Further Exploration of Universal Healthcare: A Rejoinder to Brandon's Rebuttal

Admitting a temporary and humble agnosticism regarding its feasibility and the details of an efficient implementation of it, I recently put forth an argument in favor universal health care and asked for feedback from any perspective. I got some. I here briefly, respectfully, and charitably respond to the text of Brandon's initial reply.

I am learning a lot about health care as I wade through articles, which is good since I don't know anything. I am continually humbled by the amount of detail involved in some of the issues on which the matter is hung. Let it be known that I have not yet made up my mind with certainty.

At this point I am most interested in arguments against universal health care, since I lean in the broadly stated direction "in favor of universal health care". Brandon's position constitutes one such, and I am therefore compelled to evaluate it as best I can.

I appreciate Brandon's work in replying to my little post, and I appreciate that he cited a lot of material. He also took the initiative to apologize for the fact that he "gets worked up" over the issue. I accept his apology.

Sometimes its easy to let our emotions get in the way of our reason.

He opens:

The chart you linked to tells us absolutely nothing.

While uncertain of exactly how to interpret this claim, I feel the need to point out that the chart lays out various facets of the health care systems employed by several nations. I want to draw attention to the facts that Sweden and other countries (whose health care is basically universal) have higher life expectancy rates, lower infant mortality rates, higher ratios of physicians to people, higher ratios of nurses to people, lower expenditures per capita on heath, lower ratios of cost to GDP, and lower ratios of health costs to government revenue than the United States (whose health care is partially free market). These are quantifiable, falsifiable facts. And they are "absolutely something" as far as a conversation on universal health care is concerned.

The reason is that from what I can tell, the politically libertarian, or generally anti-universal heath care, argument is constituted by two horns: the class of arguments in support of the claim that it is basically morally wrong for the government to implement universal health care, and the class of arguments in support of the claim that it is pragmatically wrong to do so.

Q.E.D., the facts that seem to support the claim that universal health care can accomplish generally higher standards for generally lower costs constitute the essence of a rebuttal to the pragmatic horn of the opposing argument, and thus ought not be simply dismissed out of hand.

At the very least give me some sort of reason why I should agree to classify such a chart as one telling us "absolutely nothing". Surely you don't expect a man with leanings in favor of universal health care such as me to simply accept such a bold and unfounded claim without so much as a polite questioning as to its motivation or rational grounding!

Throw me a frickin' bone here.

The article that you linked to from the conservative/libertarian obviously does not understand what libertarianism is.

Personally I can't speak to the completeness or accuracy of this man's understanding of political libertarianism, since I neither am him nor have a personal intellectual relationship with him. However I am interested in why you think this to be the case.

You seem to be under the impression that America's current health care system is a free market.

Nope. Well, I freely grant that the current health care situation in America is not laissez-fare, anyway.

...I am not skeptical about how bad things are here, I accept that they are bad...

Common ground! Excellent.

...that is because it is not a free market.

To be fair now, the problem with (and ipso facto the solution to) the health care system in America is precisely what we are arguing about. Confidently reiterating your position does very little persuasive work.

A centralized military is not run best by the federal government and coinage is ABSOLUTELY NOT run best by a federal government.

THEY ABSOLUTELY ARE!

If you want to protect the most individual rights possible, then obey the constitution.

Does the term "rights" in this phrase reference transcendent human rights, or "constitutional rights"? If the latter, your phrase is tautological and uninteresting.

However I suspect the former, which brings to mind some questions I've been wanting to ask an intelligent libertarian (if that isn't an oxymoron - oh snap! JUST KIDDING DON'T FREAK OUT!)

In earnest, I wonder whether you genuinely maintain that the United States constitution prescribes the defense of a well-defined, complete, accurate, and concise list of transcendent human rights. Will you please speak to that?

My other question is in regards to your advice to "obey the constitution", and it's this: can you be any more vague, please?

If you don't care about rights, follow Europe's example.

Genuinely attempting honesty with yourself, any readers of your reply, and me, please answer this: do you seriously think that "follow Europe's example" is well-defined enough to compel, merit, warrant, or even provide for the reasonable rhetorical possibility of, a response to your comment? In light of your answer to the former question, do you therefore think that I ought to reply to it, under any construal of the term "ought"?

Your answers will determine whether I interact with this paragraph.

If you really want American Businesses to be more competitive, get the government out of the market place.

While it is tempting to give this a full treatment under this post, I am going to refrain. The reality is that this comment completely sidesteps my argument. You have not addressed whether the forces I cited may operate upon American business, to what degree, at what expense, or whether such operation is relevant. Your failure to interact with the agenda I initially set is tantamount to a failure to compel, merit, warrant, or even provide for the reasonable rhetorical possibility of, a rejoinder.

...Are you suggesting that the cure to the common cold is government provided healthcare?

No, I didn't intend to imply that. I simply meant to state that a larger number of citizens would be covered under universal health care, which would have general benefits for America's workforce and consumer base.

...We don't need to raise Stalin from the dead in order to make a "democratic" decision for the people to avoid getting sick.

AHHH MOTHERLAND!

[Hint: Hover over picture.]

...Will people drive less if gas is free?

Note how I didn't claim that health care would be "used less" if it were universalized. I claimed that universalization would be a force toward balancing the use of health care. And I cited two possible ways that this might obtain: 1. rather than avoiding visits to the doctor in order to avoid expensive co-payments, one might feel free to visit the doctor, and 2. rather than visiting a doctor at the drop of a pin just to take advantage of a really nice employer-provided plan that might not have much longevity, one might feel confident in making it a practice to wait before going in, knowing full well that health care will continue to be accessible.

Health care is not a commodity in the same way things like gas are. One difference is that it is easier to consume more and more gas as prices drop (e.g. "I'll just take another trip out to Seattle this weekend to capture some additional shots with my new Canon Rebel, since I don't have any obligations and gas is only $.02 per gallon." versus "I'll just go get another brain surgery this weekend, since I don't have any obligations and health care is basically paid for by my government.").

"Ver are yer papers!"

EXACTLY, this is what we're trying to avoid! Instead of being asked for your papers, your medical professionals will already have access to them!

I don't want a government file on my entire life.

[Note how I cited a centralized database of medical records as one reason to consider universalizing health care.]

...If people don't like the amount of paperwork they have to go through to change a doctor, then the market will provide a solution.

I don't recall making a bar-none claim about the inability of the free market to reduce paperwork. I intended to make a claim about the ability of a universal heath care system to do so.

Even if you raise other complaints against the notion of a centralized medical database, or ideas for how such a database could be coughed up by the free market, you have to admit there exists benefits to such a database including, but not limited to, types of efficiency not enjoyed by a situation involving various different types of databases.

And you have to admit that universal heath care, regardless of what other complaints you raise against it, is a good context for developing such a database. These two facts ought to have some weight, however small, in one's consideration of the matter.

I don't understand how an entreprenuer like yourself doesn't see this.

I readily and passionately hail the virtues of free market forces, but fail to concede that they, left alone, are always the best, most moral and efficient, forces to see every task through in every situation.

On the topic of entrepreneurship however, I would like to mention the difficulty and expense of obtaining single or small-business heath care in today's America. This is a repelling force. Eliminating it would cause a net attraction to entrepreneurship.

Next is the question of fraud. Now, my mother used to work in medical record reviews. Insurance companies contracted with an individual who outsourced to my mom. Her job was to review and summarize a host of various sorts of medical records obtained from various providers. Her reports were used to help determine whether an insurance claim was legitimate. She got to see how much paperwork and circumstance was involved in mitigating fraud. Keeping medical records all in one place, electronically summarized, would be a force toward mitigating fraud.

The situation I illustrated in my post was a bit different. I brought up illegal aliens (I opt for this term instead of "individuals present in our country by means forbidden by our laws" so that conservatives reading this can understand me. But let the record state that I harbor a distaste for the phrase). Should the demos determine that America doesn't want to cover their health care, the centralization of information and resources would certainly help us to mitigate against their abuse of the system.

However instead of interacting with this, Brandon says

Government is the biggest fraud out there.

Okay.

So now you are suggesting... that the government should hand select people to be excluded?

Uh, no; I specifically clarified my suggestion by referencing people "we agree ought not be part of the system". I even offered the example of illegal aliens as one such class of people that we (the demos) might decide ought not be part of the system. But honestly, come on, do you really think I would be in favor of governmental hand-selection of this sort for this matter? How could you possibly justify such an interpretation of my rhetoric? I demand an explanation.

...private practices will no longer exist...

Wait - did I make this claim, or are you saying that this is an inevitable result of universal health care? I don't think I ever advocated the abolition of private practices, so it must be that you are claiming that this is a regrettable and inevitable result of universal health care. You don't expect me to stand by and watch you slip such a claim into the midst of your rhetorical flourish without pointing out that the burden of proof lies on you to establish such a claim, do you? Consider such burden officially pointed out.

Sounds a little totalitarian to me.

Since this is a a straw-man characterization I feel no need to verbally undermine or rebut it.

You said you're not a commie, but I don't buy it.

Sticks and stones, Love.

Look, even if my ideal State were congruent with that of any true communist, I have explicitly cited democracy over and over again as my preferred means of driving governmental change. This alone fundamentally separates me from Marxist prescriptions (which include the violent overthrowing of the State by the proletariat if necessary) as well as any and all derivatives thereof.

Thus it is simply unfair and inaccurate to classify my politics as Communist.

As to whether I personally am a Communist: Idaho doesn't require or allow voters to register with political parties, so it's simply not possible.

And in addition to these two points, allow me to clear up a common misconception for you. "Socialism", broadly defined, occurs when the State is in control of the means of production and/or the product (for example, the United States military is socialized under this definition because the Executive branch controls its rearing and the President [with the approval of Congress, theoretically] decides when, where, and how it's used), while "Communism", broadly defined, involves the abolition of the State and of private property (for example, the view of each dusk sky is communized in America - the government doesn't control the production or substance of any given sunset, and no individual has any private ownership of it either). Granted, these two terms are conflated all the time, due to their etymologies and colloquial uses.

So your very attempt at an ad-hominem was wrong-headed to being with.

Shame on you.

Instead of "Communist", try collapsing the spectrum of nuanced political theories broadly categorized as "Liberal" into "Socialist", since they trend toward State control, and I will agree to collapse the spectrum of nuanced political theories broadly categorized as "Conservative" into "Communist", since they trend away from State control.

If anything, you are the communist.

I guess that's not fair, since you seem pretty individualistic. I'll try again.

You dirty anarchist.

If you wanted to be charitable and accurate in order to butter me up so that I stop calling you names, you could call me "an advocate of democratically driven socialization of health care in America today".

[Note: I am choosing to skip the rest of Brandon's comments under section 5, because I feel I have already addressed them. I am willing to rehash or clarify my position on these issues upon request, however.]

So private businesses are too stupid to figure out how to reduce costs?

Again, I did not claim that private businesses are incapable of reducing costs, but that universalizing health care in America today would reduce costs (cf. also the useless chart I cited toward the beginning of my original post).

Are you suggesting there is something wrong with the profit motive?

Not inherently, no. However I fail to concede that it, left alone, always drives the best, most moral and efficient, circumstances through in every situation.

If people don't like the way their insurer handles things, they can shop elsewhere.

I am speechless that you just made this claim.

Again, the problem is government's intervention in the system.

Again, the problem is precisely what we are arguing about; reiterating your position does very little persuasive work.

Medicare and Medicaid tie doctor's hands more than anything else.

Oh no you di'n't just bring up Medicare.

I suppose we should have Federal Grocers, Federal Car Lots... Federal Abercrombies, Federal Apple... Federal Web Designers, Federal Movies...

Cf. "Slippery Slope Fallacy"

If doctors are prescribing drugs that do not help their patients, their patients will cease being their patients.

Instead of contest this claim on the basis of any of several things wrong with it, I will say that I can and do still recognize that the idea behind it is a type of free market force that, simply put, does exist and operate. Nevertheless, I remain unconvinced that such free market forces, left entirely alone, are always the best, most moral and efficient, forces to see every task through in every situation (cf. Howard A. Green, MD, FACP, FAAD, FACMS of Palm Beach County Medical Society. What Government Does Better: Health Care. Available online, at The Physicians for a National Health Program Website).

The reason drugs are expensive is because of the FDA, get them out of it.

Oh, good point, it's all very clear to me now. Let me just go push "power" on the FDA to turn it off.

All hail social progress! I'm pretty sure Hitler used that one.

SIEG HEIL!

Cf. "Reductio ad Hitlerum Fallacy"

[Note: It was Bismarck who established a type of universal health care in Germany, prior to HItler. Bismarck hated the Socialists.]

Honestly though, way to bring up the two most extreme historical caricatures you possibly can. Why not mention any of our various contemporary, wealthy industrialized nations, since they have all instituted some type of universal health care?

It is becoming apparent to me that you tend to think in extreme, and often false, dichotomies. For you it's all or nothing. It's either on or off. You lump the entire gamut of political theories into the poles of (laissez-fare) free market/ capitalist/ libertarian/ anrarchy and nazi/ bolshevik/ fascist/ communist/ socialist/ totalitarianism. Either the free market is the best, most moral and efficient, means of seeing every task through in every situation, or a dictator is. Either we give every single thing over to unchecked federal control, or we shrink the government into nothing and let the free market handle everything in time.

I think that if you make an honest attempt at thinking more holistically you will discover some nuanced middle ground and perhaps a couple shades of grey.

Are you seriously try to say that the politicans are the victims here?

Nope.

[Note: The following comment was made after a reference of mine to "insurance companies".]

...you could vote for Ron Paul and have him abolish all their agencies.

Ron Paul would abolish private health insurance agencies? Great! How are we going to get health insurance then!

Socializing anything does not increase individual freedom [at all], it decreases it (emphasis and brackets mine).

This is a good summary of your position, but I fail to be convinced that it is true. I've even offered a counterexample wherein the people of America freely vote to establish universal health care and thereby free individuals from the force of the repulsion that the difficulties and costs current individual and small-business health care generate.

Socialism means giving government more control over an individual's life.

Now you get it! Except that I am not advocating Socialism across the board - I am advocating socialized health care in America. But, you've got the basic idea.

Freedom means the absence of coercive force...

Stop right there. That strikes me as a great working definition of "freedom". But there are many types of freedom. One can be free from the coercive force of government (the type of freedom you seem to reference every time you use the term), or one can be free from the coercive force of another human brandishing a firearm and making demands, or freedom can be from the intense force of gravity felt by humans on earth, or from the force of a bad habit, or from the coercive force of the metaphysically sufficient determination of the Divine Will, etc.

And it strikes me that giving up freedom is not always morally or pragmatically bad. By marrying my wife I gave up my freedom from the legal and relational contracts of marriage. And I couldn't be more pleased. By committing my life to Jesus Christ I gave up my freedom from that commitment. There are circumstances when freedom is good, and circumstances when it is bad.

At any rate, the type of freedom I brought up was the freedom of individuals from the force that the difficulties and costs of individual and small business health care in America exert on their decision-making. This is a good kind of freedom, since it encourages entrepreneurism. There are obviously other types of freedoms that are forfeited in the process of universalizing health care, but so far I remain willing to forfeit such freedoms in exchange for the benefits I will receive, which is why I will choose to freely vote for representatives whose policies most closely match my political ideals. You are free to do the same. In the mean time we are free to argue about which ideals are ideal.

We could also make people more "free" by providing everyone with their food and housing, that way they wouldn't have to work at all and they could really pursue their passion, whether it be frisbee, or golf, or kayaking.

Please revisit "Slippery Slope Fallacy".

There is nothing prohibiting people from working together in the free market.

Perhaps this is at least mostly true, but my contention is that it could be accomplished with much more efficiency by the federal government.

...public education destroyed private schools. I want them out of that too.

Whether this is true has no bearing on the matter of health care. I have already proposed that different tasks may best be handled by different levels of governmental jurisdiction or in different ways altogether. Perhaps the private sector is the best place to handle automotive production and products, or perhaps you are right about education - I am not taking a stand on those issues now. I am coming forth with my hunch about health care as a matter best handled by the government (in the context of America today). I brought up education merely to point out that it is possible for the government to be involved in something without banning private practices as well. You are free to contest this, and you might even win me over, but you haven't done so yet - you simply missed the point.

[Brandon then cites my phrase "...depending on who gets elected and what follows..."]

That's what they said about Lenin, and then about Stalin.

Oh, right... because Lenin and Stalin were both elected democratically upon careful consideration of the details of their health care plans.

[Note: My original statement was meant to imply that there may very well be a proponent of universal health care who gets elected and attempts to implement it, but does a poor job. I was attempting to clarify that my view isn't in favor of any and every universal health care plan, but that I currently buy into the idea generally.]

[With reference to democratic forces:]

Yeah, cause that's worked so far.

I'm beginning to wonder if you've lost all faith in Democracy. Wait - didn't you suggest we "follow the constitution"? Do you consider that a Democratic document? I guess I just don't fully understand your position. Perhaps you could clear things up for me a bit.

[After my reference to the intention of the American government to be of, by, and for the people:]

If you're going to use the language of the founding fathers, use all of it.

"Free government is founded on jealousy, not in confidence; it is jealousy and not confidence which prescribes limited constitutions, to bind those we are obliged to trust with power. In questions of power, let no more be heard of confidence in man, but bind him down from mischief by the chains of the Constitution."
-TJ

Ok so you do like the United States' constitution. It seems you like it for the fetters it places on the men in government. Great. Why not exercise your freedom to vote, and use those reins to direct your representatives toward the universalization of health care?

Don't mistake my position for fascism.

And lastly, thank-you for the citations at the end of your post.