I’m busy painting a house up near the Hoyt Arboretum. It’s absolutely huge. It’s a monster, a beast, a behemoth.
It’s also a cash-cow.
(And that’s how I roll, in cash, because nobody will put me on their payroll, and so I’ve got to hustle to eke out a living. Who knew?)
Anyway, I don’t have time to cook myself a proper meal, let alone read the news. For what it’s worth, here’s a missive that I wrote in that thing I mentioned further down the page. Since I doubt many of you actually followed the link, let alone read all 46 long-ass comments (I missed a day or two, and all of a sudden I was 600 pages behind, so I feel your pain), I’ll just give you my most recent long-ass one. Take it away, me:
I’m tired. This might be cursory. It might not be. And I’m only responding to Andrew’s most recent post, because, frankly, we could argue for an eternity about all of this. And I want to move on eventually.
(As a side note and a preface, if we are ever in the same city with one another, and that city contains a saloon, we should go to that saloon, stage an argument for the cowboys for an hour, and have them shoot the two they determine to be the losers.)
Does anyone mind if I bring us back to square one?
Andrew, I can’t speak for Ben, but I think my own reasons for supporting a single-payer system over a strong public options are simple (and I don’t think, for the record, that single-payer healthcare, aka “SOCIALIZED MEDICINE!!!,” has a chance in hell of being passed by congress): the former is an end, of sorts, while the latter is a means to that end. Ultimately, we want a system that provides everybody with affordable healthcare. We believe that the current system is a failure. Why? Well, because some 50 million people are uninsured. It’s also ideological: liberals are people who believe that healthcare–at least in this day and age–is not a “good” to be treated like other “goods.” It’s not the difference between staying at the Ramada and the Ritz. It ain’t whether I eat foie gras or nachos. It’s whether I live or die, or it’s whether I go into tremendously crippling (literally and figuratively) debt because of an unexpected illness. People of a liberal persuasion believe that everybody, regardless of wealth, should be entitled (”ENTITLEMENTS!!!!”) to, you know, not suffer needlessly due to socioeconomic status. We assert that socioeconomic status is not indicative of a person’s willingness to TRY, to PERSEVERE, to COMPETE in some Darwinian sense; but, rather, that it’s contingent on history, race, sex, etc. We contend that the playing field, no matter how much we wish otherwise, ain’t level. (In fact, I think arguments to the contrary are dishonest, though you could certainly try to persuade me.) And we argue that we should do our best, as an open and democratic society, to provide the most disadvantaged among us the sort of foothold that will at least allow them the chance to live the, uh, so-called American Dream.
On that note, don’t give me any bullshit about Barack Obama or Sonia Sotomayor, please. These are exceptions that prove the rule.
Continuing with my original point, the most salient market failure of the moment is in healthcare, and the reason is pretty clear: As Ben argued earlier (I think–I skimmed, admittedly) health insurance doesn’t work in the same ideal capitalistic way that the buying and selling of other goods does. When I go to the grocery store, I look for a number of different types of, say, tomato sauce. I compare prices, I consider my experiences with various products (having purchased most of them already, I have an idea of what sort of intrinsic “value” I attach to them, relative to their actual cost), and I make a decision. If I’m making pasta with sauce, and that’s it, I’ll go for Classico, because of a cost-benefit analysis that’s unique to me. If I’m adding meat to the sauce, I might go with something cheaper, since I’ll probably add backyard herbs to the mix. If I’m making sausage and polenta and sauce (recommended), I’ll go with the cheap-o shit, since the sausage is going to dominate the flavor anyway.
That’s not the way people “think” about health insurance. They don’t get to experiment. Employer-based insurance is the de facto regime for the pre-Medicare set, and you don’t get much in the way of choice. You can pick a particular plan from your employer’s HMO if you’re lucky, but you’re always making a bet: namely, ‘I can pay what I can pay within this set of parameters, and not get what I hope not to get.’ For people of our age, it usually works out: we’re young, statistically unlikely to get a cancer diagnosis, etc. And it’s, of course, always good to have SOME insurance plan if you, you know, break your foot or something (which, I might add, I actually did, minus insurance, and which, I might additionally add, sucked).
The point is that the idea of a “rational” consumer, if it has any traction in reality, applies to things like grocery shopping. It doesn’t apply to things like health insurance. Most people aren’t rational consumers of health insurance. They don’t want to be.
And really, why should they nowadays? If pretty much every other civilized country in the world has some sort of universal coverage, is this not evidence that, No, the government does not ruin everything it touches? I mean, I’m as wary of wasteful bureaucracy as the next guy, but I wish we could all stop pretending that bureaucracy is confined to the public sector. Private health insurers waste a shit-ton of money on administrative costs. Overhead. A lot of it is wasted in the process of denying claims. It’s absurd. It’s a clear market failure. I’d cite statistics and evidence, but I’m sure that Ben already has, so I’ll move on.
The thing to take away from all of this is simple: people’s lives are at stake. If it matters, they’re American lives. If we can find a way to fund a ridiculously bloated (and, currently, misdirected) defense budget, then we can find a way (hint: more progressive taxation) to fund a guarantee of decent healthcare in this country. For everyone. Not just the ones with the referees on their side.
I.e. not just the 70% who are satisfied with the status quo.
(I haven’t read most of your comments, so pardon me if the above points have been addressed by one or both of you. I think, though, that the debate has gotten a bit too esoteric, and that we need to remember what we;re talking about every once in a while.)
So much for concision.
Back to painting the house. Hope I don’t fall off a ladder today.