What’s Wrong with the World

Can you not disagree with Obama on health care and still admit he is an American? I know he thinks different than you and he looks different than you. But why say he is outside American looking in? Comparing him to an alien. Guess what? Black people are human. They are not aliens.

The health care ideas are not just Obama's. I havn't followed the debate but mu understanding is he is proposing much of what Canada already has. I don't see it as a disaster. We have a baby with Downs Syndrome who has been to see many doctors. The system seems to work pretty well for him.

Comparing him to an alien. Guess what? Black people are human. They are not aliens.

Guess what? You're a useless troll for having to resort to a tactic like that. In fact, the English language lacks a word to properly describe how cleanly stupidity, intellectual dishonesty and a lack of character intersect in someone who can make a comment like that.

Wow Mike. Take a pill. Don't you think that the assertion that somebody is like an alien is a bit strange. I think it is easier to accept when it is made about someone from a different race and/or a different culture. Is that so hard to comprehend?

Mike T is right, we don't need to bring race into this. The English language has a word to properly describe someone who says that Obama is, "someone who stands outside America, as something foreign and meaningless to himself, and who is trying to mess it up as quickly as he can, because his main purpose is to change America completely and irreversibly from its past, and he doesn't care how much he harms America in order to accomplish that. He doesn't care about America any more than an invading alien in a 1950s horror movie cares about planet earth."

Lunatic.

I'm glad that we're not just ranting about Muslims these days.

This has nothing whatsoever to do with race. It has to do with reckless ideology. Yes, I think an imposition of Canada's healthcare system on America would be a disaster. But more than that. Obama is a liberal in an _enormous_ hurry. He doesn't care jack about letting people even modify, compromise, or take time to think. That is something one would like even his own party to criticize. Unfortunately, that sort of teeth-clenched, fist-clenched, get-out-of-my-way-or-get-run-over totalitarianism is becoming the _norm_ for liberals these days. Obama represents his base. Faithfully. And they are not nice guys either.

Disaster is an exaggeration. This is a scheme to guarantee health care to the middle class and the poor in return for the middle class accepting rationing. There is no doubt that quality of medical care will suffer. This is the case now with Medicare. The Obamas of the world will continue to have access to high quality care as they do in every nation with government-managed health care schemes.

People who advocate this kind of system are not evil. I disagree with them.

Now regarding Obama, there are plenty of reasons to be concerned about him at the level of personal morality. I do think his policies taken as a whole will impoverish America and compromise our liberty. I think he is unprincipled in his pursuit of these policies and is a masterful politician. He is an Alinskyite community organizer and this commits him to immoral and dishonest political tactics. This, by the way, has nothing to do with the melanin he inherited from his father. But no president in our history has been so far from the mainstream of American politics and so alien to our nation's traditions in his thinking and so skillful at disguising his agenda.

Gosh, Mr. Williams, every word you say (for example, about rationing) confirms that this _is_ a disaster. Got any idea what rationing has meant in the UK? Bad news. And damaging, permanently, the quality of the highest-quality medical care system in the world is, in my vocabulary, a disaster. I think we need to have a sense of the great tragedy and harm of breaking really good things that will never be put back together.

'Obama is, "someone who stands outside America, as something foreign and meaningless to himself, and who is trying to mess it up as quickly as he can, because his main purpose is to change America completely and irreversibly from its past, and he doesn't care how much he harms America in order to accomplish that. He doesn't care about America any more than an invading alien in a 1950s horror movie cares about planet earth."'

Just so. In earlier times saying something like that would have been known as calling a spade a spade. I suppose one can no longer use that aphorism without being branded as a bigot either. We are alien to Obama and he is alien to us. He intends to make America into a place which is no longer a home for us. That is simple truth. He is not a nice man.

As a UK reader I can testify to the damage that socialized healthcare has wrought on our nation; it is beauricratic, ineffcient and treats the individual in terms of their 'monotary worth to society' and not as an individual. Unless you Americans want Huxley's brave new world promised to you by Obama and endorsed by Dr Strangelove of Princeton I urge you oppose him at every level.

But no president in our history has been so far from the mainstream of American politics and so alien to our nation's traditions in his thinking and so skillful at disguising his agenda.

You really think so? Is he really different from Bush and Clinton? Any new president who starts making major changes gets people upset. Remember it isn't just him. Both the senate and the house were changed to be more liberal as well. So you expect some dramatic actions. Democracy guarentees the government people want. It does not guarentee good government. Just what people want.

One thing you need to understand is tha Clinton's attempt at helth care reform was defeated. Obama is well aware of the dangers. He is trying to avoid some of Clinton's tacitcal errors. One of which was moving to slow. I am not at all sure this will pass. If it can be delayed towards the 2010 elections it likely will not pass. It needs to be implemented and forgotten about by then. Otherwise Democrats will fear a repeat of the 1994 election disaster.

Don't worry, the magic marxist negro will fix everything and solve all the problems. No man, no problem!

Can you delete Doc Savage's comment?

"Reckless ideology." That's a great diagnosis, Lydia. If anybody needs evidence, just look at Obama's admission that he's "not familiar" with all the provisions in the health care reform bills before Congress, especially in regards to the role of private insurance under 'Bamacare. This is a major sticking point in the bill- will people be able to maintain their own private insurance or enroll in private insurance after the bill is passed? It's addressed fairly early on in the legislation, before your eyes glaze over and you need to head to the coffeemaker, yet the President is "not familiar" even with this important provision of this bill he intends to sign into law. How can he be anything other than a reckless ideologue to push for such far reaching policies without concerning himself with the particulars?

Democratic members of the House are even getting frustrated with him because they're not sure where he's headed with his "reform." (Dare I say 'objective?') members of his own party are wanting to slow this legislation down for more clarification and an opportunity to digest what Obama's pushing for. But this isn't good enough for him, it needs to happen between now and August. What, pray tell Mr. President, is going to happen in August that will make health care reform too late to enact after the recess? And why is it "playing partisan politics" to ask hard questions about your "reform?"

Obama's push _is_ dangerous and reckless for those two simple reasons- and that's not even getting into the particulars, which Obama isn't familiar with anyway! The best anybody can come up with is opposition to 'Bamacare are accusations of bigotry, racism, and lunacy. Way to keep the conversation focused away from the bullied legislation that could be headed to the White House shortly.

I certainly think Obama is more committed to an agenda than Clinton was. Indeed, the probable absence of sex scandals in Obama's administration (I really do not expect any, at least not about Obama himself) is itself testimony to the difference between them. Clinton's _wife_ was more committed to socialized medicine than Clinton himself was! He was a disgrace to the office in the obvious sense of being a nasty-minded, overgrown adolescent whose idea of being President was holding everybody up while you got your hair cut on the runway and taking advantage of a besotted young woman in the Oval Office. Obama has none of these vices, and he is a True Believer in what he wants to _do to_ America, the ways he wants to change it, as quickly as possible. This makes him, in my opinion, the more dangerous man. Very much like a committed Communist, I might add. They were supposed to give everything for the Cause, and personal vice was not what they were about.

Randy:

"If it can be delayed towards the 2010 elections it likely will not pass. It needs to be implemented and forgotten about by then. Otherwise Democrats will fear a repeat of the 1994 election disaster."

You have just proven Lydia's point. Ergo, Obama is pushing a "reckless ideology." You can debate whether the liberal Democratic ideology is reckless (even some Dems are trying to drag their feet...what's that tell you?). But if the point is only, as you asserted, to avoid another Clintonian 1994, then you have agreed that this is only about ideology.

Other than winning seats for the Dems, why does it "need to be forgotten" by 2010, anyway?

Randy says:

Don't you think that the assertion that somebody is like an alien is a bit strange. I think it is easier to accept when it is made about someone from a different race and/or a different culture. Is that so hard to comprehend?

Randy, there's this way of speaking that may appear alien to you, but it is called "metaphor." So, for example, if I were to say that Obama is taking us into an economic "black hole" or that his policies will result in a financial "crack up," I would not be making an allusion to anything scatological.

Sometimes a cigar is just a cigar, but sometimes it isn't.

Of course it is about ideology. That does not make it reckless. People called Bush's policy reckless ideology to. People only think ideology is bad when they disagree.

Why does it need to be forgotten by 2010? Because of fear, uncertainty, and doubt. People can call something a disaster until it happens. Once the messiness of implementation is over then it is much harder to characterize it that way. People will move on the some other issue.

I hear Fidel Castro is also a quite charming fellow.

Once the messiness of implementation is over then it is much harder to characterize it that way.

The UK has had socialized medicine for many-a year, and it's only getting worse all the time. The idea that by 2010 we will have seen all the ill effects of socialized medicine in the U.S. and can "move on" is simply astonishingly naive.

Randy -

"Why does it need to be forgotten by 2010? Because of fear, uncertainty, and doubt. People can call something a disaster until it happens. Once the messiness of implementation is over then it is much harder to characterize it that way. People will move on the some other issue."

Can you translate this from gibberish to English please?

It took about a minute for me to uncover using google that the IBD article is a complete distortion. I suspected as much from the phrase "Except as provided in this paragraph" from the paragraph cited. Anyone with an once of intellectual integrity would have done a minute's further research before repeating the IBD claim. The Bill does not "outlaw" anything. It sets up some basic disclosure regulations so consumers can make informed choices. According to the House summary of the Bill, the Health Insurance Exchange that will (and should) be created "creates a transparent and functional marketplace for individuals and small employers to comparison shop among private and public insurers."

In this post you repeated an obvious lie about the health care reform proposed by the House, used it to justify a comparison between Democrats and Stalin/Pol Pot, then endorsed the claim that Obama is a malicious "outsider" bent on destroying America. Classy.

Why, Mr. Shipley, I do so much appreciate your comment, which led me to find the Heritage Foundation blog post (via Wesley J. Smith) correcting _both_ the IBD report _and_ the pro-socialist-medicine spin on this. See the update above, with link. As Smith points out, the controversies surrounding interpretation only make it more clear how reckless it is to try to ram this through quickly--which in itself confirms those terrible, terrible comparisons to committed ideologues.

Lydia,

Disaster is a matter of degree. Britain is a lower-income country that spends a much lower percentage of its income on medical care than we do. Canada is between the US and Britain. Other countries do better than Canada. What we are talking about with rationing in the American context is squeezing out innovation in health care, denying certain discretionary services to the aged and waiting lists for non-emergency situations. My wife, for example, might still be waiting for the back surgery that let her work without pain as a chemistry teacher. The drug injected into my one good eye to clear up a retinal condition might never have been developed. Probably my eye would have eventually recovered, if not, I would need a magnifying glass to discern exponents in quadratic equations in the textbook I teach from. This is undesirable but not a disaster. For a small minority of people, the negative consequences will be serious: disability or early death.

The response to this of course is that many of the poor fall between the cracks with respect to access to very basic medical services today.

Obama is hiding the pea with respect to what a government takeover of the health care system will mean and what the trade-offs really are.

Randy- So it's alright with you that what's being pushed thru Congress by the Focused Ideologue is merely ideology as opposed to what's best for the American people?

The use of pressure by the White House to pass this bill that they're not familiar with can't really be said to be debating whether this bill is what's best for the American people. We here in the good 'ol U.S. of A have two houses of Congress that stand for election on set terms of years. That's to make sure nothing gets rammed into law too quickly and that the President can't impose his ideologies on us at will. We call it "checks and balances" and it helps ensure government for the people, by the people, not for and by the Chosen One (Clinton, Bush, Obama, whomever you like). Hillarycare was open to debate and not only did Congress reject it but so did the American people (i.e. 1994 elections) because it wasn't what is best for the American people.

The War on Terror was/is opposed by many as a neo-con ideological war. Granted, arguendo, but can you see similarities between that ill-advised war and Obama's reckless reform? Bush "created" an "enemy" and made it imperative to unite and fight that enemy on Bush's terms in Bush's manner, in the name of what's best for the country. Whereas Obama is "creating" an "enemy" (partisan politicians), or a "crisis" (uninsured Americans), and making it imperative that we unite to fight his fight on his terms on his timeline in the name of what's best for the country. I use the term "create" here because al-Qaeda and terrorism existed long before 9/11 and the health care crisis existed long before HR 3200 was drafted or Obama took office, but all of a sudden they became the targeted enemies.
I am NOT trying to turn this into a conversation about the Wars and there are moral differences between terrorism, war and health care... I'm just using an analogy and all analogies break down at some point.

My point is this: The use of ideology by Obama is not all that different than Bush's employment of ideology to push his ends (which presumably you disagreed with). You're correct when saying ideologies become bad when one disagrees with them. But that should be all the more reason to abandon (neo-con, socialist or otherwise) and seek to find a better path, one that's best for all Americans. Will it take time? Yes, but its supposed to.

"The "Obama is a nice guy" phenomenon, too, is much the same as the excuses made for communists. At least he "stands for" something. So did Stalin, of course. So did Pol Pot."

Ok.

I believe there have been regular proposals by American presidents since Teddy Roosevelt to rationalize American health care. Why Obama proposing what Harry Truman attempted 60 years ago makes him "outside America" isn't obvious.

It would be nice if folks learned to distinguish socialized medicine (UK, Cuba, the Veterans Administration), single payer systems like Canada, and various hybrid systems.

All systems ration. In the United States we ration by having insurance or not and then we further ration (for those who have insurance) by various schemes designed to deny coverage.

When discussing bills one should have a simple rule - read the bill or at least the relevant section (the internet makes this easy). It is easy to misread legal language and easier to outright lie. Nested sections need to be read in the context in which they lie.

Accepting at face value any assertion about a proposed law is simply foolish. If you haven't read it yourself you haven't done your intellectual due diligence. In this case IBD (and Limbaugh and Hannity) are wrong and given their records, likely lying. Excerpts are always suspect until checked and the lack of a link and bill number is always a red flag.

BTW, what does this mean "So we sought help from the House Ways and Means Committee". Why don't we have a who here?

http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf

Granted, arguendo, but can you see similarities between that ill-advised war and Obama's reckless reform?

No, I can't. American politicians have been discussing health care reform for decades, the invasion of Iraq only became a crisis situation after 9/11. Hillarycare had a far more reaching federal mandate than what Obama has proposed. Since the defeat of Clinton's health care reform, the US has fallen far behind many other industrial nations in terms of mortality amenable to health care, which is affected by access to insurance and also by unhealthy lifestyle choices. So it is difficult to formulate an exact number of deaths based solely on lack of insurance, but it is not hard to see a correlation between declining access to insurance, increasing denial of coverage based on preconditions, and mortality rates. I understand there will be trade-offs, unlike the Iraq war where we were assured a minimal price tag and being greeted as liberators.

All systems ration. In the United States we ration by having insurance or not and then we further ration (for those who have insurance) by various schemes designed to deny coverage.

Uh-huh. This is such a canard. Wesley Smith has been talking about this at some length. I add, one could say the same about food: "All food distribution systems ration. In the United States we ration by having money to buy stuff at the store or not..." etc. So, the conclusion is, we should have a central government committee that makes a computer program that tells your doctor what is and is not rational to allow you to have based on a utilitarian scheme using "quality of life years." Oh, joy. Obviously, it's _just the same thing_ as any system. Because any system rations.

Mr Willaims,

Ever since Blair came to power, the National Health Service has recieved huge injections (read billions) of Cash from the governmet, most of the money has been spent on wasteful IT systems (which have exacerbated the problems they were meant to correct) and managers brought in to ensure that government 'targets' were meet, very little has actually been spent on paitient care. The result is that people have to wait months (potentially fatal) for routine operations, if you have feel unwell and need to see your GP that alone can take a fortnight !! and I haven't even started to mention postcode rationaing, dirty wards that would embaress Africans ..... you get the drift?

Randy:

Obama is well aware of the dangers. He is trying to avoid some of Clinton's tacitcal errors. One of which was moving to slow. I am not at all sure this will pass. If it can be delayed towards the 2010 elections it likely will not pass. It needs to be implemented and forgotten about by then. Otherwise Democrats will fear a repeat of the 1994 election disaster.

Of course, some people might call that sort of behavior reckless, but not you.

While it may not be helpful to refer to Obama himself as an "alien," his policies, being neo-Marxist or (if you prefer Paul Gottfried's terminology) post-Marxist, are undoubtedly foreign to U.S. democratic republicanism and capitalism. Hence, they are "alien."

It's got zilch to do with race, everything to do with ideology.

Considering Auster's audience, I view the "alien" stuff as an appeal to the birther paranoia.

I think what Auster says in this quotation is completely clear--that Obama _views_ America as an alien would view it. That is, as something he stands outside of and wants to make over radically into something quite different from its present self. That is, I think, a perfectly fair assessment.

Lydia, I fail to perceive how Al's remarks concerning rationing-by-private-insurance constitute a canard. Insurance companies employ any number of formulae, derived from actuarial tables and other statistical analyses, in order to reach their coverage decisions, which is to say, in order to ration care. Now, my personal illustration lacks the visceral punch of Canadians dying for want of timely medical treatment, but remains apropos all the same: even a so-called "gold plated" insurance programme, such as the Blue Cross one in which I and my family are enrolled, will ration - and do so even where the expenditures in question are negligible by comparison to the catastrophic expenses that rightly concern most observers - and in my case, this means that, despite my having a herniated disc between my second and third cervical vertebrae, necessitating frequent chiropractic adjustments (the only treatment offered by 'conventional' medicine is an injection of cortisone, administered a few times per year, which always seemed like a dubious proposition, given the location of the disc, and its proximity to, oh, my brain stem, not to mention the exorbitant expense, which - perversely - would be covered by insurance), Blue Cross caps my chiropractic coverage at 15 visits per year. I require a minimum of double that allowance in order to avoid debilitating headaches, accompanied by nausea and intermittent 'visual phenomena'. Fortunately, in my case, I've been able to negotiate a special rate - equal to my co-pay - with a chiropractor, owing to my long-term patronage of his practice, bypassing the insurance submission altogether once I've used my 15 visits.

But it seems radically implausible to argue that insurance companies will not ration in cases where potentially vast sums of money are involved, though they plainly do in even comparatively trivial cases such as mine. You see, they have some statistical table somewhere, according to which no normal person ever really needs more than 15 chiropractic treatments in a single year. Except when they, like me, do.

As regards other aspects of this discussion, I don't perceive a significant difference between the Obama administration and its predecessor, at least as regards the ambitions both harboured, and harbour, to initiate transparently ideological transformations of the (bloated, putrefying corpse of) republic. The executive power claims asserted by the Bushists - and largely retained by Obama - are fully as radical as any transformation contemplated under Obama, formalizing as they do the notion that the executive branch exists in a rarefied realm beyond the purview of ordinary representative politics and legal supervision. While I can understand, and even concur in, conservative opposition to Obama's political programme, not least on grounds of the consequences, unintended or otherwise, that lie down the road, I find it mystifying that so few applied a comparable skepticism to the Bushists' assertion of the authority to declare a Schmittean 'state of exception' more or less whenever they felt like doing so. In other words, none of them are nice guys, and the sooner we acknowledge this reality, the better we'll all be, at least to the extent that we'll be undeceived.

jrshipley:

The Bill does not "outlaw" anything. It sets up some basic disclosure regulations so consumers can make informed choices. According to the House summary of the Bill, the Health Insurance Exchange that will (and should) be created "creates a transparent and functional marketplace for individuals and small employers to comparison shop among private and public insurers."

The substantive criticisms of the government health insurance bill stands. The very entrance of the U.S. government into the healthcare insurance industry as a player in competition with private companies is completely disordered and disastrous for private options because the public options are subsidized by the U.S. Treasury's balance sheet--which is evidently fine with going into debt in service to their ideology of what they opine is "fair"--and because a different department in that company creates the regulations, i.e. makes the rules. Private companies don't stand a chance, not because they are worse, but because the public option has extreme unfair advantages. It's like playing tennis with someone who's also the referee who also owns the court and has more resources than you ever will.

The public "option" will likely undermine the vast majority of private options until they get bought out, I mean bailed out, by the government.

"All food distribution systems ration. In the United States we ration by having money to buy stuff at the store or not..."

Bingo, that's what markets do and they do it very well in some areas, not so well in others. Health care is one area in which markets have serious limitations. A moments reflection should make that obvious.

"So, the conclusion is, we should have a central government committee that makes a computer program that tells your doctor what is and is not rational to allow you to have based on a utilitarian scheme using "quality of life years."

I don't believe that is anywhere in any proposed bill. If it is would you let us know the section so we can check it out? I assume you would have read the bills before making such a charge.

As with rationing that is what is happening now. Insurance companies don't stay in business by paying claims; they stay in business by finding ways not to pay claims.

Jack, no one is proposing a socialized system in the United States. Every system has its problems and ours aren't yours. Unless you believe that denial of coverage for preexisting conditions, cancellation of policies on flimsy pretexts, lifetime limits, denial of procedures or refusal to pay post procedure, loss of coverage after loss of ones job, and bankruptcy aren't problems in their own right I fail to see what you are contributing. We need to fix our system and you need to fix yours.

Oh, and we wait here also. If you you don't have insurance you wait forever - or until you die. If you have insurance and aren't getting proper service you usually have to wait until November to change over and then wait until after the start of the new year to make an appointment. You wait to see specialists and wait for procedures.

Step 2:
Even though we'd been dealing with terrorism for decades before 9/11 (i.e. Beirut, etc) and trying to figure out how to solve the thorn in our side in Iraq since 1991, I'll grant you that

American politicians have been discussing health care reform for decades, the invasion of Iraq only became a crisis situation after 9/11

So then why does health care reform need to be crammed down our throats as per Obama's mandate before August 3rd? Has it suddenly become a crisis situation since Obama declared it to be so, even though Americans have resisted similar (but different) measures in the past?

It's the inflated sense of urgency and lack of willingness to address legitimate concerns that are reckless.

When a significant percentage of your population is saying, "Hold on, I don't see how this takes care of all the old objections to a liberal health care plan," it doesn't seem like "Hurry, hurry, time is running out!" makes a lot of sense. How about, "Here's how we are addressing those concerns." The absence of that latter reply creates the impression that there IS no answer to those concerns.

Maybe the plan does address those very concerns and the message is just getting lost.

Maybe our president considers the things creating all these objections and concerns as acceptable trade-offs for getting coverage to everyone.

Maybe our president is a "big ideas" guy with not a lot in the way of "get-'er-done details" that Clinton had. Maybe it WILL get worked out in Congress. Maybe it won't.

The problem is the list of maybes, and the out-of-place administrative response of "faster, faster!" in the face of that uncertainty. For an administration that was swept into power on the strength of presentation, that seems pretty astonishing. Or maybe it just confirms what the president's non-supporters have said all along. As usual, the answers seem to restate what people have already and always believed to be true.

What Maximos said.

On a somewhat related note, does anyone know of any good free-market responses to problem of adverse selection in health insurance?

People only think ideology is bad when they disagree.

I was working through the comments and found this one to be the most revelatory : )

I'm calling the newspaper.

"I find it mystifying that so few applied a comparable skepticism to the Bushists' assertion of the authority to declare a Schmittean 'state of exception' more or less whenever they felt like doing so."

A lot of people, myself included, were lulled into a false sense of security by the Bush admin's conservative rhetoric. When the walk contradicted the talk, we naively trusted the talk, and didn't realize our error until it was too late.

Al, here is Wesley Smith's column on the proposal to pressure doctors to use more "cost-effective" treatments. Apparently the framework for the legislation was actually in the stimulus bill,
and the guy overseeing it, David Blumenthal, favors government control as a means to "keep down" healthcare costs.

http://www.firstthings.com/blogs/secondhandsmoke/2009/05/page/10/

Maximos, I call the comment about rationing a "canard" insofar as it is used to justify draconian and centralized government rationing. And it is. It would be foolish for any of us to pretend that all this "all systems ration" talk is anything other than an attempt to do what all advocates of centralization do: Focus on limited resources as an attempted justification for centralized management so that the resources are managed, supposedly, more "rationally" than they presently are. Here is a Smith blog post on a similar argument. This one includes the (related) "all or nothing" fallacy. "Either everyone should have a personal physician accompany him everywhere and anything else he happens to want, or the Almighty State must get involved telling people what they can and can't have."

http://www.firstthings.com/blogs/secondhandsmoke/2009/07/21/full-court-press-continues-for-health-care-rationing/

If anyone thinks that all this "we already ration, so let's ration more and fit rationing into a national healthcare scheme" talk isn't about what's going on right now in Congress, he is a fool. And if anyone thinks this isn't something to be worried about, he's not thinking clearly at all.

All production and distribution of resources involves scarcity. The question before us, therefore, is two-pronged, one practical and the other moral. (1) Is the government the best producer and most efficient distributor of the goods in question?, and (2) If the answer to any part of (1) is no, then is it moral for anyone to suggest that the government is the solution to this problem? It seems to me that the answer to (1) is obviously "no." Thus, the answer to (2) must be "no" as well. Does that mean that government is to play no role in solving this problem? OF course not. For example, the government should make the best roads so that the ambulance can transport sick citizens quickly and efficiently. But the government should neither man the ambulance or run the hospital.

The verdict is in, and its been in for quite some time: large federal bureacracies do not work as well as its competitors in the private sector. We've seen this in education. No matter how much the government punishes religious parents for sending their children to private religious schools, they still come. Why? Even coercion can't hide inferiority when there's a quality alternative.

Maximos, I call the comment about rationing a "canard" insofar as it is used to justify draconian and centralized government rationing.

To refer to the aforementioned comments as a "canard" is to imply, quite forcefully, that its contention is utterly without foundation, when, in this case, it is not. The truth of a statement is not affected in any way by the uses to which the statement is put.

For my part, I cannot muster any enthusiasm for the present health insurance system, dominated as it is by for-profit firms. Having one's care rationed by industry bureaucrats and quants with a view towards the maximization of shareholder value doesn't feel much different from having one's care rationed by a government bureaucrat following some ghoulish quality-of-life-assessment tables; the only advantage of the former is that, if you're rich, and/or savvy enough, which most people are not, or are not adverse to braving bankruptcy (in the more catastrophic cases), you can still operate outside the insurance system to obtain requisite (or desired) care. Sure, it's better for certain subsets of the population of the ill and infirm, but it's still a matter of "sucks less than what they do in country X", and not deserving of the boosterism one reads in some conservative outlets. In practice, the excluded middle in the fallacy Smith critiques is basically what I've sketched. And if you're neither rich, nor clever, nor willing to bankrupt your family, well, you might want to check with Dr. Singer.

Having one's care rationed by industry bureaucrats and quants with a view towards the maximization of shareholder value doesn't feel much different from having one's care rationed by a government bureaucrat following some ghoulish quality-of-life-assessment tables;

Get back to me in thirty years and tell me if you still think that, especially after yet further and more open socializations of the system have taken place. And when we are both older and even more vulnerable. As for "not being able to muster enthusiasm," I think your perspective, Maximos, is too much influenced by and too narrowly focused on the one issue of your one particular health problem and that you are ignoring the many, many ways in which, I have no doubt, you are benefiting from the high quality of medical care in this country, a quality which will certainly be whittled or hacked away by the socialization of the system. Yes, yes, I know, some of the commentators on this thread will try to argue that the UK situation is irrelevant. I say "rubbish," and right now, Maximos, I'm talking to _you_ as my co-blogger and, I hope, a more reasonable person than those people. In the UK, things are a mess. To give just _one_ example out of many others I could give, people are put into wards rather than private rooms because of the overloaded system and are in consequence dying from catching superbugs from their ward-mates, even if they were admitted with something like a fractured hip. We have _enormous_ blessings in terms of the quality of the health care we receive in this country, and you will see it on any visit to the emergency room if your child is in an accident and on any visit to your primary care physician when you have some more minor ailment. Please, be careful what you pray for. You might get it.

On a serious note, subsidization always distorts the amount of goods available. We see this in water usage, food consumption, and even trash disposal, where subsidization leads to higher than sustainable consumption. Because of this, subsidization of healthcare leads, in fact, to a greater scarcity than already exists since it inflates the perceived amount of care available.

This, to me, is really the argument against the "we are already rationing stance." The thing that no one wants to acknowledge is that we must ration; while the proposed "reforms" are based on the principle that we don't have to.

The most urgent healthcare reforms are the one's that get government back into its proper jurisdiction concerning healthcare. There is a shortage of doctors largely because the government (and doctor's boards) have created a shortage through medical school admissions policies and operating regulations. There are competition problems in health insurance almost solely because of the government and its archaic policy of tax exemptions solely for employer supplied insurance. And there are further, and probably more serious, problems introduced by current regulation of the insurance industry whereby consumers can't choose their coverage, are forced to buy acupuncture and psychological coverage ect. thus forcing the price yet higher.

Yet none of this will arrive in time for the battle at Waterloo : (

Maximos

As a UK reader I agree with Lydia 100%, the situation here in the UK is soooo grim that I once dreamed of moving to America so that I could live a life free of Government intusion (in pretty much every realm not just healthcare), now that I see America going the same way I despair, the Gipper is probebly rolling in his grave.

Yes, I believe it is Massachusetts that has had recent problems with a doctor shortage because of mandatory insurance coverage throughout the state. Yet that is considered to be a relatively "moderate" government program! This is basic economics. Apply the banana test, and it becomes obvious: If you make bananas a right for everybody, you will have a banana shortage.

"The question before us ... is two-pronged, one practical and the other moral. (1) Is the government the best producer and most efficient distributor of the goods in question?, and (2) If the answer to any part of (1) is no, then is it moral for anyone to suggest that the government is the solution to this problem? It seems to me that the answer to (1) is obviously "no." Thus, the answer to (2) must be "no" as well. Does that mean that government is to play no role in solving this problem? OF course not. For example, the government should make the best roads so that the ambulance can transport sick citizens quickly and efficiently. But the government should neither man the ambulance or run the hospital.

The verdict is in, and its been in for quite some time: large federal bureacracies do not work as well as its competitors in the private sector. We've seen this in education. No matter how much the government punishes religious parents for sending their children to private religious schools, they still come. Why? Even coercion can't hide inferiority when there's a quality alternative."

I don't think that's _the_ question before us. Suppose FB's answer to his own question is right. Conceding that the government is not the best producer and most efficient distributor of the goods in question (for everyone? anyone? someone?), would it be better if we had some sort of government program in addition to private insurance? To use FB's homeschooling analogy in the way it should be used and not the way he's used it, no one should say that it follows from the fact (?) that parents who home school do a better job than public schools there shouldn't be public schools and the government should stick to paving the roads rather than drive the bus and cut checks to the teachers.

Any nutters here want to nut up and say that we should shut down Medicare and Medicaid because people who aren't on Medicare or Medicaid can get better coverage when they can afford to pay for it?

This is my first time posting on this blog (be kind :) )

I take it that the original idea of health insurance was to insure that the person with the insurance was "sure" to have access to health services. Back in the day of the family doctor, almost everyone had access to some sort of health care and fairly cheaply. Back then, we didn't have the extraordinary, super-sophisticated machinery or knowledge we have today and pretty much everyone received a fairly narrow range of care. It was, in fact, harder to be medically negligent when there were fewer things a doctor had to consider. There does seem to be a lock-step correlation between the rise in super-sophistication of medicine and malpractice insurance as well as the general rise in health costs being correlated with the disappearance of the house-calling family doctor.

It seems to me that many people would be happy to receive the care afforded by the old family doctor, but doctors are not, for many reasons, allowed to practice this ancient art. The art of the family doctor goes back to Hippocrates's time.

The whole health care debate is, in my opinion, focused on the wrong issues. The need for rationing can be a conjured affair if services are concentrated in one group at the expense of another. If you have 500 cans of food and there are 500 people, but three people control 450 cans, then anyone can make the claim that rationing of the "scarce" resources must be implemented. Is there any evidence that regular health care needs to be as expensive as it is so that poorer people cannot afford it or that wealthy people can be permitted to hoard it?

Healthcare management systems never existed during the house-calling days of doctors. One must wonder if the healthcare management system isn't a case of the tail wagging the dog. When did people begin to think that managing healthcare was a good thing and why? Let us call that the terminus a quo from which to start any sort of analysis, since things were relatively stable, in terms of cost, before that time.

I can think of at least five alternatives to the way healthcare is doled out in the U. S. without breaking a sweat. Surely, congressmen can, too. Why such a rush? This whole affair is being treated more like a marketing exercise than an exercise in the science of prudence or even as an exercise in the scientific method (which is kind of ironic).

This is a problem that has been poorly analyzed, poorly planned, and is in the process of being poorly executed. Generally, as in the case of the iphone, as a product becomes more popular and the technology becomes more common, price comes down. Has anyone ever seen this with the recent healthcare system? An ace bandage is an ace bandage. Why does it seem more expensive, now then it did ten years, ago? It is actually easier to make an ace bandage, today and yet, the cost continues to go up. I am probably an economic ignoramous. Can someone explain?

Clearly, the problems in the health field have only a little to do with insurance. I would rather take some time and do a good analysis of the real things that sustain high health costs, first, using good science so as to proceed with prudence, than act quickly and what seems to me to be in haste. Sometimes, speed is needed. In the case of setting a national policy, it is, generally, not.

The Chicken

P. S. Probably everything I said, above, is naive. If I am wrong, teach, don't yell.

Clayton, I'll "nut up" and say that if we could find a way to phase out Medicare and Medicaid everyone would probably be better off. One of the crazy things about the present situation is that Medicare is practically bankrupting us yet we're being urged to expand it to a much larger group of people. That does not sound smart to me. One result of Medicare has been that everyone 65 years old and over gets his healthcare rationed to some degree (payment limitations, for example) according to Medicare standards so long as his doctor takes any Medicare patients, even if that particular patient has employer insurance. That one got slipped through in the Clinton years, I believe. NRLC was yelling about it fifteen years ago or so but, in the end, to no avail.

I think Masked Chicken has an interesting point, as well. Part of what has happened is that we are so rich that everyone thinks he has a right to everything. So far we've been lucky enough and still retain enough vestiges of market mechanisms in the system to come close to providing that medical nirvana, with high-tech provisions for all. But to some degree this has been done by deficit spending and cannot be continued. The back-down will only be made the harder the more government gets involved and encourages even _more_ of an idea that everyone has a right to everything--i.e., vast overuse of the system.

I would add that large govt. programs are in my opinion much like drug addiction. Once a country is hooked, it can be incredibly difficult to get off without the patient's dying of withdrawal, even though the drug is itself doing enormous harm and building up to a crash. This may be an argument for gradual withdrawal of the drug rather than precipitate action, but by the same token it is an argument against increased dependency, i.e., greatly expanded government programs.

Lydia:

I think Masked Chicken has an interesting point, as well. Part of what has happened is that we are so rich that everyone thinks he has a right to everything.

This was the very same thing I had mentioned once before; amazing that it took a Chicken for you to finally agree with such a notion as this!

I couldn't find anywhere in that particular thread, Ari, where I disagreed with you. I did only a quick search though. I suspect I had left the thread because of the pro-bailout talk. Remember me? I'm the nutcase with the sympathy for the gold standard. You won't hear someone from that perspective disagreeing with the idea that people have too much of a sense of entitlement and that too much of it is being paid for with red ink. I do, however, object in the strongest terms to being made to live simpler by bureaucrat busybodies centrally managing the economy--in healthcare or elsewhere.

I want to add, Maximos, that under Hilarycare your deal with your chiropractor would, as I recall, have been illegal. All of that stuff where you, the patient, deal with your doctor as one real person to another and the doctor considers your situation and your relationship with him as a patient and decides how much of a break he can afford to cut you is a vestige of the "fee-for-service" model at which present advocates of Obamacare sneer and of the individual pricing which is anathema to the socialized medicine mindset. It is "unfair," you see. And too much of that mindset has already entered so-called private insurance. I was told years ago that Blue Cross Blue Shield institutes lawsuits against doctors who gave any price break to one patient, did any services at no-charge, on the grounds that a similar no-charge arrangement had not been made for everyone. Under that bureaucracy, generosity was banned by threat of suit. I was given the wink and told "not to talk about" an offer a doctor had made to do one extremely minor surgery for a member of my family at no additional charge while doing another minor surgery which was documented. The more we return to the days when people paid for more of their own stuff and doctors could make individual deals with individuals, the better. All further socializations and centralizations of the system take us in the opposite direction where everyone is supposed to be equal and generosity and individual treatment are suspect if not outright prohibited.

"On a somewhat related note, does anyone know of any good free-market responses to problem of adverse selection in health insurance?"

No, because adverse selection and moral hazard are inseparable from a free market in health care.

"But the government should neither man the ambulance or run the hospital."

Dr. Beckwith, with all respect your reply typifies the problems when one attempts to deal with public policy issues by applying conservative principles in a reality free context. In most of the jurisdictions with which I am familiar, the guys who come over and do things like restart your heart and who also transport you to the er are government employees and have been for decades. They are called paramedics and are also firemen and they do a great job. If I go fishing and have an emergency the responders will be employees of the dreaded federal government also known as the Coast Guard. They will do a great job and I will be very glad to see them.

There is no logical reason why your formula shouldn't apply to all providers which gets us to the conclusion that no one should provide health services. Besides (and again) no one is talking about socialized medicine and the government as a sole provider (or any provider for that matter).

Lydia, we are going in a circle here. You link to Westly and Westly links to IBD. All of this is opinion and quite fact free. Op-ed pieces from IBD are not primary source material and, based on your first link, are written by folks who have serious problems with reading comprehension. I don't see how we get rational public discourse by ignoring the actual content of bills. You have a right certainly to oppose all health care legislation at the federal level but it seems to me that you also have an obligation not to pass on opinion as fact.

As with civil rights, the conservative position is on the wrong side of history with health care.

Has it suddenly become a crisis situation since Obama declared it to be so, even though Americans have resisted similar (but different) measures in the past?

Let's look at the numbers:
143,000+ will lose their health insurance each month.
53,000+ will file for bankruptcy because of medical bills each month.

A Kaiser foundation poll found that in the past year, 23% of U.S. residents said they or a member of their household had either decided to stay with a current employer, instead of accepting a new job, or had switched jobs because of health insurance coverage. In addition, 7% of respondents said that they, or someone in their household, had decided to get married to obtain health insurance through their spouse.

I don't have a problem with good faith negotiations to reform health care, even if that takes a few months. I do have a problem with people who deny there is any need for reform and/or the government has no right to interfere in the marketplace when the marketplace is clearly inadequate.

I do, however, object in the strongest terms to being made to live simpler by bureaucrat busybodies centrally managing the economy--in healthcare or elsewhere.

Amen, Lydia!

Although, I do recall your labelling me (or rather implying) that I was heartless merely because I originally opposed the bailout then and cited payroll and all other manner of the impending Apocalypse as an example of which I was opposing as a byproduct of such opposition that only the cruelest of villains could allow (or, at least, that was what seemed to play out in the Zippy thread).

Anyway, glad though that you are making a stand against Obama here.

Interesting to note how at CNBC, they played a clip of Obama's speech in contrast to Hillary's back in the Clinton era and how remarkably similar their ultimatums appeared to be (and, of course, how likewise remarkably risible, too).

Oh and check out the quarterly profits United Health Care just reported:

http://online.wsj.com/article/BT-CO-20090721-711785.html

A Kaiser foundation poll found that in the past year, 23% of U.S. residents said they or a member of their household had either decided to stay with a current employer, instead of accepting a new job, or had switched jobs because of health insurance coverage.

This is an interesting statistic. Suppose we restated it: A Kaiser foundation poll found that in the past year, 23% of U.S. residents said they or a member of their household had either decided to stay with a current employer, instead of accepting a new job, or had switched jobs because of better pay.

Because that's what it means. Weighing a job based on health benefits is no different than weighing it based on salary, as health benefits are literally part of your salary. So why is this bad?

"We have _enormous_ blessings in terms of the quality of the health care we receive in this country, and you will see it on any visit to the emergency room if your child is in an accident and on any visit to your primary care physician when you have some more minor ailment." (Lydia)

That is if you are fortunate enough to have health insurance. Why aren't Obama's critics here showing any concern for the plight of the uninsured? Isn't that inconsistent with our mandate as Christians to look out for the poor?

Step2 wrote:

Let's look at the numbers:
143,000+ will lose their health insurance each month.
53,000+ will file for bankruptcy because of medical bills each month.

Here may be a dumb question for the demographic nerds in the crowd, but just how sick are we, as a country, such that so many people have to be spending so much on health care? Are the number of people who need super-duper care that large? Does regular health care have to be so expensive? It costs me $75 just to walk through the door of my doctor's office when I have a sinus infection. Why? Instead of charging by the visit, suppose we charged by time spent with the patient? My, wouldn't costs suddenly go down, then?

People are losing healthcare because healthcare is no longer affordable. A simple question: why? Shouldn't we start looking for answers, there? I don't buy managed healthcare without understanding the real reasons for the rise in cost. It costs less, today, to make penicillin than it did in 1950 and yet it costs, probably, ten times the amount to actually get a pill, all things, factored in. Why? This makes no sense, to me. Perhaps 70% of all medical problems can be solved with 1960's technology. Health costs should be dirt cheap. What am I missing?

If those 143,000 people were charged a correct amount for the dispensing of penicillin, say, costs would go down. I say, follow the money. Who stands to gain from an artificially inflated healthcare system? This is where congress should focus.

The Chicken

"Are the number of people who need super-duper care that large? Does regular health care have to be so expensive?"

Good question. Every other industrialized nation manages to provide care to evertone for half the amount (per capita) we spend on considerably less than everyone.

Matt Weber,
Medical conditions discovered on the original insurance plan are not automatically covered by the new insurance. In the case of switching jobs to obtain insurance or get better insurance you are on more solid ground, although it should be obvious that obtaining insurance as an individual is vastly more expensive than obtaining it through an employer's group plan. So you easily could be taking a pay cut in total dollars, but the coverage available through the employer provides enough security to make it worth the difference.

The more interesting result to me was the 7% or so getting married to obtain insurance. How romantic is that?

Step2 wrote:

The more interesting result to me was the 7% or so getting married to obtain insurance. How romantic is that?

Maybe online dating services should include one of the following questions:
a. Do you have health insurance?
b. Do you work for an health provider?
c. Are you a doctor/pharmacist?

We could make a reality show:
Have Insurance, Will Marry
or,

So, Who wants to be a Millionare (and Insured)?

We could have a quiz show.

The Chicken

Yes, I understand that they may take a cut on the cash pay, but this comes at an increase in value in the insurance portion of their pay, which is obviously more valuable to them, meaning that they got a pay increase. This is just economic reasoning in action, and I don't understand why we should attempt to engineer it so that people don't have to make such decisions.

As for the marriage statistic, I'm surprised it's not higher than 7%

Lydia, et. al. -

I'm coming late to the party, but I want to note a couple of points:

1) On the substance of Obamacare and health-care reforms, I couldn't agree with Lydia more and especially the notion that true reform will empower consumers and doctors to make decisions for themselves ("The more we return to the days when people paid for more of their own stuff and doctors could make individual deals with individuals, the better. All further socializations and centralizations of the system take us in the opposite direction where everyone is supposed to be equal and generosity and individual treatment are suspect if not outright prohibited.")

2) For more good substance on what market-based health-care reforms would look like, please check out David Gratzer's excellent work: http://www.manhattan-institute.org/html/gratzer.htm. He also posts regularly at my other internet hang-out, "New Majority".

3) Al and other supporters of government reform who claim something like Obamacare is necessary because "our current system is failing", should note one very important fact: our current system is ALREADY heavily regulated by government and/or paid for directly by government bureaucracies. Why do you folks think, a la Dr. Beckwith's question (1), that getting the government more involved will solve all our current problems?

4) Finally, I don't understand how Lydia can endorse Auster's quote. As detrimental as I think the public policies enacted by our current Congress and President might be, I don't then think to myself how "alien" the folks who dreamed up these policies are from me or my fellow Americans who do agree with my policy analysis. It seems to me a dangerous proposition to begin questioning folks' motives and intent, unless they are straightforwardly proposing to do something evil. Is Auster (and you Lydia) suggesting that something like Obamacare is evil? I think unions lead to more unemployment then necessary and are harmful to the productivity of corporations that employ union labor -- does that make every American "alien" to me who supports unions? Does that mean that union supporters don't mean well? I think Maximos is wrong about free trade and globalization -- if he was in power and implemented tariffs does that make him an alien or someone I have to label as "trying to harm America" when in his prudential judgement he is trying to help? Can't we agree to disagree without the drama?!

If I were in power, I 'd make everyone go to medical school. Ha! Take that! When everyone is a doctor, who will foot the bill, then?

The [You-think-trying-to-get-cheap-healthcare-try-getting-cheap-vetcare] Chicken

P. S. If laughter is the best medicine, can I charge?

Masked Chicken,

I should have answered your earlier questions about health care expenditures. This link gives a good overview:

http://www.ahrq.gov/research/ria19/expendria.htm

Hi Jeff, if this question is too cryptic [regarding your point #4], let me know: Were you there to witness the tower of Babel, and recognized it's offense, would you not call it evil and it's supporters "alien" to your way of life? I tend to see this as another an attempt/step by the government to set itself up as God in similar light and that it's personnel are not innocent players, I suspect Lydia intuits something more also.

Wow Mike. Take a pill. Don't you think that the assertion that somebody is like an alien is a bit strange. I think it is easier to accept when it is made about someone from a different race and/or a different culture. Is that so hard to comprehend?

Uh huh. Sure. You just happened to have innocently used the same sort of language that the average race-baiting troll uses.

The similarities in the promotion of ObamaCare & Iraq are pretty obvious. So too their lasting impact;

* Fear is ginned up. The prospect of WMD's landing or personal bankruptcy due to inadequate insurance are bluntly exploited.

* Warnings against deliberation abound. Prudence is derided as a form of cowardice, treason or greed. Must. Act. Now.

* Constitutional norms and customs are circumvented and the legislative process is a burlesque of the blind being led by the ambitious and shabby back-room deals.

* Little transparency in the policy making process is evident and details are scarce.
Despite his campaign promise to "make White House communications public," the Obama administration again is blocking the public from seeing White House visitor logs, this time refusing to disclose meetings with health care executives.
http://www.msnbc.msn.com/id/32087532/ns/politics-white_house

* Hubris. Each President and his cadres are confident they can transform complex and daunting problems and peoples through their own ministrations. They are dismissive of the wisdom earned through experience.

* Electoral Reward. Each man is convinced that certain success will lead to the political hegemony of his party.

* The Will to Power is concealed by rhetorical appeals to patriotism, compassion and noble intentions.

* Warped Anthropology. Human life is implicitly considered expendable. The destruction of innocent Iraqi civilians, unwanted babies, terminally ill patients and elderly is accepted and subsidized.

* Death, suffering, debt and the concentration of power and wealth in fewer hands are the only legacies of each scheme.

Brad,

I get the question and my answer is that government-run health-care and the Tower represent two related, although conceptually distinct ideas. Let me put it this way -- because just about every advanced industrial country has a government-run health-care system, are we to conclude that these governments (and the people who support them) evil? I suppose we could argue they are alien to the American way of life, but would you argue then that the people and their leaders mean harm because they think a government-run health-care system serves their needs? I guess what I'm really arguing for is a matter of perspective -- if Obama and the Democratic Congress were proposing to abolish private property and string-up capitalists from light-poles, a la Lenin and gang; then yes, I wouldn't hesitate to argue they mean harm and seek to do evil. But increase the amount of government regulation and/or increase the % of GDP going to government expenditures? Foolish, bad public policy, harmful to economic growth, etc. -- but the intent is JUST NOT to do harm as a concrete action that is taken to hurt another individual or group of individuals. Otherwise, as I said earlier, every single policy difference between us becomes a morality play -- if you don't support policy X, you mean to do harm to me, my neighbors and friends and you are a bad person! Is that what we really want all but the most fundamental disagreements about public policy to be about?

Robert Allen says, apropos of my reference to the blessings of our quality of healthcare,

That is if you are fortunate enough to have health insurance.

Robert, you are wrong. When illegal aliens go to the emergency room for government-mandated birthing, they get a system that is enormously high quality and higher in quality than comparable care would be in a socialized government. Of course, the more we burden the system with such mandated benefits and encourage over-use and non-paying, the more we will lower the quality. But _for now_ there is enough actual money going into the system because it is _not_ completely socialized that even those who do not have insurance do have access--in an emergency, and less access than others do--to care that is clean, efficient, and high-quality. This is saying a lot. The quality of care is amazing. And by the way, when I was a graduate student 20 years ago, I had only high-deductible insurance and paid for my own medical care almost entirely, on a fee-for-service basis. I got excellent care from doctors who engaged in "cost-shifting" and gave me a break, because they knew I was poor. They could afford to, and the system could afford the arrangement and _permitted_ the arrangement, because it wasn't so over-regulated and socialized as to make such arrangements impossible.

Step 2,

You say "although it should be obvious that obtaining insurance as an individual is vastly more expensive than obtaining it through an employer's group plan. So you easily could be taking a pay cut in total dollars, but the coverage available through the employer provides enough security to make it worth the difference."

Why do you think this situation exists? Hint: its not the free market at work. Here is the always interesting Betsy Hart discussing how a market in health-care should work when centered on individual needs:

http://www.suntimes.com/lifestyles/betsyhart/1667097,HOF-News-EasyHart16.article

My Health Care Reform Proposal (general overview):

http://allhands-ondeck.blogspot.com/2009/07/my-health-care-reform-proposal.html

Mr. H

"When illegal aliens go to the emergency room for government-mandated birthing, they get a system that is enormously high quality and higher in quality than comparable care would be in a socialized government."

Yes, Ms. McGrew so-called aliens often manage to access ER care. But you were also talking about visiting PC physicians. Good luck trying to see one of them sans insurance. (And inability to receive treatment thereby is precisely why many of the uninsured end up in ERs.) I too was a grad student in the late 80s and also made enough to pay for medical care out of pocket as you did. But we both know that neither once of use was really poor; underpaid yes, poor no. I was asking you where your concern as Christian was for those without any job at all. For the homeless and the elderly. For the mentally ill and, yes, even for those who are in some way responsible for their plight: whatever happened to 'There but for the grace of God go I'?

Hi Jeff, although I get your point, my response to it may be for more clarity about what I see as the perniscioun-ness of this movement toward almighty Govt. Any, and I mean any government social program is an attempt at displacing God and His directives toward men to care for each other. Government is too impersonal to do this job correctly, and it has caused many to say "I dont have to care, there's a goverment program for that"--I see this as evil, and alien to what God has commanded.

Also, when government attempts to fill this role, it is setting itself to be the preeminent one[idol worship]--Obama I believe has taken this on seriously. At some point, it's good to have nowhere else to turn, but to Almighty God, and to be so desperate that family, neighbors, community take note and inspect to see how to help--and this may come in form of tough love, not the *enabler* type of love. This isn't *just* a healthcare specific complaint by me, but it does also apply because if the personal touch is missing, I cant serve men fittingly.

Hi Robert, your question to Lydia:

"I was asking you where your concern as Christian was for those without any job at all. For the homeless and the elderly. For the mentally ill and, yes, even for those who are in some way responsible for their plight: whatever happened to 'There but for the grace of God go I'?"

prompted me to ask you to consider what I said just above your post. I suspect that I see this issue much the same way Lydia does.

God didn't say to institute a goverment program to "love thy neighbor" for you, and it seems to me that government's only ordained job is to reward the righteous and punish the wicked.

I like Bobby Jindal's approach: http://online.wsj.com/article/SB10001424052970203946904574300482236378974.html. He's got solid experience in this area.

I was asking you where your concern as Christian was for those without any job at all. For the homeless and the elderly. For the mentally ill and, yes, even for those who are in some way responsible for their plight: whatever happened to 'There but for the grace of God go I'?

Agreed, our current system cries out for reform, but the prospect of medical care being managed by abortion enthusiasts, self-proclaimed mercy killers and life-qualitarians is terrifying. Throw in the green eye-shade pretext provided by dire fiscal pressures and you have an unbearable nightmare in the making.

Knowing how our managerial class thinks, is there any doubt that it will be the poor who bear the bloody brunt of this Darwinian ethos once it allowed to prowl with the full force of the State behind it?

Let us not buy into the "hegemony of the binary model of market-plus-State", nor in our seeking a more just system wind-up unleashing even more evils. I don't have a specific plan, but the vague outlines to what is being constructed in Washington has Servile State written in red all over it.

Any, and I mean any government social program is an attempt at displacing God and His directives toward men to care for each other.

Followed by;

it seems to me that government's only ordained job is to reward the righteous and punish the wicked.

So Brad, I guess our penal system and massive national security apparatus are the only acceptable forms of public administration in your ideal theocracy. Sounds like an Old Testament Sparta.

I would supplement Masked Chicken's contribution by suggesting that one intervention the government can make to help the health care problem is to force the medical community to integrate preventive medicine more aggressively.

It seems the "medical industrial complex" (to paraphrase Eisenhower) continues to be massively skewed toward curative medicine, and biased against preventive medicine. The reason for this is eminently logical: curative medicine, as it has morphed into gargantuan sophistication (technically, institutionally, and theoretically), generates a lot more money for the healers than would preventive medicine.

A lot of money would be saved for the patients and taxpayers, however -- and simplification achieved -- if the worsened conditions of innumerable patients out could have been prevented by preventive measures in the first place.

As Florence Nightingale said on viewing for the first time the field hospital on the site of the Crimean War which she was sent to administer --

"I don't know how to run a hospital; but I know this is how not to run a hospital."

A question for Lydia:

Throughout the course of my life I have suffered (not simultaneously, thankfully) from mild asthma, bad ankles and chronic back pain, the last of which is ongoing. I have broken bones in three separate incidents (arm, ribs, and foot), and as an unusually sickly child was admitted to the hospital on a number of occasions for tests and observation.

My friend's wife is pregnant, now, with their third child, and will soon give birth. The first was born without incident; the second was three weeks premature and both baby and mother required a lengthy hospital stay, the former in NICU. There have been no signs of complications with this third pregnancy, but they are still anxious.

My mother suffers from crippling arthritis and back pain. Her treatment comes in the form of a ceaseless battery of pills - more even than I had thought it possible for one person to take. Without them she can barely stand, let alone work the two jobs that she does.

We all live in Canada - in Ontario, to be exact. Certainly you know what our system is like; if we were to move to the United States and live under your current system, with ailments and events such as those I've described to take into account, what differences could we expect to see?

robert allen,

You seem to be under the impression that folks without insurance can't get PC treatment in this country. This is ridiculous for a couple of reasons:

1) it depends on what you mean by no insurance: are you suggesting that the poor have no insurance? We have a massive government insurance program designed for the poor called Medicaid and while I would agree the program is a mess, it does provide coverage for the poor;

2) are you talking about those too poor to pay for insurance but are working and so don't qualify for Medicaid? In that case there are still all sorts of community health clinics that while not perfect, do provide PC treatment to working poor folks (usually on a sliding scale of ability to pay).

3) even given #2 above, you yourself have acknowledged that if you are working poor you can save enough money for an annual PC doctor visit -- it is then a question of managing your money properly.

Brad,

I respect your point of view and since I've been reading a lot of Charles Murray lately on social policy, I find myself agreeing with you that our federal government, as well as many State/local governments are all too big and do too much. But this is different from saying that those who support these big governments or those who want the government to take care of the sick mean to do harm. Again, I think they may be misguided, but I also think we have to assume their sincerity.

Michael L.,

I forgot to mention in my previous post that the link you provided for the Jindal article doesn't work. I'd be very interested in reading what Jindal has to say...I still think he could be our next President!

"this is different from saying that those who support these big governments or those who want the government to take care of the sick mean to do harm. Again, I think they may be misguided, but I also think we have to assume their sincerity."

Jeff, read Thomas Sowell's 'The Vision of the Anointed,' James Kalb's 'The Tyranny of Liberalism,' or Paul Gottfried's "liberalism" trilogy. These people are sincere, yes, but what they are sincere about is their own ideology and their desire to be in charge so they can implement it. As Claes Ryn puts it, they are the New Jacobins. The only difference between them and the old Jacobins is that they are quieter and gentler. Hence no guillotines. Yet.

(This is not to say, of course, that every single liberal/progressive is knowingly a neo-Jacobin. But that is definitely the direction of the "movement").

Playing catch-up, here, so it may take me a while to get to everybody. For Robert Allen--I should have been clearer. For a couple of years, we were a couple in which only one of us, my husband, was a graduate student. We lived, two people, in Nashville on $10,500 per year in 1988-89. Yes, I would say we were poor. We were not homeless, chiefly through teeth-gritting, squeak-by thrift. I consider that the doctors who gave me a break on medical care were helping the poor themselves. Thank goodness they were allowed to do so. I'm sure we would have been eligible for some sort of public assistance, but it never occurred to us to seek it, and we would have been too proud to do so had it been suggested. As Jeff Singer says, it's a mystery why you are bringing up all this "help the poor" stuff now in this thread, given that the U.S. _already_ has government programs for the people you cite. I myself would like to see those government programs slowly replaced by private charity, but I recognize that, govt. programs being (as I said) like a drug addiction, this would be a difficult process to carry out. Unlike Obama moving us in the opposite direction towards full socialism in the medical realm, I would not do so suddenly and recklessly were I in his position.

Jeff, I do want to address what you say about the quotation from Auster, after first thanking you for coming into the thread on my side concerning socialized medicine. Rob G. has done a good job of explaining where I'm coming from on this. As for using the word "evil," I would tend to reserve the word "evil" for a _different_ aspect of Obamacare, which I haven't mentioned before--the mandatory abortion coverage, which we all would have to pay for. I have indeed on past occasions referred to Obama as a "moral monster," in the context of his views and agenda in the area of abortion, his opposition to the born-alive infant protection act, and the like. So that's where I tend to use words like "evil" and "monster."

In this post I was highlighting something a bit different--an arrogance and ruthless intention to use power to ram things home with heedless speed because America has to change drastically and immediately. You may have heard the story (I was told it verbally and haven't had a chance to look it up on-line) about a so-called bi-partisan conference with Republicans during the early days of O's administration. As the story goes, one of the Republicans raised some objections to some of Obama's plans (it may have been about healthcare, but I don't know if I ever heard), and O looked coolly at him and said, "Well, I won, so I'll trump you on that." Now, you can call that--and his whole approach to this healthcare bill--a lot of things, but "nice guy" is not one of them. In fact, "no more Mr. Nice-guy" would fit better. It's all the more ironic given his talk during the campaign about bipartisanship! That's _one_ thing I think we can say he hasn't been sincere about. That he's sincere about his agenda I have no doubt, but to my mind his level of power combined with his level of determination and his insistence on speed make him dangerous, just as any committed ideologue would be in a position of great power. For these reasons, it doesn't make sense merely to treat him as just someone, anyone, with whom you happen to disagree.

Hi Kevin, I'm certainly not in favor of any theocratic system, and I dont know what you mean by Sparta. The point is that if the people are *tempted* to ignore the responsibility they ought to embrace because an artificial system that cant really substitute is set up as legitimate, most will take the easy way out--I think at God's displeasure.

As far as the role of government that is good, I'm not making statements about any current execution of of the process we see before us now. To give you an idea of where I am coming from, I dont consider myself a "green" person at all, but I think government is right to enforce environmental law to counter the greed motive that might/will make people take short cuts. This is surely intrusive, but good in that it makes/discliplines men to be better stewards. I think this falls under the umbrella of punishing the wicked and rewarding the righteous.

The individuals ability to care for others is hindered by government programs that take resources from the pople and use them indiscriminently and inefficiently. So, it costs more, cant really replace the real McCoy, and it offends God. Government run health care already has it's three strikes before it comes to bat.

"At some point, it's good to have nowhere else to turn, but to Almighty God, and to be so desperate that family, neighbors, community take note and inspect to see how to help--and this may come in form of tough love, not the *enabler* type of love. ... God did not say to institute a government program to love thy neighbor." Brad

Yes, Jeff/Brad/Lydia some underpriveleged people do manage to access various parts of our health care system. But PLENTY do not-certainly you cannot denying this basic fact. Poverty is real and not every impoverished person is lazy and/or profligate. Some don't even have a family or neighbors, or at least any in a position to help them. But, yes, we do belong to a community and I am asking you what as Christians we should do, beyond giving as much as we can to CRS and the like, to address this problem and poverty in general. Granted if everyone was motivated by charity the well off would help their less fortunate neighbors, a la the early Christians described in Acts. But, sadly, many people are not, which is why a government program may be the only viable solution: sometimes people must be forced to do the right thing. Now, maybe a government program won't work here. However, if that's what you believe it is still incumbent upon you, as Christians, to propose some alternative (and Medicare/Medicade are obviously insufficent given the evidence, both anecdotal and statistical, of people 'falling between the cracks'). Denying the problem or simply ignoring it is not an option for us: "Whatsoever you do to the least of my brothers that you do unto Me."

Brad:

I dont know what you mean by Sparta.

It's essentially a rhetorical device (now becoming remarkably trite, unfortunately, due to Kevin's seeming overly frequent use of it, as in past threads when alluding to Bush's foreign policy which virtually amounted to outright war as in the case of Iraq).

It merely seeks to point out the apparently unseemly belligerence of the State -- you know, like Sparta?

Sorry, Robert, I'm not going to take the bait and suggest some new major "program" to address ad hoc situations of individual people who for heaven knows what reason are so poor they can't get any medical care themselves _and also_ are ineligible for Medicaid. Obviously, the phrase "slip through the cracks" can cover a lot of things, and it likely includes people who I would think are lucky to receive what medical care they do receive at taxpayer expense in our high-quality system and for whom we certainly shouldn't develop some new government program! Beyond that, the very fact that we already have what we do have and that you are supposedly talking about people who "slip through the cracks" is overwhelming evidence to me that this is a situation for case-by-case consideration rather than wide-ranging so-called "solutions" that will almost certainly make everyone worse off in the long run by overburdening the system and lowering its quality. As the old saying goes, hard cases make bad law.

Besides the issue of the rightness/wrongness of the plan itself, there is also the little matter of funding. Where is all the $$$ going to come from to pay for this? Is it not immoral to saddle our children and grandchildren with this enormous burden of debt? The Dems talk as if all we need to do is raise the taxes on a few hundred millionaires and "Voila! -- the problem, she is solved!" But that's complete rubbish.

Rob G,

Where is all the $$$ going to come from to pay for this?

Finally!

But, more to the point, doesn't anybody with any reasonable cognitive ability rightly cognizant of current medical health care environment know just how incredible a rise in health care costs such a plan would actually cause?

If you guys are railing against the cost of medical care now, just you wait & see how enormous it will be come Obamacare!

"We all live in Canada - in Ontario, to be exact. Certainly you know what our system is like; if we were to move to the United States and live under your current system, with ailments and events such as those I've described to take into account, what differences could we expect to see?"

This is interesting. The Canadian system seems to work for these folks. But how can that be? Probably because (and this is the answer to your question Jeff) the Canadian government is capable of doing what every other government of every other industrialized nation seems to be able to do - provide some form of national health care for its citizens that on the whole is equal or better to our increasingly dysfunctional system at a fraction of our costs.

Flee your socialist hell hole Daniel, flee.

If your mother is over 65, she would be on medicare but her drugs would still cost a few thousand. if she is under 65 she is uninsurable. Your medical history would likely make you uninsurable on an individal basis. If your friends had the right insurance they would be ok otherwise its hello bankruptcy court.

It would seem to me that either Americans are especially incompetent or conservative notions of governance are wrong.

Yeah, like P.J. O'Rourke said: if you think it's expensive now, wait till it's free.

Brad - I appreciate your invitation to apply our faith to finding a just solution to our nation’s healthcare system rather than references to secular sources. While I agree a top-down, one size fits all, federal healthcare program would be a monstrosity, I think the status quo also morally unacceptable. And, yes to your point that the State is a poor alternative to private alternatives and typically squashes personal initiative. Thanks for clarifying your comments and it is good to know you believe government has a legitimate role in the realms of economics or social welfare. Not that many of us need a reminder after experiencing the consequences of the deregulated CDO & CDS markets. It is striking the right balance that seems the challenge and it is apparent that is impossible without a genuine Christian understanding of what it means to be human informing any of our institutions or proposed reforms. Hence the wariness with prescriptions drummed up by both the Left and Right.

Those reminding us that our real struggle is against “the powers and principalities of this world” and to resist the temptation to focus on persons and personalities should be heeded, even if takes some of the fun out of these polemics. Otherwise, we just confirm the old adage that politics is a clash of organized hatreds and we become obstacles to the Gospels taking root.

Since he was referenced above, Claes Ryn’s book American the Virtuous concentrates on the revolutionary origins of Neoconservatism more than it does any other school of Liberal ideology but aspects of his critique can be applied to all modern “isms”.
http://books.google.com/books?id=yEbiWf0Oye8C&pg=PA9&lpg=PA9&dq=the+virtous+empire&source=bl&ots=QkMgOw3w6s&sig=MjnjQu-hvO-lXL3XXMcwvjzkC7s&hl=en&ei=snNoSsHnDI6OMaXm_c8M&sa=X&oi=book_result&ct=result&resnum=2

Daniel,

Throughout the course of my life I have suffered (not simultaneously, thankfully) from mild asthma, bad ankles and chronic back pain, the last of which is ongoing. I have broken bones in three separate incidents (arm, ribs, and foot), and as an unusually sickly child was admitted to the hospital on a number of occasions for tests and observation.

My friend's wife is pregnant, now, with their third child, and will soon give birth. The first was born without incident; the second was three weeks premature and both baby and mother required a lengthy hospital stay, the former in NICU. There have been no signs of complications with this third pregnancy, but they are still anxious.

My mother suffers from crippling arthritis and back pain. Her treatment comes in the form of a ceaseless battery of pills - more even than I had thought it possible for one person to take. Without them she can barely stand, let alone work the two jobs that she does.

I see no reason why you should not have received childhood treatment of the sort you describe yourself as needing in America. On the assumption that you would have been a dependent of someone having an insurance policy (your father or mother, for example), everything you describe as a child would have been treated, and treated extremely well. And if you were not covered by such insurance, the only question then would be whether your family qualified for some form of public assistance, which would have covered your medical care. The ER visits, in any event, would have been covered, and as I have noted before, the _overall_ quality of care one receives on such visits is in part a function of the fact that our system is not as far socialized as some would like it to be.

I have elderly neighbors who constantly receive care, presumably on Medicare, for chronic back pain and many other conditions. They were just going on and on to me the other day about the high quality of their care. I assume this is relevant to the question about your mother.

In America the best thing for a man thinking of getting married is, of course, to seek a job with health insurance benefits, but many jobs, including blue collar jobs, do indeed have such benefits. Birth treatment for women in labor is in any event mandated in emergency. I can't understand why you bring up the mere fact of a pregnancy as though this were a challenge to the American healthcare system! That's ridiculous, given that we have millions and millions of babies born here and cared for wonderfully, including the babies of impoverished crack mothers and all sorts. Perhaps someone has given you the impression that American mothers give birth on the streets? To the contrary, our NICU care is top-notch. Two of my children were premature, by the way, and I also have had to go to ER to stop premature labor on more than one occasion.

Let me add, too, that numerous stories come out of Canada of longer waits for comparable treatments than we have in the United States, and even if this phenomenon hasn't affected any of the people you mention yet, it may well do so later. Here is a post on that subject:

http://www.firstthings.com/blogs/secondhandsmoke/2009/07/22/effective-political-ad-against-obama-health-care-reform-effective-because-its-true/

"Sorry, Robert, I'm not going to take the bait and suggest some new major "program" to address ad hoc situations of individual people who for heaven knows what reason are so poor they can't get any medical care themselves _and also_ are ineligible for Medicaid."

Fine handle it on a case by case basis and forget about a complete overhaul. But something must be done and my question is, who should do it? Who but the government has the resources to address the very real medical problems faced by these people? Again, I am sure that each one of us is aware of and meeting his/her obligations under the Corporal Works of Mercy. But that is not making these cases go away. Something more is required. It sounds like you have a hard time believing that there are individuals suffering because of the high cost of medical insurance who are not in some way remiss. But surely you are aware of workers losing their coverage as the result of being laid off from their jobs. What should they do until they find employment? Go without health care? (That's probably what many of them do.) Ask for help from mom and dad? They may be struggling themselves. Same thing with friends/acquaintances. No, the problem is real and I find your unwillingness to at least concede as much and propose a serious solution surprisingly callous, something I'd expect from a follower of Nietzsche, not Jesus Christ.

"Besides the issue of the rightness/wrongness of the plan itself, there is also the little matter of funding. Where is all the $$$ going to come from to pay for this? Is it not immoral to saddle our children and grandchildren with this enormous burden of debt? The Dems talk as if all we need to do is raise the taxes on a few hundred millionaires and "Voila! -- the problem, she is solved!" But that's complete rubbish."

Maybe not but that's as good a place as any to start. It never ceases to amaze me when Christians resist attempts to make the wealthy part with some of their wealth to help the needy. Shouldn't we be taking the opposite tack? Let's suppose for the sake of argument that raising taxes on these folks would help some and not create a greater problem elsewhere. Would you oppose such a measure then? If not, then, again, I believe you are failing to take seriously our Lord's injunction: "Whatsoever you do ...." You are putting ideology ahead of the Gospel.

"I have elderly neighbors who constantly receive care, presumably on Medicare, for chronic back pain and many other conditions. They were just going on and on to me the other day about the high quality of their care. I assume this is relevant to the question about your mother."

Lydia, Medicare is a singlepayer system - just like Canada's and your neighbors are happy just like Daniel, his family, and friends seem to be. You are correct, of course, about our NICUs and if ones child's stay exceeds ones covered limits one gets a huge bill and is likely bankrupt - something Damiel's friends don't have to worry about. Canada's base is the whole population; ours is fractured in multiple ways.

"It never ceases to amaze me when Christians resist attempts to make the wealthy part with some of their wealth to help the needy. Shouldn't we be taking the opposite tack?"

Please provide any Scriptural reference in which the state is authorized to coerce its members into giving up their wealth.

Thought so.

Redistribution of this sort is theft by government. Being firmly ensconced in the middle class myself, I'm not a huge fan of the obscenely wealthy or their often hoggish behaviors. But this doesn't mean I believe the state has any business confiscating their property and playing Robin Hood with it. It's an old cliche but it's true: liberals have no problem spending money as long as it's someone else's.

And I notice you didn't address the 'saddling our children and grandchildren with debt' part.

Dear Rob G.,

You might consider that the rich have a higher obligation to giving up some of their wealth than mere coercion by the state. As for Scriptural references for that (approximate quotes):

For those who have been given much, much will be expected.

Whatsoever you did for the least of these brethren, you did to me.

Any one who gives even a cup of cold water to one of these little ones because he is a disciple of mine will receive a prophet's reward (paraphrase).

This is not to say that the poor also don't have obligations.

The Chicken

Of course the rich have an obligation to help the less fortunate, and will be harshly judged if they don't. But Scripture nowhere gives the mandate to the state to enforce that obligation.

Lydia, Medicare is a singlepayer system - just like Canada's and your neighbors are happy just like Daniel, his family, and friends seem to be.

But they don't have to wait six months for an MRI, and they aren't even _tempted_ to consider going to another country to seek care (as many of Daniel's countrymen are) because our quality and availability of care is higher than Canada's overall. There is a reason for that.

RA

and propose a serious solution

Right. A serious solution, on your view, can only come with my making some kind of vast statement about what they "should" do and who "should" do what and probably conceding a large-scale expansion of government aid. And of course I am not going to do that. Yes, it may be that in tough times people have to do with less medical care, maybe a lot less. We don't crash the entire system and (as Rob G keeps pointing out) saddle later generations with an unsustainable program and masses more debt just to avoid this possibility. Talk about short-sighted.

I am not addressing Mr. G's issue because I don't believe it exists; I think there is more than enough wealth extant to meet everyone's needs. The problem is with how it is distributed. And we do have an obligation to demand justice for the poor even if that involves getting the government to do its part in making all citizens sacrifice for the common good.

"I think there is more than enough wealth extant to meet everyone's needs. The problem is with how it is distributed."

Whoa, someone's been at the socialist kool-aid.

"And we do have an obligation to demand justice for the poor even if that involves getting the government to do its part in making all citizens sacrifice for the common good."

Based on what, your ipse dixit? Chapter and verse please.

Mr. Allen, almost every _word_ in that last comment is an illustration of the extreme economic confusion that besets redistributionists at all times and in all places. There is, for example, the tacit "all else will remain equal" assumption, which is flatly false. I suggest you consider at least the possibility that economic redistribution simply does not work the way that you think it works--that you just delve into greedy Mr. Ford's mattress where he has that "extra" wealth stowed away, spread some of it around, and voila, the problem is solved and poor people are helped. This entire set of confused economic assumptions has been discussed again and again and refuted again and again both in more works than I could begin to name and also, as it happens, in human experience.

Dear Rob G.,

You missed the point when you wrote:

But Scripture nowhere gives the mandate to the state to enforce that obligation.

Scripture has mandated something higher than the state. In fact, although the state may cooperate in the process (and, hence, its coooperative authority), the mandate to give to the poor supercedes any human authority because it is a divine command. The state should not have to mandate anything, but if they do, they do not contradict the divine request, to the extent that they act morally in not asking for too much or without good reason.

The Chicken

Chicken,

Scripture teaches "Charity", not some state-mandated surrender of one's hard-earned money, which average families typically lack a substantial enough amount to even give; which, undoubtedly, Obamacare will force these to surrender above and even beyond the current allotment.

I hope you are well aware of the fact that to be forced to give one's earnings is not charity at all; indeed, there are other more fitting words for this.

The Chicken: what Lydia said.

"We don't crash the entire system and (as Rob G keeps pointing out)"

Please explain why every other industrialized nation can provide some system of national health care that is as effective or more effective as ours and costs far less per capita but we Americans can't.

Re: waiting. Do you have a non-anecdotal source for your six month figure? This might help:

http://secure.cihi.ca/cihiweb/products/Final_Wait_Times_AIB_EN_080229.pdf

Of course if you need a scan in the US and can't afford it and are uninsured the waiting time might exceed six months.

Rob G.

I'm rather taken aback by your most recent comment; I thought you were distributist, not unlike Byronic.

Also, I'm surprised that folks continue to think that it will be the wealthy that will finance such a program as this when, in fact, it will again be the middle class families that will be hit as well; as with any past programs advanced by exponents of the social welfare state.

Please explain why every other industrialized nation can provide some system of national health care that is as effective or more effective as ours

Not as effective as or more effective than ours. I recall, Al, that you are the guy trying to make the UK irrelevant to this discussion, but if the UK counts as an "industrialized nation," I submit that the mess there is relevant to your statement here. As to the question of why such nations are able to *do even sorta-okay* (Canada apparently not crashing right now as badly as the UK) in their healthcare systems with more socialization than ours, there are many reasons. We could start with the fact that the U.S. is doing a heck of a lot of new drug and treatment development with all that nasty, capitalist money, and that the drugs and treatments thus developed are then able to be made available in these other countries and *would not be developed at all* if the economic situation in the healthcare and drug industry in the U.S. became much worse. We could move on to a statement that has already been made regarding the possibility of coming to the US for needed treatment to avoid waits as a "safety valve" for Canada. We could go on yet further to the existence of a larger underclass in the U.S. than in, say, Sweden. And we could loop back finally to questioning the original premise by pointing out the willingness to have less good healthcare in these countries than in the U.S. (Anybody ever notice how much better teeth Americans seem to have, on average, than Englishmen do? We have much higher expectations here for dental care.)

I suggest you consider at least the possibility that economic redistribution simply does not work the way that you think it works--that you just delve into greedy Mr. Ford's mattress where he has that "extra" wealth stowed away, spread some of it around, and voila, the problem is solved and poor people are helped.

Oh boy, that is a cartoonish rendering of a Christian understanding of redistributive justice which lacks the envy and resentment imputed to our feathered friend, The Chicken.

Oddly, a couple of posts back you hailed the wonders of Medicare in regards to your neighbors. Is that system not based on income redistribution?

I want an alternative to our State too, but we won't get one with this; "where did Christ say to give on to Ceasar so he could set up a social safety net" rap or descending into a that discourse sounds eerily like the rights without obligations rhetoric we normally assail the life-style Left when they use it.

And no Lydia I don't expect you to adhere to Catholic Social Teaching, but Ari? He should know better.

Why thanks, Al, for the link. The majority of the web sites linked, in turn, from that pamphlet to provincial sites that report MRI wait times (since that was the specific thing we were mentioning) are no longer available at those links. I did, however, find the Manitoba wait site for MRIs here:

http://www.gov.mb.ca/health/waittime/diagnostic/mri.html

And interestingly, it contradicts the summary given in the pamphlet you linked in table 4-2. There the average wait time for "CT-MRI" (but why combine them?) is given as 42 days. On the Manitoba site, the average for an MRI is given as...18 weeks. And the wait ranges even higher, too, up to 22 weeks. Data for May, 2009.

The average Manitoba gives for CT scans is six weeks. Perhaps the summary just decided to use the CT scan average for both, huh?

This does cast some doubt on the reliability of the pamphlet, but even so, I'd be interested in comparisons to American wait times for other tests and services, such as angioplasty, etc., even as given in the pamphlet.

Kevin,

My dear & highly esteemed co-religionist; since when did the Chester-belloc distrbutist doctrine suddenly become an infallible decree binding amongst our fellow caths?

Perhaps we should re-acquaint ourselves with the social physics of reality before attempting (and even engaging in) such mechanistic solutions that are not principally based upon charity rightly regarded (as pursuant to passages in Scripture) but rather (and quite ironically) the cold and calculating statistics which a certain Russian Great himself once deplored and made a subject in a very esteemed and prominent work of his, which I thought both you and Rob G even admired and had only but the highest regard.

Oddly, a couple of posts back you hailed the wonders of Medicare in regards to your neighbors.

There is a persistent ambiguity and movement back and forth in this thread (by me, among others) between the quality of our medical system and the way that the medical care presently available is paid for. I was hailing the wonders of the quality of our medical system in the U.S. That my neighbors are apparently able to get such good care *even when paid for by the government* in this country is, in my opinion, a result of the fact that the *system as a whole is not more socialized*, in other words, that Medicare or something of that ilk doesn't cover more people than it does, which I believe would seriously lower the overall quality of care available to _everyone_, including the poor it was intended to help. I thought I had made this clear before, but if not, hopefully that clarifies it.

Ari,
The alleged "social physics of reality" sounds very mechanical from a guy deploring "mechanistic solutions".

Why are you and Rob G battling Chicken Man on points which seem far more compatible with Catholic Teaching than your rebuttals? You want to make a case that any and all income redistribution is unjust, then you do so without anything more formidable to stand on than an ephemeral tract from a polemicist. Do you really want to go that route?

a result of the fact that the *system as a whole is not more socialized*, in other words, that Medicare or something of that ilk doesn't cover more people than it does, which I believe would seriously lower the overall quality of care available to _everyone_, including the poor it was intended to help"

So do we accept some redistributionism, or are we saying medical care in this country would be vastly better if left solely in the hands of market forces unimpeded or restrained by the government?

Kevin,

The socialist enterprise (be it past or present) for me operates more on utilitarian ethics rather than some scriptural notion of charity.

Even further, it has been the case repeatedly as in times past that such enterprise has often inevitably resulted in consequences that were found to be more deterimental to the common man than it was actually charitable.

These have often not led to an improvement of life for the poor; indeed, it merely multiplied members of its population.

Do you really believe that such nationalized healthcare will be a boon to the citizenry?

Who will foot the bill, do you think?

Surely, with the rise of healthcare costs even now, imagine how incredible they will be once Obamacare gets into gear.

And you actually believe it is the Wealthy who will finance such an outrageous endeavour as that?

Puhleese!

I deem you to be a man of both intellect and respect; not a man deplorably without faculties.

I definitely lean towards distributism/agrarianism; but that does not make me a RE-distributionist. The latter implies that the state will take from the haves and give to the have-nots. That's not what distributism is about.

I for one am not in any way against a safety net. I just don't want it turned into a hammock. Let's do repairs on the safety net, by all means. But let's also provide ladders so people can get off the damn thing.

So do we accept some redistributionism, or are we saying medical care in this country would be vastly better if left solely in the hands of market forces unimpeded or restrained by the government?

I for one certainly do not accept "redistributionism." However, as I've already said twice now, large government programs are like drug addictions, and getting back off them can be incredibly difficult, even if they are causing harm, once the country is addicted. I'm not going to try to write some sort of alternative history in which the U.S. never had a large Medicare/Medicaid program in the first place. And all of this is very much bound up with questions of inflation and deficit spending. But I certainly think that a far more market-based approach than our current one would be preferable and that the involvement of the government is part of what is driving up costs. This often happens with third-party payers. Consider even in the private realm how much more expensive body work is on cars because of the high prevalence of insurance payments rather than individual payments for body work. Payment by someone other than the person to whom the job is directly important is often a source of local price inflation.

I'm afraid it just isn't obvious that there is a moral imperative to ensure everyone can obtain medical care. Consider the 99th percentile here, the drug using welfare collecting single mother of 3 (not entirely a hypothetical, unfortunately). I'm honestly supposed to believe that I am obliged to donate for her medical care needs? Bosh! She has made her choices and ought to live with them. The three children are a more sympathetic cause, but frankly guaranteed health insurance is the least of their problems.

I'm afraid it just isn't obvious that there is a moral imperative to ensure everyone can obtain medical care.

Sure; including the octomoms of the world and those desiring abortions.

"Based on what (do we have an obligation to demand justice for the poor even if that involves getting the government to do its part in making all citizens sacrifice for the common good)?
(Y)our ipse dixit? Chapter and verse please."

I have said it twice already. That is my reading of Matthew: "Whatsoever you do to the least of my brothers that you do unto Me."

Again, Lydia, is there or is there not a problem and what is your solution if not a govt. program? I'm anxious to know what YOU as a Christian think your obligation is to the poor. Same thing with Mr Weber and Mr G.

That is my reading of Matthew: "Whatsoever you do to the least of my brothers that you do unto Me."

Do you even know what charity (which the passage in Matthew 25 is principally based) is?

For your information, socialist tyranny is NOT charity.

is there not a problem and what is your solution if not a govt. program?

No, Mr. Allen, there is no more of a problem than there always is, always has been, and always will be. The poor we have always with us. Nor are there such things as solutions. There are only tradeoffs and compromises. I advise you to read _The Vision of the Anointed_ in which this is explained more eloquently than I could explain it. Your whole way of thinking in terms of "problems and solutions" is gravely misguided in such areas. My obligation is to help the poor with whom I am confronted and to whom I believe I can do good by helping them, not to make up grand schemes which purport to be, but never can be, "solutions."

I think it's a problem if someone who is genuinely good and wise cannot obtain an operation that they need due to price. I am sure this happens, though not nearly as frequently as liberal rhetoric implies. But it happens, and these people who are genuinely in need should receive help. So to that end, I would lower taxes drastically, to afford people more money both to spend on healthcare and to help others less fortunate (this would, of course, require a drastic cut in government spending, but there is much fat to trim there). I would remove most of the legal barriers to entry that currently exist in the healthcare market, to lower prices. I would support the creation and donation to charities that either provide medical care to the needy or provide funds to the needy to obtain medical care from other parties. These charities would be able to allocate intelligently, so that resources are not wasted on vagrants and lowlifes.

If all this fails miserably, and the needy are still needy, then the culture is rotten and nothing can save it. Instituting full out socialism would be an appropriate last gasp of death.

Would it make any economic sense to have a government administered catastrophic care fund, to which taxpayers could voluntarily remit a portion of their paycheck? It would be interesting to see what the American public would be willing to contribute. Based on income level, any care above such-and-such amount would make you eligible. Below that amount and you're responsible. Pay for it the same way I paid the hospital for my wife's first baby: monthly payments.

I don't think there is anything necessarily wrong with your idea, Bill, but it is unlikely to address what the liberals insist must be addressed--namely, _all_ the hard cases and (most important) giving _all_ those hard cases _all_ the healthcare that in any sense they "need." This obviously goes far beyond catastrophic care. Part of the question is the definition of "need." For a good twenty years or more now the liberals have banged the drum to the effect that catastrophic care only is no good because prevention is so important. It's the whole "ounce of prevention is worth a pound of cure" idea, but unfortunately, it is being applied, IMO, much too widely and in an area where this is only partially true. Getting your cholesterol levels checked doesn't prevent car accidents! Nowadays people (and their doctors) believe that they need every possible kind of screening and test, every possible form of preventative maintenance, rather than realizing that to some degree these are luxuries and that one can forgo them if necessary during one's personal economic tough times. The incredibly high standard we have for what people need--including, for example, largely pointless yearly physicals for people who are to all appearances and as far as they themselves know _completely healthy_--is part of the reason for skyrocketing overuse of the system once everyone is guaranteed coverage by the government for all the healthcare he needs. Nor am I trying to say that doctors are greedy and are encouraging this out of greed. On the contrary, it's a whole philosophy that is being dinned into them in the course of their training.

Lydia,

Thanks as always for your thoughtful response. Let me just say that it amazes me that someone like "robert allen", "Al", the Democrats in Congress and especially President Obama (because he supposedly understands how markets work and the importance of economic growth) can all believe that the solution to the "problems" with American healthcare is more government. How about wiser government? How about a government that regulates less and encourages more individual responsibility (I like Matt Weber's suggestions and I would again highlight the idea of personal medical savings accounts, discussed in Betsy Hart's article or the whole range of market reforms discussed in Dr. Glatzer's book, The Cure: How Capitalism Can Save American Healthcare which comes complete with a forward from Uncle Milt). I would also echo more strongly the point that America gets similar or worse health outcomes than the rest of the West only when we examine out health stats holistically -- because more Americans die from violence, bad eating habits, etc. thanks to our large underclass and for some of us, unhealthy lifestyles. When you look at specific outcomes based on medical interventions, we do better than the rest of the West: http://www.newmajority.com/americas-healthcare-system-still-works/.

More generally, this discussion is amazing as it does highlight the fundamental differences in how many liberals (and even some conservatives) thinks of good public policy versus how someone like Dr. Sowell thinks of good public policy (i.e. the issue is one of competing visions of what it means to be human and how we as human beings can realize our potential.) In one of those awesome life coincidences, just as Rob G. recommends Sowell's book A Vision of the Anointed and Lydia seconds the recommendation, I'm reading Charles Murray's fantastic book In Pursuit: Of Happiness and Good Government and I come across Murray quoting Sowell's book A Conflict of Visions which I suspect deals with some of the same themes we are getting at here.

Which brings me back to Auster's quote. I appreciate the clarification on what you think Auster means, but even if I tend to agree with the idea that rushing massive health-care changes through Congress is a bad idea, I still think this statement is unfair: "In this post I was highlighting something a bit different--an arrogance and ruthless intention to use power to ram things home with heedless speed because America has to change drastically and immediately." By unfair, I mean that you still fail to acknowledge that we can have a fundamental disagreement with President Obama about the need for America to change "drastically and immediately". The President will simply respond (and basically said this at his press conference the other night) that he is rushing because he believes the problems are so serious and terrible with our current system that something has to be done as soon as possible. I guess this might be arrogant, but I don't see it as ruthless -- he and many Americans and members of Congress actually believe that changing American health-care "drastically and immediately" IS A GOOD IDEA. And by good idea I mean that they think the benefits to those who are suffering (by whatever measure they use) outweigh any costs imposed on those who aren't suffering. Again, we are in total agreement that this is nonsense, but I hope you can understand the point I'm making -- that our conflicting ideas about man and his nature make our policy perspectives radically different but that doesn't mean that Obama willfully intends to do concrete harm to Americans overall well-being AS HE UNDERSTANDS that idea of "well-being".

Here is Murray discussing this idea:

"In the chapters that follow, the logic will be underwritten, inevitably, by the vision that I hold, my understanding of the amalgam of man-as-he-happens-to-be and man-as-he-would-be-if-he-realized-his-essential-nature, just as your reaction to it will be shaped by your vision of the nature of man.

There is no point in trying to "prove" one set of views about this Brobdingnagian topic, but neither need we ignore it. Just being explicit about who believes what will help."

I think we would all be better served by rhetoric that focused on being explicit about our competing visions and making a case for what I'll call the more conservative policy ideas (at least with respect to social policy and the role of the federal government in our lives) without attacking those who disagree with us as folks who "mean harm" (or aren't decent people, etc.) Attack the ideas of Obama as harmful or dangerous -- but to impute bad motives seems counter-productive in the sense that we want to win people over to our side and convince them of the Truth of our ideas.

I realize that this is painfully simplistic (and likely, unworkable) but it seems to me that the best solution to the health care problem is not to grapple with what type of insurance we are to be burdened with, but rather to elimiante (or at least drastically reduce) insurance itself. Insurance, government or privately sponsored, has created the false market and high costs that we currently find ourselves living with. Changing insurance companies (govt or private,) insurance plans, insurance strategy, etc. still seems to ignore the elephant in the room.

Aristocles, we're 100% in agreement:

Even further, it has been the case repeatedly as in times past that such enterprise has often inevitably resulted in consequences that were found to be more deterimental to the common man than it was actually charitable.

These have often not led to an improvement of life for the poor; indeed, it merely multiplied members of its population.

Do you really believe that such nationalized healthcare will be a boon to the citizenry?

Let's consider how public schools and the VA are run. Those are good indicators for the sort of national health care regime we would have. Highly political, grossly incompetent, unaccountable and extremely expensive for what they deliver. One issue which I doubt Kevin has considered is the fact that it's highly like that doctors who work in a nationalized system will enjoy sovereign immunity like most other government agents.

The simple fact of the matter is that we have not even explored less expensive alternatives like diverting funds from Medicare and Medicaid directly to public universities for the purposes of increasing their student enrollments. We don't have nearly enough doctors, but if we made it possible for many more intelligent people to get into medical school and become doctors that would naturally create a lot more competition and lower prices.

All the plans for nationalized health care will give us is a system where the diminishing pool of medical labor is rationed, rather than expanded by healthy competition and openness.

Here is a fun description of how Cook County Hospital provide care here in Chicago and some recommendations on how to improve the system:

http://www.suntimes.com/news/otherviews/1680972,CST-EDT-open23.article

The article is called "Too many county patients are their own worst enemy."

The latter implies that the state will take from the haves and give to the have-nots. That's not what distributism is about.

Are you sure about that? Clearly its thinkers did not think some intervention by the State qualified as theft;

"Since the state is given more power under distributism, we must be careful that only moral regimes employ it."
Hilaire Belloc

“The poor have sometimes objected to being governed badly; the rich have always objected to being governed at all.”
G.K. Chesterton

"From the standpoint of any sane person, the present problem of capitalist concentration is not only a question of law, but of criminal law, not to mention criminal lunacy."
G.K. Chesterton

But I certainly think that a far more market-based approach than our current one would be preferable

Well, that is vastly different than saying the market alone can create a just and viable healthcare system in a country as vast, diverse and as secularized as this one. It is redistribution of wealth that ensures;

Birth treatment for women in labor is in any event mandated in emergency...millions of babies born here and cared for wonderfully, including the babies of impoverished crack mothers

Branding the commonsensical and moral need to occasionally redistribute wealth has Socialism is a historically false and reckless argument. And one that plays into the hands of the Statist.

Can we claim market mechanisms and incentives would generate the same humane protection?

I think it plausible that they would, but in any event, I think it undeniable that they or their vestiges have generated the wealth that even make such a thing _possible_. Without the wealth, there would be no possibility of such high-quality treatment for such a large number of people, *with all the good will or all the government mandates, take your pick, in the world*. And the more that the making of wealth is disincentivized and punished by forcible redistribution, the more we risk the very existence of the benefits that the redistributionists wish to extend to all. How do you spell killing the goose that laid the golden egg?

It seems that some who're arguing that government is the "buck stops here" last resort when there is no alternative to solving the problem have to step back and look at certain cause and effect relationships. American freemarket capitalism has produced the most generous people in the history of the world, even in our overtaxed state it's still true. Our expressions of gernerosity are known worldwide whenever a need is made known. We would [as a people] take care of each other, and do it more responsibly. The wisdom of the people couldn't carry the day when some government do gooder[sorry Jeff, that's the best I can do right now] said "there's a need, and we cant just.... when in fact they *ought* to have left it up to 1)close family 2)extended family 3)Church 4)local community and in every step of the way, petitioning God. There is a struggle going on and it's as plain as good vs. evil and good hasn't fought hard enough--to our shame.

I think that the way government does social programs is like a drug dealer getting people hooked or just common pandering to base lusts-and it's done for power [a point that I believe Rob and Lydia have made in their own way]. Another point is that some government workers encourage abuse and overuse of the system for their own job security--I know this from personal exchanges with civil employees who have no shame taking part in this immorality. As they secure the dependancy [read get the user hooked], those who ought to care for their own people are free to abandon their *personal* obligation in similar dependancy--not needing the care themselves, they lose the sensation to and drift away toward a less personal life--one that doesn't really interact humanly.

Why does perichoresis keep popping into my mind about this? I think it's because ideally, we ought to strive for relationships the are deep, government social programs are [and cant help from] driving the population in the opposite direction-away from one of personal interpenetration-a deep understanding and loving of others. I guess I'm rambling now but I think this is behind the intellectual posturing. [lest anyone figure I'm abusing the term "perichoresis", read John 17:11]

I thought you were distributist, not unlike Byronic.

You rang?... I think the Distributist argument is a very serious grappling with the social teaching of Rerum Novarum and with the Real World. But we must stay current. One of the great insights of JP II's Centesimus annus is that "Capitalism" does not auto-correct towards justice and mercy.

Centesimus annus, 40. It is the task of the State to provide for the defence and preservation of common goods such as the natural and human environments, which cannot be safeguarded simply by market forces. Just as in the time of primitive capitalism the State had the duty of defending the basic rights of workers, so now, with the new capitalism, the State and all of society have the duty of defending those collective goods which, among others, constitute the essential framework for the legitimate pursuit of personal goals on the part of each individual.

Here we find a new limit on the market: there are collective and qualitative needs which cannot be satisfied by market mechanisms. There are important human needs which escape its logic. There are goods which by their very nature cannot and must not be bought or sold. Certainly the mechanisms of the market offer secure advantages: they help to utilize resources better; they promote the exchange of products; above all they give central place to the person's desires and preferences, which, in a contract, meet the desires and preferences of another person. Nevertheless, these mechanisms carry the risk of an "idolatry" of the market, an idolatry which ignores the existence of goods which by their nature are not and cannot be mere commodities.

I think it plausible that they would, but in any event, I think it undeniable that they or their vestiges have generated the wealth that even make such a thing _possible_

How do you explain destitute poor women being cared for then in the socialized states of Europe and Canada? According to your theory they would be too overly taxed to provide "free" medical coverage.

I think that the way government does social programs is like a drug dealer getting people hooked

That still does not alter the fact that the redistribution of wealth is a morally valid, socially essential time-honored practice that enjoys deep and broad support throughout the West and has nothing to do with the S word. To argue otherwise is to pick a fight you cannot win while sounding like a crank.

Centesimus annus, 40. Here we find a new limit on the market: there are collective and qualitative needs which cannot be satisfied by market mechanisms.

Appealing to an authority other than the Heritage Foundation is going to drive Ari and others crazy. Besides doesn't the Church celebrate The Solemnity of Supply and Demand Sunday this weekend? One would think so reading some of this thread.

Yes, we need to strip the government down to where it's only providing for the very most basic things that government clearly must provide -- stuff like the national defense, police, and philosophers to teach their discipline to students at state universities. :)

Kevin, I already answered your question above. First, when I spoke of the wealth that makes "such a thing" possible, I was referring to the care the poor receive in the United States, which is of an exceptionally high quality as compared with the care that the poor (and others) receive in relatively far-more-socialized Britain, for example. So "such a thing" doesn't actually happen in the countries you mention. I also spoke of the Canadian "safety valve" of America's medical system. I also spoke of America's development (with "capitalist" dollars) of treatments used elsewhere, which would not otherwise be available. Finally, as P.J. O'Rourke said in _All the Trouble in the World_, Sweden itself has poked and harassed the goose but hasn't killed it. That is, even in these relatively far more socialist countries there are still some vestiges of market mechanisms at work.

I wonder which Keith "Keith" is. A fellow philosopher, perhaps? In any event, at risk of allowing him to threadjack I will only say that there is nothing wrong with believing that the good of education would be better taken care of by entities other than the state while at the same time accepting the job available where one can do one's valuable work well and support one's family, even if this job happens to be at a state school. To suggest otherwise in an attempt to make some sort of performative tu quoque point is childish. To do it with regard to the husband of the blogger who wrote the post is more childish still and smacks of the actions of a certain other ideologue philosopher we both know who shall (here) remain nameless. Bag it.

Let me add that if the American medical system is socialized further, I would not suggest that every doctor who believes that to be a bad move must quit his job merely to be consistent with his economic views, though of course if actual, specific acts against his conscience are demanded (as is more and more likely under a more centralized system including rationing), he should refuse.

Okay, how about this: we mostly agree that the current health plan is poor considered? Are there any creative alternatives?

I have one. Let's call it the Exodus Meal model: let each "large-enough" community "adopt" a hospital and through a flat tax, pay for its upkeep. Then, citizens of that community get health-care for free or almost free. If there is an unusual disease or something rewuiring more advanced care, these can be sent to national centers. If a community is too small to afford its own hospital, they can partner up with another community.

Can communities support hospitals? I suspect the overall cost would be smaller than what is put into the health system in most communities under the current system. Communities, likewise, could adopt doctors/nurses through medical school if they agree to work in the community for, say, five years after graduation. The community could also adopt whatever else seems reassonable.

This gives the communities direct say over their healthcare and makes changes much easier.

Perhaps the way to get good healthcare it to think insmaller and more personal terms.

Any comments (be kind).

The Chicken

Chicken, I think one major part of the problem right now is the artificial driving up of prices through not enough "customer" involvement. Your idea simply doesn't address that problem, though heaven knows at least one could vote with one's feet, so it's _less bad_ than the Leviathan suggestion of Obamacare.

Kevin, listen: I don't expect that you and I will ever have any common ground on economic issues per se. But you have two eyes in your head and you are, I have always understood, strongly pro-life. Why are you coming rampaging into this thread so strongly (apparently) on the side of Obamacare, simply because those of us on the other side appear to be more of a libertarian frame of mind than you, when you _know perfectly well_ that it includes nationalized abortion coverage paid for by all of us? In Oregon the state health plan for the poor also includes euthanasia!!! Why is this not a wakeup call to you that *in the present political context* your pro-life stand and your desire for greater government payment for (and consequent control of) medical care are in conflict? Can you not see the way the Moloch-worshipers are in charge of what is being proposed and the way that their power over all of us, including in end-of-life care, will only be extended by greater centralization of medical care? Do you not understand what "rationing" should mean to a pro-lifer? Don't you realize how much harder rationing is going to make it in the long term for those of us who don't believe in feeding tube withdrawal to cause death by dehydration? Why isn't there common ground between you and me in opposing this out of sheer realism on your side and the other common ground we share? I swear, sometimes I think your economic ideology blinds you in other areas.

What distributism and like systems propose is what might be called an "organic" redistribution. Remember that it's based on land more than on money, so the main idea is widespread ownership of real property. What you'd need to do to start is to revise the tax code in such a way as to encourage small business and property ownership, i.e. promote subsidiarity. This in itself would prompt a sort of "redistribution" but not that of the state-mandated Robin Hood type.

I believe that although Kevin is correct when he says that not all redistribution is socialism, the type of redistribution currently being proposed in Obamacare definitely is. Still, it's probably more beneficial to our argument to attack the plan directly than to rail against 'redistribution' in the abstract.

Rob G.,

You wrote:

Still, it's probably more beneficial to our argument to attack the plan directly than to rail against 'redistribution' in the abstract.

But, but, if we attack the plan, directly, we might hurt it and then it will need healthcare...

The Chicken

Kevin,

Regarding this quote:

"Since the state is given more power under distributism, we must be careful that only moral regimes employ it." Hilaire Belloc

What regimes that have actually existed or do exist would you trust to wield that power in a moral fashion?

ByronicMan,

Glad you've returned (at least, returned to commenting, that is).

One of the great insights of JP II's Centesimus annus is that "Capitalism" does not auto-correct towards justice and mercy.

I have only the highest regards for your intentions; however, here, it seems you presumably think that such a mechanism as Obamacare will somehow (auto-)correct the sorry state of affairs as regards overall healthcare for the citizens of our nation; however, given the data for present healthcare for just a fraction of most, even here we've frequently had to wrestle with several issues wherein various abuses have been remarkably prevalent and medical reimbursements for both groups and the individual themselves are found to be conspicuously wanting -- how much more when we usher in a plan that supposedly seeks to serve for the benefit of all?

If anything, it will simply excruciatingly exacerbate the current state of affairs.

Mike T,

I'm certainly glad we have come to reach some kind of agreement on at least this!

What regimes that have actually existed or do exist would you trust to wield that power in a moral fashion?

Precisely -- which is why distributism, however attractive it may very well be in theory, will inevitably devolve, in practice, to a mere semblance of yet another Soviet Union experiment in Marxism.

Lydia
I am opposed to ObamaCare and said so from the beginning.Early on I called it a monstrosity and said its only legacy will be death and suffering and compared the ramp-up and will to power in this gross overreach have echoes of the Iraq debacle. ObamaCare must be defeated.
However I am not going to make bad arquments and claim that economic redistribution is immoral or circle my wagons around the status quo.

"which is why distributism, however attractive it may very well be in theory, will inevitably devolve, in practice, to a mere semblance of yet another Soviet Union experiment in Marxism."

Not necessarily. If it works from the bottom up, as intended, rather than the top down, that likelihood is greatly reduced.

It is of the nature of liberalism to fail to self-correct. Laissez-faire capitalism, as a species of liberalism, has the same problem, when the moral component is left out of the picture. Even though Adam Smith realized this, it's not something that those on the 'Mises' side of the false Mises-or-Marx axis like to hear.

Kevin, I apologize for not remembering your remarks earlier in the thread.

Kevin, I apologize for not remembering your remarks earlier in the thread.

An egregious error often unfortunately repeated for so distinguished and refined a lady, too.

Rob G:

Not necessarily. If it works from the bottom up, as intended, rather than the top down, that likelihood is greatly reduced.

I don't see, pragmatically, how such a feat could be accomplished without governance by the state.

There are those who even suppose some version of a cooperative; yet, even there, I remain skeptical of such a notion being practically employed nonetheless.

"I don't see, pragmatically, how such a feat could be accomplished without governance by the state"

There is a difference between "governance by" and "imposition by." There would necessarily be some amount of governance by the state, just as there always has been in any market society. But if ownership of property was widely diffused, the accumulation of wealth and power by both the government and big business would be limited.

here, it seems you presumably think that such a mechanism as Obamacare will somehow (auto-)correct the sorry state of affairs as regards overall healthcare for the citizens of our nation;

Aristocles,

I wish that you wouldn't have lept to that conclusion. I am not a supporter of the president's healthcare initiative. I just wanted to bring the pope's teaching to the fore, to note that the Catholic Church does not support laissez-faire economics, and that she recalls governments to their true responsibilities, which includes positive action to correct wrongs perpetrated by broken systems--including broken government systems (there is perhaps a difference between auto-correction, supposed correcting mechanisms built into a system, and self-correction of the intentional kind that works by means of extra-systemic interference). So, I think that there must be healthcare reform. The president is going about it mostly all wrong, and that within an unacceptable philosophical framework. Kevin has used somewhat stronger language, above, to describe plan as it seems to sit currently on the floors of congress.

I say that the "Free Market" does not auto-correct toward justice and mercy. For a just and merciful system, the citizens must actively interfere. There are some powers that only a federal government can exercise. That's why we have federal governments. The president is correct about one thing, when he speaks of cynicism about government in the public mind, the sort of cynicism that leads to despair over federal solutions. Perhaps we'd begin by Gov. Jindal's series of proposals under his "bipartisan reform" plan. We cannot build a utopian system where every American will get the sort of care that President Obama gets. But we can make things better than they are now. I think that there are some answers out there. In addition to Jindal's proposals, there must be a restructuring of the tax system to allow for greater contributions to private foundations that supplement the insurance gaps respecting care for indigents. How much of the assets of such foundations have been wiped out by the recent (and much discussed in its moral implications here on W4) financial collapse?

Rob G,

I think your assumptions are being colored by some idealistic (seemingly overly optimistic, even) notion of the Chester-Beloc doctrine rather than historical precedence wherein anything governed by the state (since the state itself is run by men and, therefore, subject to the quality of such men) will determine whether such a system will rise or fall.

In the case of past (and even the relatively recent) history, it has often been the latter -- to the very detriment of the citizenry, in fact, rather than for its benefit as was originally intended by several previous systems bent on doing just that; i.e., help the poor and promote equality amongst all citizens.

About the free market being a panacaea for all the world's wrongs, let's be clear that this is not the case. What the free market will do, rather, is produce the most tolerable situation for the largest number of people. It will not be a perfect situation for everyone, and most likely won't be perfect for any one person. That's just the consequences of a world with scarce resources and competing demands.

The things to remember from this are:

1) for some commodity that is morally irrelevant, like toilet paper or coffee mugs, the free market will produce the best state of affairs with regards to efficient allocation.
2) for commodities with a moral dimension, the free market alone will not produce the best state of affairs, because any free market equilibrium is going to have margins that are priced out of the market. The good thing is that many members of the margin are fools and good-for-nothings that deserve exactly what they have. The bad thing is that this is not 100%; and some genuinely good people will be priced out as well, for various reasons.

All this is to say that, while some people, say at lewrockwell.com, do believe that the free market in an anarcho-capitalist or minarchist state will bring about the best possible world, most people realize that this isn't the case.

"I think your assumptions are being colored by some idealistic (seemingly overly optimistic, even) notion of the Chester-Beloc doctrine"

I am not a doctrinaire distributist; in fact, my sympathies probably lie even more strongly with Southern Conservatism. But there are enough points of contact between that and distributism to make it appealing to those who refuse to accept the limitations of the Mises-Marx axis. My main beef is not with capitalism per se, but with corporate capitalism, which is a different animal.

there must be a restructuring of the tax system to allow for greater contributions to private foundations that supplement the insurance gaps respecting care for indigents.

That's sounding okay to me. I wd. also note that the Obamacare direction will (so it is said) make medical savings accounts even less attractive, and I have no doubt that this is true. MSA's have always been anathema to the liberal approach to healthcare.

Again, in my opinion any key to making things better will lie in _encouraging more_ fee-for-service rather than moving yet further away from fee-for-service. A natural concomitant of this will be that people will get fewer screenings, checkups, and other "preventative" attention when they are apparently healthy, because they will not value those things enough to do them unless some third party is paying for them. I think this is likely a _good_ thing, whereas the approach that has been regnant now for a very long time (and has in fact affected the philosophy of HMO's themselves) is that this is a very _bad_ thing.

A natural concomitant of this will be that people will get fewer screenings, checkups, and other "preventative" attention when they are apparently healthy, because they will not value those things enough to do them unless some third party is paying for them. I think this is likely a _good_ thing, whereas the approach that has been regnant now for a very long time (and has in fact affected the philosophy of HMO's themselves) is that this is a very _bad_ thing.

This is a wickedly bad thing for anyone, such as myself, with a family history of predisposition to certain catastrophic illnesses. By the time your colon cancer is sufficiently advanced to cause the perception of unwellness, necessitating a trip to the doctor, you're flat doomed. Fee-for-service does not work for the prevention of such illnesses, because most people do not, and will not, have thousands of dollars in disposable income to commit to annual/routine screenings; fee-for-service does not work, that is, if one's objective is to avoid dying at the age of 51, like one of my uncles.

Lydia,

A natural concomitant of this will be that people will get fewer screenings, checkups, and other "preventative" attention when they are apparently healthy, because they will not value those things enough to do them unless some third party is paying for them. I think this is likely a _good_ thing...

Just how would you know that they are healthy without even performing such screens?

Even further, don't you realize the fact that the later you detect a disease that may very well be lingering within an "apparently healthy" person, the more expensive it gets to provide health care in the latter stages of the disease (not to mention, the less likely of survival for that person too!)?

In fact, early screening is comparatively less costly than the tremendous costs that inevitably swells should they detect it later, with all the medical visits & treatments and so forth that such latter stages of a disease just happens to entail!

Believe me -- I know (both from second-hand as well as, unfortunately, personal experience).

I am writing this on a purely text-based browser. Let's see if it works.

I can support both Lydia and Aristocles. Some diseases need to be caught early on, so a doctor's visit is necessary. On the other hand, how many doctor visits could be avoided if people stopped smoking, ate fruits and vegetables. got off their duffs and started exercising, etc.?

The three biggest reasons for health expenses are cancer, heart disease, and problems related to obesity. We can't cure cancer. Treatment will remain high for the foreseeable future; we can't cure heart disease, but its primary cost comes because we can treat it fairly effectively; we can "cure" obesity. Why not a carrot-and-stick approach. Give cheap health care to the working poor who stop smoking, eat reasonably (poor people often can't afford to eat perfectly). exercise, etc. That way, we can limit doctor visits and improve the overall health of the country.

Its either that or go Khan Singh and start developing eugenics, which, sadly, may be an invisible hand behind a lot of healthcare regulations.

The Chicken

I can support both Lydia and Aristocles. Some diseases need to be caught early on, so a doctor's visit is necessary. On the other hand, how many doctor visits could be avoided if people stopped smoking, ate fruits and vegetables. got off their duffs and started exercising, etc.?

Oh, that's right; if only my niece stopped smoking (which she never actually did anyway), ate fruits and vegetables (although she did), got off her duff and exercised (which she also did daily); she wouldn't have actually died of cancer.

Brilliant, Chicken, just brilliant.

Better yet, what a joke that her physician had actually thought up the wonderfully risible notion that if her cancer was only diagnosed earlier, she need not have undergone such a severe tragedy; but, hey, what did she know?

Chickens trump physicians, hands down!

Dear Aristocles,

I started my comments by saying that there were some diseases that required testing. I think any charitable reading would have assumed that I meant cancer screening in that. Don't start in on me with this. Both my father and a woman I dearly loved died from cancer and I was with them through the whole thing.

My point stands and you will not find a single epidemiologist to disagree - we live a very unhealthy lifestyle, on the whole, in this country.

Sorry if I sounded flippant to you in my earlier post or testy in this one. I know how painful watching someone go through cancer can be, so I sympathize, and I did not mean to be either flippant nor testy. If it came off that way, I apologize. My comments about preventative medicine were meant in the best of possible ways, not the worst.

The Chicken

This is a wickedly bad thing for anyone, such as myself, with a family history of predisposition to certain catastrophic illnesses.

Maximos, I'm going to say something that will probably make you angry, but here goes: In that case, you, as a reasonable person, should of course place a higher value on early screening. We need to get back to the point where these arguments are made _to people_ and they decide how much they are willing to pay for that screening on the basis of those arguments. The trouble is that our costs are cut so free from any possible affordability or desirability by the individual that we have artificial inflation going on. If people don't agree or don't believe that this screening is important, that *should be* taken into account. When it isn't, and when everyone knows that it is being paid for by a party with a lot more money than the individual, you will get inflation of the cost. If we go on paying amounts of money that, by our own admission, are unaffordable to individuals for screening and that most people don't value at the amount it (now) costs, we are simply asking for trouble in economic terms. How will those vast screening programs-for-all be paid for, then? Ultimately, I suspect, by inflation--that is, by borrowing from future generations.

I would add, too, that the "cancer model" is applied far too widely. Everything is now considered to be like cancer--an invisible thing that gets worse and worse when you think you are fine. People should realize that increasing calls for _mandatory_ mental screening of _children_ (sometimes even against parental wishes) are a result of our culture's learned obsession with screening and our learned assumption that everything is like cancer and has to have "something done" about it early even for people who appear to be just fine. Everything isn't like cancer. For that matter, not even all cancers are like cancer, so to speak. Consider the conflicting reports that seem to come out day after day as to whether early screening and/or treatment of prostate cancer really increases life span, given the slow-growing nature of that type of cancer.

When I talk about preventative medicine, here, I'm also talking about the push for yearly physicals for everyone, however beautifully healthy. This is ridiculous, and it results in a great deal of mischief inter alia for children being taken to pediatricians, who are taught to use these empty and medically pointless visits as opportunities for intrusive questions and discussion about family activities, family gun ownership, and sexual topics that the parents may not want to have discussed between the child and a stranger. Such pointless physicals-for-all also cost a heck of a lot of money total. Again, people wouldn't usually do them if they had to pay for them themselves. As it is, people are being turned into sheep who herd themselves and their own children into the pen year after year to be questioned by doctors who already act like social workers to some degree and who, the more socialized our system, will eventually actually be direct agents of the state. This is bad from many perspectives, cost being only one. Or consider the unnecessary medical cost and physical intrusion for a chaste woman married lifelong to a chaste man to have yearly pap smears for a form of cancer that is highly unlikely to affect her. Examples of this kind could be multiplied. Fee-for-service would help to curb such unnecessary expenses and intrusions into people's lives.

The trouble is that our costs are cut so free from any possible affordability or desirability by the individual that we have artificial inflation going on.

Artificial inflation isn't being caused by early screenings; again, early screening saves money as compared to the tremendous costs that are spent on multiple hospital visits/treaments for diseases detected in their latter stages.

Artificial inflation is actually caused by cons who charge healthcare 8 times over for such things as medical necessities for the elderly only so that they can reap in tremendous profit.

Ari, it's just too sweeping to say that "early screening saves money." The truth is, _it depends on what it is_. In some cases it does, in other cases it doesn't. I will go out on a limb and say that I seriously doubt that all the prostate-specific antigen screenings that have been done in the past 10-15 years have saved money. And even the medical profession is starting to question that. But it took a while. The over-standardization of the medical profession leads to over-eagerness about screening based on the _assumption_ that all screening is alike, all screening saves money and is worth doing, even perhaps urgent. This is not only economically questionable but also, as I have said, leads to unnecessary intrusion into people's lives. I think the pap smear test example I gave is a very good one. On the assumption that most cervical cancer is caused by a sexually transmitted disease, we have over-standardization when women at no risk (or only miniscule risk) of that causal disease are having pap smears every year. People are taught not to think for themselves on these matters and simply to accept whatever "is done" now, and this combined with the fact that someone else always pays leads to massive over-standardization, haste and lack of due diligence in imposing new standardized services, and unnecessary cost.

Part of the problem with those doctor visits that are just knee-jerk as opposed to reasoned is that the public has been told by a medical establishment that certain tests are necessary. Few people can read the technical literature and decide for themselves. Doctors order the tests to keep from getting sued for malpractice. I don't blame either group, separately, but synergistically, they operate to drive up costs. Patients ask for and demand the latest medicines they have seen advertised on tv - tv of all places! Doctors are afraid to say no to their patients because of threats of laws suits for lack of seeking the "best" care.

The real villains, I suppose are the advertising companies and the congressmen who think that making sales pitches to uninformed and ill-trained laymen in thirty-second spots is morally defensible.

I make it a habit to wait five years after I hear of a medical breakthrough before I look at it. How many medical discoveries will be overturned in a five year period? We like to think of medicine as a science, but it doesn't have enough depth of knowledge in certain areas, yet, to qualify.

It used to be that people had common sense, but advertisers and others have instilled so much fear into the public that they will buy almost anything. If you want to drive down cost in one area of medicine, this might be one place to start.

The Chicken

What regimes that have actually existed or do exist would you trust to wield that power in a moral fashion?

Mike T.,
Governments have been redistributing wealth since the Flood and they naturally vary in their moral quality. Belloc was adding an instructive accent to a fact of Western political life. If you want to argue that the right to property is absolute, you should ask; what society has ever embraced and put that view to practice?

Repair our communities with life affirming programs. My fellow civil rights workers and I will be on Capitol Hill to say that if President Obama, Speaker Pelosi, or anyone else truly wants to reduce the number of abortions, they will not coerce Americans to pay for them and they will not subsidize Planned Parenthood, the billion-dollar business that has killed more black children than the KKK," King charged.

Lydia, a lot is riding on the fortitude of 20 prolife House Democrats. Good to see Alveda will be there to stiffen their spines.

"Without the wealth, there would be no possibility of such high-quality treatment for such a large number of people, *with all the good will or all the government mandates, take your pick, in the world*. And the more that the making of wealth is disincentivized and punished by forcible redistribution, the more we risk the very existence of the benefits that the redistributionists wish to extend to all. How do you spell killing the goose that laid the golden egg?" Lydia

Who created this wealth and to whom does it belong? Why shouldn't the workers of this country enjoy the same health care advantages as the wealthy investors? Markets don't create wealth; real people do. But when workers lose their jobs, because companies are mismanaged, they can't afford health care. Their corporate masters, on the other hand, are still sitting pretty as far as that and everything else is concerned. Not everyone without health care is a lazy would be criminal who has blown every chance he/she ever had at respectability. You are supposed to be a Christian and it's obvious that our Lord was VERY solicitous of the needs of the poor: another great example of this was the parable of Lazarus and the rich man. (I also recall Him saying "It is easier for a camel to pass through the eye of a needle than for a rich man to enter into the Kingdom of Heaven.) An economic meltdown is not going to ensue if those enjoying luxuries are required by the government- yes the government- to sacrifice some of them so that everyone can enjoy decent health care. As a Christian, you should realize that it is immoral for anyone consume beyond his needs while others he could help suffer. The atheists Peter Singer and Peter Unger have figured that one out- why haven't you? The failure to do amongst so-called Christians is nothing short of a scandal.

Robert Allen, are you for a plan that subsidizes abortion? You've been remarkably quiet on the matter.

I think his strategy has been to try to increase the "misery index" so much that "the people" demand nationalized health care. That's the drive behind keeping "stimulus" and TARP money locked away out of the economy; IOW Obama wants higher unemployment & more dependents on government. Only thing is that it seems like it is backfiring to a degree and time is not on his side. Cloward & Piven finally got welfare reform, but it took them 30 years. And it still didn't lead to a "guaranteed national income". Obama only has 7.5 years and with his sinking approval rating is going to have to give in to a more moderate agenda to jack up his waning political capital.

The Chicken adds a great point, that of malpractice suits. Their threat adds a great deal of cost to the system; doctors feel that they have to order all possible tests as a CYA exercise, because if they miss something they'll be sued. Any real reform has to include an addressing of this problem.

"An economic meltdown is not going to ensue if those enjoying luxuries are required by the government- yes the government- to sacrifice some of them so that everyone can enjoy decent health care. As a Christian, you should realize that it is immoral for anyone consume beyond his needs while others he could help suffer."

Crikey, a Leveller! Any who gets to decide, pray tell, when a given person has consumed "beyond his needs?"

Robert Allen, there are people everywhere, and people always create wealth. But to try to turn that insight into some sort of "leveling" claim is economic insanity. The people create wealth through human action and the free exchange of goods and services. The more that free exchange and action is disincentivized by continual redistribution to make everything "fair," the less the wealth. You just don't, I'm sorry, know what you're talking about regarding where wealth comes from if you think you can have it both ways--continual production of wealth while Big Brother snatches it in large chunks away from the "over-users" and gives it to everyone else. At some point, you kill the goose. You just don't seem to know this.

Kevin also asks a good point, but I'm _guessing_ RA is one of those "Christians" whose concerns are for "social justice" rather than all those darned divisive life issues.

Chicken, tests and shots don't become the standard of care based on advertising on TV alone. There's usually something else that has to happen--namely, doctors and/or government have to be convinced that this can result in "prevention" or "early treatment." Trouble is, it doesn't take much to convince them. There's no skepticism there. We so idolize prevention and early treatment that we buy the idea for _anything_. Thus it was only some last-minute sanity that prevented every 11-12yo girl in Texas recently from being vaccinated at public expense for a sexually transmitted disease with a vaccination whose length of effectiveness is still unknown. The cost was, fortunately, a deterrent.

Lydia, we need to distinguish between unfounded hype heaped upon new discoveries, which are often merely new discoveries of profit-making opportunities, and the sorts of medically unnecessary pharmaceuticals advertised on TV, not to mention morally dubious vaccinations, on the one hand, and legitimate preventative medicine on the other. The abuse of a thing does not invalidate the licit use, and - to continue with the example I have been using, on account of its familiarity to me - routine screenings for colon cancer for persons with a direct family history of the disease certainly fall into the latter category. Moreover, the general claim that we valorize prevention in this nation strikes me as bizarre. Were it so, HPV vaccine machinations notwithstanding, we'd not be telling people with family histories of cancer to do nothing so long as they're feeling well, and we'd certainly be taxing the processed foodstuffs that virtually every reputable study associates with an increased incidence of heart disease. That we do not is a testimony to the strange alliance of conservatives concerned about "lifestyle fascism" among liberals, and a medical-industrial complex that earns more profit treating the complications of crappy diets than it ever could preventing those complications. In other words, the problem is more nuanced than a simple valorization of preventative medicine and lifestyle adjustments; it more a question of who and whom, of situational prevention. Preventing HPV is good, because profits can be earned selling the vaccine, and because the entire enterprise validates the sexual revolution. Preventing heart disease and obesity, not so much, at least not beyond the admonitions of physicians.

we'd not be telling people with family histories of cancer to do nothing so long as they're feeling well,

As far as I know, I'm one of the only people even remotely inclined to say anything like that, and even I would probably hesitate to say anything so sweeping. I'd be surprised if doctors would say it.

As far as taxing food because it causes heart disease, well, yes, I do oppose that, and I'm glad enough other people do, too, that it hasn't started happening. But having everybody get a cholesterol screening (not to mention the sudden springing up like mushrooms of "healthy heart" symbols on foodstuffs everywhere, including McDonald's) is to me evidence of very strong concern about heart disease in our population. I guess it depends on one's priorities, but I think we show a lot of concern about preventing heart disease.

I'm one of the only people even remotely inclined to say anything like that

It is mystifying that anyone would ever say anything like that, inasmuch as, with a significant percentage of cancers, waiting until one actually feels ill, in consequence of what turns out to be - from one's perspective - cancer is a death sentence. It sounds altogether too much like telling people to gamble with their lives, or to just flat out get on with the business of dying, so as not to make them pay more for insurance. Even absent my family history and personal health circumstances, I'd have not a scintilla of sympathy for such a view.

But having everybody get a cholesterol screening (not to mention the sudden springing up like mushrooms of "healthy heart" symbols on foodstuffs everywhere, including McDonald's) is to me evidence of very strong concern about heart disease in our population.

Well, yes and no. All of those screenings are lucrative, as is the routine dispensing of anti-cholesterol medications, many of which have dreadful side-effects. So also, for that matter, are surgeries intended to correct heart ailments resulting from years of crappy food, inactivity, and general neglect. Actually incentivizing people to refrain from at least some of the activities that contribute to heart disease, not so much - that's why it hasn't been done yet. Do you imagine that the pharmaceutical corporations want to sell fewer drugs, because people have stopped eating crapola, or that hospitals raking it in performing surgeries want to perform fewer of them, for the same reason?

I'm not much for officious bureaucrats, but there's something anti-intellectual in much of the opposition to merely labeling, let alone taxing, crap food as the crap food it is, a desire either to remain ignorant of what one is doing to one's body, or to not ever be informed by others that what one is doing is harmful, even to others, and this psychology can be as much a product of a deformed liberal mindset as, well, officious bureaucrats. It's simply liberal voluntarist egoism as applied to food.

For the record, things such as cholesterol screenings cannot be conducted on a general basis, but must be tailored to the requirements of individual patients, which is why, after learning, as a result of my last comprehensive physical exam, that my (bad) cholesterol was extraordinarily low, I decided not to waste time and money on another such screening for years to come. But the general, screen 'em all approach is a function of the overall indifference of the American people to their own health, their belief that they can live precisely as they wish - and don't you dare suggest that chugging Coke and gorging on Big Macs is a lousy idea - and the miracles of medicine will keep them alive. Officiousness is the counterbalance to personal indifference and rank ignorance.

Lydia, the broken links can be fixed - just take the address back to basics and when at the site click on waittimes. All the sites and studies make it clear that wait times exclude critical cases which are done as needed.

"Robert Allen, are you for a plan that subsidizes abortion? You've been remarkably quiet on the matter."

Oh God no. And please forgive me for not saying so earlier. Obama the Church Shopper is morally and spiritually benighted. I'm not necessarily in favor of the other parts of his plan either. I'm only saying that we as Christians MUST be advocates for the poor.

Governments have been redistributing wealth since the Flood and they naturally vary in their moral quality. Belloc was adding an instructive accent to a fact of Western political life. If you want to argue that the right to property is absolute, you should ask; what society has ever embraced and put that view to practice?

Governments have also been waging unjust wars, murdering dissidents, engaging in cronyism and all sorts of other practices. The fact that it has happened from the beginning of time is no defense. Switching it from a discussion about the morality and efficacy to a discussion of absolute property rights is just an evasion of the underlying fact that redistribution of wealth is a terribly dangerous power to give government, especially in modern times.

With regard to welfare and medicare there is literally no good reason to provide those through the government. The church and secular charities are the more than capable of providing for these needs in a free society, for the people who are humble enough to seek them out. Of course, that will deny the poor the prerogative to decide who their doctor is, among other things that the guaranteed infrastructure permits them.

For me, this issue hits close to home because I have a relative who is too proud to go to their church and seek help, but rather would stick the cost to society through Medicare. In fact, despite the fact that they have barely worked more in several decades of life than I have in little over 26 years on this Earth, they believe that they are **entitled** to have their costs assumed by others who make more money than they do. The plural of anecdote is certainly not data, but I know from experience that one of the problems is that low income earners and even a good chunk of the middle class are too proud to humble themselves to seek charity rather than treat this coverage as a "moral right."

I'm only saying that we as Christians MUST be advocates for the poor.

Obviously. I don't think that's the controversy here. The question is, how do we do that? Through the state or through the church? If through the state, then it will overpower the church. That is simply how the implementation invariably works regardless of how it looks on paper.

With the secular state doing it, you may get a form of Christian protection of the poor, but it will "have the form, but deny the power" behind it by being statutorally forbidden from centering the focus on Jesus or even some notion of God.

redistribution of wealth is a terribly dangerous power to give government, especially in modern times.

Agreed. However, the alternative seems even more brutal; the cultivation and administration of justice left to a wealthy elite. Especially in modern times.

With regard to welfare and medicare there is literally no good reason to provide those through the government. The church and secular charities are the more than capable of providing for these needs in a free society, for the people who are humble enough to seek them out.

Not too long ago you were saying the spiritual decline of this country was so great Christians might have to consider alternatives to our current arrangements and armed force might have to raised against the abortion regime.

What recent developments have occurred that changed your mind? Clearly you've seen a sea change in our society that makes it now the fertile ground for the ideal Libertarian non-State.

"the general, screen 'em all approach is a function of the overall indifference of the American people to their own health, their belief that they can live precisely as they wish"

There is a large measure of truth to this, but as I said above, another factor that appends to it is the threat of lawsuits against doctors who fail to run certain tests, and the resultant enormously high cost of malpractice insurance.

No doctor wants to miss a diagnosis, if at all possible. But the pressure to avoid misdiagnosis (or a missed dx) is increased exponentially by the ever-looming threat of civil action.

For a Christian website, it saddens me that there is so much biblical illiteracy.

2 Corinthians 9: 5So I thought it necessary to urge the brothers to go on ahead to you and arrange in advance for the gift you have promised, so that it may be ready as a willing gift, not as an exaction. 6The point is this: whoever sows sparingly will also reap sparingly, and whoever sows bountifully will also reap bountifully. 7Each one must give as he has decided in his heart, not reluctantly or under compulsion, for God loves a cheerful giver. 8And God is able to make all grace abound to you, so that having all sufficiency in all things at all times, you may abound in every good work. 9As it is written,

"He has distributed freely, he has given to the poor;
his righteousness endures forever."

Socialists repeat after me: not reluctantly or under compulsion. Not Reluctantly or Under Compulsion. NOT RELUCTANTLY OR UNDER COMPULSION. And yes, the context is St. Paul's request for charity by the Church authorities herself for fellow brothers and sisters in Christ who are poor and needy, i.e. the Church, to whom we owe a higher duty than to those outside the faith. And this is given as a general principle concerning the nature of Christian giving and not limited to a specific instance. The reason is because if grace is required as a matter of justice, the gospel of grace itself is nullified because God (or others) owes us grace as a matter of justice as opposed to being an unmerited and undeserved gift that is not due.

Romans 4: 3For what does the Scripture say? "Abraham believed God, and it was counted to him as righteousness." 4Now to the one who works, his wages are not counted as a gift but as his due. 5And to the one who does not work but believes in him who justifies the ungodly, his faith is counted as righteousness, 6just as David also speaks of the blessing of the one to whom God counts righteousness apart from works: 7 "Blessed are those whose lawless deeds are forgiven, and whose sins are covered; 8blessed is the man against whom the Lord will not count his sin."

It is insane for Christians to accept modernity's expansion of the concept of justice, which is the only ideal liberals like Rawls can appeal to, into a conflation of justice and grace, which the State is only happy to encourage in its rejection of limits and desire to be the salvation of man.