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The Role of Government

September 20, 2009 Leave a comment Go to comments

The other day, a couple of friends and I were talking about healthcare, and one of them expressed surprise at the fact that I am often so resistant to the idea of the government involving itself in certain sorts of things. She thought that this contradicted the fact that I, in other instances, have been quite adamant about the idea that some things are wrong, and should be forbidden by law simply because of this fact, and not based on any foreseen calculations of what the consequences of legislation against them would be. In other words, I believe that sometimes it is a moral imperative for the government to act, to do something, in the interest of justice, regardless of the potential negative consequences. The example of this that I think she had in mind is my stance on abortion. Another good example of such a situation–a situation far less controversial now than abortion–is the issue of slavery in the 19th century. Basically everyone now agrees that it was the right thing, the moral thing, for the government to abolish slavery, regardless of the potential consequences. Now, for my friend, the basic right of every citizen to healthcare is example of a similar sort of moral imperative. Her basic question was this: why do I support a sort of universal government intervention in one such case, but not necessarily in another? Why do I apparently believe that the state should guarantee an unborn child the right to live, but not the right of every citizen to receive medical treatment?

To begin to answer this I think we should first notice that, in fact, the government is neither able to guarantee the life of every unborn child, nor is it able to guarantee every citizen medical care. Many abortions will still take place if abortion is made illegal. And if we add a federal option to the health care system, this will not mean that no one will ever be deprived of appropriate health care. Both of these problems–abortions and lack of health care–are caused by much more than simply how the government has chosen to involve itself in these matters. Secondly, let me make it clear that I absolutely believe that every person deserves adequate health care. To be able to help someone live, and to decide not to, is clearly immoral. I believe this in the same way that I believe every person deserves to be fed, or to have clothing and shelter. When we–any of us–are able to provide things to people, and instead look the other way, we are committing evil. With this out of the way, I would like to try to explain why I would support government intervention in some situations, but not in others. Basically, my answer has to do with the kind of government intervention that would take place. But, to understand this, I think I must first explore some interesting theoretical questions about the nature of goodness and justice in society.

Global and local principles

Goodness, though intuitively perceived by everyone, is hard to define, and thus perhaps ought to be taken in this discussion as basic and undefined. But what is justice? Most people would probably agree that the concept of justice refers to a good or right ordering of things on some level. And there are really only two levels with which I wish to concern myself in my attempt to understand justice: there is the local level and a global level. What does each mean? Well, let’s start with the local level. Locally, justice has to do with a right relationship between individuals: when human beings relate to each other properly (i.e. “goodly,” whatever that means), we might call that justice. But actually, justice is usually spoken of more often in reference to it’s negation: injustice. That is, justice is usually talked about in the context of a breach of good relationships: for example, when people break the law, we talk about bringing them to justice, giving them a punishment appropriate to their crime.

It is, incidentally, an interesting and important question as to why, how, or whether people should be punished for crimes. Many have asked what justification there actually is for doing this. And attempting to answer this question, I believe, leads to a consideration of the global aspects of justice. In particular, one justification for punishing people for crimes is the following: when a person commits a crime, we might think of him as having disrupted a sort of “universal balance.” He has sinned against an absolute law, and thus disrupted something fundamental and universal. Then his punishment is meant to, in some way or another, restore the balance. Now, most societies throughout history have believed in some sort of moral reality. That is, they have believed in some sort of real “moral fabric” to the universe: when people commit wrong, they are affecting this. The eastern idea of karma is a good example of this. Many people today, on the other hand, tend to believe that laws and punishments are really only a means to an end: for example, laws are meant to deter people from committing crimes, and thus bring about a more peaceful or ideal society.

So here we have two different “global” components that come into play when thinking about justice: a sort of “moral fabric” notion on the one hand, and the notion of a good or well functioning society on the other. Many disagreements in ethics have to do with these different conceptions of justice on a global scale.

Global justice and God

I believe that these two different conceptions of justice on a global scale actually come together under a Christian understanding of justice. Christianity teaches that a good and wise and powerful God created the world we live in to be absolutely good, but that we, his creatures, have turned against this plan. In some sense at least, the injustice that we see in the world is ultimately our own doing–all of us our responsible. And actually, Christianity believes in non-human spiritual entities, and believes that the bad ones (demons–i.e. angels that have turned against God) are also at fault in some way too. But, whether through demons or through human beings, injustice originates on the individual level, in all of us, and this adds up, on the collective level, to the world not functioning in the way that God would have it. In this sense, Christian ethics is “consequentialist”–that is, concerned with the overall goodness and flourishing of society.

On the other hand, in the Christian understanding of things, there exists a real moral fabric in the sense that God, and only God, knows what each of us have done, and how it has affected the whole. He also knows how our decisions affect our relationship with him, he who is the author and standard of what is good, beautiful, and true. He cares about this, and will hold each of us accountable for it in the end. In Christian theology (at least in the west–I know the eastern Church thinks of things a bit differently), our sense of guilt is actually more than just a feeling: it is a reality that has to do with how we stand before the good God who created us. So our intuitive notion of a universal moral fabric ultimately goes back to our relationship with our Creator.

Now, God has a plan to fix things through his own grace and mercy, brought into our world through the suffering love of Jesus. Much could be said about this, of course, but for our purposes it is enough to know two things. First we must know that the plan is is taking place right now, and so what we do matters in terms of that plan–that is, in terms of God bringing about a right ordering of things. Secondly, we must know that God’s global plan begins on an individual level, and proceeds from the inside out. Christianity teaches that “the kingdom of God is like a mustard seed”–that true healing tends to come from the inside out, and often in unexpected ways, through the work of God himself. One of Christ’s most basic teachings was that a focus religious ritual and external appearances–what he called “the righteousness of the scribes and pharisees”–will never bring about true change to our hearts.

This principle, I believe, is also true on the level of societies. Think, for the moment, of humanity as being a vast web of personal interactions. These take place every day–some seem inconsequential, others of great import. A man buys a hot dog, and chats with the vendor. A woman decides to forgive her husband. A teenager decides to join a gang. A teacher says some encouraging words to a child. A couple decides to get married. Now, whatever broader social structures exist in society, this is what society actually looks like close up. And it is here, I think, that the most important battle between good and evil is fought, and the overall health of society is determined. Thus I believe that changes in the large social organizing principles of our society will never bring about any real improvement if the individuals that inhabit that social structure are still just as broken. Conversely, genuine moral improvement within individuals will lead to a better social structure naturally. But it is God–either through design or through his own continued presence and influence in the world–who will knit this all together on a global scale. And this brings us to:

Government intervention

In our increasingly secular society, I believe that liberals and conservatives both look to some sort of impersonal but universal structure to fill the role of God in the above regard. For liberals, that structure tends to be government. For conservatives, it tends to be the free market. Let me say that I don’t trust the free market to fix things any more than I trust the government to do so. Believing that any of these organized products of fallen humanity will ever bring about the peace and justice that only God can bring is a recipe for frustration and despair. Most systemic evil we encounter is a result of moral evil on the individual level. A greedy choice here, a decision to look the other way there–it all adds up to people who can be helped not receiving help. Things are not so complicated, after all. What is really needed in our society is not a a massive reform bill, or a more consistent embrace of free market principles, but better, more loving decisions made by individuals.

According to Christianity, no human entity–no person, committee, or government–is even remotely capable of bringing about the overall sort of justice that God will eventually realize in the new creation, when he finally puts the world to rights. Part of this is due to our own brokenness: any plans we come up with to put things right will ultimately be affected by our own tendencies towards evil. But, more than this, understanding how to correctly order things is not our job, it is not a task our finite minds are capable of, even in their ideal state. It is beyond us. And even if we could imagine it, we do not have the power to enact it. A total right ordering of things is accomplished by God; we can participate in it by being obedient to him, but only he knows how to bring it about. But the great thing is that, as human beings, we can contribute to the overall right ordering of things, by obeying Jesus’ great commandment to love him, and thus love our neighbor as ourselves. If you aren’t a Christian, you may have a bit of a problem with the former, but you can still try the latter.

Now, one cannot conclude a priori that doing so will never entail support for government intervention of the sort called for by president Obama’s health care plan. But we must recognize the limitations and potential dangers of such things, where they exist. For me, the real area of disagreement between myself and my friend, in this case, is obviously not what is right or wrong. We both agree that it is wrong for people to be deprived of healthcare. The disagreement stems from what each of us thinks the government is, and what the government should actually be doing. I see the basic power of the state, in terms of bringing about real social healing–that is, the repairing of social relationships that would facilitate the availability of healthcare to everyone, not the literal healing provided by healthcare itself!–to be fairly limited. As I said before, a Christian ethic believes that social healing ultimately comes from the inside out. It is brought to individuals by the Spirit of Christ within them, and to society by the actions of individuals, guided by that Spirit. Government, of course, cannot provide this. It can only administer things from the outside in.

I believe the government can most positively contribute to good by forbidding certain clear individual acts of evil: murder, rape, theft, etc. Thus I always support “government intervention” in situations where justice is most clearly able to be brought about by their controlling influence, and even then I am wary of potential problems: how do we know what those situations are? What is an appropriate punishment? How do we avoid corruption and abuse of power? In spite of these difficulties, the government is fairly capable of enacting laws that forbid certain grave evils on this individual level. It is capable of setting and enforcing important universal commands on the behavior of individuals–do not kill, do not steal, etc. Certainly, no government is perfect at this, and there are still many problems. But we all seem to agree that it is the right thing for the state to pursue justice in this way, that it is preferable to the alternative of anarchy.

“The reformer is always right about what is wrong. He is generally wrong about what is right.” –-GK Chesterton

Much of the systemic evil in our society, however, is more complex than simple “law breaking.” For example, consider gentrification and the related lack affordable housing. This is caused by many factors, and there may be some actual lawbreaking involved. But it is not easy, overall, to say who exactly is at fault or how they should be dealt with–landlords, tenants, real estate brokers, etc. I don’t mean by this that nobody is at fault, but rather that too many people are at fault in different ways for us to really be able to adequately assign blame. Many individual decisions add up a complex, collective evil. I would say that the rising cost of healthcare, and the lack of coverage for many individuals, is a similar problem. For this reason, I think we have to consider such issues differently when we ask ourselves whether or not there is a moral imperative for government intervention. It may be that we can isolate some basic evil that is being committed on an individual level, which is causing the problem, and agree as a society that this sort of thing should be forbidden. Sometimes, even in what seem like complex social issues, this may happen–I don’t rule this out. But I don’t think this is the sort of thing we are talking about when we consider the healthcare plan advocated by president Obama. Here we are talking about a complex and specific social plan enacted by the government. The question of supporting it becomes a practical one more than a moral one. This is true even though there is a moral imperative to try to deal with the social problem. In other words, it is society’s moral duty to try to deal with the social problem, but government is not necessarily the appropriate entity to act, at least not in the way that Obama has envisioned them acting. It may be, but determining this is may be a practical question rather than a moral imperative. And it may be a very difficult question, and one for which the burden of proof is on him, to show that it will result in a greater good. I admire the fact that he has actually tried to do this (and I also acknowledge that I really ought to research the issue more), but still I remain somewhat skeptical.

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  1. Clay
    September 20, 2009 at 3:30 pm

    Regarding your statement: “Basically everyone now agrees that it was the right thing, the moral thing, for the government to abolish slavery, regardless of the potential consequences.”

    I’m afraid that’s not true. I’ll grant you that it is now virtually unanimous that slavery is wrong. But it is still a widely held belief down south that the federal government was wrong to go to war to prevent secession and, in so doing, abolish slavery. They believed back then (as many still do today) that it was a violation of their “state’s rights”. Ditto reconstruction, ditto civil rights act, ditto desegregation, ditto voting rights act, ditto fair housing act, ditto affirmative action. It’s a continuum of resentment of government intervention that lasts to this very day.

  2. September 20, 2009 at 3:44 pm

    You’re right. I’ve never lived in the south so I don’t realize these things. This gets into the complication of the distinction between federal and state (as well as local) government, which I was trying to avoid. Would you say that it’s fair to say that its virtually unanimous now that slavery should be made illegal by the government at least at some level–i.e. if not the federal government then the state or local laws? From this it would follow that virtually everyone agrees that it is right for us to abolish slavery through government action, even if they disagree with the means by which we originally did it.

  3. September 20, 2009 at 11:23 pm

    I didn’t come away from reading this with a clear feeling about why you do not believe the government should be involved with health care reform. I understand that the article is not solely about this topic, but since a discussion on health care reform appears to be the catalyst for this post, I would be interested in an elaboration of your thoughts on the subject.

  4. September 21, 2009 at 12:03 am

    Well, you don’t have a clear feeling of why I don’t believe the government should be involved with health care reform mainly because I don’t have a clear idea of why it definitely shouldn’t, and this is why I didn’t write about it. I suppose I didn’t really make that clear. I’m not going to defend an opposition that I don’t firmly hold; to I admit the need to do more research. I’m saying that, at the present moment, I am unconvinced that it is a good idea. I have a basic intuition that I ought to be skeptical of the effectiveness of such things, and so this is my “default” position, and I was trying to explain the nature of that.

    • Janet Thayer Wiliams
      September 21, 2009 at 10:33 am

      I used to think that the whole idea of health insurance was clearly corrupt, and possibly immoral. I happen to be a person with no health problems, though. Now I do carry health insurance, while still being the picture of health, and I tell myself that, oh well, at least someone who actually does need health care is getting something out of my shelling out more and more money to the big business of Health Insurance. I would definitely feel better about contributing to a system that really did include everybody, though. Now THAT would be moral.

      • September 21, 2009 at 5:28 pm

        You’re right that the morality of health insurance is suspect. Indeed I think that is one of the major roots of the problems we have with health insurance–greed on this level. And that is a moral advantage of the public plan, that the money paid by the individual is actually being used, in some sense at least, to provide for everyone, at least ideally.

  5. September 23, 2009 at 1:06 am

    Phil, the following link leads to an interview with Washington Post columnist TR Reid, in which he provides an outline of the 5 types of health care systems around the world, including systems in Canada, England, and Japan: http://www.npr.org/templates/story/story.php?storyId=112172939
    I believe that it is a largely unbiased presentation of the options open to health reform in the United States. Additionally, I would suggest trying to watch C-Span when they are interviewing a Senator working for Health Care reform. If you by chance see Senator Grassley, a republican from Iowa, please stop and listen to him. He is the fellow that began the ‘death-panel’ accusations, (and he doesn’t deny it) but aside from that he is the leading voice from the conservative side; a foil to Obama’s liberal perspective, if you will.

    In any case, as it stands now, the problem with health care insurance is that it is based on a profit motive. As long as an insurance company is able to place a price on an individuals head there will be inequity in the system. The reason this problem requires government intervention, is that no matter how loud the moral uproar, it will never convince these companies to sacrifice their profits; they have to be made to. With a government run public option, (or heaven forbid, a single-payer plan) there will be a choice, and the choice is so important. I understand your skepticism of government intervention in general, but the reality is that no other entity could dare to compete with the insurance industry. If one does not absolutely have to turn to the insurance industry for health coverage, it will force them to be more equitable, and reasonable when it comes to rates, care, and general human decency. As it stands now, they are running a monopoly (literally, in Alabama) with peoples live at stake.

  6. Andy T
    September 23, 2009 at 4:13 pm

    Phil W

    Your lack of trust in the free market is upsetting, individuals making choices instead of a central authority deciding for everyone is what made this country so prosporous. I think some people want everything for free and done by someone else and thats what they think the gov is, a seperate entity. The gov is not a sepearte entity like a business.

    • September 23, 2009 at 6:20 pm

      Please define what you mean by ‘individuals’ here. Certainly you can’t mean ‘a person’ by individuals. By individuals you mean to say ‘corporations’, right?

  7. September 23, 2009 at 6:15 pm

    I guess talking about politics is the way to bring comments to this blog!

    Catastrophysicist:
    Thanks for the links. I agree with you that one of the central problems is the profit motive in the sale of health insurance. On top of this you have the monopoly issue. I think these two ideas should really be separated. A monopoly is much more destructive than simply a for profit company, because it has the power to not abide by ordinary market principles–it can set the price artificially high if it finds it profitable to do so. I guess what I need to understand more is how this is going on in the case of the health insurance industry, so I can get a better idea of what the ideal response is.

    Andy T:
    I don’t trust the free market to accomplish anything moral. Prosperity, sure, it can and does generate that. But prosperity isn’t everything. A society can be very prosperous yet on the verge of self-destruction. The free market cannot solve intrinsically moral problems–there is no reason at all to expect that it could.

  8. Janet Thayer Wiliams
    September 23, 2009 at 7:19 pm

    Yes Castrophysicist! Andy T definitely means corporations when he says individuals.

  9. Andy T
    September 23, 2009 at 9:55 pm

    By individuals I mean people free to make their own choices without a central authority forcing them into something, people are at their best when they are truly free – ask Russia. The gov is a huge corporation with more power than any business, and surely much more prone to corruption. I dont think its moral to force people into something they do want to do.

    Phil W
    If the natural tendencies of people are so horrible that they cant be free, how is it that the tendencies of a central authority are any better? Arent these legislatures cut from the same cloth? Are they somehow better than everyone and know what everyone needs and whats best for them. The gov agents are the most powerful people by far and much more influencial than any corp, to think that they will be less corrpupt or more efficient is hard to beleive. To call the insurance industry a monopoly is no question without an understanding of what a monopoly is, its actually the opposite. Its amazing to me having these convos w people that assume noone can make good decisions and that we need someoen to step in and make them, I know alot more people that make good and charitable decisions than not. People did not go without care when churches and volunteer hospitals and other groups used to take care of people, but now, everybody has to have this insurance, which doesn’t do a whole lot more than boost prices and then cause shortages and then there’s a demand for more government and that’s where we are today.

    • September 23, 2009 at 10:55 pm

      Andy:
      Well I don’t think I said anywhere that the natural tendencies of people are so horrible that they can’t be free allowed to be free. In fact, I feel like I’ve been advocating an attitude that could be called radically conservative. I distrust centralized authority just as much as you do.

      I’m not against the free market. I am only saying that it, in and of itself, will not necessarily produce good. Think about it: lots of evil things operate on free market principles. The underground drug market operates on these principles. But I’m NOT saying that, therefore, we need to government to step in to produce good. On the contrary, I’m saying what our society really needs most is moral healing.

  10. September 23, 2009 at 10:49 pm

    Unless you are old, really young, or extremely poor, (in which case you are eligible for medicare/medicaid,) the Health Insurance Industry is running a Monopoly on the health and well-being of the citizens of the United States. They charge whatever they want, provide care selectively to those that aren’t a serious financial risk, and can more-or-less cut off your benefits at any time. If that’s not the exclusive supply of a service, than I don’t know what is. And you have to buy their services (if they let you) otherwise you are totally screwed.

    • September 23, 2009 at 11:01 pm

      Have you seen this:
      http://leahy.senate.gov/press/200909/091709a.html
      I came across it while searching for info on whether the insurance industry qualifies as a monopoly. I find this somewhat astonishing: the healthcare industry is actually exempt from anti-trust laws? Is this being talked about?

      • September 23, 2009 at 11:17 pm

        As far as I know, the answer is no. I personally have not heard anti-trust laws mentioned. I will say, though, that paragraph 4 of your link seems to say it all.

  11. Andy T
    September 24, 2009 at 12:09 am

    You still havent showed insurance companies to be a monopoly, and I think its very naive and impractical to think that any insurance company will pay for everything. When third parties pay the bills the doctors, labs, hospitals, and everybody else, have an incentive to charge more, not less. This creates fraud and abuse. Insurance was never meant for all medical care. The term “insurance” has been largely misinterpreted. Insurance is a measure risk of and you buy that protection – life insurance works the same way. So if you want medical insurance, you would be insuring against bad accidents or major surgeries or against cancer or something like that.

    I’ll leave it at that, Ive spent alot of time getting people qualified for medical equipment, this year at least a couple million dollars worth, and I think people are deserving of that and it feels good to help people. This whole thing is about how big a gov we should have, Im always for a smaller one, or one that will let me blaze freely – id give u ur public option for that.

    • September 24, 2009 at 12:33 am

      We are in agreement that the billing cycle is out of control. The introduction of a single-payer system would be ideal, but how is that accomplished without a public-option? One of the main arguments against a single-payer system is that it would eventually lead to a public option. So now that that’s more than dead, how else to you clean up the billing cycle?

      And fine, the health insurance industry is not a quote-unquote Monopoly, if that makes you feel any better, but how can you say that they don’t operate from a monopolistic rubric? They are raping people, and they do it everyday, unabashedly. Also, I know how an insurance company works, and I don’t expect them to pay for everything. However, I think we need a system that does, in one way or another, and that’s one of the major problems I have with a for-profit health care system. Furthermore, I don’t expect insurance companies to pay for everything. I don’t even expect them to pay for what they say they will in the policies they sell.

      • September 24, 2009 at 12:37 am

        Oh, I also meant to say that if you want to blaze freely, you should probably get out of your small government state, Florida, and into a big government one like California. You can get a medical marijuana card and smoke out like whoa even as we speak.

      • September 24, 2009 at 6:07 pm

        Doesn’t “single-payer” basically mean “government controlled monopoly on insurance”? Certainly, by doing this, you can eliminate the profit motive, but that won’t necessarily drive the price down. The economic forces that affect prices are not simple. Andy makes a good point which is that (if I understand this correctly) if an entity is paying for everything, this encourages the suppliers (like Andy’s company) to charge more. The government would be an entity paying for everything, an entity with a virtually unlimited supply of money, and furthermore they would have to pay for it since they have guaranteed healthcare to the citizens. This might encourage suppliers to raise their prices even more, especially if those suppliers are operating based on monopoly principles, and thus aren’t worried about the government turning elsewhere. This means government healthcare could prove to be even more expensive.

        I would think that a good way to get prices under control would be to push for a genuinely free market, where the price reflects what the product is actually worth. One way to do this would be by holding the insurance companies accountable for their anti-trust violations.

  12. Andy T
    September 24, 2009 at 1:06 am

    I’ll stay put Im good on the greens here, – about monopoly it doesnt make me feel any better I feel worse that I cant draw the graphs on here to explain why its not a monopoly but maybe u can draw on here, PW can prolly get at it.

    • September 24, 2009 at 5:43 pm

      Well, if you scan me a photo, can post it; not sure I can post it in the comments though.

  13. September 24, 2009 at 3:54 pm

    The insurance industry started in a cafe in London, betting on whether ships would come back from India. But the English don’t allow insurance companies modulating and betting on their health care system. In a democracy, health care is by definition a moral issue, and becomes precisely a responsibility of government oversight. Profiteers and gamblers (insurance companies) should be, and eventually will be, eliminated entirely from the process.

    Side note to Andy T. Their are two words in the phrase: “free market.”

  14. Andy T
    September 24, 2009 at 10:30 pm

    The only scanner I have access is to is the one at work that noone can find the install cd to and will be prolly never be used as a scanner, it gets brought up maybe once a week with no further effort to actually get the cd. I recently do have the internet again and have caught up on ur blog, i seem to be getting more responses than u, I dont want to steal ur blogs thunder. Phil W, noone will be as wise and frugal w your money than you, if you let a third party spend it for you theres opens the chance to over . Its not natural to have someone spend ur money for u, so why do we expect it when it comes to medical care. Why single out medical care? Food is more essential to life than medical care. Why not have a third party decide how much food costs, and how much you pay for your clothes. I think I understand your doubt of whether the gov should be involved and people questioning you about it like your a bad person, “Without medical insurance” and “without access to medical care” have come to be treated as nearly synonymous, but arent. Insurance was never meant to cover all people needs, charities and churches and other forms of individuals deciding for themselves that they wanted to help people made sure people did not go without care, and the numbers were nowhere near they are today. Gov oversight, a central authority deciding what is right and wrong, who would ever suggest that?

    • September 25, 2009 at 12:16 am

      Phil, I agree what you say above is a possibility, but consider that Medicare, the system which covers senior citizens, is single-payer. It needs some work, admittedly, but it has been more or less a success for almost 50 years. Also, it doesn’t give the government complete autonomy over Health Care, only of the billing cycle.

  15. September 25, 2009 at 3:11 am

    “Single payer” means the government institutes a tax specifically to collect money for health care. Taxes are based on income, so people who earn more put more into the pot. That is fair, if you think health care is a universal right—as has already been established with Medicare for older people. (The money for Medicare comes from taxes.) It is fire departments, or having police. SIngle payer does not dictate how the delivery of health care operates. The government can disburse the tax money to existing hospitals, etc,, and/or regulate it how it is spent by these health care providers.

    Insurance companies, which are nothing but speculators, meanwhile are eliminated altogether. If anyone thinks that would not dramatically lower the gross cost of the whole system, they are not looking at reality. If they think government can not run effectively, with the health of the people in mind, they apparently think they don’t live in a democracy.

    • September 25, 2009 at 9:03 am

      “If they think government can not run effectively, with the health of the people in mind, they apparently think they don’t live in a democracy.”
      I don’t think that the government can run health care effectively, with the health of the people in mind and I still think we live in a democracy. Honestly this is a bizarre statement to me. Democracy means that the people get to decide what the government does. It doesn’t mean that people have to believe that that government can do everything well.

      • September 25, 2009 at 2:22 pm

        Health care isn’t “everything”. It is a straightforward necessity. But under private insurance it is becoming practically everything: 20% of the economy, and operated by playing upon people’s fears. The government IS the people, To think it is otherwise is to doubt it will act fundamentally for the common good, and therefore to believe you don’t really have elected officials that truly represent you. That is what I mean by my bizarre flat statement. Now tell me I am naive, and that government is a runaway tyrant. And that health care something other than for the common good.

        The problem is that people assume the government would get into administering health care. That is absurd, it would simply fund it, out of your taxes, like other public services. It would become a utility.

      • September 25, 2009 at 4:12 pm

        I didn’t say that health care is “everything.” I was saying that a person can believe that government involvement in something, like healthcare (either in general or a particular proposed model), is a bad idea, without rejecting democracy. I agree with you that private insurance has been bad for health care. The question is whether the new sorts of government funding of health services will make things better.

        The question of whether the government should be funding health care is not a question of whether the government is fundamentally trustworthy or not, or fundamentally interested in the common good or not. It is not fundamentally a question of their intentions (which are always a mixed bag, due to the fallibility of human beings). Nor is it a question of whether health care is a basic right–part of the point of my original post was to explain how everybody already agrees on this. The question that people actually disagree about the answer to is whether the government funding of healthcare, as currently envisioned, would ultimately make healthcare better and more available, both now and in the future, and thus contribute to the common good. This is the only question that matters in this debate, and the only question I’m interested in having the answer to.

        There may be valid economic reasons for believing that the government funding of healthcare, in its currently proposed forms, will not be helpful, in that it will not ultimately lead to better care for more people. This is what the health care debate should be centered on.

  16. Andy T
    September 25, 2009 at 11:03 am

    Yeah more taxes will really help everyone in this economy – its easy to spend everyone elses money but thats not really a free society – to force people into paying taxes they dont beleive in is close to communism.

    • September 25, 2009 at 2:54 pm

      They don’t have income taxes in a communist system, Andy. The people don’t have incomes at all. You should read more about this kind of thing before wildly popping off with these comparisons.

  17. Andy T
    September 25, 2009 at 3:10 pm

    Lloyd, economics is a foreign language – you cant pretend to speak chinese. It would do you good to read this article, it might blow your mind. http://www.hoover.org/publications/digest/3459466.html. And I didnt mean income tax, I mean allowing people do be free from force.

    • September 25, 2009 at 3:31 pm

      Ah, the notorious conservative economist Milton Friedman. So that is where you get your ideas? You must be brilliant. I can’t make head or tail of this guy.

  18. Andy T
    September 25, 2009 at 3:58 pm

    I like your little digs, very adult. I have got alot of ideas from him, particuarly on this subject. he also not a conservative, but a classical liberal. China is communist, they earn wages ie income. I dont understand the “you must be brillaint” comment, I actually have a background in economics and have worked in the medical supply field for almost 2 years, having worked with patiens w everyting from MS to brain cancer, I love to see them get the help they need. Besides that to try to belittle someone for not having your genius seems a little unnesseary, especially from someone I would consider a friend. I simply asked you to read it because I think what he says to say on the subject is mind blowing.

  19. September 25, 2009 at 4:44 pm

    “Friedman’s political philosophy, which he considered classically liberal and libertarian, stressed the advantages of the marketplace and the disadvantages of government intervention and regulation, strongly influencing the outlook of American conservatives and libertarians.”

    Is this Wikipedia entry wrong? Friedmans thinking was most useful to Reagan. I am sorry if you feel I am just issuing “digs”, Andy, but this a serious subject, and you seem wildly opinionated. I did try to read the article you linked, and found it incomprehensible. I too am over my head on this subject, but a few simple distinctions seem appropriate. Like what a “single payer” system really is, and that we do live in a democracy, and should expect our government to provide essential services.

  20. Andy T
    September 25, 2009 at 5:10 pm

    yeah its like reading chinese unless you have a solid background in econ and have been reading this stuff for ahwile, so when I hear people mention stuff like competition and lower prices it baffles me where they came up with it. If you think people should be forced to pay for other people healthcare thats fair and alot of people feel that way, I just dont. Im not a big fan of taxes and I cant imagine in any situation the gov taking over healthcare and running it efficiently, too much buearocracy. As a side note, there is always a percentage of people in a democracy who are in the minority, who feel they are being repressed. I never advocate democracy as a true form of liberty.

  21. September 25, 2009 at 9:16 pm
  22. September 25, 2009 at 9:31 pm

    Phil, I just want to point out that the bills that are being written now are not calling for a governmental takeover of health care. They mainly concern how to curb what many feel are unfair practices and procedures carried out by the health care industry–things like terminating your policy because you had a precondition such as a case of acne, when now you need care for your breast cancer. Things like that. What they new policies are shaping up to be is essentially a health care mandate in which everyone will be required to purchase health care from somebody, and the public option is meant to be only a small portion of the proposal aimed at providing care to those that can not afford it or acquire it by any other means. Government-run health care absolutely will not happen this time around, or for many years to come.

    • September 25, 2009 at 11:14 pm

      Yeah, I understand that (better now than when I wrote the original post). And I agree with the regulations on health insurance, that they should be required to actually deliver the main produce that they claim to be selling (financial insurance for unanticipated health problems). But I don’t understand the logic behind requiring everyone to purchase health insurance. And I am wary of the economics of government funding for healthcare; if you read that Milton Friedman article Andy posted, it makes some good points. I have no idea how airtight his analysis is, but a lot of it seems pretty reasonable.

      When you think about what healthcare actually is, there is no practical reason why it can’t be affordable and available to everyone. Think about what happens when you go to the doctor–often they don’t even really do anything. Sometimes a procedure with special training is required, or a special drug, or use of expensive equipment. But the price tags don’t reflect what is actually going on. This is true even in countries with single payer systems, or universal healthcare. Friedman argues that it is because the health care providers don’t interact in any market driving fashion with the people actually receiving the health care. So people can’t make decisions that affect the market in a meaningful way, in a way that would cause the price to actually reflect the value of the service offered. Rather, the in-between, be it the government or a private insurance, is the one billed.

  23. September 25, 2009 at 11:40 pm

    I think that the logic is that if you mandate health insurance, it will mean that everyone is in the pool–60 million more people or so–thus, it will lower costs because there will be a more even dispersion of risk. That couple with curbing the questionable practices, and fixing the billing cycle. The company my brie works for has a crazy billing cycle that takes 12 steps before anyone sees payment. That’s insane, and it’s all just excessive administrative things.

    A small story relating to your second paragraph–Brie and I recently enrolled at a health clinic sponsored by the local medical school, Oregan Health & Science University, or OSHU. When you enroll you have to talk to a financial advisor, fill out the obligatory resident and work status paperwork, and then you have an entrance interview with whatever doctor that they assign you. I asked the receptionist up front what the cost would be for the entrance interview, she told me it would be $25 total, and I paid it. Brie and I both did all that. So, because of how much I earn, I was qualified for a 50% discount on services, and Brie, on the other hand, was not. In other words she had to pay 100% for whatever services they administered. A week passes after my interview and I receive a bill for $300 dollars, discounted at 50% for a total of $150. Needless to say I was pissed, because I was told there would be no other charges. But anyway, Brie’s bill comes a few days later, and her bill was for less than my bill, even with no discount! It was like $140 or something. I would like to know how it’s possible that we could receive the exact same service (only talking, oral history, no physical exam or services at all), and yet my bill would still be higher after 50% discount. It all seems abjectly absurd, and completely arbitrary. I should of went down there while I still had fire in my belly and demanded satisfaction!

  24. Clay
    September 25, 2009 at 11:44 pm

    Phil, the rationale behind requiring everybody to purchase insurance is that it further spreads out the risk and therefore brings down the cost of premiums for the rest of the insured. For example, many young healthy people are uninsured, which seems fine until one day this young person either

    (a) gets cancer, gets run over by a bus (and survives), or gets some other unforeseen, highly expensive medical condition or

    (b) gets old and sickly.

    One of the two will very likely happen, and when it does the person may try to purchase medical insurance. To the rest of us who have been dutifully paying into the system all along, while not using our share of the benefits, this may seem unfair. That is why insurance companies don’t take you if you have a pre-existing condition. But since we are now talking about requiring insurance companies to provide insurance regardless of pre-existing conditions, it makes that sense that we also require healthy people to buy into the system BEFORE they know they need the benefits. I’ve heard it said that we all have a pre-existing condition: mortality.

    This concept: to require insurers to take all customers, and to require all people to purchase insurance, is called the “double mandate”. Many countries have some form of it, and it makes a lot of sense. In fact we already have at least two forms of it right here in the USA. The first is the FICA tax, which funds social security and medicare (which are forms of insurance). SS and medicare are available to all of us when we get old, and in the meantime we all have to pay into the system. The second is car insurance: most states require that you have car insurance, and the reason is quite clear: if only half the drivers out there on the roads had insurance, then the insurance premiums would be a lot more expensive for those of us that have it.

    Of course Milton Friedman and his followers hate the FICA tax, social security, and medicare, but thankfully most Americans disagree with them.

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