The only really good argument against Obamacare I have read...

[fpb]

...mainly because it acknowledges two things: first, that American healthcare is the most expensive in the world; and second, that "insuring the uninsured is a moral imperative", the point is how to do it. http://townhall.com/columnists/CharlesKrauthammer/2009/11/27/kill_the_bills_do_health_reform_right?page=full&comments=true

Comments

[stigandnasty919.livejournal.com]

I'm not convinced that the American right would have accepted that "insuring the uninsured is a moral imperative" without Obama's health bill. Even if the bill fails, he has moved the debate from a question over, if we need health reform, to, how we need to reform health.

[fpb.livejournal.com]

Yes, but Krauthammer - in spite of the insults by one or two commentators over here - is a much more thoughtful person than the average right wing American commentator. And you can take that from me - I've read them all.

[fpb.livejournal.com]

Plus, there's a bloody awful lot of them who still think they can just destroy the Obama bills and leave nothing in their place. The most extraordinary thing is how many people seem to have forgotten that health reform is not only the one thing that Obama had been clear about, but the one thing that had been uncontested during the election - McCain had offered his own plan as well. Obama Derangement Syndrome seems to have recreated a past in which there was no dissatisfaction with the horrendous American system and no widespread call for reform.

[cerebresque.livejournal.com]

I agree entirely wih his points, and that this is one of the best arguments I've read on the topic (although there's more to say in some areas, like the effect of other nations' price controls on domestic prices, I do think.)

But as one of the uninsured, I beg to point out that at least some of us don't feel the need for it and don't particularly want it imposed on us, thanks so much.

[fpb.livejournal.com]

I take it that you are so rich that you do not feel threatened by any prospect of long lingering and disabling illnesses.

[cerebresque.livejournal.com]

No, I have merely considered the odds of long, lingering and disabling illnesses for someone at my time and situation of life, and made an informed trade-off of risk versus cost.

Since the risk isn't infinite and the cost of insuring it isn't zero, sometimes, that calculation is going to come out in favor of taking the risk; which it's my free choice to do, at least for now.

[fpb.livejournal.com]

Can't you tell sarcasm when it bites you on the leg? My argument for universal health cover has nothing to do with the risk to you in particular. If you want to risk and waste your silly life, nothing to do with me. But health as such is a concern for society at large, and as such, a public concern. If you get bubonic plague or Ebola virus, that is emphatically not your own business alone - to take an extreme case. And it is nothing but know-nothing hypocrisy to argue that the state has the right and duty to protect citizens from external aggression (through the army) and internal violence (through the police), but not from health problems which are quite as dangerous and ruinous as any kind of human violence.

[cerebresque.livejournal.com]

Can't you tell sarcasm when it bites you on the leg?

Unfortunately, no. The wide range of arguments which people make that I find it hard to believe that anyone would make in all seriousness have more or less broken my sarcasm detectors.

But health as such is a concern for society at large, and as such, a public concern. If you get bubonic plague or Ebola virus, that is emphatically not your own business alone - to take an extreme case. And it is nothing but know-nothing hypocrisy to argue that the state has the right and duty to protect citizens from external aggression (through the army) and internal violence (through the police), but not from health problems which are quite as dangerous and ruinous as any kind of human violence.

I think we would find this much more plausible as an argument - and reasonable minarchists, by and large, might even agree with you - if we had any reason to believe that anyone proposing a universal healthcare system had protecting the public from transmissible dangers like epidemic and even hereditary genetic disease as its aim - but since every proposal for one wanders back and forth from broken bones to senility via other such non-transmissible/personal issues as cancer, contraception and childbirth, such claims simply aren't credible. Not for a moment.

[mindstalk.livejournal.com]

Conversely, the rest of us have little reason to believe that someone who has chosen to remain uninsured won't turn up at the emergency room demanding care if they turn out to need it. "I know I'm risking my life and won't ask for help if I'm wrong" isn't a credible committment.

[cerebresque.livejournal.com]

Oh, I'll ask for help at the emergency room if I'm wrong.

But since if I do turn up at the emergency room, which I very well might, I will be handed the large bill for whatever care I do receive (which is significant, but is by no means the entire menu), which will be processed through the normal collections procedures should I decline to, or not be able to, pay it, and which I am in every ethical sense of the word obliged to pay... well, then, much as it would suck to be me if I have my risk assessments wrong, I fail to see what makes it anyone else's damned business, quite frankly.

[mindstalk.livejournal.com]

The nature of modern medical care -- especially delivered via ER -- is such that there's a high chance you wouldn't be able to afford the bill, at which point you declare bankruptcy and walk away. (And if not you personally, certainly many of 'you' following this strategy.) Thus it becomes our business, following from our initial commitment to provide care to everyone who urgently needs it, even if they don't have proof of ability to pay. (As might happen to someone who was well-insured, but mugged and lacking any proof of this at the time his body was picked up.)

[cerebresque.livejournal.com]

Does this, then, not reflect a fatal flaw in the committment you are attempting to undertake?

[mindstalk.livejournal.com]

Only for a rather idiosyncratic value of "fatal".

[mindstalk.livejournal.com]

I have to disagree, sorry. He may *say* "Insuring the uninsured is a moral imperative", but he proposes *nothing* that would actually get there. He says kill the bill and do one reform at a time -- and all those reforms he mentions are about cost control, not insuring the uninsured.

And they're not very good reforms, either. Tort costs are overrated, from everything I see, and part of the malpractice suit lottery is hurt people desperately seeking funds to keep going after the malpractice. If we had universal care and decent social security, there'd be less suits.

Selling insurance across state lines: AIUI, this would basically wipe out state regulations, such as those underlying Massachusetts' attempt at universal health care. It'd allow for a nice cheap nationwide plan for the young and healthy... and screw the rest.

Taxing employer health insurance: a lot of experts like that as a funding/cost control mechanism in *conjunction* with reform. Taken by itself, it would mean employers would have less incentive to bother with group plans, dumping their employees on the mercies (hah) of the individual market, when it's employer plans (and regulations on how they can treat members) that are the only reason the non-government part of our system works as well as it does.

So no, it's a horrible set of ideas, with just a fig leaf of social responsibility.