grounds that if you expect :free" health care you need to keep your noggin safe.
On the opther hand this health insurance reform expands private insurance NOT a national health care state. Besides which these reforms were made critically necessary thansk to the avarice and intransigence of the isnurance companies themselves. I beleive they deserved to be reined in with a "strong puiblic option" not the proposed insurance exchanges.
The question of whether or not to cover pregnancy (with its inevitbale unpleasant hidden anti-migrant agenda) is good public policy. We want healthy offspring as part of our society. It is in our interest to have trained mothers raise healthy infants insofar as it is possible, of whatever they race they be.
Please don't assume that I think this reform package is my ideal. It's nobody's ideal (not the President's if his electioneering rhetoric is to be believed) but in the face of the just say no campaign by the Republicans the change wrought was quite an achievement.
Personal liberty? On a planet with a ballooning population such as we enjoy (I use the word broadly) you and I will die with less of it than the world we were born into. Might as well be reigned to that. I'd also like to grow older in aworld with less greed. Yeah, I know, I am a dreamer to quote one other multi-millionaire who died a violent death.

Conchscooter said...

Oh rats, in my lengthy reply above I forgot to answer the last question. This package of reforms is so "light" it exempts anyone who already has insurance with which they are satisfied from changing anything. My insurance stays the same as it was, with the City, as does the federal employees plan ( which includes Congress). Sorry, no conspiracy theory there!
ps someone called me up at work last night, threatened to sue me, blow me up and called me a mafia faggot. I'm telling you, there are crazy people out there! Be careful!

The Anonymous said...

Anonymous here:

...correct me if I'm wrong here, but aren't the labor union health plans exempt as well - why does this sound vaguely like "Animal Farm?"

My sentiments on personal attacks is over-documented here. We can agree to disagree, debate, argue, and verbally parry 24/7, but there is no place for personal attacks. Ever.

I declined to respond to today's essay regarding the boorish behavior of a few attention seeking "entertainers" on the far right - and it continues to suprise me that the far left still take the bait by responding to these shills - giving them the limelight they so despirately crave. There are so many instances of this behavior along the entire continuum of political thought, it serves little intellectual purpose to keep shouting "He said...! She said....!" ad infinitum like trying to moderate at a day care center. One could find endless quotes from all political leanings - and would accomplish nothing other than contributing to the pointless din.

Conchscooter said...

This last comment is hard to decipher because I don't know who all these anonymous people are or if they are the same person.
the mafia faggot was just one of many calls I get at work from drunks who have nothing better to do than call the Southernmost police department at one in the morning to harass the operator. They usually constitute a light moment in a dreary list of human failings we have to deal with. I meant that comment as a joke. Instead I am being told (I think) that adult debate is a waste of time. How dreary.
I disagree.
Union health plans ar epre-existing ehalth plans just like my city funded plan is. thus they too are exempt. How this fits into Orwellian double think I'm not sure.

The Anonymous said...

Annonymous here:

Honest debate is healthy for a society IMO - that's why I tune out the nonsensical rantings of "Listen to ME!!" from "entertainers" posing as persons interested in intellectual reparte. They (and I'm tarring the entire political spectrum here as I can find plenty of examples from ALL points on the political continuum - not just the far right) their intent is to attract eyeballs/ears to their handlers interests, not to engage in debate. If "Cokie Roberts and her husband Steve" were to just ingore these shills (along with the rest of the media) they'd cease to have any economic purpose to their owners - and they'd go away. This may open room for us idealists to have a real discussion on topics that matter - not just "He used a bad word!!" or "She called another drone a bad name!!"

Spare me.