Health Care Opposition Not About Being Uncharitable

I have seen several folks of late testing out a meme that opposition to health care reform is mostly about churlish unwillingness to help people.  My sense is that this is dead wrong.

As a strong libertarian, that may well be my motivation.  But the vast majority of Americans accept and support the government safety net and generally will support reasonable expansions of it to address true need.   I think most Americans would be willing to help people who honestly need financial aid to pay the health care bills.  This is particularly true for children -- you don't remember people going ballistic over SCHIP, do you?

I am not representative.  The vast center of this country is willing to accept, even embrace, increased government interventions in the right cause.  I forgot to blog on it, but remember that poll a few weeks ago that a majority of Americans think the government should required that women take their husbands last name after marriage?  I think the notion that there is any kind of sizable block of small government libertarian type folks out there is simply a myth.

So health care intervention and spending can be sold - again remember SCHIP but also the prescription drug bill.  I think the Administration is having trouble selling it in this case for two reasons:

  • They are having difficulty showing people who truly are not getting care.  Sure there are a lot of people who are uninsured, but I think that meme has been around enough for people to deconstruct.  Who isn't getting care?   Sure, for some folks getting care is a real hassle, but there are arguments to be made that accepting charity should not be that easy (remember the old Welfare?)  And sure, some folks have financial straights and can even face bankruptcy over health care bills, but our bankruptcy laws are incredibly generous and when tens of thousands are facing bankruptcy because they bought too many TV's on their credit cards, it almost seems honorable to face bankruptcy over your wife's cancer treatment.
  • The second problem is what I call the public housing problem.  In the late 1960s, Americans were concerned about the poor and homeless and spent billions to build housing projects for them.  It turns out that this doesn't work out so well, but that is not my point.  My point is that Americans could be convinced to spend money to build poor people government homes.  BUT their position would have been very different if investments in public housing required the rich and middle class who were paying for the program to move out of their homes and into public housing as well.That is the fear that I think much of America has today.  If asked, they would likely pay to provide government health care in an instance where it was demonstrated that health care was entirely lacking.  They would likely suspect that such care, like much of public housing, would suck, but as it was being offered to someone who supposedly had nothing, it would represent a net improvement.  But they don't want to move into the projects themselves, and frankly don't understand why agreeing to help poor people afford more health care also means they have to move into the government system themselves.
  • happyjuggler0

    Warren,

    But they don’t want to move into the projects themselves, and frankly don’t understand why agreeing to help poor people afford more health care also means they have to move into the government system themselves.

    Bear with me on the following questions, I have a point you might be interested.

    Are you photogenic? Do you spit when you talk? Do you break out in uncontrollable sweat when you are put on the spot in public speaking? Can you string together your thoughts into words as seamlessly when you speak as when you write here and at your AGW blog? Or do you break into stutter, or lose your train of thought?

    The reason I ask is, if you can pass the above with flying colors, I'd absolutely love for you to try to get yourself invited onto something like Larry Kudlow's show at CNBC (via satellite of course, most of the time anyway) to share your opinions on, well, on everything you share your opinions about here. I don't have any pull on getting you an invite, but you are oh so smart so I think that you could pull it off. Where there is a will there is a way.

    Seriously. Think about it, your country needs you. Your fellow libertarians such as I need you. Do it for the children....

  • happyjuggler0

    Hmmmmm. In my second to last sentence I used the word "I". Should it be "me" instead? Is it a subject or object?

    Anyone have any thoughts on the matter?

  • ColoComment

    "Your fellow libertarians, such as I, need you."

    It's the subjective form of the pronoun because it is the subject of the understood verb "am." If it were written in the long form, it would be: Your fellow libertarians, such as I am, need you.

    From a former English teacher who loved diagraming & think that it's a lost art:
    Dorothy in Fort Collins, Colorado, where we are enjoying a beautiful summer, at last!

  • ColoComment

    Oh, there I go and misspell diagramming (one too many glasses of Sauvignon Blanc this evening, dare I say.)

  • Doug

    "But they don’t want to move into the projects themselves, and frankly don’t understand why agreeing to help poor people afford more health care also means they have to move into the government system themselves."

    I absolutely LOVE this analogy. You have nailed it exactly on the head. Sorry, but I'm stealing your line.

  • MGW

    Public housing was never meant to house 1/6 of the population. I think the healthcare debate has been going something like this:
    1) Healthcare is really expensive (18% of GDP), which is something like $8k per person, note that this assumes 300mm people all get the same care. More likely, your average middle class person with insurance uses more than your typical uninsured person.
    2) Approximately 15-20% of Americans have no health insurance
    3) We should cover the uninsured and bring them up to the middle class standard of care
    4) Unforunately, covering the uninsured and increasing their consumption of medical costs won't solve problem 1, if anything it will make it a lot worse.
    5) Therefore, to solve problem 1, some form of rationing has to take place, which means that everyone has to be part of the plan.

    Healthcare is being sold as a way to reduce costs for everyone. I suspect that a majority of people would not choose to pay for the healthcare of others. However, it's being sold as a package that includes reducing costs. It's the classic case of the underwear knowns: 1) insure everyone 2)___ 3)cheaper healthcare for all (profit)

  • MGW

    Should be Gnomes - not sure how I mispelled that one so horribly.

  • Michael

    I think many politicians don't realize how many Americans have some form of exposure to British and Canadian health care. About 10 years ago, I was a poster in a newsgroup forum. A few of us started to chat over IM systems and it turned out while most of us were in the US, there were UK and Canadian members. We had a British fellow that needed a heart transplant and we waited with him to see if the government there valued him enough to approve the transplant. He got an infected transplant which required a second transplant. We had a Canadian gal that came down with pneumonia, and while she got to see a doctor, she had to return to work while infected until she could afford the medication.

    Now I read papers and follow events in Europe and Canada, but over the last 10 years I got the hear from people just how crappy the health care was in their country. So when a politicians says "but the British this", "and the Canadians that", I know it's not true and I know I'm happy with the care I have.

    So I don't think most Americans put the degree of intellectual thought in to the health care issue as you have, but in the back of their minds their instincts tell them reform isn't good.

  • dri

    "BUT their position would have been very different if investments in public housing required the rich and middle class who were paying for the program to move out of their homes and into public housing as well."

    Best explanation I have seen of why most Americans are against Obamacare.

  • happyjuggler0

    ColoComment, a.k.a. Dorothy,

    Bless you.

  • Michael

    I don't see most people looking to the public housing programs of the past and making the link to a current issue like health care. People are just to short term minded. If you want to use public housing as an example, use Section 8. People know it's a government run program, and they know they don't want it anywhere near their neighborhood.

    For most people today, it's easy to compare apples to apples in the health care debate without bring in an orange. Most people are smart enough to know they aren't going to get congresses apples. And they can see the apples congress "gives" to vets and seniors, so they realize it's best to stick with what they currently have, even with the flaws.

  • shunha7878

    I just found your web sit from Moonbattery. I like your point about housing projects and government system of health care. The reason I am at your site is infant mortality. Do you also have something on people living longer in Canada?

  • DKH

    Shunha,

    You should try a google search for such things; for example, use the search query

    site:coyoteblog.com infant mortality

    in google. That gives results like this one from a year ago:

    http://www.coyoteblog.com/coyote_blog/2008/08/why-does-the-us.html

  • CT_Yankee

    shunha7878,

    You have to be very carefull about comparing infant mortality between countries, because they each gather the information so differently. Some do not even count stillborns, or if the baby doesn't survice at least 24 hours or a week.

    A couple I know did not expect to be able to have a second child at all, and when it happend, the pregnancy was very delicate. The child was born very prematurely because the umbilical cord was choking it. Tiny size and possible brain dammage put this child's future in doub't, however the superior American healthcare system means the kid will have a chance.

    In most other countries this child would already be buried. It would have been counted as stillborn, and thus would not be included in some country's infant mortality statistics. By getting the baby to live at all, the American healthcare system has accepted the risk of later losing the child.

    The greatest heart surgions often have poor patient recovery rates because they accept the challenge of trying to save people in such bad condition that lessor skilled doctors would not even try. Medical statistics are very hard to compare, because so many unmentioned things can make all the difference.

  • Link

    There's a back story to public housing. Back in the the 1940s MetLife created Stuyvestant Town in Manhattan and Parkchester in the Bronx as working class housing projects that it owned privately. They worked well, especially post WWII. Many of the tenants were NYPD. MetLife was merciless at kicking out families whose kids caused trouble. Rents were just a bit below market, the waiting list to get in was long.

    Robert Moses thought government could do the same thing on a bigger scale and so got NYC into the public project business. Like a lot of things Moses started in NYC, the federal government bankrolled elsewhere.

  • http://evilredscandi.blogspot.com EvilRedScandi

    I think that you have to be careful in distinguishing people's gut reactions to positions they take after they've thought things through. I don't know about the rest of you, but if I had a dollar for every time I took somebody's fervently stated opinion and then had them just as fervently believing the exact opposite five minutes later, I'd have retired by now. My own (considered - I promise!) take on this is that at least three generations of Americans have been taught by the public school system that they should not to think too much - just swallow what you're told and vomit it back up on command. These practices are then applied to things they learn from on television, movies, their parents, their church, their boss, etc. Their heads are filled with conclusions whose dominance is determined by "what sounds best." Then they go around responding to polls, giving "man on the street" television interviews, (choke) voting, and (gag) getting elected to office.

  • Dr. T

    The weirdest thing about the Obamacare debate is that the supporters don't ever talk about what's in the bill. They talk about the currently uninsured (irrelevant). They talk about compassion and care (government won't be more compassionate than private companies). They talk about a safety net (irrelevant). They talk about how having federal health insurance will increase competition and cause the private insurance companies to lower prices (completely incorrect).

    None of those points represent the purpose and effects of the bill. The purpose of the bill is to get another federal tentacle in the door of the largest non-government sector of the economy. It already has at least five tentacles in the door: Medicaid, Medicare, CDC, NIH, and the Indian Health Service. Federal health insurance will be the thickest tentacle. By using taxpayer money to subsidize the insurance, the feds can offer below-market-value premiums, and, of course, the "poor" (however defined in the final bill) will get free or reduced cost insurance. The low premiums will attract many people. Small businesses will drop health insurance and tell employees to buy federal insurance. Once tens of millions of people have signed up, Obama will declare that this shows how much the people want government-run health care, and he will push for the next step: federal government single-payer care. And, with one more step, we move to socialist medicine where all health care facilities are nationalized and all health care employees are now federal employees. That's the plan and the progression that the Obamacare supporters don't talk about.

  • Michael

    I was wondering about 2 things. How would Americans act if another country passed the US in GDP. And if a medical price transparency movement began to form, what groups in America would oppose this idea.

  • sabril

    I basically agree. Pretty much everyone knows that (1) If Obamacare doesn't work out very well, it will be used as an excuse to make the program bigger and more invasive; and (2) if Obamacare does work out, it will be used as an excuse to make the program bigger and more invasive. Thus, there is a good chance that the program will naturally grow once started.

    In essence, we would be planting the seeds for socialized medicine.

  • tim

    What a foolish analogy.

    It might make sense if after all those public housing projects created some kind of moral hazard that led to the eventual end of private home ownership. But that didn't happen. Creating housing projects didn't lead down the slippery slope to socialized housing.

    A more apt comparison between the 60s and today would be the racist opponents of open housing laws, who used arguments about the sanctity of property rights to avoid looking embarrassingly racist.

  • Scott Wiggins

    Obama and the dems would have more success selling their healthcare proposals if they were more honest with the American people. Tort reform has scarcely been mentioned in the debate yet Americans know that the legions of lawyers who make their livings sueing doctors and insurance companies drive up costs...As well, excessive litigation has precipitated defensive medicine where doctors do test after test in order to protect themselves from charges of negiligence which again drive up costs...Americans know that any serious healthcare debate must include tort reforms and so they clearly see that Obama and the dems mean to sell yet another government bill of goods for which they will get the bill...

  • signalfire

    Just wanted to point out that the White House is public housing...

  • Michael

    Howard Dean admitted that tort reform would cut costs, but since the current house bill is taking on many entrenched interests, it wouldn't be irresponsible to deal with the trial lawyers. I believe there is a section in the house bill that will expand the ability of lawyers to sue. It was something like they could sue as a 3rd party to collect a medical bill without the approval, consent or knowledge of the person owed the debt.

  • http://www.activhull.com Ben Gardiner

    Just don't do it. Once you give the state control over your healthcare, you will give it control over your lifestyle.

    Just look at the latest totalitarian nonsense which has been introduced in Scotland:

    http://thescotsman.scotsman.com/scotland/Bar-staff-to-be-banned.5600156.jp

  • sabril

    "Creating housing projects didn’t lead down the slippery slope to socialized housing."

    I agree. The difference is that pretty much nobody is demanding that all Americans live in public housing. If there were a signficant movement demanding that all Americans be charged a "housing tax" and receive housing from the government, I would be much more wary of any plans to increase government involvement in housing.

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