![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
fpbOne: there already are death panels in American health care provision. They are the accountants who decide how long the companies can afford to give healthcare to customers who have chronic or expensive conditions.
Two: the Republican notion that the current system can be tweaked or bullied to remedy such problems is nonsense. It is positively crazy. If seriously pursued, it will lead to a situation where corporations have to deficit spend to keep patients with chronic and expensive conditions alive, which will eat into their budgets and threaten the rise of a Fannie May and Freddie Mac situation.
Three: in order to deal with chronic, expensive or long-term cases, there is need of a body which is not only capable of but allowed to deficit spend. There is only one such body: the State. The State routinely deficit spends on such things as the police and the military, the courts and the jails, which never will bring in an income but which are indispensable for society. Indeed, Adam Smith's classic definition of the "expenses of the sovereign", by which he meant the public sector, is: all those expenses which are necessary for society but which the private sector cannot profitably pursue.
Four: it is an atrocious lie that people who demand a right to health care are "inventing new rights". The denial of health care to anyone is the denial of the three basic rights: life, because it places the person in the immediate and evident danger of death; liberty, and the pursuit of happiness, because it reduces what is left of life to a despairing struggle to be allowed to draw a few more breaths. If you think this is what the Founders meant, you are not only a fanatic, but a sadist.
Two: the Republican notion that the current system can be tweaked or bullied to remedy such problems is nonsense. It is positively crazy. If seriously pursued, it will lead to a situation where corporations have to deficit spend to keep patients with chronic and expensive conditions alive, which will eat into their budgets and threaten the rise of a Fannie May and Freddie Mac situation.
Three: in order to deal with chronic, expensive or long-term cases, there is need of a body which is not only capable of but allowed to deficit spend. There is only one such body: the State. The State routinely deficit spends on such things as the police and the military, the courts and the jails, which never will bring in an income but which are indispensable for society. Indeed, Adam Smith's classic definition of the "expenses of the sovereign", by which he meant the public sector, is: all those expenses which are necessary for society but which the private sector cannot profitably pursue.
Four: it is an atrocious lie that people who demand a right to health care are "inventing new rights". The denial of health care to anyone is the denial of the three basic rights: life, because it places the person in the immediate and evident danger of death; liberty, and the pursuit of happiness, because it reduces what is left of life to a despairing struggle to be allowed to draw a few more breaths. If you think this is what the Founders meant, you are not only a fanatic, but a sadist.
![[identity profile]](https://www.dreamwidth.org/img/silk/identity/openid.png){kind=small}
no subject
Date: 2009-10-20 12:39 pm (UTC)The alternative of a death panel in whom we have no choice, whose word is law, and whom it is illegal to circumvent is much scarier.
Also, as Lewis pointed out, the greed of those who treat you for their own benefit may someday be sated, or sleep; but the zealots who treat you 'for your own good', as defined by themselves, never give up until you are 'cured'. Given some recent ill-publicized fiascos involving insane, poorly researched, anti-child, anti-family, economically devastating regulation shoved through under cover of obfuscation with the hand-wave "It's for the children", I am extremely reluctant to hand over any more health care power to those who would do me good whether I want it or not.
(Google CPSIA, lead, childrens' books, used clothing. Just part of the insanity: circulation (sold, lent, or given) of all childrens' books' printed prior to 1985 PROHIBITED.)
2. Agreed. There is no remedy for it, Democratic or Republican.
3. I think the body that is supposed to be dealing with it is the church. But we are sadly a long way off from that.
4. My right to life, liberty, and the pursuit of happiness is the right to not have them taken away from me, not the right to have them provided for me. The right to the pursuit of happiness taken as a positive, not a negative right, leads to a mare’s nest that you will never find the end of. With the founders, I distinguish between rights and obligations. I have a right to life. I also have an obligation to care for the sick. I do not wish the government to co-opt that obligation any more than I desire it to raise my children for me. Social justice, mercy, and charity are not served when the government regulates our virtues as it does our vices, performing our acts of mercy for us and denying our personal agency in them. This is the role of church and family.
And do not try to make me believe health care we cannot afford as a collective of free individuals somehow becomes affordable when the government gets involved. Health care costs what it costs, and government pork and inefficiency is not going to make it cost any less than self-interest and market forces will.
I don’t expect to change your mind on health care, but perhaps you may allow I am not a nonsensical sadist. :)
To oversimplify, I suspect you view (and perhaps not without reason) government as an imperfect father, obligated to provide for his children as well as protect them; while business is a powerful cutthroat, exploiting the poor for gain. Wheras I veiw (and perhaps not without reason) government as necessary social contract with an alarming tendency to sprout sucking tentacles which invade every home and church given half a chance; while businness is a bunch of people like any other, good, bad, and indifferent, trying to get along in the world, but who will ultimately thrive or perish according to how well they fill other people’s wants and needs.
no subject
Date: 2009-10-20 12:51 pm (UTC)A series of bizarre assumptions that suggest that you do not live in a land of law and order.
Business cannot provide universal health care. It cannot provide all the health care that a radnom person may need in the course of a lifetime (e.g. chronic illness). Any attempt to force it to do so will result in a Fannie Mae type disaster. You need the state; or you need to throw the rights to life, liberty and the pursuit of happiness overboard and decide that you are only allowed to live so long as you can pay good money for it.
Britain has been under the rule of free-enterprise zealots and liberists of all kinds (including the so-called Labour government, better defined as Forced Labour) for all my adult life. I have seen the result, and the result stinks. Business big or small cannot supply all the services that any country needs; that is an absolute fact, and your crazed terror of the state doing anything at all leads you into complete and catastrophic fantasyland in this matter.
no subject
Date: 2009-10-20 04:22 pm (UTC)As for the "taken to court" option, I invite you to consider the example of Nataline Sarkisyan: http://cbs2.com/local/nataline.sarkisyan.CIGNA.2.615167.html
At any rate, the "death panel" myth is just that, and if you want to be considered sensible, you'd do well not to rely on nonsense.
no subject
Date: 2009-10-20 06:26 pm (UTC)That's not in the health care proposal. There will still be private insurance providers. It won't be illegal to pay for private health care anyway.
no subject
Date: 2009-10-20 06:47 pm (UTC)Don't they have voting in your part of the US?
no subject
Date: 2009-10-21 02:33 am (UTC)no subject
Date: 2009-10-21 03:51 am (UTC)I go to Pitt. I don't like UPMC? Tough bananas. Pitt is my "employer" and to go to any other plan would be more than I could ever afford.
I am putting my health where my mouth is, after all--I'm moving to Canada, and I'll be under socialized health care OMG hopefully in late 2010. So I'll be able to speak from personal experience what the difference is like. But in my own experience, lighting a fire under one's congressman is not impossible if it's a campaign where they think it will make them look good. My brother didn't get something he was supposed to get from the army (he's a vet), my mother raised hell with our senator, the senator raised hell, and my brother got what he deserved. I have no reason to think that a National Health Care service would be any different.
I am seriously concerned that if I ever develop arthritis again, as is likely (I had the juvenile form), any States insurer would disqualify my treatment as a preexisting condition. That's not a problem in Canada.
no subject
Date: 2009-10-21 04:47 am (UTC)It's one of the ways it works in Britain, at least - go to your MP and make a fuss. The other is a built-in system of appeals and inspections, which however has its flaws. Then there is the press, which is the nuclear option; people who get seriously taken to task in the press, in those stories that get to America, most often have to resign. In Italy there is a fourth and much better way, that is "Administrative Justice" - a system of independent and very powerful courts that adjudicates in any complaint against public bodies.
no subject
Date: 2009-10-21 02:34 am (UTC)no subject
Date: 2009-10-22 04:59 am (UTC)It's also a fantasy that has no relevance to US heath reform, or to most countries with "socialized medicine".
Well, apart from the FDA and DEA telling you what drugs you can use. Cancer patient wants marijuana? The DEA will be their death panel.
And do not try to make me believe health care we cannot afford as a collective of free individuals somehow becomes affordable when the government gets involved. Health care costs what it costs, and government pork and inefficiency is not going to make it cost any less than self-interest and market forces will.
But you're wrong on all counts.
Health care for the sick will be 'affordable' specifically because the rest of us will be picking up the cost, rather than leaving them to die as unprofitable.
Health care costs are not fixed, nor correlated with outcomes. For-profit doctors have incentives to charge for more and more tests. Doctors in general have to charge more to cover those who don't pay -- or whose payment insurance companies balk at -- and to cover the costs of dealing with multiple hostile insurance companies. Insurance company premiums are higher to generate profits, and to pay people to figure out how to deny care and wriggle out of their contracts, while the doctors pay people to argue with the insurance companies.
And insurance companies have little incentive to pay for long-term preventive care, saving money for future companies or for Medicare. A system that took global responsibility for lifetime health could save a lot of money by paying for full preventive care.
As for inefficiency, Medicare's overhead is about 2%; insurance companies have overhead of 14%. And as a whole, the US spends far more than any other country, while having worse outcomes.
no subject
Date: 2009-10-20 12:54 pm (UTC)In other words, it is a worthless abstraction that has no relevance on the way anyone or anything is supposed to behave towards you ("no... right to have them provided for me"). The right to life begins with chucking anyone who violates it into jail. That means that someone else is providing it for you.
I have rarely seen so much unreason concentrated in so few statements outside a Communist Party policy statement.
One must, then, either be a sadist or a statist?
Date: 2009-10-20 01:46 pm (UTC)Then again, the third possibility - excluded in your attempt to formulate a false dilemma - is that one who disagrees with you is neither a fanatic nor a sadist, but, rather, possesses at the least an elementary knowledge of economics.
You know, if people look at you askance, my dear Fabio - and they do - it's not what you think. No, literally: it's not What You Think, which, bar the 'social conservatism' on abortion and sexual morality, is quite surprisingly congruent w the sodden and undigested mass of Euro-socialist, er, thought (to use the term loosely). It's the unnecessarily rebarbative fashion in wh you so often say it.
I'm commonly quite tolerant of this, but then, I'm a bird of rare plumage; others may be less so. I merely implore you, in a friendly manner and for yr own advantage, to consider a different rhetorical mode. It wd serve you better, and yr causes w it.
Re: One must, then, either be a sadist or a statist?
Date: 2009-10-20 02:07 pm (UTC)It also excludes the definition of the duties of the State in the Declaration of Independence: "That to secure these rights [life, liberty and the pursuit of happiness], Governments are instituted among Men". According to you, the State should do nothing to insure that a citizen's life is not destroyed by disease, his liberty reduced to a mockery, his pursuit of happiness turned into a nightmare. Congratulations. Real friend of liberty you are.
You right-wing anarchists all fail to understand what the Founding Fathers said - their actual words go in one ear and out the other. And as it never occurs to you to imagine that there might be an ethical foundation to the duties of the State - a foundation expressed by Jefferson and his co-signers in language so luminously clear that only ill-will can explain its being misunderstood - you end up with the nightmare of a State that is force for its own sake; from which you escape into anarchistic dreams that will never have any reality. The dreams go away; the nightmare bully State of your own evil dreams becomes reality - because you have rejected the plain substance of Jefferson's luminous words. And that is why every bout of Republican rule ends up leaving the American state more legally omnipotent, more unbound by law or custom, and more indebted and predatory, than it has ever been before. Ayn Randism and George W.Bushism are Siamese twins, and neither can live without the other.
Well, if you'll not be said, you'll not be said.
Date: 2009-10-20 02:40 pm (UTC)I am not, of course, a Randian, come to that.
As for yr suggestion in the succeeding reply that I 'probably have more enemies' than do you, well, I suppose that's possible. In my experience, those who choose to be my enemies are the sort of persons whose enmity is a credit to one. They tend to be driven by political ideals, wh, although idealism is to be appluaded, they have conflated w their own self-identities. They commonly behave by indulging in ad hominem attack, reckless or knowing misrepresentation of my views and position, and an unseemly rejection of relations that were previously congenial, collegial, sometimes positively amicable, and in some instances materially supportive. I make certain you shd not wish to be that sort of person, naturally.
My point, such as it was, was that you shd have fewer enemies and more hearers were you to adopt a different mode: in homelier and more proverbial terms, honey rather than vinegar. But you must do as you will to do; you're under no obligation to accept the suggestion. You are obliged, I shd think, to treat it less as an affront deserving this sort of response, but that' yr pigeon, old boy.
Re: Well, if you'll not be said, you'll not be said.
Date: 2009-10-20 02:56 pm (UTC)You, my lad, want to calm yourself before you turn into...
Date: 2009-10-20 04:03 pm (UTC)If you read my suggestion that there was an excluded middle in yr statist-or-sadist straw-man as suggesting you were 'economically illiterate', I apologise. (On the other hand, mere argument from authority is not necessarily exclusive of error or nescience on the part of the arguer.)
I am not (here) attacking what I have seen of yr views so much as I was deploring the fashion in wh you chose (and choose) to express them. As to your suggestion that I 'owe' you an essay, I can only say that I will doubtless take it up when time and inclination permit: that is not a failure of promised performance under contract, you know; this is after all a hobby, not my life.
Re: You, my lad, want to calm yourself before you turn into...
Date: 2009-10-20 04:12 pm (UTC)As for my tone, I am still seething at an encounter with a so-called American Catholic who perverted everything I said and quite deliberately, and with the evidence in front of her, ascribed to me views that I have denied for years, in public, and in the plainest and most vernacular possible English. My experience of the American anti-health-care movement is generally bad, and I do not think I am going to meet many reasonable or even sincere people there.
Yes, well.
Date: 2009-10-20 04:41 pm (UTC)Ad interim, we can return to discussing cricket, much more happily.
no subject
Date: 2009-10-20 02:12 pm (UTC)Re: One must, then, either be a sadist or a statist?
Date: 2009-10-20 04:09 pm (UTC)Re: One must, then, either be a sadist or a statist?
Date: 2009-10-20 04:14 pm (UTC)Re: One must, then, either be a sadist or a statist?
Date: 2009-10-20 04:15 pm (UTC)Not recognising standard British abbreviations, however -
Date: 2009-10-20 04:35 pm (UTC)Re: Not recognising standard British abbreviations, however -
Date: 2009-10-20 04:42 pm (UTC)Re: One must, then, either be a sadist or a statist?
Date: 2009-10-20 06:50 pm (UTC)Is this a verb form of blatherskite? I love it!
I'm also loving the scare quotes around "social conservatism", but in a self-consciously ironic way, unlike my love for "blethering skite" which is pure and untainted by this sinful world.
Re: One must, then, either be a sadist or a statist?
Date: 2009-10-20 06:54 pm (UTC)no subject
Date: 2009-10-20 04:12 pm (UTC)no subject
Date: 2009-10-20 04:14 pm (UTC)no subject
Date: 2009-10-20 04:17 pm (UTC)Now granted I've not been fond of any plans I've seen so far, but I think it's because they ignore social and financial realities and do not fix the errors other federal plans have made, not because I think the idea in and of itself is not worthwhile.
But of course in congress all intelligent debate is eclipsed by hysteria on both sides. One the one hand if you support it at all for any reason you are "facist," (or a nazi or a communist pisk one *eyeroll*) but on the other of you opposse it at all for any reason you are "evil" and "hate poor people," and "have no soul."
With such well thought out debating points as those, we're never going to get anywhere >.>
no subject
Date: 2009-10-20 04:29 pm (UTC)Seriously, the plan as forced through Congress by the Democrats is insanely complex and has all the makings of a coming failure. But that is no reason to become hysterical about the principle of state-run health care. It took me about a hundred rounds of mutual insults before I could get
no subject
Date: 2009-10-22 05:03 am (UTC)no subject
Date: 2009-10-22 06:51 am (UTC)You right-wing anarchists all fail to understand what the Founding Fathers said - their actual words go in one ear and out the other. And as it never occurs to you to imagine that there might be an ethical foundation to the duties of the State - a foundation expressed by Jefferson and his co-signers in language so luminously clear that only ill-will can explain its being misunderstood - you end up with the nightmare of a State that is force for its own sake; from which you escape into anarchistic dreams that will never have any reality. The dreams go away; the nightmare bully State of your own evil dreams becomes reality - because you have rejected the plain substance of Jefferson's luminous words. And that is why every bout of Republican rule ends up leaving the American state more legally omnipotent, more unbound by law or custom, and more indebted and predatory, than it has ever been before. Ayn Randism and George W.Bushism are Siamese twins, and neither can live without the other.