The Capt. Kirk theory of health-care policy.
Last week I posted a clip of a GOP debate audience cheering state-imposed death. During Monday night’s Tea Party-sponsored debate, audience members applauded the idea of allowing a sick person without health insurance to die. Ron Paul was asked how an uninsured thirty-year-old who has a serious accident would pay for health care under his plan. ”That’s what freedom is all about, taking your own risks,” he replied. (Implying what? The hypothetical thirty-year-old should have known better than to have put himself in harm’s way?) That’s when the applause started. He continued: “This whole idea that you have to prepare to take care of everybody…” Wolf Blitzer interrupted: ”Are you saying that society should just let him die?” More applause. (Ron Paul’s “no” is barely audible over the noise–an answer he gave for a good reason.) You can watch the clip right here.
Have these whooping Tea Partiers ever had an accident requiring medical attention? Do they know anyone who has fallen ill through no fault of his own? Or a smoker who’s died from emphysema? Maybe they haven’t given a moment’s thought to such questions, preferring instead to take Capt. Kirk’s lead. You think I’m kidding? It’s well known that the Tea Party has modeled much of its economic policy recommendations on the philosophy of certain Star Trek characters.
Tags: Kahn!
I’m sure glad Dr. Paul isn’t my MD. I cseekers him now:
“Doctor, my baby has pneumonia, but I can’t pay you because my husband is out of work.”
“Come back when he has a job”
Sorry, this iPhone keeps “correcting” what I write.
Should be: “I can hear him now”
Yeah Ann, except for the fact that Dr. Paul has said more times than we can count that he never turned people away that couldn’t pay. At least you’re up on the things you’re commenting on.
Maybe you should use your iphone to tell you Dr. Paul’s positions instead.
Isn’t it just stunningly cold to applaud at the idea of people dying for lack of health insurance? Regardless of one’s position on how to fund health care for all, to cheer like that is reprehensible.
And what’s the figure? Something like one in 6 bankruptcies are the result of health care issues. Who among us, except the VERY wealthy, isn’t a bad illness away from living on the street?
As to Perry’s decrying of Social Security as a “ponzi scheme,” same thing. That kind of language isn’t a call for reform, but sounds more like a call for abolition. Does he want the elderly poor out on the streets selling pencils to try to survive? Of course, there’s a gender question here too–most of the elderly poor are women.
What kind of nation discards the sick and elderly, and cheers for their death?
On a more analytical note: One way of framing this question is to ask whether health care is a right or a consumer good that those who can pay for it may enjoy. Likewise, whether it is a matter of charity (a requirement for Christians to practice generally, but optional in any given case, yes?) or justice. If it’s a matter of justice, then to deny access to health care is a violation of human dignity.
But Captain Kirk supports Health Care reform. http://videos.mediaite.com/video/William-Shatner-Rush-Limbaugh-D
Sounds like justice to me. Aquinas says that justice is the virtue that puts order into our interactions with others, making sure we render to our fellow humans what is their due, the goal of which is the equitable flourishing of all.
He says it is a “stable and lasting willingness to do the right thing for everyone.” (Summa, 2a2ae, 58, 1) This includes justice to society as a whole (e.g., the common good) and justice to individuals in society, including justice between people and the justice of the community to the individual, providing proportionally what is owned in common and sharing equally the burden of the common good.
“Isn’t it just stunningly cold to applaud at the idea of people dying for lack of health insurance?”
Oh, you ain’t heard nothin’ yet! Once we Boomers start retiring en masse–many of us will tap into our SS earlier than we’d hoped because we’ve been laid off and need SS to supplement income–you’re going to hear a lot of clapping as we die off, and I suspect we’ll be offered help to make our final bows as we become truculent and burdensome.
Who needs death panels, when we can just leave the uninsured to die for lack of care? Strange, how some who question Darwinism fully accept a vision of “nature red in tooth and claw.” (Tennyson, right?)
Call me crazy or naive, but i don’t think it’s accurate to suggest – based on the clapping of some group gathered in a televised debate alone – that the GOP position on health care equates to cheering for the death of the uninsured.
The debate is over what we mean when we say “health care is a right” in light of the particular economic and political facts we encounter. Simply saying “health care is a right” or a matter of justice (which I agree with) doesn’t end the analysis/debate. Indeed it raises a host of questions and arguments over how to best deliver that good, how much health care is one entitled to, etc.
WPK–
Nice that Dr. Paul treats some indgents. And how does that relate to his refusal to help the other 5,000,000 ? Or is it 30,000 ,000 without health care?
The number of those without health insurance has risen to over nearly 50 million, an increase of 16 percent from 2009, an increase that is growing far faster than the rate of unemployment, which seems to be holding at about 14 million people unemployed.
http://money.cnn.com/2011/09/13/news/economy/census_bureau_health_insurance/
http://www.bls.gov/news.release/empsit.nr0.htm
That means that 36 million Americans who work do not have any health care. Put another way, 72 percent of those without health care insurance get up every day and go to some type of job and contribute in some way to the wealth of our nation and to fulfilling their own financial obligations. (Jim Pauwels, please check my math …)
However, the applause seems to demonstrate Ayn Rand’s epigram that “guilt [that impels one to take care of others] is a rope that wears thin.”
If you HAVE health care insurance and are a complete utilitarian, of COURSE you’d applaud the demise of those of us without health care insurance. If we get sick from some chronic or catastrophic illness, we won’t be able to pay the bills, and YOUR health care insurance will go up to help pay for it.
For those who have the stomach for it, here’s Al Franken’s “Supply Side Jesus”:
http://www.youtube.com/watch?v=AK7gI5lMB7M
From the Dept. of It Could Be Worse, the CHA and others note that the early Obamacare provisions for allowing young folk to stay on their parent’s policies has significantly mitigated some of the uninsured:
http://andrewsullivan.thedailybeast.com/2011/09/obamacare-at-work.html
http://www.chausa.org/Pages/Newsroom/Releases/2011/CHA_Statement_on_2010_Census/
Meanwhile, the Dish flags a libertarian answer Ron Paul could have given, though I find it unconvincing, to say the least:
http://andrewsullivan.thedailybeast.com/2011/09/how-ron-paul-should-have-answered.html
Interesting to think that a large number of those 810,000 middle aged adults who lost employer-provided healthcare when they lost their jobs would have fared better if the ACA would have included the GOP’s proposal to delete the tax credit for employer-provided health care. ACA would have been a much bigger success at this stage on the coverage front perhaps.
Jeff, why would they have fared better?
Jeff, I’m not sure I understand that one either. ‘Splain?
Of course, Grant doesn’t believe that Tea Party people want to kill the uninsured. He was just looking for an excuse to bring up Star Trek. Cute photos.
Is the government doing anything to address the problem at the other end of the equation:regulating the actual cost of medical care? When I get the statements from my insurance company, my jaw drops: self-pay clients would be paying 6 times what my insurance company pays for routines tests and services. It seems like some of our health care issues could be solved by regulating what providers are allowed to charge (I mean price-gouging is price-gouging by any other name, no?) Why should LabCorp get away with charging Empire Blue Cross $100 and my uninsured neighbor $600 for the same tests?
Is that kind of regulation in the works anywhere at the State or Federal level.
Why should LabCorp get away with charging Empire Blue Cross $100 and my uninsured neighbor $600 for the same tests? Because Big Insurance insists on it. Since most people have insurance, the doctors have to accept insurance. The contract with the insurance (take it or leave it) says the insurance company will pay a fraction of the “usual and customary” fee. If a doctor offers reasonable fee to cash patients, the insurance company then uses that lower fee to calculate its own discount. If a doctor tries to hide the fact that he has offered a lower fee to cash patients, he is found by the courts to have engaged in insurance fraud. The only way the doctor can cover his overhead with insured patients is to charge the few cash patients a much larger “usual and customary” fee.
Apparently Ron Paul has the courage of his convictions—at least to the point of allowing his 49 year old campaign manager to work without health insurance and to die of pneumonia with $400,000 in unpaid medical bills:
http://nymag.com/daily/intel/2011/09/ron_pauls_campaign_manager_die.html?mid=rainout_di_all
http://www.washingtonpost.com/wp-dyn/content/article/2008/07/10/AR2008071002937.html
Kent Smith, RIP.
See that linkified “a good reason” in my post? It goes here:
http://www.washingtonpost.com/blogs/ezra-klein/post/why-libertarianism-fails-in-health-care/2011/08/25/gIQAA4VkSK_blog.html
Ah, yes. My mistake. And apologies.
This is mostly off topic, but indirectly relevant.
Mitt Romney, when asked what sort of person he’d like to have as Vice President replied, “Dick Cheney”.
Yes, folks, Darth Vadar. And I thought Ron Paul was mean :-(
See Huffington Post for a video clip.
http://www.huffingtonpost.com/2011/09/15/mitt-romney-dick-cheney-vice-president_n_964644.html?icid=maing-grid7%7Cmain5%7Cdl8%7Csec1_lnk2%7C96031
Call it cruel, but rationing is on the way. People will deliberately, by public policy, be let die who could have been saved. By then, of course, Commonweal will have come around and learned to spin it. I wonder how. Probably at least partly by saying that it was made inevitable by Republican intransigence. The world would be perfect if it weren’t for the Bad Guys over there.
Do you even read Commonweal?
Say what?
“Call it cruel, but rationing is on the way. People will deliberately, by public policy, be let die who could have been saved. By then, of course, Commonweal will have come around and learned to spin it. I wonder how. Probably at least partly by saying that it was made inevitable by Republican intransigence. The world would be perfect if it weren’t for the Bad Guys over there.”
Call it cruel but rationing is here now. Call it cruel, but there is more than enough money already flowing through the health care system to cover everyone in the United States. And call it cruel, but the GOP has managed to talk the working class into fighting the middle class over what the upper class leaves them in the form of “wages”.
Ann–
Though it could never happen, if Mitt Romney does become our president, I think Dick Cheney would be the perfect VP. My biggest concern about Romney is that unlike Bush, Clinton, Reagan and, to a lesser extent, Obama, Romney has never been through the dark forest and emerged learning things that you can’t learn anywhere else.
I agree with Unagidon that rationing is here, but that’s not really a bad thing–we never have an unlimited supply of anything. I also agree that we spend “enough” money on healthcare, but I do not think the purchase/delivery mechanism is nearly efficient enough. I would not agree any suggestion that the working or middle classes are easy to command.
I think the word “rationing” with it’s many muddled meanings and connotations needs to be looked at more carefully. Just what do the anti-Obamacare critics mean by the word? Just what are they objecting to? As one who remembers the rationing of WWII I can’t make sense out of its current uses.
WWII rationing was a government system which was a a method of sharing scarce food and gas equitably. Each eligible driver got the same share of the gas available to civilians — so many gallons over a month’s period, say. The food system limited each person to a certain definite share of the foods that were available. The rationing of food was a bit mor complex. It involved each person getting the same number of food stamps, stamps which could be used like money (together with money, of course) to buy scarce food. The scarcer foods “cost” more stamps than the less scarce foods. Each person decided how to spend their stamps, whether on fewer scarce things or more less-scarce foods. There were no government employees deciding who would get which foods and how much of it. It worked automatically without any government employees deciding who got which kind of food.
Palin’s “rationing” would have doctors and government deciders assigning available health care on the basis of some as yet unformulated principles, except that the “system” would relate to expensive end-of-life care.. But the Democrats have NEVER proposed anything even vaguely resembling that. So just what in the world are the Palinistas about?
I do think we need to also talk about end-of-life care and the many varied issues — moral, financial, administrative, political — involved in it. Even just talking about it is painful for many people, but it’s necessary.
Ann,
Rationing in health care means committing the same amount of money/health care to every individual, without regard for need. People could decide what health care to get, up to the point where they do not have enough ‘credits’ to pay. That means expensive care would be out of reach for everyone, but only those at the end of their lives would notice, for the most part.
Those of us with multiple health problems might be forced into unpleasant situations, ie life as a contented amputee vs as a depressed two legged person. But that is mostly unlikely. Mostly it comes down to spending on end of life care.
As Unagidon stated, rationing is here already. Palin et alia offer no system that offers less rationing than Obama’s plan, just a hope that when you get near the end of your life you will be able to spend all you can to keep yourself alive. That sounds good, until you find out how little you have compared to the cost of staying alive.
“I think the word ‘rationing’ with it’s many muddled meanings and connotations needs to be looked at more carefully.”
This strikes me as a really excellent point. “Rationing” has connotations of both giving and withholding, and it muddies the waters and points the debate in the direction of someone getting what they don’t need or deserve. Or someone failing to receive lifesaving care.
In a Playboy interview in 1970, William Buckley addressed the problem of hunger and “the dole” this way:
“I’m attracted to the notion of giving out four basic food materials, free, to anyone who wants them. The cost, according to one economist, would come to a cost of about a billion dollars a year. The idea is that these items would be available at food stores to anybody–you, me, Nelson Rockefeller–because it simply wouldn’t be worthwhile to catch anybody who was taking the free food and didn’t need it. With such a plan, you could officially and confidently say that the residual hunger in America was simply the result of people not knowing how to utilize these materials.”
The items to which Buckley alluded were bulgar wheat, powdered skim milk, soybeans, and lard.
It seems to me that the average person who is in relatively good health would be happy to have the medical equivalents of bulgar wheat, powdered milk, soybeans and lard: A yearly check up, flu shot, and dietary and exercise advice. Biennial blood work to check blood health and lipids. And cancer screenings at intervals intervals determined by a GP based on medical and family history. (I have no history of cancer in my family, and my doc says I’m just fine with some screenings every two years, and others every 10.)
Let anybody walk into any county health department and get these things, no questions asked, and it seems to me that you could do a lot of good. The out-of-pocket savings these services would offer would allow many of those working without health care to pay for vision, dental, and other health care costs out of pocket.
Perhaps, given that most of us will die of complications from being overweight and obese, perhaps you could even offer a tax write-off on a per pound basis for every BMI point you take off during the fiscal year.
There needs to be more thought about how best to care for those with chronic or catastrophic illnesses, and, as Ann noted, those facing end-of-life care.
Maybe the Ferengi could help with those end-of-life issues … I think that one guy is Principal Snyder from “Buffy.”
Effective rationing and official rationing are very different animals. We’ve not yet crossed the Rubicon of official rationing.
“Effective rationing and official rationing are very different animals. We’ve not yet crossed the Rubicon of official rationing.”
Yes we have. People without insurance CAN go to Emergency Rooms if they need to. But the kind of treatment they are able to obtain is very limited. It is, in fact, rationed.
Different dictionaries.
Ah America, where it isn’t rationing until it’s officially called “Rationing”.
Official and efficient rationing, I suppose, can occur if you have private health insurance or none at all and rely on one or more public programs.
Where public policy raises and lowers the accessibility bar based solely on income, it is inefficient. Where it factors in income along with age and need, it becomes more efficient.
It is also more efficient where public health staffers are knowledgeable and can screen queries and applications quickly. (Three years ago, it took about an hour’s worth of calls and queries to try to find out whether the public health department offered monthly blood pressure and weight checks. I still don’t know, so that was an hour of taxpayer-paid money wasted.)
Somewhere along the line, perhaps owing to Michigan’s abysmal economy and the increase in low-income households, my public health department underwent a transformation. I can now get answers in one call from the screener.
Taxpayers might do themselves and their fellow citizens a favor by sitting in the waiting rooms of their public health departments for an hour or two once a year and observing what goes on. Find out who the poor are, what they need, how they are treated, how the staff treats people, etc.
It’s not rationing until it’s written in regulation and law. Until then, it’s just a metaphor.
What good would that do, other than probably raising their empathy quotient a bit (and, maybe, picking up bedbugs)? Now, if part of the duties of governors, mayors, presidents, and congresspeople were to rely on public assistance for themselves and their families for, say, two months out of every year, and go through all the paperwork and office sitting themselves – no stand-ins – that the recipients of public assistance have to go through….
“It’s not rationing until it’s written in regulation and law. Until then, it’s just a metaphor.”
But IT IS written in regulation and law. The law says that the uninsured will not be turned away from Emergency rooms. And this is the only kind of care the uninsured can count on. If it looks like rationing, smells like rationing, and tastes like rationing, it’s rationing. No matter how people want to fool themselves.
ER access is a floor. In my dictionary, “rationing” means setting ceilings. At any rate, that’s the way it’s been used. We need a better word. “Ceilinging” is unpronouncable. Maybe just “limiting” – health-care limiting. Grandfather was limited – funeral Tuesday.
“What good would that do, other than probably raising their empathy quotient a bit (and, maybe, picking up bedbugs)? … Grandfather was limited – funeral Tuesday.”
This blog has seriously gone to hell in a handbasket.