Previously, I speculated that Hillary Clinton would win most delegates on Super Tuesday and also pointed out that Clinton’s health care plan is more universal than Obama’s (as analyzed by Paul Krugman).
And there goes Matthew Dallman in the comment section using the phrase "totalitarian State coercion". Here’s exactly what he said:
"If it is a mandate that comes from the federal government, it is by definition totalitarian State coercion."
My knee-jerk reaction is that, why the heck equate universal health care with "totalitarian" and "coercion"? There are other sound arguments against universal health care
but using scare words such as *totalitarian* and *coercion* are, to me,
just plain silly.
As a case in point, let’s look at Hillary Clinton’s health care plan.
"Americans
can keep their existing coverage or access the same menu of quality
private insurance options that their Members of Congress receive
through a new Health Choices Menu, established without any new
bureaucracy as part of the Federal Employee Health Benefit Program
(FEHBP). In addition to the broad array of private options that
Americans can choose from, they will be offered the choice of a public
plan option similar to Medicare. "
Does this strike you as
totalitarian or coercive? Ok, granted Hillary’s health care plan
involves mandates which requires that everyone have insurance. As
Krugman explains:
"But the big difference is mandates: the Clinton plan requires that everyone have insurance; the Obama plan doesn’t.
"Mr. Obama claims that people will buy insurance if it becomes affordable. Unfortunately, the evidence says otherwise."
Ergo, Clinton’s health plan is more universal than Obama.
So let’s go back to Matthew Dallman’s argument and dissect the phrase "totalitarian state coercion." I’ll start with the word "coercion." Coercion
is already a strong negative word. But I’ll use a more generic
definition, such as "the act of compelling by force of authority." By
this definition, mandates *could* be seen as a form of coercion (but
without the threat or intimidation). Next word is "totalitarian." Again, totalitarian
is also a strong negative word. So I’ll use a more generic definition,
such as "of, relating to, being, or imposing a form of government in
which the political authority exercises absolute control over
everything."
So what’s my point? My point is that, even with the more generic
definitions of "totalitarian" and "coercion" the phrase "totalitarian
state coercion" when used to describe universal health care (whether
it’s Clinton’s plan or Edward’s plan) is a lame and poor choice of
words argument.
First, the only compulsory requirement is that for all
citizens to have a health insurance, but within that requirement there
are lots of options to choose from. Not to mention that the wealthy
could always pay for insurance from a "broad array of private options."
People have freedom to choose from other health plans, so where is the
totalitarian coercion? I doubt that the citizens who are enjoying the benefits of universal health care in other developed countries are suffering under a coercive totalitarian nation.
That said, I don’t think that Matthew is equating universal health
care with totalitarianism (Goodness! I hope not!). What I’m saying is that
Matthew has committed another instance of poor choice of words in arguing against universal health care. The essence of Matthew’s argument is this:
"Dude. I don’t have to come up with a plan (though I favor private
insurance made more affordable by free market principles) because I’m
not running for president."
(Um yeah, I don’t expect Matthew to come up with his own health plan. I can’t
even imagine him running for president.) In short, Matthew is more
in favor of private insurance via free market principles. Fine.
What
I expect from an intelligent guy like Matthew is to come up (or point
to) sound arguments supporting why health insurance via free market
principles is economically and ethically better than universal health care alternatives. Using scare
phrases like "totalitarian state coercion" is just poor taste. (Unless
of course he could dance around and give a better definition for totalitarian
and coercion to justify his use of those words in the context of this discussion. I doubt it.)
In the meantime, allow me to rehash this video of Tony Benn. He
makes a very compelling argument for universal health care,
economically and ethically. It’s a bonus feature from the documentary
movie, SiCKO.
P.S. Dear readers: Feel free to riff on this discussion as well. I’d especially like to hear from those people who live in countries with universal health care.
P.P.S. I’ve also riffed on the moral hazard argument against universal health care. Check out this previous entry: Tony Benn and the Bogusness of Moral Hazard.
Comments (40)
If universal health care, the way I know it from my own country (Norway), is totalitarian coercion, then I am all for it!
Didn’t realize I would ever support totalitarian coercion, but I do now.
Hi, ~C4, great post. I agree with your assessment.
I have been unemployed several times in my life, and I always had medical coverage (in Croatia, both before independence and post-1990). Most if not all European countries, in and out of EU, have some form of universal – even those who can barely afford it, because it’s a fundamental human right, and a non-issue in political terms. In US politics the left is completely absent, so much that you can’t even use the word “social(ist)”. Even Canada is different. Yes, Matthew is wrong in this respect, and not just by bad choice of words, as there’s no way of saying that to make it right. And, as you have pointed out, what H. Clinton is offering leaves many options to citizens (and, presumably, states and cities). The additional question is the quality of medical service itself, and whether universal healthcare affects it for better or worse. I believe it makes it generally better. Rich people will still have the privilege of travelling to other continents, if so they wish, and have their organs transplanted in an elite private clinic, but they’re not the ones we’re considering here.
Rommel, you write:
“the only compulsory requirement is that for all citizens to have a health insurance,”
That is precisely the point. Compulsory requirement = coercion. It would be against the law not to own health insurance.
Yes, a mandate at the federal level is totalitarian. It is the federal government asserting its power, by force of law, within what has been a sector of the economy confined to the private sector.
Then you write:
“(Um yeah, I don’t expect Matthew to come up with his own health plan. I can’t even imagine him running for president.) ”
Well, you asked me to argue for a plan. You wrote “or better yet, you could cite an alternative”. I didn’t feel I needed to, and that remarking briefly about the main problem with universal health care — that it is totalitarian state coercion — is all I wanted to do.
“Scare phrases”?
Lame, Rommel. Very lame.
MD
And you want me to point to something? Fine.
The Declaration of Independence, and the U.S. Constitution.
The former says nothing about health care being any kind of “right”; and the latter explicitly says matters not specifically assigned to the federal government are the responsibility of the states.
Health care thus rightly belongs at the state level.
This is all America 101. I didn’t realize that you didn’t take that class.
MD
MD, I guess you support a constitutional amendment to make health a right then? Or maybe you have the same incoherent patchwork quilt of libertarianism plus constitutionalism that Ron Paul does?
It’s true that technically, universal health care is “coercion”, but that implies an ideological committment to liberty as the ultimate moral good while marginalizing and minimizing other perspectives on moral goodness such as compassion. There’s no real philosophical support for that position. Some point to various evils you find in the absence of freedom in totalitarian states, but that is lazy thinking — just because one thing is bad doesn’t mean its polar opposite is good. Total freedom has it’s own set of evils: anarchy, anomie, social disintegration and dissociation. Maybe you prefer those evils over another set of evils, but that’s your preference, and so far you have no grounds on which to claim that those preferences are binding on anyone else.
Matthew said: “The Declaration of Independence, and the U.S. Constitution.”
goodness! so are you now implying that Clinton’s health care proposal (including Edward’s health care proposal) or any universal health care proposal are unconstitutional? i’m glad that there are politicians out there who don’t think like you.
in any case, the constitution is not written in stone. ever heard of amendments? then again, we don’t even have to take this route as argument against universal health care. i’m quite sure that Kucinich, Edwards, and Clinton are well aware of the repercussions of their proposal. but universal health care as being unconstitutional? your arguments are just getting sillier and sillier.
“This is all America 101. I didn’t realize that you didn’t take that class.”
you’re right. i didn’t take that class. i didn’t study in America. but i have my own reasoning to depend on based on my understanding of universal health care and the definition of totalitarian and coercion, and arguments for universal health care based on ethical grounds.
my point is: those words (totalitarian, coercion) that you keep using are scare tactics used to argue (or demonize) against universal health care. you can throw in “socialist” with that too. i would have more respect for your arguments if you’d argue on the grounds of budget (although that argument is shallow too). but then you continue to argue using scare words and then pull the U.S. constitution gambit. swell.
i took the time to define totalitarian and coercion. it seems like you didn’t take the time to understand that the principles of universal health care as implemented in other developed nations is far from being labeled as either totalitarian or as a form of coercion.
anyway, if you can’t provide a better argument against universal health care aside from labeling it as “totalitarian coercion” then i don’t think we have much to discuss about.
so i’ll just leave you with a couple of arguments for universal health care, one of them being more “totalitarian” and “coercive” than the Clinton health care proposal. enjoy.
PNHP: I Am Not a Health Reform
“With the exception of Dennis Kucinich, the Democratic presidential hopefuls sidestep an inconvenient truth: only a single-payer system of national health care can save what we estimate is the $350 billion wasted annually on medical bureaucracy and redirect those funds to expanded coverage. Mrs. Clinton, Mr. Edwards and Mr. Obama tout cost savings through computerization and improved care management, but Congressional Budget Office studies have found no evidence for these claims.” [read more]
Universal Health Care: Lessons from the British Experience
“It is important to understand, given the dominance of conservative views in US politics, that the NHS and related systems may be characterized by some as “socialist” but may actually support conservative values: to maximize the ability to exercise individual freedom and responsibility by enabling people to take care of themselves and be productive. Indeed, conservatives in every other industrialized country believe their values support universal access to health care.”
…
“The United States is now more than a generation behind, unable to reduce health disparities in a system characterized by ever-shifting market shares among competing managed care plans that change insurance coverage from year to year and policy to policy for “populations” of employees. The real chasm in US health policy is between the rhetoric to reduce health disparities and the realities of organization and finance.” [read more]
~C
P.S. as a bonus here’s a good debate on health care without resorting to scare words.
DEMOCRATS DEBATE – UNIVERSAL HEALTHCARE
i guess Clinton and Edwards are more totalitarian and coercive than Obama. ah, well.
The idea that health care is a universal human right is flawed because health care is a potentially limited commodity. What happens when there aren’t enough resources to provide everyone with health care? Who decides who gets health care and who doesn’t?
Liberty is not a limited commodity. It is something that everyone is born with. It is a God given right, whether or not the government recognizes or respects that fact.
We are not born with health care. Health care is not something innate in human beings. Everyone has the right to be healthy. But no one has the right to force someone else to bear the responsibility of providing you with health care. It is your responsibility to seek out health care when you need it, and no one else’s. The government is not responsible for your physical health anymore than it is responsible for your job or your relationships.
The idea that people can’t deal with their own problems is not compassionate, it is demeaning. It implies that people are too stupid to figure out their own problems, and that politicians, being the infinitely superior beings they are, are better able to handle the task. It’s as if the people are helpless little children and the government is their mother.
Perhaps the good intentions behind universal health care are inspired by a sense of compassion, but I think that this is a case where the road to hell is paved with good intentions.
Rommel writes:
“i’m glad that there are politicians out there who don’t think like you.”
Ha. Try the entire Republican party, and most of the Democrat party up until about 10 years ago.
Rommel, I’m not trying to scare anyone. I’m using accurate terms you don’t like, or don’t like to be associated with. That is your problem, not mine.
Federal mandates are coercion. Forcing all citizens to follow them is totalitarian.
And this might happen in America, which means that the principles that this country was founded upon matter. And those principles are found in the Declaration and the Constitution.
If you want to amend the Constitution, good luck with that.
I don’t really care how health care has been implemented in other countries. I care about how it is proposed to in America, since I live here and won’t be leaving this country.
MD
Just to paraphrase the above argument:
We are not born with justice. Justice is not something innate in human beings. Everyone has the right to justice. But no one has the right to force someone else to bear the responsibility of providing you with justice. It is your responsibility to seek out justice when you need it, and no one else’s. The government is not responsible for your justice anymore than it is responsible for your job or your relationships.
The idea that people can’t deal with their own problems is not compassionate, it is demeaning. It implies that people are too stupid to figure out their own problems, and that politicians, being the infinitely superior beings they are, are better able to handle the task. It’s as if the people are helpless little children and the government is their mother.
Perhaps the good intentions behind the legal system are inspired by a sense of compassion, but I think that this is a case where the road to hell is paved with good intentions.
I think the proof is in the pudding on this issue. As Hokei describes from Croatia, it is a non-issue in Norway as well. It works great. Benefits everyone. Has few if any drawbacks, as I can see. And it is a basic human right.
There may be some obscure philosophical concerns, such as the ones MD brings up, but for most people, this is just a very practical issue. It is about the quality of life of regular people, on a day to day basis.
My brother and cousin both have serious medical problems, and it is a good chance they and their immediate families would have serious financial hardships if they lived in the US.
In Norway, it is not an issue. They are both taken well care of in terms of medical services, high quality and elegant housing (both have their own apartments), regular help with the household, and money.
I see this is a matter of practicality and compassion, and a recognition that we are all in this together.
And to be honest, I see Matt Dallman’s views as heartless and an example of letting some obscure philosophical points get in the way of basic compassion and care for fellow human beings.
Get a grip, MD.
Per,
I, and my family, were without health insurance for four years, and yet I still don’t think the government should get involved with insurance. Imagine that! (And I had a major injury, and my wife bore our first child, during that time.)
And the nature of America’s founding, and the continued protection and defense of the hard-won principles that made and makes America unique are not “obscure philosophical concerns”. At least to people who live here.
Compassion and care are typical buzzwords, but they aren’t the issue. The issue is what level of American government, if any level at all, should attempt to manage 1/7th of the American economy.
Its track record on large-scale management is far from exemplary. But you wouldn’t know that, would you.
Per,
thanks for sharing you personal views on this.
i’m aware that Norway is one of the progressive “enlightened” nations when it comes to health care and politics.
not sure if you’ve seen this post, but i riffed on this previously. check it out.
SiCKO: Deleted Scenes from Utopia
my question to you is: did Michael Moore presented Norway accurately when it comes to health care?
someday i want to visit your country and compare its socio-economic living standards with the U.S. and other places i’ve visited in Europe
thanks!
~C
Dan said: “We are not born with health care. Health care is not something innate in human beings. Everyone has the right to be healthy. But no one has the right to force someone else to bear the responsibility of providing you with health care. It is your responsibility to seek out health care when you need it, and no one else’s. The government is not responsible for your physical health anymore than it is responsible for your job or your relationships.”
thanks for expressing your views. although i don’t agree with your premise, this is the kind of argument i’ve been asking for in which we could start the discussion. your argument of that health care is not a basic human right is the most common argument against universal health care. if you’ve watched the video i posted above, Tony Benn addressed this argument eloquently. keep in mind that Britain (and other developed nations which have universal health care) had struggled with this debate too. in their case, individualistic argument (such as the one you’re arguing for) lost its case with the more compassionate (and more practical) benefits of universal health care. instead of me rehashing the argument against “health care is not a basic human right” allow me to point to a proposal put forward by physicians (which is even more “radical” than the Clinton health care program).
see Proposal of the Physicians’ Working Group for Single-Payer National Health Insurance.
“For physicians, the gratifications of healing give way to anger and alienation in a system that treats sick people as commodities and doctors as investors’ tools. In private practice we waste countless hours on billing and bureaucracy. For the uninsured, we avoid procedures, consultations, and costly medications. In HMOs we walk a tightrope between thrift and penuriousness, under the surveillance of bureaucrats who prod us to abdicate allegiance to patients, and to avoid the sickest, who may be unprofitable. In academia, we watch as the scholarly traditions of openness and collaboration give way to secrecy and assertions of private ownership of vital ideas; the search for knowledge displaced by a search for intellectual property.” [read more]
the ironic (or sad) thing is, “the U.S. is the only industrialized nation that does not guarantee access to health care as a right of citizenship.” what does that tell you? this is not a rhetorical question. i’m requesting you to reflect on this fact using your own innate intelligence and compassion.
i suggest that you inform yourself of all the arguments and counter arguments on universal health care and then see if your argument sticks.
~C
Rommel,
Get real. Anyone in America can go to an emergency room right now and get treatment. Sure the wealthy would get better care, and having insurance will be a great financial help. But, really, cut the crap. The distortions about what is and what is not going on with regard to health care and sickness insurance (which is the original name, previous to the propoganda of “health insurance”) don’t help anyone, and in fact I think make more people prone to throw up their hands and say, “okay, totalitarian, coercive State-managed care it is!”
In not so many words, of course.
I haven’t met anyone against government-mandated universal insurance that also doesn’t think the current insurance system in America is badly broken.
The question is not whether to change the system, but now to change the system. The socialists among us say “let the government manage!” and that is hardly a surprise, given that they are socialists (conscious or not).
And you, advocating for socialistic, government medicine, to throw off the arguments that ANY kind of proposal like yours go against the grain of American principles is mere convenience, and telling for just how unseriously you take the issue, your pleas of “compassion” blah blah not withstanding.
For you claiming “compassion” for the side of socialized medicine pretty much defines below-the-belt behavior. “Compassion” takes no sides in a political debate such as this. Enemies of government insurance like myself feel just as much compassion for those in need. AS I said above, my wife bore our first daughter while I had four broken bones, we had zero health insurance, and I still don’t think government coerciveness in this matter will be the best solution.
Offensive, you.
MD
Health care must be available to everyone. Some participation may be retained in terms of costs, and of course the rich will still get the best care there is, if they care. However, the underprivileged often work in professions that are more detrimental to health, and it’s in everybody’s interest, not just a humane thing, to make health care available even for those who can’t afford it, and there are quite a few in US, from what I know. It has nothing to do with being socialist (that’s just an evasion, not an argument). What would MD say if health care was mandated for everyone at the level of, say, California? Would other, more progressive states follow the example? I certainly hope so.
Another point is that not all industries are best left to unregulated or deregulated market and private business initiative, such as some transportation, national security and intelligence, army and police, and – very important – urban planning, part of which is hospitals. I’m sure a place can be made for privately owned hospitals in the system of universal health care. We have private doctors, and hospitals, along with public ones, and everyone gets to work, while private doctors are not forced to participate in the public health care if they so choose, and patients are also not forced – they can have their own medical plan and insurrance, but such is always more expensive, as it should be.
Americans should be aware how this issue looks from any other developed country, and not just say “I don’t care what others think”, but be interested in other perspectives and experiences. Some of this stuff really can work well for the benefit of one and all.
Health care is already available to everyone. Of varying degrees of quality, to be sure, but if you go to a hospital emergency room, you will get care. You may have to wait a while if the problem is not life-threatening. This is what happened to me. And I got care without insurance.
Yes, it does have to do with proposing socialist, or proposing non-socialist solutions. Whether to go with a socialist solution is an self-descriptive argument to anyone who knows what socialism is. You just don’t like the argument. Whether or not to socialist in America is another way of saying it is not just the ends that matter, but the means, too.
Are you prepared to say that means don’t matter?
MD
Regarding:
Another point is that not all industries are best left to unregulated or deregulated market and private business initiative, such as some transportation, national security and intelligence, army and police…
Agreed (minus the hospitals). What you mention comprise what in America are known as “public goods” and are considered best managed by the federal government. Add borders, large-scale disease prevention, and a few others, and you have the libertarian view of a federal government of limited ambition (yet powerful within those limits). I.e., you have the ideal.
MD
Regarding:
What would MD say if health care was mandated for everyone at the level of, say, California?
Already the case in Massachusetts. Their example is not my preference, but it is better than the mandate coming from the federal level by a long shot. America was set up so the individual states could function as laboratories for policy and law experiments.
Again, this is America 101 stuff.
Presumptuous, don’t you think, for non-Americans to be pronouncing to Americans what we should do when you don’t understand America. More respectful, don’t you think, for myself and Dan Allison, who do understand how America works, to not be pronouncing what other countries should do. I don’t understand Norway, and I don’t understand Canada. So I keep my mouth shut.
Take the cue.
MD
I hear your arguments, MD. And I certainly have no intention of telling anyone, much less Americans, what they should do. Nor do I pretend to “understand” America. Do your compatriots understand America? Does knowing other countries help or hinder one’s understanding of America? Is “understanding America” a prerequisite for discussing a universal healthcare proposal in principle? Is universal health care something with which Americans have more or less experience? Is federal regulation something of which many Americans have an especially biased view, either pro or contra? Etc. etc. Yes, I hear your arguments, but since your government is daring enough to see the whole wide world as it’s own field of national interest, you should be wise enough to accept everyone having an opinion of all things American. It’s quite natural, right? Even if I didn’t have a clue… Even if “health” and “healthcare” was something non-universal, something peculiarly American. But in this case, United States lag behind in the developed world, or that’s the (wrong?) perception some may have, having stayed in US, having relatives born US citizens, having heard and read what various American politicians have to say on this matter, etc. You, sir, should take the cue. And I will keep my mouth shut.
Take (universal health) care,
Hokai
Hokai,
You ended your previous comment by saying “Americans should be aware…” and so I have a hard time squaring that with how you opened your most recent comment.
Do your compatriots understand America? Does knowing other countries help or hinder one’s understanding of America?
Too few Americans understand America, I will unhesitatingly grant, in terms of its fundamental principles. To your second question, I would say it is irrelevant to the matter at hand.
Is “understanding America” a prerequisite for discussing a universal healthcare proposal in principle?
There is no “in principle”, because the important parts are always in the details, of how a country in particular would jive or not with such a tyrannical imposition of State power. Generalized talk, in other words, is cheap, and worth the same.
To your other questions, intelligent Americans have enough experience with socialism to be able to decide that it goes against the grain of America. It is fine for other countries if they choose it.
As far as “national interest”, you make a mistake. America sees the spread of democracy as a national interest. Not something as juvenile and naive as “the whole wide world”. In other words, America’s national interest is philosophical, not geographical.
The agreement on this thread is that America’s health care system needs a fix. The disagreement on this thread is that a coercive, government-managed, socialistic system is the solution for America, given its nature.
Why is that distinction so hard to grasp?
MD
Ok, I haven’t read all the comments up to this point, so I may have missed some crucial points, but I had a thought. So I’ll share.
My thought is this: Doesn’t our health care problem seem like a great opportunity for some philanthropic entrepreneur to create a health insurance company that provides insurance at a higher than normal price for those who can afford it and then uses the extra profits to provide free or very cheap insurance for those who can’t afford it? Or something along those lines?
Rommel, you’re big into conscious capitalism, right? Triple bottom line? Why is this not a problem conscious capitalism can solve?
My point is that people are intelligent enough to solve this problem on their own, without the government dictating their own mediocre solution. The only real obstacle to this kind of self-reliant, compassionate thinking is the idea that it is the government’s responsibility to deal with this problem and not the people’s.
Personally, I don’t trust the government enough to let them deal with this problem. The government tends to fuck things up a lot of the time, usually motivated by the best of intentions. Just think of the federal government’s prescription for a healthy, balanced diet. It’s a joke, the result of nothing but lobbyists, and big part of the reason American’s are so sick and fat right now.
Wow. What an interesting, if angry, discussion.
I’m pretty open-minded as to the arguments, but it seems to come down to what we should include as “public goods.” Where do we draw the line?
MD and Dan seem to concede that some “public goods” are acceptable and beneficial (i.e. law enforcement, national security, large-scale disease prevention, etc).
Is it not possible to argue for universal healthcare on the grounds that it too should be considered a “public good,” using the same reasoning it takes to allow for the other public goods mentioned?
What is the rationale for: “Yes, law enforcement and large scale disease prevention should be public goods” but “Basic healthcare should not be a public good”?
Again, I have not made up my mind on this, so no need to blow a gasket (but feel free, if you want)
–Bob
Another thought:
If part of the reason that Americans are so sick and fat is the government’s brand of a “health, balanced diet”, then why would we trust them to take care of us now that we’re sick? That’s like getting punched in the face by someone and then expecting that same person to tend to your broken nose. If somebody fucks me over, then I know not to trust them. Why does this principle not apply to our government?
Thanks, MD. I appreciate your take on this subject, and I see how this sort of argumentation will play a role in getting the healthcare rigth. As to the philosophical nature of the national interest, well that’s another can of worms. Anyway, good night and good luck.
Hokai
Bob,
Public Goods are those things enjoyed equally (equal being key to the definition) by all citizens within the borders of a country simultaneously. National Defense, Clean Air, Large-Scale Disease Prevention (keeping it from entering the borders), and such.
Health Care, on the surface, might seem a candidate for Public Good. But in practice, that is far from the case. Health care is always on a person by person basis. It requires a doctor/nurse, and a patient. “Health Care” as an umbrella term, in fact falls apart the closer you look at it. But, as Dan pointed out above, health care is a Service, that much you can say.
And being a Service, this Service cannot be simultaneously enjoyed by all citizens. Doctors see only one patient at a time. Same for nurses, and specialists. Health Care, in practice, is a shared good — all citizens can, and do, share in it, from the widest point of view.
When you say a Good cannot be simultaneously enjoyed by all citizens equally, that easily is seen to apply the Health Care. At a given moment, people will be excluded by care. That exclusion may be an hour. It may be a day. A month, or longer. But an exclusion of some duration is part and parcel of all health care.
These conditions are not the case for National Security, Clean Air, Disease Prevention.
And note that by “law enforcement”, I mean at the Constitutional level, in the Supreme Court and the judiciary branch, in general, when determinations are made whether federal laws are being enforced, or should be enforced. Garden-variety local crimes or questions of law are not the purview of the Federal Government, but obviously local jurisdictions.
All of which is to say, the definition of “public good” is more than the two words that make it up seem on the surface. The plain, separate meanings of “Public” and “good” do not equal the meaning of “Public Good”.
take care,
MD
- No candidate is proposing universal health care, they are proposing universal health insurance.
- The legal system is not a public good. Judges and lawyers can only try one case at a time, police officers can only patrol one street at a time, therefore the legal system should be abolished?
MD said: “Ha. Try the entire Republican party, and most of the Democrat party up until about 10 years ago.”
exactly. and that’s why i’m not voting for a Republican, at least in this election.
“If you want to amend the Constitution, good luck with that.”
Amendment 13 always gives me hope.
but amending the constitution to implement universal health care is not required. laws change. constitutions change. and i hope that the U.S. someday change its views on health care as a basic human right (the way other industrialized countries had already done so). politicians who support universal health care (whether they be Republicans, Democrats, or independents) just need to be more creative in their approach and not get swayed by special interest groups.
“I don’t really care how health care has been implemented in other countries. I care about how it is proposed to in America, since I live here and won’t be leaving this country.”
i guess our difference in our approach to this issue is that you’re focusing too much on your *own* point of view (i.e. ” i don’t really care…”, “i care about…”, “i live here…”) and your preferred values (i.e. Republican values). well, there are millions of Americans who also live here but care about universal health care. in fact, majority of Americans prefer universal health care. here’s the data from Pew Research.
“Fully 72% of Americans agree that the government should provide universal health care, even if it means repealing most tax cuts passed since Bush took office. Democrats overwhelmingly favor this proposal (86%-11%) and independents largely agree (78%-19%). Even a narrow majority of Republicans (51%) favor providing health insurance for all even if it means canceling the tax cuts, while 44% disagree.”
so if you’re right with your assertion, then majority of Americans prefer “totalitarian State coercion.” what does that tell you?
since i’ve started my musings on universal health care i’ve taken the perspectives of politicians (i.e. Democrats, Republicans, independents), physicians (i.e. PNHP, Insuring America’s Health: Principles and Recommendation), millions of American without insurance, American who’ve been screwed by their health insurance (that’s the topic of the documentary SiCKO), other countries which have successfully implemented universal health care, and as well as my own perspective as an American citizen (yes, i can afford health care. i don’t have any insurance horror stories. so i’m neither angry at the government insurance nor private insurance companies). between the two of us, i’m coming from a more neutral position.
my question to you is: how many perspectives have you looked at before sticking to your position? if you have taken the same perspectives i’ve taken above (or more) and you still stick to your conclusion (i.e. belief) about universal health care, then fine. that’s your prerogative. go and stick to it. but don’t expect people to be swayed by you using scare empty words like “totalitarian”, “coercion,” “socialist”. they may be accurate to you, but they don’t support your argument that America is better off without universal health care.
in my case, i’ve taken all those perspectives above and upon considering the economic, moral, and ethical arguments, i’ve come to agree that universal health care is not only a basic human right but also an economically sound alternative to the current mess of American health care system.
and i’ll just leave it at that.
oh, get real too.
~C
Dan said: “Rommel, you’re big into conscious capitalism, right? Triple bottom line? Why is this not a problem conscious capitalism can solve?”
are you implying that you trust BIG business more than the government? since when did you come up with this notion? yes, i’m all for conscious capitalism. but i’m not handing public policy making to big business.
you may want to take a look at Lawrence Lessig’s take on Super Capitalism because he eloquently addresses your argument. and i share his opinion. here’s a key quote:
“Corporations are not more efficient governments. They are instead increasingly efficient money making machines. And while there’s nothing at all wrong with money making machines — indeed, wealth and growth depends upon them — there is something fundamentally wrong with trusting these machines to restrain the drive for profits in the name of doing the right thing.” [read more]
~C
Rommel,
I don’t know what gave you the impression that I’m in favor of handing public policy making to big business. Quite the opposite, actually. I’m in favor of taking it away.
In general, I do trust business more than government because, ideally, businesses do not have the power to create or change public policy. Unfortunately, because our federal government has overstepped its bounds to a large degree, we have the congressional-industrial complex, and big business does essentially have the power to create or change public policy to fit their interests (remember those lobbyists I mentioned?). The answer to this is not to get the federal government involved in yet another domain of public life, thus perpetuating the growth of the congressional-industrial complex. The answer to this is to get the government out of cahoots with big business by limiting the government’s role in regulating things like food production, energy, transportation, and yes, health care.
I agree with Lessig that we shouldn’t trust corporations “to restrain the drive for profits in the name of doing the right thing.” I wasn’t suggesting that run of the mill corporations can solve our health care problem. That’s why I was talking about conscious capitalism and not just plain ol’ capitalism. As I understand it, conscious capitalism is essentially for-profit charity, more or less. Charity, whether for-profit or not-for-profit, is the solution to our health care problem, in my eyes. The federal government, as it has overstepped its bounds, has taken over many of the duties that used to be the sole domain of charities. It’s almost like we’ve forgotten about charities, and we immediately look to the government to provide us with things like college loans, housing for the poor, disaster relief, and now health care. This is not the role our government should play. It is not the government’s responsibility to provide these things, and I think that the belief that it is the government’s responsibility is part of what has weakened our health care system.
After reading this entire thread I find I fall entirely on the opposite side of the Dan/Matt fence. At least I think that government should handle all kind of things. I definitely think they should handle stuff like disaster relief and housing for the poor and college loans and health care. Relying on charities to do this stuff means a civilian has to pay taxes and make a bunch of other decisions on how to spend his money. If Bush wouldn’t have cut taxes maybe concerned citizens wouldn’t have had to watch as no help arrived in New Orleans. Maybe they wouldn’t have had to try to fix it themselves with money they didn’t have. The Canadian government automatically pays for most of my health care. I’m happy about that. I am truly happy to let my government take care of as much as they feel like they can. I don’t feel coerced. ~C really does seem to have taken more perspectives on this one. I’m sensing a sort of “mouthpiece for libertarianism” style here from the notorious MD. Of course, who knows what ‘coercion’ and ‘totalitarianism’ actually mean to he and his family. They might mean ‘a light tickling which causes a sneeze effect’ and ‘a system of government which forces its citizens to grow flowers’ Hehehe. This is a spiteful reference to a previous thread. Also, am I alone in feeling a little regretful twinge whenever the constitution is mentioned? I mean… anytime someone references a document circa the 1800s and starts pontificating on its irrefutability with any sort of seriousness my eyebrows go up. I saw Dennis Kucinich whip one out in an interview with Charlie Rose and claim to be the only Democratic candidate who truly understood it. I groaned. I readily invite the polemic that comment deserves.
cheers,
b~
Rommel,
One. Just like you. Just like everyone here. Cut the Wilberian New Age delusions about “perspectives”.
And for the record, I don’t have Republican values; I have American Conservative values. I would explain the difference but you’d ignore it, then cherry-pick it out of context, and then find 5,000 links that I don’t care about.
I’ve said all I have to say, again noting that I agree that the system America uses for sickness insurance should change. The question is how, given that we are talking about change in America, not some imagined place. America, with a history, with a set of unique principles, with a heritage of liberty and a government with limited ambition.
I’ll also note that no one disputed that government-managed care is coercion, and no one meaningfully disputed that it is form totalitarianism. I’ll also note that the people who argued most passionately for universal insurance admitted they didn’t understand or study America, its principles related to this matter.
I’ll finally note that Dan’s first comment (Feb 7, 2008 6:25:47 PM) stands undisputed; rightfully because his points shine the brightest, by my lights.
MD
Actually, I have one other thing I meant to say earlier.
I’ve previously mentioned that my wife’s pregnancy with our first child, Twyla, occurred while we had no health insurance.
What did we do?
Well after making many phone calls to various medical practices in Chicago (shopping around!) we found a hospital that had a small clinic of four nurse-midwives. Informed that we had no insurance, the hospital responded that they have a seldom-used option whereby the patient and hospital agree to a flat-fee arrangement, to be paid in installments if we chose.
We were excited, and we happened to have the $2500 available, so we paid in full right away (transparency of costs!)
This agreement included as much prenatal care/visits with the midwives as we wanted, including as many ultrasounds as we wanted (ended up to be two), included a 24-hour stay in the hospital after the birth. If Hannah had elected to have an epidural injection, it would have been $500 extra. But she didn’t want that, and had an entirely intervention-free birth.
The point is how often do people shop around, and how often are all the costs transparent.
Rarely, especially on the latter. People sometimes find out about the costs of a medical procedure far after the fact, through documentation sent to as a matter of procedure by our insurance company.
But before a procedure, I don’t think I’ve ever known before it happened how much it was going to cost. I’ve since tried to ask, and what happens is invariably a headache. America does not have a habit of medical cost transparency.
The rule of thumb is that when people know how much something costs, then the cost of that something goes down over time. It is pretty much true about everything, even complex technology.
Whereas the costs of medicine, which has plenty of complex technology, in America, isn’t going down generally, but going up. It doesn’t obey basic laws, because it is not allowed to by the current American system.
If people shopped around more, and if costs were transparent, then the overall costs of medical care would go down for everyone, because that is the way of technology.
I think the model for America involves more out-of-pocket expenditures by private citizens (paying hospitals and clinics directly, w/o insurance involved) as well as having a wildly competitive market for catastrophic-care type insurance, for the care that is too expensive to save for. This wild competition between insurance providers would drive down the prices, and no longer would insurance have to come in cooperation with your employer (which was a bad idea from the start and came about on the scale we currently have it completely as an accident).
HSAs, or health savings accounts, could be become more common, and continue to be untaxed as incentive to save to pay for routine-care stuff out of pocket, and perhaps some more emergency-type care.
Anyway, the basic point is that our first pregnancy opened our eyes to the possibilities and problems of our current system. But nothing at all tells me that intervention on the part of the federal government — all ready so big as to perform most of its bureaucratic tasks unsuccessfully — would help matters whatsoever. Because neither would help create a habit of shopping around, or the habit of transparency of costs.
We need empowered citizens, who know their options and are free to find what works for them, and have the incentive to do so. Insurance companies, being businesses first and foremost, will respond to the market. People must lead, the rest will follow.
End of story.
MD
I should say for the record I’m not a big fan of government mandates nor worse in my view Government Care (i.e. single payer system).
But I do disagree with the language of coercion and totalitarianism in this context.
Matthew cited the 10th Amendment as proof that health care is not a power delegated to the feds.
On the other hand, one could make a legitimate argument (I think) that the promotion of the General Welfare clause to the Fed. Legislative branch is a rationale for the justification of federal level legislation on health care.
Welfare is defined by the American Heritage Dictionary as “health, happiness, or prosperity.”
Granted the Framers of the constitution were not thinking about 21st century health care issues when they inserted the Welfare clause (how could they?) and I don’t want to get into a huge legal debate on Original Intent vs. Original Meaning vs. Living Constitution.
Just to say that IF one made a reasoned argument for health care under the Welfare clause and IF the process was democratically verified through the Three Federal Branches, then yes I think that reduces the import of the coercion and totalitarian argument. Whatever one’s personal views on the specific policy in question.
I mean I haven’t seen anyone on either side of this debate make an argument that somehow they expect this (as of now) hypothetical law would be instituted by some non-congressional measure, like a coup or dictate by fiat.
Sure such a law would be coercive in the sense that any law is coercive. I mean the government creates coercive measures to prevent/discourage tax evasion, homicide, and any other law passed frankly. Can’t say I think it is more coercive necessarily than any of those.
I disagree with all kinds of law that I still comply with–and there are mechanisms from within the republic to overturn laws one finds objectionable.
What I mean is there is coercion and then there is coercion.
There has been no discussion I’ve seen here of what would be the penalty for non-compliance with the law, for example. What if it were say a small fine?
Matthew and I have had this disagreement elsewhere and I don’t want to re-hash it, but I think totalitarian means gulags, concentration camps, and military dictatorships making people disappear, minus trials, legal rights, etc. Iow, Organized systematic violence and propaganda.
Obviously I can’t imagine Dear Leader Hillary sending in shock troops to break down your door and put boots on your neck to enforce a health care mandate.
I understand Matthew to have a different understanding of the word totalitarian which he is employing in this context.
It might help Matthew (unless I missed you already having done so which is possible) for you to define what you mean by totalitarian, so others can judge whether it would be applicable in this case or not.
Peace.
Chris
thanks again for all your feedback.
i just posted a follow up. check it out.
Busting the Myths of Canadian Health Care.
~C
This might be the last comment on this thread.
Coercion is being forced by law to do something you wouldn’t do of your own free will.
Not all forms of coercion are bad. The collection of taxes by local, state, and federal government is a classic case of coercion that is generally accepted to be necessary.
However, you really can’t get around the fact that a “mandate” on the issue of sickness insurance is coercion. What does a mandate mean if not to coerce a person to do what the law mandates one do?
I mean, basic definition here.
As far as totalitarian, plenty of forces are totalitarian. Nature is totalitarian. Electricity (the electric field) is totalitarian. Sound can be considered totalitarian. The consistent thread through these different forces is that the thing in question (nature, electricity, sound) completely fills up, by nature, its container. By perceiving it in any form, you perceive essentially its entire form.
For more on how nature is totalitarian, see Paglia. For more on how electricity is totalitarian, see McLuhan. For more on how sound is totalitarian, see W.A. Mathieu.
But those are in different categories, for sure, than what federal governments do. But still, one looks for totalitarianism when, within the category of law/society, an government entity completely fills up its container.
Such is precisely the case with federal government-mandated (or worse, managed) sickness insurance. With the Clinton plan, for example, nothing is left out, is it. There is no where for a person to go where the federal government is not involved directly or indirectly. Indirectly, in this case, is in evidence in the celebrated “choices” that the Clinton government plan offers. If the government is behind the choices (which it would be in her plan), AND allows no one to opt out of the government involvement in their sickness care choices, then the federal government has exhibited the same basic quality of all totalitarianisms: it has filled up the container.
The rest of your argument, Chris, boils down to the assertion that because there exists in present day America clear violations of the principle of Federalism, enshrined in the constitution, there exists justification to further violate the constitution.
Which is to say, your argument is weak. And your definitions very narrow. Mine includes yours, but allows for more, in other words.
MD
“But those are in different categories, for sure, than what federal governments do. But still, one looks for totalitarianism when, within the category of law/society, an government entity completely fills up its container.”
“different categories”! exactly my point! you are conflating the definition of totalitarianism (i.e. nature is totalitarian) knowing that the most common notion of that word when used in the context of political discussion is *negative*, and when used in the context of the government, it is a scare tactic.
i would appreciate it if you could link to the Paglia and W.A. Mathieu articles so i would have more understanding of your context.
nevertheless, your assertion only proves that all federal laws are “totalitarian coercion” (by your definition). so how does that advance your argument against universal health care?
i think you’re better off arguing on the free-market angle or the inefficiency of government angle, or maybe some other angle, instead of throwing ambiguous labeling.
that said, the free-market and the federal government as already “so big as to perform most of its bureaucratic tasks unsuccessfully” angles are weak arguments that have already been busted.
see Mythbusting Canadian Healthcare, Part II: Debunking The Free Marketeers
see The Universal Declaration of Human Rights, adopted by the United Nations in 1948, proclaimed that “everyone has the right to a standard of living adequate for the health and well-being of oneself and one’s family, including food, clothing, housing, and medical care.” (note that this also disputes Dan’s ideological argument–”idea that health care is a universal human right is flawed…”)
see also PNHP: Single-Payer FAQ
i suggest that we continue the discussion in this thread:
Coerciveness of Health Insurance Industry
~C
“different categories”! exactly my point! you are conflating the definition of totalitarianism (i.e. nature is totalitarian) knowing that the most common notion of that word when used in the context of political discussion is *negative*, and when used in the context of the government, it is a scare tactic.
I’m not conflating anything. Totalitarianism is the name for a force that has its origins in the natural world. Electricity comes from the natural world. Sound comes from the natural world. Humans, having the same origin, are prone to totalitarianisms of various kinds.
so how does that advance your argument against universal health care?
Because the point of America, bluntly, was to enact a system of government to prevent totalitarianism!
Why do you think America was the philosophical “dream of Europe”? Why do you think the principles used to found America were so exceptional, so unique?
Because in virtually every society before the founding of America, power by those at the “top” was abused. From tribal to monarchical.
Understand the history of the battle between individual liberty and the State before you continue to embarrass yourself like this.
“Understand the history of the battle between individual liberty and the State before you continue to embarrass yourself like this.”
i think you’re the one who continue to embarrass yourself by using bogus terms like “totalitarian coercion” in describing universal health care.
but that’s just me.
’nuff said.
~C
You calling them bogus doesn’t make it so.
Tell me, in your own words, how federally managed health insurance does not
1) by law, coerce participation
2) leave the citizen no other option
MD
I enjoyed reading the above debate. Personally, I am against Universal Healthcare and mandated Universal Health Insurance.
I have good reasons. In the current hysteria over “poor lifestyle choices” that are fueling smoking bans, trans fat bans, potential future bans against who knows what, and the concomitant rush by employers to fire or refuse to hire smokers or others with unhealthy lifestyle choices, Universal Healthcare will give government (and Universal Insurance coverage will also give insurers) the right to discriminate against people who do not choose to lead purely healthy lifestyles.
True, some insurers already do discriminate in the form of higher premiums. I am not here to argue the validity or non-validity of this position or whether personal choices pose an undue burden on society as a whole. People being born at all poses what some might consider an undue burden on society and the environment. Any kind of child or adult abuse, being born into poverty, war, racism, classist pressures, or the simple pursuit of pleasure/fun will always lead some to escape through less than optimal lifestyle choices – drinking, smoking, drug use, food, sedentariness, extreme sports, etc. that can all be argued to detract from optimal societal and health conditions and costs. Driving cars could be considered a culprit as well since it is dangerous and leads to many deaths per year not to mention the pollution it causes.
These conditions of mainstream defined imperfection have always been present throughout human history and will not abate significantly even with governmental or industry pressure. They will simply be driven underground. You can argue this idea endlessly on both sides.
How healthy you are and what vices you indulge in is becoming a determining factor in whether or not you deserve full citizenship rights in the US and abroad. In my mind, this is a dangerous trend that marginalizes all who are not perfect.
http://mu-warrior.blogspot.com/2008/01/universal-healthcare-not-at-all.html
As several pointed out above, compassion may drive the idea, but limited resources will force it to devolve into constant bickering and polarization between those who are healthy and those who are not – for whatever reason – personal choices, poor genetic makeup, being raised in a poor environment, etc.
The state is already intruding on people’s right to choose how to raise their own children and into various other “personal choice” issues – for the “public good.”
Requiring Universal Health Insurance or implementing a Universal Healthcare system will only cement the state’s ability to coerce and control people’s personal habits and legalize discrimination against all who do not measure up. This, to my way of thinking, is quite totalitarian in nature.
The new battleground in the 21st Century will not be about race, religion, sexual orientation or any of the other civil rights issues on the books. It will be about health – who has it – who does not – why? and what should be done to enforce conformity to the societal standard of perfection as dicated by Government, the Healthcare industry, Insurance companies, and increasingly, employers..
The battle has already begun and it will bitterly divide the classes, the parties, employees/employers, and all Americans ultimately. Mental acuity and competence regardless of health are being sidelined in favor of bodily perfection and purity. Employers are already doing this – not hiring fully qualified, competent people with less than optimal lifestyles in favor of healthy specimens that decrease their financial healthcare costs. People will be valued or marginalized based on how they look (healthy or not) and whether or not the perceiver feels they are a “financial burden” on their healthcare premiums and/or their quality of life as a whole. To some extent this is already true but will become more extreme in the future.
Ironically, Healthcare Insurance was orignally structured to spread the risk of an imperfect society across all. Insurance company greed for optimal profits, high doctor malpractice fees and the increased (and often unnecessary) testing that accompanies this, plus onerous government paperwork requirements are major causes of increased Health Insurance premiums, not an increase in imperfect lifestyles. Ironically, people are living longer and are healthier than ever, on the whole, when compared to historical norms, which almost guarantees rising medical costs (which impact insurance premiums for all) to treat the elderly that have reached that status largely by virtue of being healthy/receiving more adequate healthcare most of their lives.
Americans are already attacking each other on these issues and asking for government mandates in their quest for the perfect social utopia. Adding Universal Healthcare to the mix will only add fuel to the fire, legitimize discrimination, and lure power greedy politicians to mandate policies of coerced conformity to whatever health norms they are able to “prove” through the latest scientific studies (many of which are discredited within 20 years or distorted or culled to fit their personal viewpoints or feed large corporate interests) in order to win votes/slash costs/act like they care and are doing something for the “public good.”
The danger of imposing health norms that marginalize a certain segment of the population is too tempting with Universal Healthcare. This approach was tried in the past by Hitler – who held the same ideals as many healthcare zealots of today – a perfect, healthy and superior society, beneficial to those who met the “norms” he established and quite debilitating to the rest of the population. One could argue that he didn’t marginalize people over health issues, but because of genetics and ethnicity. However, he did ban smoking for all Germans and was a practicing vegetarian, consistent with his quest for “health purity.” And with gene therapy a very real possibility in the near future, it could be argued that those who do not use this therapy to overcome their own genetic limitations or flaws (as defined by policymakers and healthcare wonks of this time) will add to the burden of society and therefore should be marginalized and denied healthcare since the state is providing it.
I believe the totalitarian dangers of a Universal Healthcare and/or Insurance mandate are real and I have tried to make my case without attacking anyone or impugning anyone’s opinion.
This is my opinion – please feel free to disagree – politely if possible. Thanks for the space to express it.
I leave you with a link to this well-reasoned article that addresses some of the issues I spoke to above:
http://www.sirc.org/publik/bad_habits.shtml
Enjoy!