Bricker, wouldn’t you be having an easier time of it if you had a better case? You advocacy skills are on display, as per usual, as what we would expect from a smart man who advocates professionally. But a man who advocates professionally must, at some point, find himself advancing a weak case, making the best of a bad hand.
Isn’t that the situation here? If you had a better case, couldn’t you say “Well, look, other nations as diverse as Germany, Ireland, Canada, Japan…they do some version of UHC, and are going along quite well. Not perfect, certainly, but not subject to the brutal methods we see in play here. We have direct testimony from the people involved, leaning solidly in the direction of “OK, not perfect, but OK”. Given the wide disparity of cultural norms and ethnic values, the only thing that they have in common is this form of health care, and it works.”
Wouldn’t you just love to have that argument to make, rather than falling back on ever more excruciatingly exact semantic hair splits? If you had the better argument, would you be compelled to buttress your points with ethereal abstractions like “spirit” and “gumption”, basing your argument on a firm foundation of cotton candy and marshmallows?
Your skills are not in question here, they are on display, and are formidable. But they are in the service of a weak position. No doubt, at some point, you have been compelled professionally to argue a position you know to be rather weak, to make the best out of a bad hand. (Unfortunately, this is a situation where bluffing simply won’t work.)
When you have had to do so, didn’t it look a lot like this does?
We look forward to your eventual turn from the path of political error, the calf is fatted, the guest list grows daily. And it will be easier, too, I can safely offer my preferred content-free one-liners, secure in the knowledge that our wise latino bulldog can be unleashed, to rend our enemies arguments into shreds and gobbets of torn flesh.
It is sad, really, to see such skills wasted on such a weak position, its like sending an Olympic swimmer to a meet but insisting he carry a bowling ball in a backpack while he competes. Its wonder enough he doesn’t drown, its too much to expect any medals.
You are a man of reason, and reason is your friend, but it is a harsh taskmaster. When you find yourself holding your argument together with scotch tape and invocations of ethereal presences, you are in deep kim chee. I suspect you already know this. We await you with calm anticipation. The angels will not sing any more than usual, I’m sure, but at least one aging hippy will applaud most generously.
(Well, I’ll be darned! Did you know that my spell check thinks “hippy” isn’t a word?)
What’s most amusing to me through this whole thread is Bricker’s stance on “Millions for defense, not one cent for tribute.” Er, don’t you work in the defense industry, Bricker? And what’s Catholic for chutzpah anyway?
Well, that was only to point out the obvious parallels between the seafaring marauders based in Tripoli and universal health care, which would probably be more glaringly obvious if I were smarter. I am loathe to confess it, but I still don’t see any such similarity at all. Alas.
It has been expunged from the US English spell checker for being to socialist. Try a British English or Canadian English spell checker. (Well, no, that’s not true. Try spelling it with an “ie” rather than a “y” for the noun form.)
The perception of basic social responsibility as “tribute” is, I think, the fundamental pathology in Bricker’s thinking. It’s also completely counter to the Christian values I thought conservatives were so proud of.
Oh, I completely agree with that too. Historically, the phrase meant "Millions (when ‘millions’ was more like ‘billions’ today) for defense, not one cent for bribes to a foreign power. Caring for the sick is intrinsically similar to bribery? Caring for our own is just like paying off a foreign power?
So far we’ve heard plenty of “Bricker logic” against UHC:
I don’t want government to pay for healthcare, because there are more important things than potentially keeping people alive longer, like defense and roads.
It’s God’s will if I or others die because we couldn’t afford healthcare.
Paying for healthcare will result in a national shortage of entrepreneurialship and gumption.
Even if I have to pay more for healthcare, I’ll bask in the satisfying knowledge that others who didn’t deserve it aren’t getting it.
And he’ll scream till he’s blue in the face that, no, Duke’s misrepresenting me, my position is more nuanced than he can possibly understand, blah blah blah. Yeah.
Ariely has a chapter in Predictably Irrational describing an experiment where making something free drove up demand. I can imagine that the nominal co-pay requirements we have now help by making things not free anymore. It is true that any visit to a doctor has cost, but I suspect people assign time off from work costs and transportation costs to different mental buckets.
However, can you give some instances of patients demanding extensive testing, and doctors agreeing? I can imagine some highly educated patients, who have researched their condition, asking questions that might lead to tests, but I can’t see your average patient even knowing the tests possible, let alone “demanding” them.
By the way, how does one go about getting a hangnail on one’s foot? The hangnails I get are almost exclusively the result of my habit of using my teeth to groom my fingernails.
Well, let’s distinguish between two different factors: unhealthy behavior/habits, and overutilization of the medical system.
The former is ludicrous, as people just don’t think about how much a coronary PTA will cost while scarfing down a burger, or whether they’ll be able to afford the ER visit while bungee-jumping. (Conversely, they also don’t think about how much money they’re saving by being healthy.) I assume that’s fairly obvious.
Now, as for overutilization, I agree that it’s a problem, but far less of a problem than the costs of *not *covering people and paying for emergency treatment, dialysis, etc. That doesn’t mean that there is no waste to be extricated from the current system. But it’s a two-way street. And cost controls are best achieved on a system-wide level, by not only incentivizing preventative care, but also encouraging healthy lifestyles through social programs, the design of cities, etc.
I personally support a single payer system, but would not be averse to co-payments, so long as they were fairly nominal (e.g., the price of 2 sandwiches) and linked to a person’s wealth (so that the truly destitute would not need to pay anything). I think co-pays are the least controversial health insurance company collection method, and have never heard anyone voice opposition to them specifically.
Unless I’m much mistaken, Meltzer and Richard 1978 is “Why government grows (and grows) in a democracy”, with Meltzer and Richard 1981 being “A rational theory of the size of government”.
But I haven’t read either, though if I’m right about what they’re about, I think I’m vaguely familiar with the general argument, the relationship between the deciding voter and mean income in determining government size.
We already have universal emergency room care. We don’t specifically need to adopt UHC to avoid bankruptcy–we can simply refuse to treat people who don’t have health insurance. We can have the ambulances leave those people bleeding to death in the cars. We could also strip Medicare from granny, or at least severely curtail it. These are non-UHC solutions to the budget problem.
But if we’re going to pay for these things (and politically, that issue is not up for debate) then we must find some other way to finance it, because our present ad hoc system is not sustainable. I did not make an argument about the specific need for UHC. I made an argument about the fact that the present system, if left unchanged, will bankrupt the country. It’s true that I emphasized the efficiency of UHC compared to what we have, but later in my post, I even went so far as to mention one libertarianish suggestion, quite different from the current proposals, that might work to solve the problem. But if you want a cite specifically about the unsustainability of the present system, I can provide that.
The CBO actually divides the situation into two scenarios. The first is what I like to think of as Congressional GOP bankruptcy plan, “No taxes!”, where we surpass WWII debt levels, as a percentage of GDP, quite quickly. The second isn’t much better, though. It takes three and half decades to reach WWII debt levels, but that’s even with unprecedented levels of taxation. This current situation is, as people have been pointing out for pages now, not sustainable. And that’s been obvious for years now, literally years, for anyone who has bothered to take this situation seriously.
Meanwhile, we have the ready example of universal systems which are, yes, much more efficient than what we have.
Alright. I see what you’re saying here. I don’t agree at all with it, but maybe this is a legal/scientific terminology difference. A scientific hypothesis isn’t evidence by itself. It needs something else backing it up, real facts to give it support, or else it’s baseless speculation.
But we can use your definition. I’m not a semantic nitpicker. I’ll be happy to refer to my objectively measurable stuff as “data” and your idle speculation as an extremely weak form of “evidence”. This doesn’t change the situation.
Your fundamental claim has never been the surface level efficiencies (or inefficiencies) of universal coverage. You said that it was “myopic” to refer to these surface level efficiencies. Somehow, it was myopia even when I specifically mentioned a decades-long planning horizon. Regardless, the argument you actually put forth was, by your own admission, broader, that implementation of this program will cause an even deeper and more serious harm to the long term prosperity of our country, “what made our nation great”, than the benefits we receive from the obvious, abundant, incontrovertible (and somehow “myopic”) data that shows the efficiencies of a universal system compared to what we have.
And for this very broad and very extraordinary claim, for which reasonable people would require very extraordinary evidence, we still don’t have any reliable data. None at all. You have exactly jack going for you on your most absolute, absolutist principle on which you have totally relied.
Your evidence, as you refer to it, is so entirely hypothetical that the negative effect, which you have prejudicially decided to be the overriding factor in this discussion–conveniently allowing you to ignore all the real data that’s thrown at you–quite likely does not exist. You are relying on the overwhelming importance of a factor that we have no objective reason to believe is even true. And even if it were true that a negative effect did exist–which we have no cause to believe at this point–we still would have no cause to believe that the negative effect is anywhere comparable to the real damages that are facing us down right now, plain as day in the data we do have.
You are emphasizing the overwhelming importance of a hypothetical fantasy, a chimera, a factor whose very existence cannot be established, and you are further giving this fantasy an emphasis over the very real, very verifiable facts that people have been slinging at you for pages. You are doing this because to accept the verifiable data would destroy your position. Well, no, I can’t falsify a fantasy. This is in the exact same sense that I can’t falsify the idea that the universe was created five minutes ago, and all our memories of previous months and years were just implanted within us when the universe began five minutes ago.
And here’s the kicker: When people point out these real costs with real figures, you compare us to Maoists. You claim that we’re the ones who are “myopic”, that we’re the ones who aren’t facing up to reality, that we’re the ones who have “no idea” how the world works. That’s just gotta be the piss icing on this turd of a cake.
I’ve been dealing with specific criticisms of your irrational principles, not singing the hosannas of the current less-than-ideal bill. You want to discuss ALL care? Well, okay. Discussions of ALL care are already summed up by the efficiencies of universal systems in other countries. You remember those efficiencies? The ones you said were unimportant? The ones you said it was “myopic” of us to discuss?
Is there a danger that free health care will cause overconsumption? Yes. Of course. But health care, even subsidized health care, does not have to be completely free. Other advanced countries have found ways of dealing with those problems to create, as we’ve said a thousand times, a system that is ultimately more efficient than what we have now. That does not mean that those other systems are ideal, the best of all possible health care systems. But it is yet another indication that our present system is a nightmare that can’t continue as it has been going.
If you want to talk about disincentives such as welfare can create, then that’s important, but it’s still a different situation. Welfare provides such a disincentive to work because it provides people with what they need to crawl around on the dirty surface of this planet for another day. Going to a health clinic, in contrast, won’t fill an empty belly, won’t put a roof over your head at night, won’t fill your tank with gas, won’t fill any other essential everyday want or need. People are still going to have to bag groceries at the local super, or flip burgers at McDonalds, or steal your TV and pawn it, if they want to scratch up some cash.
That’s the typical cause and effect mechanism that’s related to welfare. If you want to argue health care is similar by analogy in this respect, then you need to do more than assert the analogy and feel smug about it. You need to argue why cash payments, which provide a fairly clear disincentive to look for gainful employment, are similar to a new magical disincentive–for which we have absolutely no data–that people won’t want to go to work if suddenly the government helps them out with the doctor’s bill whenever they catch the sniffles.
Unlike you, I’m not going to bring the broader group into it and mock all conservatives for your own puerile attempt to ridicule something you haven’t even thought about before. It isn’t the fault of conservatism at large that you deliberately refuse to engage your mind. This is on you, alone.
The last time I read about a happiness index was quite recently, from a laissez-faire libertarian economist whose ideal government size corresponds to the Singapore model. It popped into my head precisely because an honest libertarian honestly accepted the idea. I think he’s a bit kooky sometimes, but at least he’s forthright with his beliefs. He was arguing against the implication of the index in that particular case (and personally, I don’t favor it either), but at least he had the intellectual decency to engage the idea on its own terms, without flippantly rejecting it without any consideration at all. He had enough integrity to not summarily dismiss a measure whose implications he disagreed with.
And now you place yourself proudly in the company of all others who hold blindly to unprovable, unfalsifiable beliefs.
The world was created 6000 years ago. Any data to the contrary must be a trick of the devil, because the world was created 6000 years ago. Humankind is not related to the other great primates, or to any other species at all (god just designed us to have 98% identical DNA), because the world was created 6000 years ago. The light from stars that appear to be older than 6000 years old aren’t older than 6000 years old (the universe was created with that light already on its way to earth), because the universe was created 6000 years ago.
I know the drill. I know how this mindset works. With enough logical twisting, absolutely anything can be made to fit the original premise.
I haven’t been denying the logical soundless of the ridiculous inferences you’ve made from your ridiculous premises. I even explicitly acknowledged that you are, indeed, logically arguing from your ridiculous premises:
The problem is, and has been, and will continue to be that your premises are horseshit with no substantive basis. They’re ridiculous. And because they are unfalsifiable, they are the very incarnation of irrational fundamentalist thinking.
And now that you’re permanently on the record as a market fundamentalist with unfalsifiable beliefs, there’s nothing more to discuss. I don’t attempt to reason about adult issues with people who claim that satan planted evidence to trap humanity, and I will spend no more time talking to you about efficient public policy for the very same sorts of reasons. With your unassailable premise, you can ignore every fact in the world.
It is easy for me to imagine that while a very small subset of people may demand needless and completely unnecessary medical tests and procedures under UHC if everything was somehow free. Yet, the vast majority of people are not likely to do so precisely because most people would get no perceived benefit from something patently needless and unnecessary. Why is your imaginative scenario more valid than mine or anyone else’s? Moreover, since medical copays are generally small - at least in relation to the treatment or function the insurance is covering - how is such a small fee holding back this potential flood of frivolous medical tests or procedures?