A Moral Imperative

Monday, November 23, 2009
The debate over health care reform is really quite simple. The talking heads would like you to believe it's complicated, but really - it's not.

It's a simple matter of answering the following questions:
  • Do you believe that access to health care is a basic human right in an industrialized country?
  • If you don't, then you've condemned thousands to die because they don't have enough money, or because they lost their job (and their health insurance), or because they're used up all their benefits and have no more assets to sell. While I find such a position morally repugnant, those who are honest about it at least have the courage not to weasel out of their self-serving narcissism by obfuscating.
  • If you do, and you're intellectually honest, then you realize that such a position comes at a cost. That cost is...wait for it...HIGHER TAXES.
You don't get to say that you want universal health care (and a public option) out of one side of your mouth and then claim that such services won't result in higher costs. That's Bread and Circuses democracy, and that ways lies ruin. Somebody is going to pay. You can bet on it.

So it's simple - you either believe that basic health care is a moral imperative, and you're willing to pay for it, or you believe that the "fuck you, I've got mine" system is perfectly acceptable, and you don't want to give up any of your assets to assist those who need help.

I'm a self-described liberal. And I'm a fiscal conservative. The two are not mutually exclusive, and I believe the label used for people such as myself is "tax and spend liberal." I'm a proponent of social services that result in a higher quality of life for everyone, and I'm willing to be taxed at a higher rate to achieve that goal. What I'm not a proponent of is offering additional social services and then failing to provide sufficient funds to pay for them. A balanced budget is a thing of beauty, political hacks - learn it, love it, live by it.

Inspired by Jim Wright over at Stonekettle Station, this morning I've been thinking about how both sides of the health care debate are giving me high blood pressure with their partisan bickering. The basic issue is not rocket science, you weasels. Either you believe in universal health care, and you're willing to pay for it, or you don't give a good goddamn about it, and you're not.  Simple.

Now, execution? That's a different matter, and one of infinite complexity. Single payer, private insurance, public insurance, insurance exchanges, public options...it's mind boggling, and people of good conscience can disagree about the means we use to achieve health care reform.

But the partisan obfuscation, the grandstanding (*cough*Joe Lieberman*cough*), the sea of red herrings that are being thrown out in an effort to feather their own nests, or advance their own agendas, or save their campaign contributors? Transparent, buckos. Really transparent. And you're insulting my intelligence by attempting to make the issue into something it's not. I know health care reform is going to cost - I'm not stupid. And I'm willing to pay. For me, it's a moral imperative

Of course, not everyone feels that way. But can we at least be honest in the way we frame the debate?

16 comments:

Phiala said...

Yeah, that.

We need to pay for what we think is important, be it physical or social infrastructure.

The people making me insane right now are the ones claiming that universal health insurance will make it impossible to see your doctor because all those other people who never see doctors because they can't afford it will now be trying to see them.

So having to wait for non-critical doctor visits is worse than having large portions of the population with no preventative/routine care, who get what little health care they receive from ERs???

Seriously, people.

Warner (aka ntsc) said...

I'm willing to pay for it and I've got decent insurance already and get medicare in 3 more years.

Costs will go up, but not much, because ER costs should drop.

And it should cover everybody. Most ER costs are at the municipal (possibly county or state) level. Undocumented workers pay taxes to municipalites, either through property taxes or at the cash register. Same way to counties and to a lesser extent to states.

As well, and the feds don't want it well known, illegals do pay into Social Security in a lot of cases. They also pay the IRS, and they lose all of it.

Warner (aka ntsc) said...

Phiala

My Internist isn't taking new patients right now as he if full. His group tries to add Internists as needed so that the group is never full. their specialists really don't take many referals from outside the group

Phiala said...

I'm not saying access to doctors won't be a problem. I'm saying that's a dumbass reason for opposing universal healthcare.

Access to doctors could be achieved by providing some incentives to go into general practice, especially in underserved areas. There is a necessary lag time, but none of this is going to happen overnight. But wait... that's government meddling too, isn't it?

Janiece said...

Warner, when it comes to health care, I am so lucky. I've NEVER been without coverage, and neither have my children. And, like you, I'm willing to pay for other people to be as lucky.

And Phiala, I tend to agree - it'll all come out in the wash. We may have a temporary increased wait time for routine care (which we can, as individuals, totally manage), but eventually supply and demand will even out.

Eric said...

Everybody except a hardcore libertarian and/or anarchist is "tax and spend." The issue isn't taxing and spending, it's people disagreeing on what the spending should be on. I can guarandamntee you that if you tell the run-of-the-mill conservative you plan on balancing the budget by slashing defense spending he/she will become apoplectic.

I'm proud to be a tax-and-spend liberal. I brag about being a tax-and-spend liberal. The people who use the phrase pejoratively are morons.

Steve Buchheit said...

"That cost is...wait for it...HIGHER TAXES. "

For certain values of taxes. As a friend of mine said to a local republican chairwoman who was espousing on teh evils of having the rest of "Us" pay for the Public Option, she recently had to go to the emergency room, had lost her insurance because of layoffs, she was a charity case that we're already paying for (through higher premiums and direct government payments to hospitals to cover charity cases).

Some of the cost can be paid through shifting dollars already in the system, some through premium payments into the Public Option, and then some through taxes on the rest of us. Few will get it for free, and we're already paying for them anyway.

As to fixing the primary care doctor shortage, that will take a little more work at shifting priorities within the medical community. That change is going to hurt a lot more (and hopefully will be corrected through the market force of supply and demand, but I have a feeling Adam Smith's invisible hand will need some pushing there).

Janiece said...

Eric, I didn't mean to imply that "tax and spend liberal" was a pejorative in my eyes. I, too, am proud of the title, especially since the only other way I can push my social agenda is to be a "Bread and Circuses" liberal. Which makes me throw up in my mouth a little.

Steve, I wasn't trying to say that all the costs associated with universal health care would come from new tax dollars. Clearly there are economies of scale and purpose (such as your ER example) that will help to allay some of the costs associated with such a large undertaking.

I'm saying that the current "party line" spouted by the Democrats (No new costs! EVAH!) is disingenuous and insulting.

Steve Buchheit said...

Well, yeah. Although to be co-dependent with them by making excuses, I think it's the counter argument to "ZOMG we're going to be taxed into the dust because of this" coming from the other side of the aisle.

The Congressional Divide is giving a whole new meaning to pole dancing.

Janiece said...

You said it, brother.

Warner (aka ntsc) said...

I was without insurance for the weeks it took after discharge to find a policy. You could do that in the 70s, especially if you were young. I don't remember it as expensive.

I may have been without it between two jobs, but I had a new job before they stopped sending severence checks.

On the other hand my best friend got let go the same day I was, about 15 minutes after me, and he didn't get medical retirement. For him COBRA runs out in 5 more months. Everybody is healthy but he has two high school kids.

Tax and spend is better than borrow and spend.

Warner (aka ntsc) said...

Should have added, in today's market I would never get health insurance.

I've had a stroke and I've a recuring hand problem that requires expensive surgery.

Janiece said...

Yeah, that whole "pre-existing condition" thing is a real bitch.

mom in northern said...

How come no one has mentioned the ambulance chasing lawyer who contributes to the cost of Doctors liability insurance? There are Doctors taking down their shingles because of the cost of doing business…

Janiece said...

Mom, I'm pretty sure there was some talk of tort reform, but I'm not sure what came of it.

Jim Wright said...

I've said it before, I'll say it again here:

The difference between a liberal and a conservative is circumstance.

My dad is a staunch, and I mean hardcore, conservative. Period. He hates the ACLU with a passion - until the town council in his town passed an ordinance that he didn't like. Then they gave him a ticket and a fine for violating it. And suddenly, he was all up about The Man and wondering if the ACLU would take his case (they didn't, I did and got the council to rescind the whole mess).

Healthcare is the same exact thing. Those opposed have healthcare, and their response is almost universally - "get a job, Hippies, and you'll have healthcare too." Let those folks lose those jobs though, or be forced into retirement early, too early to qualify for Medicare - and you'll hear a different tune just as soon as they get sick.

My folks hate the idea of universal access to healthcare, it's socialism, get a job hippies, no government in our business - and they're on Medicare and have been for a decade.

Pointing out the hypocrisy got them to stop speaking to me for almost two months.