Waterloo

It is of course ungentlemanly to gloat, but were I that sort of person, today’s doings on Capitol Hill would have provided a rare opportunity. The Democrats today are routed, their fearsome assault repulsed, their Utopian schemes undone. Their mighty socialist war-machine lies in splinters on the battlefield. Their armies broken and scattered, they keen and lament in abject disarray. On the horizon is the glint of steel, and the thunder of hooves.

Is this a great country, or what?

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28 Comments

  1. the one eyed man says

    It is inevitable that many of those who oppose health care reform will some day find themselves uninsured and facing a life threatening illness. It is equally inevitable that when they are in that situation, they will feel differently about health care reform.

    Posted January 21, 2010 at 11:28 pm | Permalink
  2. Malcolm says

    Well, not for long.

    Good riddance to this misbegotten abomination of a bill.

    Posted January 22, 2010 at 12:17 am | Permalink
  3. the one eyed man says

    In my view, the health care bills are far from what I would like to see, but they are also far better than the status quo. Those who argue against the bills rarely offer any alternatives, and more rarely defend the current system and its copious faults. Hence without acknowledging it, they take a position in favor of tens of millions of uninsured, high morbidity rates, health care decisions being made by insurance companies, and so forth. If you’re willing to accept all that because of the cost of reform, or whatever reason, that’s fine. But come out and say it.

    If peoples’ views about health care were subject to a John Rawls veil of ignorance – you have to decide on what sort of health care system without knowing if you would be sick or well, insured or uninsured – then Obama-style health care reforms would pass in a heartbeat. None of us knows what the future holds, and I doubt many of those who implicitly support the status quo would do so if they or their child had a catastrophic illness and they couldn’t afford health care to treat it.

    Posted January 22, 2010 at 10:56 am | Permalink
  4. Malcolm says

    Speak for yourself, Peter. We all live behind a “veil of ignorance” about the future, and there are other considerations here besides narrow self-interest.

    Nobody is arguing that the current system can’t be improved, and contrary to your assertions, there are plenty of alternatives to this grotesque monstrosity of a bill, this unconscionable expansion of government bureaucracy, spending and power, this brazen Progressivist coup-d’etat.

    The Democrats tried to do far too much, far too fast, at the worst possible moment, all in smug and cavalier defiance of both the traditions and the explicitly expressed will of the American people. And they went about it not in the “open” and “transparent” way so piously promised by candidate Obama, but rather by the most distasteful late-night, closed-door bribery, lecturing us all the while that anyone so impertinent as to question their wisdom was some sort of extremist nut-job — or, adopting the tactic so commonly used by liberals to besmear their critics, morally deficient. Dissenting voices were even likened to Holocaust deniers. The Democrats have got the come-uppance they deserved.

    Now, perhaps, we can go about this health-care reform business with a little more prudence, and a little less arrogance.

    Posted January 22, 2010 at 11:42 am | Permalink
  5. the one eyed man says

    I did not say that there are not alternatives to the current bill. I said that they are rarely suggested. Fixing health care involves unpalatable choices, and there are no solutions which everyone (or even a plurality) will agree upon. There have been no serious proposals from the Republican leadership, their allies in the right wing media, or virtually anyone else except health care professionals and people writing in scholarly journals. If someone has a better idea, fine: let’s hear it. Regrettably, all one hears is why this or that part of the bill is wrong, but rarely will you hear a serious alternative.

    The “expressed will of the American people” was in 2008 when Obama, running on a campaign platform of health care reform, won by a landslide.

    The likelihood of going “about this health-care reform business with a little more prudence” is nil. After all of the blather about death panels and pulling the plug on Grandma, the possibility of meaningful reform is nil. You can thank those who oppose but fail to suggest for the perpetuance of the status quo.

    Posted January 22, 2010 at 12:31 pm | Permalink
  6. Malcolm says

    No, the “expressed will of the American people” I refer to is their sentiment about this legislation, and the process that created it, now.

    Obama was elected for a broad variety of reasons — racial pride (and guilt), visceral loathing of George Bush, well-founded fear of Sarah Palin, and so on — only one of which was his intention to do something about health care. To interpret his 2008 victory as carte blanche for any audacious Utopian scheme, perpetrated on the grandest possible scale, that a transient and swaggering Progressivist majority can conjure up without regard to public sentiment, or even common decency, is exactly the same sort of tone-deaf, we-know-best-what’s-good-for-you arrogance that swept Scott Brown to the Senate.

    There are better ideas out there, and now that this audacious socialist putsch has been thwarted, I expect that in the coming months you will be hearing more of them.

    Posted January 22, 2010 at 12:59 pm | Permalink
  7. Chris G says

    That is some well-written gloatage.

    Are votes for this healthcare bill split so evenly along party lines that they can’t buy off a couple of defectors from the republicans?

    I have said it before and my wife is tired of hearing it at dinner parties but I am THRILLED with my current health care coverage. In fact, I love it. It’s an HSA account combined with a high deductible, no frills catastrophic health insurance plan. I can contribute $5900 per year, a little less than $500 per month, to an account that I oversee. My contribution is tax deductible. I can use that money immediately anyway I see fit (massages, dental, glasses, surfboard wax, maybe even medical marijuana!). I pay $194 to a health insurance company. It covers my entire family (3 of us). If we have more than $5000 per person in medical expenses then they pay for everything above that. What is not to like about that plan?

    Doctors have to go to school for a long time. They need to get paid for their human capital. Money is the stuff we use to ration goods and services. Whenever government steps in to try to make something artificially affordable (mortgages!) then we all pay. That being said, they did the right thing with HSA accounts.

    Posted January 22, 2010 at 2:28 pm | Permalink
  8. I’m not sure that the Waterloo analogy is quite correct, Malcolm, but if it is then Scott Brown should be renamed Blucher – he arrived just in the nick of time! “A damn fine thing; the finest thing you ever saw” said the good old ‘Duke of Boot’, using the word ‘fine’ in its traditional sense.

    My doubts remain because the enemy, in Clausewitzean terms, is not ‘annihilated’, merely pushed off the battlefield. It didn’t take them long, about 24 hours, I think, to redeploy and counter-attack up Wall St.!

    Posted January 22, 2010 at 3:18 pm | Permalink
  9. Malcolm says

    From a military POV you are quite right, David. I only used the title because the word has come up often in public discussions of this particular political initiative.

    Posted January 22, 2010 at 3:48 pm | Permalink
  10. the one eyed man says

    1) To be sure, Obama was elected for a variety of reasons. However, he also ran on a platform, which explicitly advocated both universal access to health care and a public option. This is the core of the health bills which were passed, which fit squarely within the party platform adopted in the 2008 convention. The expressed will of the people was for the Democrats to enact their platform, which they have done. If it’s an “audacious Utopian scheme,” it’s the one they ran and won on.

    2) I believe that the best health care system would be one similar to what the British have, where resources are allocated based on criteria such as age, efficacy of treatment, the individual circumstances of the patient, etc. I can’t speak for John Rawls, but I bet he would be with me on this one. I support it because I believe it to be the most humane way to allocate limited resources, and because the level of health care a country chooses will be a direct result of their decision on what percentage of national wealth should be directed to health care. But enough about me. You’ve criticized the health care bills without offering an alternative. What would you do, if anything, to change health care in America?

    Posted January 22, 2010 at 5:44 pm | Permalink
  11. Malcolm says

    Peter, forgive me, but you are just completely out of touch with reality here. Indeed, new polls are in that show that the Brown victory in Massachusetts was clearly and explicitly an expression of voter outrage at what the Democrats have been up to in Washington since Mr. Obama’s election, and in particular this monstrous health-care package. And that is in the bluest of blue states, a place that Obama won by 25 points in 2008! Just imagine what voter sentiment must be like elsewhere.

    I know you are no fan of Charles Krauthammer, but you should read this essay anyway. In it he refers to a Fabrizio-McLaughlin poll that found that 78% of Brown voters cast their vote for the specific purpose of defeating Obamacare. Krauthammer quotes the Democrat Evan Bayh:

    “If you lose Massachusetts and that’s not a wake-up call,” said moderate — and sentient — Democratic Sen. Evan Bayh of Indiana, “there’s no hope of waking up.”

    Less drastic measures for improving healthcare might include allowing buyers to purchase insurance across state lines, allowing them to form arbitrary groupings to buy in bulk, the way employers and unions do, malpractice reform, and a variety of other things, not least of which is all the “trimming of waste” that is always put forward by the Dems as a reason their bill won’t raise costs. Let’s do that stuff first, then see where we are. It would be easy to get broad Congressional agreement, except from the far Left. But no, that isn’t “sweeping” enough.

    Posted January 22, 2010 at 6:19 pm | Permalink
  12. the one eyed man says

    Brown won against a feckless opponent who vacationed in the Caribbean before the election and seemingly doesn’t know who Curt Schilling is, in the only state in the country which already has a robust health care plan. Sure, the people who voted for Brown are against health care reform, and he won 52-47, which is hardly a landslide. You’re going to extrapolate a five point victory margin in a one-off election in a state unique for its own health care plan to the rest of the country? An election on a snowy January day will bring out the passionate, but not necessarily the masses. Nor is Massachusetts as liberal a state as it’s cracked up to be – after all, it elected Mitt Romney as governor. I could just as easily argue that NY-23 points to the nationwide popularity of Democratic agenda. But I would be wrong.

    The last poll I saw (about two weeks ago) showed 42% of the country in favor of the health care bills. Presumably some of those who oppose the bills do so because they don’t go far enough. To be sure, those who oppose health care are a lot louder than those who support it, and because the mainstream media tilts right, their voices have been amplified far beyond their numbers. However, to say that there is popular outrage against health care reform – meaning a plurality of citizens is strongly against it – is simply untrue.

    I’m not sure what malpractice reform means – should those who are grievously injured through negligence be denied the right to seek redress of grievances? – and, in any event, the cost of malpractice insurance is a negligible percentage of overall health care cost. Allowing the bulk purchase of insurance is an uncontroversial idea, but it doesn’t address the core problem of tens of millions of people who lack insurance and cannot afford health care. The “audacious Utopian scheme” of universal health care, which nearly all industrialized countries have, is certainly attainable here. In addition to being a perfect physical specimen, I have comprehensive health care. Maybe I don’t have much to worry about. However, I shudder to think of what life would be like if I were unemployed and had a very sick child. There are tens of millions of people who ought to be supported by a safety net, and in my view, it is shameful that we do nothing to help them.

    Posted January 22, 2010 at 7:19 pm | Permalink
  13. chris g says

    Other countries have health insurance and we don’t? We should get more from our government. It appears they’re holding back on us.

    Posted January 22, 2010 at 10:41 pm | Permalink
  14. Malcolm says

    Peter, did you hear a word I said? A clear majority of Americans opposed this bill. 78% percent of those voting for Brown did so not because of Curt Schilling, but with the explicit purpose of defeating Obamacare.

    And if Massachusetts isn’t “a liberal as it’s cracked up to be”, then what state is? Where is this enormous base of liberal support you are counting on, if you can’t even find it there??

    The fact is, Peter, that you are in a rapidly dwindling minority here, like it or not. Americans are seriously pissed off, and it’s time you faced facts. If Barney Frank can do it, so can you.

    Posted January 22, 2010 at 11:05 pm | Permalink
  15. the one eyed man says

    78% of 52% is 40.6%. Last time I checked, that’s less than a majority. Moreover, the type of people who will vote In a January special election are likely to do so because they’re passionate about something: it’s not a representative sample. You can bet that nearly everyone in Massachusetts who is hot and bothered about health care reform showed up to vote, and the people who don’t care so much stayed home. If the issue was about abortion, you can bet that the zealots would show up and the people who don’t care as much wouldn’t. That wouldn’t indicate that the vote, whichever way it went, is representative of the whole. In determining whether most people are for something or against something, the apathetic count just as much as the passionate. Extrapolating from one voting sample in a single state to the entire country may be gratifying, but it is intellectually reckless.

    The facts are these: Rasmussen has been conducting weekly polls since June. As the blue bar on the right indicated, the percentage of people in favor has consistently been in the low forties. The percentage of people opposed has consistently been in the high fifties. To be sure, the majority are opposed, but their numbers have always been less than 60%. The meme that arrogant Democrats are trying to ram a hugely unpopular bill down the throats of an aghast public is simply nonsense. Most Americans are against the bills, but not by that much; many Americans are for the bills, but not enough to claim a majority.

    http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/september_2009/health_care_reform

    Posted January 22, 2010 at 11:39 pm | Permalink
  16. the one eyed man says

    Sorry, indicates, not indicated.

    Also, majority is, not majority are.

    I really ought to proof these first.

    Posted January 22, 2010 at 11:48 pm | Permalink
  17. Malcolm says

    “Most Americans are against the bills.”

    So what was your point again?

    Posted January 22, 2010 at 11:49 pm | Permalink
  18. JK says

    I think Peter was saying/implying “The “expressed will of the American people” was in 2008 when Obama, running on a campaign platform of health care reform, won by a landslide…” couldn’t/wouldn’t muster the votes.

    Posted January 23, 2010 at 4:01 am | Permalink
  19. the one eyed man says

    What is my point?
    1) Obama has an obligation to make his best efforts to effect the agenda he was elected on, independent of weekly opinion polls. Indeed, he would be faulted for breaking campaign promises if he did not do so.

    2) If, instead of asking “do you support the health care bills,” you break it down into its constituent elements, you often find that a majority supports the substance of what is in the bills. If you say “do you think that the government should provide a mechanism so that people who can’t get insured by private companies can get insured?” – aka the public option – you’ll get a majority saying yes. However, the bill has been so distorted by the numerous lies and misrepresentations of its opponents that a sizable number of people think that it includes death panels, insuring illegal aliens, and pulling the plug on Grandma. I don’t see that there is any huge shift in how Americans feel about health care since the 2008 election, but the bills themselves have been so misrepresented that you have a majority who will tell pollsters that they oppose the bill and also tell them that they support what’s in it. You can’t (or at least shouldn’t) let public policy get hijacked by polling. Moreover, it’s not 90-10 against the bill: it’s spitting distance from even. The meme that health care reform is wildly unpopular – or even that it’s less popular now than it was before – is demonstrably untrue. There is nothing that has happened since Obama was elected, including the surveys, which should stop him from pursuing a robust health care plan.

    3) I’m less concerned about the politics of the thing than the morality of the thing. You have politicians who piously tell us to “choose life” and simultaneously support a status quo which leads to the deaths of untold tens (hundreds?) of thousands of people who die because they are unable to get medical care. We’re told that health care reform is pulling the plug on Grandma by people who are, quite literally, pulling the plug on thousands. We’re warned that it will lead to fiscal catastrophe by a Republican leadership which was all too happy to pass a more expensive prescription drug plan for seniors. The health care system we have exists not because it is wise or efficient, but because it was largely shaped by the electoral clout of the elderly and the lobbying power of AARP and the pharma, insurance, and HMO lobbies. The Republicans will fight Obama on everything he wants to do, regardless of what it is, simply because they have made the calculation that if they can use their 41 votes in the Senate to block anything from passing any legislation, they can regain power by faulting him for not achieving anything. They have an enormous fog machine to distort and demonize the bill, up to and including heckling him in the halls of Congress. You can’t let public policy be hijacked by those who will not have an honest debate. So let’s get the political calculus out of the picture and solve the problem. The politics of the thing should not prevent Obama from doing everything he can to fix it.
    The morality of the thing seems fairly simple to me. The unemployed man with a sick child is not an abstraction: he exists in horrifying numbers. Grayson’s statement that the Republican health care plan is to let people die, and die quickly, isn’t far off the mark. The cynicism of denying care to that child in order to regain political power is mind-boggling. My point is really what I started out with, that those who support a status quo which directly leads to the illness, death, and suffering of many ought to at least be intellectually honest and acknowledge their complicity. You can’t save these lives without spending money: if you oppose the plan because of its cost, then recognize that the ineluctable consequence of continuing the status quo that in doing so you are making the utilitarian calculation that society is better served by not raising federal spending than by preserving the lives of those who universal health coverage would have saved. If you oppose the plan because it makes the federal government larger, then recognize that you are making the utilitarian calculation that a smaller government is better than preserving lives. There is nothing evil about making these choices, although they are certainly not the choices I would make. My point is simply that those who support the status quo ought to be honest about the full implications of their doing so.

    Posted January 23, 2010 at 7:32 am | Permalink
  20. JK says

    “Weak and Feckless.” Seconded.

    http://www.nytimes.com/2010/01/22/opinion/22brooks.html?em

    Posted January 23, 2010 at 3:56 pm | Permalink
  21. Malcolm says

    Peter, I understand the well-intentioned motivation behind your position — you’re a good guy — but you are completely in denial about what’s going on in America right now.

    First of all, you keep trying to shift the conversation to general sentiments about health-care reform. But nobody, including me, is opposed to making good-faith efforts to improve the legal framework of America’s health-care system in a prudent and responsible way. No, what has people hopping mad is this particular legislation, and the process that led up to it.

    You certainly do not advance your cause, either, by making ad hominem attacks on Republicans. The voting bloc that has swung the most on this issue, and who put Scott Brown over the top in Massachusetts is the independents, who are generally fiscally conservative and social liberal. They went strongly for Obama in 2008, but are are mad as hell now.

    As for “spitting distance from even”: did you even read the Rasmussen link you posted above? This is no momentary weekly polling blip: 50% are strongly opposed to this reform package, and only 18% strongly favor it. That’s almost even? For the Democrats to press forward here as you suggest, in blatant defiance of the public sentiment, would not only be monumentally arrogant, in the familiar and condescending we-know-best-whats-good-for-you liberal way; it would also be political suicide — as even the most liberal leaders of the party, such as Barney Frank, and even a reluctant President Obama himself, have publicly acknowledged. If they can see this, why can’t you?

    David Brooks certainly can. Here he is, from yesterday’s Times (as linked to by JK above):

    Instead of building trust in government, the Democrats have magnified distrust. The country already believed Washington is out of touch with its core concerns. So while most families were concerned about jobs, Democrats in Washington spent nine months arguing about health care. The country was already tired of self-serving back-room deals, so the Democrats negotiated a series of dirty deals with the pharmaceutical industry, the unions and certain senators. Americans already felt Washington doesn’t understand their fears and insecurities. So at the moment when economic insecurity was at its peak, the Democrats in Washington added another layer of insecurity by threatening to change everything at once.

    Instead of building a new majority, the Democrats have set off a distrust insurrection (which is not the same as a conservative insurrection). Republicans are enraged. Independents are furious. Democrats are disheartened. Health care reform is brutally unpopular. Even voters in Massachusetts decided it was time to send a message.

    The Democrats now have four bad options. The first is what you might call the Heedless and Arrogant Approach. A clear majority of Americans are against the Congressional health care reform plan. Democrats could say: We know this is unpopular, but we think it is good policy and we are going to ram it through and you voters can judge us by the results.

    The second route is what you might call the Weak and Feckless Approach. Democrats could say: We have received and respect the message voters are sending. We are not going to shove the biggest social transformation in a generation down the throats of a country that has judged and rejected it. We are not going to concentrate immense new powers in a Washington the country detests.

    I must point out also that you aren’t even being consistent. You mock people who express concerns about “pulling the plug on Grandma” — but just above you yourself wrote:

    I believe that the best health care system would be one similar to what the British have, where resources are allocated based on criteria such as age…

    Now, I am well aware of the deliberately inflammatory effect of dysphemisms such as “death panels”. They are a commonplace in polarized political discourse, as in the way opponents of this bill were likened to Holocaust deniers. Nevertheless, the more centralized our allocation of health-care resources becomes, the more you will indeed have government panels making these decisions. It is hardly irrational for people to suggest that Grandma might have reasons to be leery of having the State’s immense bureaucratic apparatus in charge of her plug.

    As for the thoughtful questions you ask at the end, you are right: there are tradeoffs between various forms of government. I think most Americans will agree that that the government should, as Churchill put it, “spread a net over the abyss”. How that should be done though, and to what extent government should, in addition to spreading such a net, level a society’s peaks to fill in its valleys, is a matter that is ultimately for the people to decide. It is my belief that to the degree the State, and not private and individual initiative, becomes the source from which all blessings flow, its people are infantilized and made dependent. And to the extent that the State provides all blessings, it empowers itself also to supervise and regulate the lives and enterprises of its dependents. Expansion of government comes always at the expense, not only of individual wealth, but also individual liberty. Alexis de Tocqueville, writing in the 1830’s saw that this seductive path was a possibility for the USA:

    The sovereign extends his arms over the whole society; he covers its surface with a web of small, complicated, painstaking, uniform rules through which the most orignal minds and the most vigorous souls are unable to emerge in order to rise above the crowd; it does not break wills but softens them, bends them, and directs them; it rarely forces men to act, but constantly opposes itself to men’s acting; it does not destroy, it prevents things from coming into being; it does not tyrranize, it hinders, it presses down upon men, it extinguishes, it stupefies, and it finally reduces eash nation to no longer being anything but a herd of timid and industrious animals, whose shepherd is the government.

    I have always believed that this sort of regulated, mild, and peaceful servitude, whose picture I have just painted, could be combined better than one imagines with some of the exterior forms of liberty.

    How right he has turned out to be; we have already gone a very long way toward the dystopia he described, in which the American people, so virile and enterprising in Tocqueville’s day, become as dependent children — nourished and smothered by the State’s distended bosom.

    Posted January 23, 2010 at 4:29 pm | Permalink
  22. the one eyed man says

    1) “Nobody, including me, is opposed to making good-faith efforts to improve the legal framework of America’s health-care system in a prudent and responsible way” I disagree. I have yet to see anything from either the Republican leadership or its allies in the media which could remotely be described as a good faith effort. Your title is reminiscent of Jim DeMint, who also used Waterloo as a metaphor: the political opposition to health care reform is not based on a sincere attempt to solve the problem, but rather is nothing more than a massive effort to “break” Obama. A good faith effort would involve alternative ideas and meaningful negotiations. There have been neither.

    2) From the Rasmussen link: “support (for the bill) has remained between 38% and 42% every week since Thanksgiving” and closed at 40%. So much for David Brooks’s claim that “Health care reform is brutally unpopular .” 40% support doesn’t seem brutally unpopular to me. I’d call it spitting distance from 50-50.

    3) “The more centralized our allocation of health-care resources becomes, the more you will indeed have government panels making these decisions.” We currently have centralized government health care for veterans, the indigent, and everyone over 65. Nobody’s pulled the plug on Grandma, or anyone else, yet. There is no reason whatsoever to think that anyone would start now. Grandma has no reason to be leery. This is fear mongering with no basis in fact.

    4) If I were in charge of health care, Grandma might have cause to worry. I don’t believe that there is a sacrosanct right to unlimited health care simply because you’ve passed your 65th birthday, while those who are younger and uninsured have no access at all to health care. Allocating extravagant resources to keep a, 85 year old man with diabetes and a bad heart alive for another three months, while denying care to someone much younger whose treatment could add decades of life, is a misallocation of resources. Our system is irrational and unfair, but it’s a reflection of the enormous political power of AARP and seniors, not to mention the pharma and insurance lobbies. I believe that we would have a much stronger health care plan if we emulated the British, but there is nothing in the current legislation which remotely resembles it, as the political reality is that a British type plan will never be adopted here, despite the fact that it is the most humane and rational way to allocate finite resources.

    5) “Expansion of government comes always at the expense, not only of individual wealth, but also individual liberty.” The first part is true, the second part is sometimes true. My liberty is not infringed by, for example, establishing an FDA which regulates drugs or by bureaucracies establishing minimum safety standards for cars, unless you consider taking unsafe drugs or driving exploding Pintos to be an element of individual liberty. However, individual liberty is not an absolute good, and there are many occasions when it is trumped by other values. You could make the same argument against Medicare, Medicaid, Social Security, and many other government programs which have demonstrated great value over the years (and, in fact, the same arguments were made when these programs were adopted). Universal health care falls squarely within that tradition.

    Posted January 23, 2010 at 7:09 pm | Permalink
  23. JK says

    Peter, I present you with a “heartland” discussion, though not using the sophisticated language as is used on Waka. As you’ll note – the primary subject of the discussion is not “healthcare above all” – but as one sloshes through the comments, it figures mightily.

    http://www.baxterbulletin.com/article/20100119/OPINION01/1190314/Here-s-a-tea-partier-s-perspective

    Posted January 23, 2010 at 7:51 pm | Permalink
  24. Malcolm says

    Peter,

    1) That’s it? From the Democrats nothing but sound ideas and saintly altruism, and from the Republicans only venom, and nary a suggestion as to health-care policy? Please. Yes, many conservatives saw this liberal juggernaut as a march of political conquest that needed to be defeated, for the sake of the nation, and indeed I took the title of this post from that very metaphor. But to imagine all the politicking is on the conservative side only, and that there have been no serious proposals from them about what the nation might do do improve its health-care system, is simply wrong.

    2) You really do have your head in the sand here, Peter. Again: 50% strongly opposed the bill, while only 18% strongly supported it. And it is perfectly clear that a consistent majority of Americans were against it; according to the Rasmussen link, “61% of voters nationwide want Congress to drop the health care plan and focus on the economy and jobs.” Sixty-one percent! If this were the margin in a presidential election, it would be a landslide. And if our system of government is supposed to represent the will of the people, clearly this legislation should not be passed. All of Congress, as well as the President, has now accepted this. You should too.

    3) The systems you mention, which have hemorrhaged money for decades, are already strained beyond the breaking point. Add to this overburdened system another forty million patients, and then start allocating resources, as you suggested, according to age. Grandma has every reason to be concerned.

    4) As for sacrosanct rights, they are nothing but human conventions, and are whatever we decide they are. Of course there are utilitarian calculations to be made regarding allocation of resources, but when the resources are all to be allocated from a single pool by government bureaucrats, options — degrees of freedom — dwindle. I am inclined to resist legislation that moves us in that direction. And I can tell you the British health-care system is no bed of roses, despite what Paul Krugman would have you believe.

    5) Infringements of liberty come in various forms. Keep in mind that every right imposes a corresponding obligation. Your right to FDA-approved drugs obligates a researcher, for example, to withhold a profitable and life-saving drug from the market for years whilst submitting to a burdensome and costly approval process. It may fairly be argued that in this example it’s a price worth paying, but let’s not pretend that individual liberty is not always and everywhere infringed by expansion of government regulation.

    Is individual liberty an absolute good? Perhaps not, but here in America it is about as close as you can get. It is the very wellspring of American exceptionalism, and should not lightly be attenuated. Here’s Dennis Prager:

    Hillel, the most important rabbi of the Talmud (which, alongside the Hebrew Bible, is Judaism’s most important book), summarized the human being’s obligations in these famous words: “If I am not for myself, who will be for me? But if I am only for myself, what am I? And if not now, when?”

    What does this mean in the present context? It means that before anything else, the human being must first take care of himself. When people who are capable of taking care of themselves start relying on the state to do so, they can easily become morally inferior beings. When people who could take care of their family start relying on the state to do so, they can easily become morally inferior. And when people who could help take care of fellow citizens start relying on the state to do so, the morally coarsening process continues.

    There has always been something profoundly ennobling about American individualism and self-reliance. Nothing in life is as rewarding as leading a responsible life in which one has not to depend on others for sustenance. Little, if anything, in life is as rewarding as successfully taking care of oneself, one’s family and one’s community. That is why America has always had more voluntary associations than any other country.

    But as the state and government have gotten bigger, voluntary associations have been dying. Why help others if the state will do it? Indeed, as in Scandinavia, the attitude gradually becomes: why even help myself when the state will do it?

    And regarding socialized medicine, here’s Mark Steyn (my emphasis):

    It’s often argued that, as a proportion of GDP, America spends more on health care than countries with government medical systems. But, as a point of fact, “America” doesn’t spend anything on health care: Hundreds of millions of people make hundreds of millions of individual decisions about what they’re going to spend on health care. Whereas up north a handful of bureaucrats determine what Canada will spend on health care — and that’s that: Health care is a government budget item. If Joe Hoser in Moose Jaw wants to increase Canada’s health-care spending by $500 drawn from his savings account, he can’t: The law prevents it. Unless, as many Canadians do, he drives south and spends it in a U.S. hospital for treatment he can’t get in a timely manner in his own country.

    … How did the health-care debate decay to the point where we think it entirely natural for the central government to fix a collective figure for what 300 million freeborn citizens ought to be spending on something as basic to individual liberty as their own bodies?

    I’ll say it again: an overwhelming majority of Americans, including me, think the laws governing healthcare in this country could be improved. This bill was clearly not the right way to do it, that’s all. Now the bill is dead, and the public uprising that killed it has done a lot to restore my faith in America’s fundamental character and principles. Back to the old drawing board.

    Posted January 24, 2010 at 12:08 am | Permalink
  25. the one eyed man says

    I’ll respond briefly (OK, not so briefly) and then leave any further comments to you and others.

    1) Well, yes. The Republican leadership and their allies abdicated themselves from the process. There is no Republican plan, no Wall Street Journal plan, no Rush Limbaugh plan. (If there is, what is it?) All of their efforts were devoted to destroying any and all efforts at health care reform, with no efforts towards negotiating or presenting serious alternatives. I’m not sure if the Democrats are altruistic, but I give them a lot of credit for tackling a difficult and intractable problem which is a political loser from the get-go, and making a serious attempt to solve it.

    2) Malcolm, there are three different questions here. The first question is whether you support health care reforms. This has consistently been in the 40% range. The second question is whether you support or oppose it passionately. Here the numbers are lop-sided in favor of those who passionately oppose. (Let’s not forget that some of the people who oppose it do so because it doesn’t go far enough. The Howard Dean – Kos axis of the left is strongly opposed for that reason.) Passion doesn’t count for much in politics: it’s one man, one vote, even if one man’s voice is louder than another’s. Those who initially opposed the fiasco in Iraq were far more passionate than those who supported it, but their voices were ignored.

    The third question is whether Congress should simply drop consideration of a health care bill. Count me in the 61%. It’s obvious that the Republicans will use the filibuster to prevent anything from passing, so it’s pointless to continue. (Actually, I would like to see the Democrats force a filibuster for the political theater value. If the Republicans are going to stand up for the status quo, let’s see them do it.) I stand by what I’ve said all along: there is a substantial percentage of Americans who want to see health care reforms enacted, and it has consistently been around 40%. They may not be as passionate about it – if I thought that the government was going to impose death panels or eviscerate Medicare, I’d be passionate too; on the other side, talk about public options and Medicare reimbursement rates is not the sort of stuff to get people all steamed up – but at a consistent 40%, Brooks’s claim that the reforms are “brutally unpopular” is simply untrue.

    3) It’s arguable whether Medicare is broken or strained. I think a fairer statement is that it is currently solvent but faces a financial problem in the years ahead because of demographic trends and aging baby boomers, which can be compensated for by an increase in FICA withholding. Speaking for myself, I would be happy to pay higher taxes for universal health care and a more robust Social Security. Or cancelling Bush’s tax cuts, which I benefit from. Or reducing Bush’s prescription drug benefits and reallocating some of the money to insuring the uninsured. There are lots of ways to provide the same level of universal health care which nearly all major industrialized nations provide to their citizens, while absorbing the financial hit in a responsible way.

    4) I would prefer resources to be allocated by the government than by insurance companies and lobbies. The government is a disinterested party and, with the right set of minds on it, can determine the most humane way to allocate resources. Insurance companies, pharmaceutical companies, the AMA, and the senior lobby are intrinsically self-interested parties, but they have been the ones which have built our health care system.

    5) Re Prager: the issue is not the “people who are capable of taking care of themselves (who) start relying on the state to do so.” It’s about people who can’t take care of themselves or their families. Someone who is unemployed and uninsured cannot afford extensive medical treatment: it’s as simple as that. Perhaps the most distressing part of the health care debate, aside from the political shenanigans, is the way in which we seem to care only for ourselves and not for those who are in trouble and need help. You get the feeling that Republicans lay awake at night and tremble at the thought that they would be asked to contribute money to a government program where someone, somewhere gets helped by it. Sure, American exceptionalism was built on individualism, but it was also built on the notion that we are all parts of a unified whole – e pluribus unum – and it is our collective duty to take care of those who are unable to take care of themselves. It disturbs me greatly that there are so many people in this country who are aghast at the thought that they might have to sacrifice something so others may get health care. Which brings us back to the beginning: some of them will inevitably find themselves facing a catastrophic illness without access to health care. Doubtless it will lead to an epiphany, but one which is too late to do any good.

    Posted January 24, 2010 at 3:29 pm | Permalink
  26. Malcolm says

    Peter,

    1) That’s just not true. Here, for example, is a 219-page proposal from the GOP. You may not like it, but to say that the Right offered no alternatives is simply false. And if the Democratic proposal is a “political loser from the get-go”, then you are saying is that it is something that you think should be forced on the people even if they don’t want it, which is exactly the sort of we-know-best liberal paternalism that has so many folks so hopping mad.

    2) Glad at least that you agree the Dems should, at this point, just drop it. I will also point out that saying “hey, 40% of voters support X, even if 60% don’t, and 50% passionately don’t” is hardly a compelling argument for ramming X through Congress. Rather the opposite, I should think.

    3) From a recent Newsweek article:

    That the programs [SS and Medicare] will ultimately go bankrupt is clear from the trustees’ reports. On pages 201 and 202 of the Medicare report, you will find the conclusive arithmetic: over the next 75 years, Social Security and Medicare will cost an estimated $103.2 trillion, while dedicated taxes and premiums will total only $57.4 trillion. The gap is $45.8 trillion. (All figures are expressed in “present value,” a fancy term for “today’s dollars.”)

    By all means, the government could do the things you recommend, if there were sufficient popular support, and decently crafted legislation. What is specifically at issue here, however, is the bill presently at hand, which is (perhaps I can now say “was”) a monstrosity.

    4) Ah, but the government is not a disinterested party. It has, rather, its own set of interests, which often take the form of various types of political and budgetary intrigue. Also, it is entirely reasonable that a free and competitive marketplace may offer better and more creative options than a government monopoly. (That has been, in fact, one of the Republicans’ main points all along: that we ought to remove the artificial barriers standing in the way of free interstate access to, and competition between, health-care providers.)

    5) This is a principled response, of course, and, on the face of it, idealistically well-intentioned in the way that liberalism and socialism always represent themselves. And as I have said, I agree that a decent society ought to “spread a net over the abyss” for those who genuinely cannot help themselves. (And why, for that matter, stop at health services?) But at the same time we cannot ignore the other consequences of our policies, and the interactions between them; for example, you cannot for very long run a welfare state with open borders. To quote Churchill again, you can either have an unequal sharing of blessings, or an equal sharing of misery; if we provide such a cornucopia of state-sponsored blessings that we drive the state into financial ruin, or its citizenry into dependency, lassitude and thralldom, what have we gained? We must strike a responsible balance, and we must honor the will of the people. This awful bill, and the machinations employed to get it passed, did neither.

    Posted January 24, 2010 at 11:41 pm | Permalink
  27. Jeanie Oliver says

    Cannon to right of them,
    Cannon to left of them,
    Cannon in front of them
    Volley’d and thunder’d;
    Storm’d at with shot and shell,
    Boldly they rode and well,
    Into the jaws of Death,
    Into the mouth of Hell
    Rode the last six hundred bleeding-heart liberal Democrats and me!
    Someone blunder’d in Massachusetts in running a woman against a charismatic male. By the time of the election, I declared that I would vote for him. The entire Democratic enclave surrounding me looked aghast, but I want some answers, also. As my husband declares often,”Jeanie would give away the farm for some cause, and the Democrats are losing her in Massachusetts.Someone had better sit up and take notice.” He told our son that it was time for a do-over on the healthcare issue. We have an ongoing fight about all of it.
    I would have tried for a better poetic example, but by the time I read all the points and counterpoints, I was confused on who I would back, Peter or Malcolm! And, actually as you two are far better wordsmiths than I, I decided to fall upon my sword and wait for the next issue that Malcolm can find for you two to discuss!
    Jeanie

    Posted January 25, 2010 at 9:30 pm | Permalink
  28. Malcolm says

    Jeanie, I thought you were down South! Now I’m confused.

    Anyway, you can count on me to keep speaking out on behalf of liberty, responsible government, and core American principles, and you can count on Pete, the loyal opposition, to keep harassing me for it.

    And I do hope you didn’t fall on the pointy end of that sword.

    Posted January 25, 2010 at 10:43 pm | Permalink