Sunday, February 18, 2007

Response to Response to Response to Response

Ok, well, I didn't really expect a response to my response to Mr. Tweedy's post on Obama - but I got one. At the time of writing, it's the first item on Mr. Tweedy's blog.

Mostly it addresses my concerns, but there are one or two quick clarification-type things I think I should address, so here goes (the following probably won't make much sense if you haven't read the exchange to date, so click on the links, etc. etc.):

Mr. Tweedy writes:

...I'm going to stand by the point that, because several countries, including Finland, have relatively successful economies and still manage to provide free or cheap education and health care, it would be ridiculous to flat-out discount the possibility of providing universally affordable health care just because we're not them.

Interesting thing to say - considering no one was "discounting the possibility of providing universally affordable healthcare just because we're not them." All that was said was that you can't cherry-pick countries like Finland and expect their "success" to be duplicated in the US. You need a US-specific plan - and so far I haven't heard one. More than that, it's the "relatively" in "relatively successful economies" that matters here. By Mr. Tweedy's own figures, Finland - with a per capita GNI roughly $6000 less than ours - is 7% poorer than the US. That's not insignificant by ANY measure!!! You can't just say "well, Finland does it and stays relatively wealthy." The thing that's missing from the argument - as I pointed out in my last post, and which still hasn't been addressed in Mr. Tweedy's latest post - is how this stacks up to a cost-benefit analysis. At 7% poorer than the US (and this WITHOUT running a significant military budget, I should add), Finland's welfare state sounds very expensive indeed. You'll have to demonstrate that we're getting something for our 7% (or however much it turns out to be - could be more, could be less) pay cut that makes it all worthwhile.

(II) Can we afford it?
If we can afford the war in Iraq, then we can (or should have been able to) afford some minimal universal health care.

Well, not exactly, no. Just because you can afford one expensive thing doesn't mean you can afford similarly expensive things whenever you want. More to the point, wars end and spending goes back to normal. You can pay down the debts you accumulated. Healthcare is forever, and it only gets more expensive with time. But the real issue here, as I've said before, isn't whether we can pay for this, it's whether we want to. This is where that pesky cost-benefit thing comes in. Is there some reason to believe that a government-micromanaged healthcare system would be better than the one we have now - better to the tune of $2.4trillion a decade in extra budget expenses? I don't see any reason to believe such a thing. I'd much rather just pay my own insurance for the flawed, but generally superior to the rest of the world's, coverage we have now, thanks.

(I) Should it be done?
If it's the responsibility of the government to provide for the well-being of its citizens, then how could this basic need not be considered an important obligation?

Since when is it the responsibility of the government to provide for the well-being of its citizens? It is each individual citizen's responsibility to provide for his own well-being, no? I am not my brother's keeper. But more to the point, Mr. Tweedy seems to be unaware that our government already does provide basic healthcare for its citizens. It's called Medicare/Medicaid, and it's currently the biggest item on our federal budget - larger even than the military or the War in Iraq. This is a service for people who can't afford healthcare themselves. In other words, what he's arguing is that people who can afford to pay their own healthcare shouldn't have to - and I really don't see the basis for that argument? Isn't the point of welfare systems to provide a "safety net?" They're not there to give you a free ride - they're just there to help you pick yourself up when you're down. Well, if that's the case, then we're done. That already exists for healthcare in the US. Those people who can afford to pay their own way should do so. That's a general principle that I think we can all agree applies to everything. If you can pay your own rent, you shouldn't be in public housing. If you can pay your own grocery bill, you shouldn't be on the dole. If you can pay your own education, you shouldn't be getting need-based scholarships. How do we get from "those who can should provide for themselves" to "universal healthcare is a basic responsibility of government?"

We've spent $1.2 trillion dollars on the war in Iraq so far. Given that the current U.S. population is about 300,000,000, this means that we've spent over $600 per person per year on this war. That's $50 per month, which is about the cost of basic health insurance for a healthy individual. If you were to consolidate that $600 per person into a fund to offset costlier insurance rates or provide coverage for individuals who can't arrange for insurance at all (such as in cases of chronic illness), then we're talking thousands of dollars.

Well, again, yes, I've never disputed that the money is there. But please remember - we're having trouble paying for the War in Iraq. This isn't an easy level of expense to maintain. Furthermore, we only have to maintain this expense for the time being. National health insurance would go on forever - so it's a much bigger burden over the long run. Finally, the relevant question isn't so much whether we can afford it (we can) but whether it's a good buy for our money. All evidence indicates that it would be a pretty dumb investment decision to trade in the profitable system we have now for the kind of system that Finland et al have - ESPECIALLY at the pricetag that these systems generally come with.

If you're lucky enough to be wealthy, then don't whine about paying some extra taxes within the system in which you developed that wealth...

Lucky enough to be wealthy? Wealth never comes from effort, then? In other words, everyone who is wealthy is the moral equivalent of a lottery winner? None of them got wealthy by, oh, say, providing the public with something that it found useful? Please!

Why should these productive wealthy people, in addition to having already provided the public with some utility (the method by which they got wealthy in the first place) also have to give large amounts of their reward back? I mean, isn't it enough that they start companies and provide jobs for people, invent things that are useful to people, and in general are the ones who keep the economy running? It isn't the cashiers at McDonalds that make America the powerhouse that it is. It's the inventors, the CEOs, the industrialists. These people create wealth - and this benefits everyone. It's true that some people are wealthy through luck, but that's hardly the whole picture. It's not even a significant portion of the picture.

But as far as health care is concerned, a good work ethic doesn't eliminate cancer.

That's true. It's equally true that a good government doesn't eliminate cancer. The people who work to cure cancer should be properly rewarded for their efforts - not taxed to death and/or forced to provide their extremely valuable services at government-controlled costs. The cure for cancer will come faster if we pay these people well and let them get on with their jobs.

Again, this is all based on my personal assumption that trying to provide public health care options is a 'good' choice. And given that, I'm suggesting that we collectivize it and set up a socialized health care base (a base, mind you, not a replacement) to provide for the small number that need more than minimal-cost health insurance.

I think you'll be surprised how many more of these people there are than you think once you start footing their bills. The chronic problem with these kinds of government programs is that they always look to current demand levels to draw their plans. But of course, once the price for something comes down (as is the case when you subsidize it), demand goes up. This is, for example, what happened in the early 70s when Nixon tried to control the oil crisis by regulating the price of gas. Because gas was artificially cheap (that is, the price was low relative to the demand for it - which was considerable at the time due to the panic), people bought it up, and the crisis only got worse. This scenario has been repeatedly endlessly in history. You can see it going on right now in Venezuela. I think if you start "guaranteeing" people free money to pay for their healthcare you will find that two things happen: (1) there are more such people than you thought and (2) prices rise to adjust. It is, simply put, impossible to predict anything about the cost of a welfare program except that it will end up being more than you think. It sounds reasonable now - the way that Social Security sounded reasonable in the 30s. It quickly becomes an albatross. Finland, ironically, is a good case in point here. It has been privatizing its system over the last 15 years becuase it can't pay for it any more. I think you'll find this is generally true for all countries with socially planned healthcare systems - whether fully socialized (the UK, Canada, the Netherlands), merely heavily subsidized (Finland), or something in between (Germany).


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