The Health Care Debate: Splitting Families Down the Middle

This is an exchange between me and my sister. I've posted it here because I feel it represents clearly the split in the nation on healthcare. Also due to the way she has handled our differences and her choice to cut all ties and continue to denounce me in forums where I cannot defend myself and behind my back, I have decided to end all connection with her.

I'd like you to note the tone of contempt with which she starts out and then notice as she gradually becomes more and more blatantly abusive the more I try to debate the points she brings up. She accuses me of not being civil, but I maintain that all I have done is restate exactly what she has claimed. The exchange ended with her defriending me and severing all contact, which I assume gives me full license to reproduce this conversation on my page so that she doesn't have free-reign to distort the issue any further. If you're interested, please feel free to read this and comment freely. I would be interested in other perspectives on the exchange. You be the judge--who was being rational? Who was flying off the handle with vague accusations?

[Further note: she decided this was hilarious enough to repost this on her page as a note with the heading: "Call me a liberal, but I thought this conversation was fun enough to share...", that was right before I responded with "Well, at least you're being a little more honest now" Let's just say she lost her sense of humor soon after that.]

[Names have been removed to protect the identity of those involved--a courtesy she did not extend to me.]

AmericanAntitheist joined the group WE THE PEOPLE will NOT COMPLY with SOCIALIZED HEALTHCARE!

Sis

Some of us people want socialized healthcare.

AmericanAntitheist

Also you've never lived in a country with socialized healthcare :S

Sis

True, but there should be a public option because it is the only way to actually control costs. Today, a given portion of the population is not covered by insurance, these are the same people who both lack preventable care, and will wait until they are sicker before going to the ER and hence need more treatment and more expensive treatment. The hospital can try to bill them, but may not suceed, causing the hospital to absorb costs. The hospital in turn raises thier fees, which causes the insurance to raise thier premiums. Fact is, we are already paying for the uninsured's treatment, just ineffectively.

AmericanAntitheist

Cost control doesn't work. It just drives down quality. You're ignoring the fact that one of the major reasons insurance and health care expenses are so high is because of the confused nature of and depth of government presence in the health care industry already. Inconsistency in application of malpractice law has driven malpractice insurance through the roof. In the absence of any transparent and explicit guidelines, doctors often feel they have to assign extra tests just to cover their liabilities. This drives up the premium of general diagnostic care. Other hidden costs associated with corporate and small business taxation drive up the cost of employment so that more and more companies shoulder less and less of the benefit cost. Add to this that federal law prohibits insurance companies from competing across state lines and thus eliminates the possibility of developing an economy of scale. Also, one more thought...if socialism worked so great, then wouldn't soviet doctors have been the best in the world? Oh, that's right, most of them risked life and limb to get out. Over regulating the medical industry creates the very serious risk of driving skilled professionals out of medicine and into other fields, or of creating "bubbles" of certain kinds of practitioners. Japan is constantly dealing with these problems. Not enough maternity specialists, so pregnant women die in the ambulance as it runs round in circles for hours trying to find an open maternity ward. Not to mention the complete lack of preventative care. Doctors can only claim a certain amount from the national insurance per visit, so they have to drag out your care as long as possible. I had to go to the dentist 5 times before one would actually pull my wisdom tooth. I get back to the US and my dentist takes care of everything in a couple months. Be careful what you wish for, you may get it.


Sis

They call it an option because it is optional - you can still get regular insurance if you want it. And nobody's saying cold-war Russia was better (tell me you aren't a tea-bagger, please tell me that). But, one way or another, we the people are still shouldering the cost. Do you really think that the insurance companies aren't also driving the MDs out of their fields with pre-authorization clauses and deny-first policies and endless phone trees just to get paid for a single office visit? Why do office visits cost a 120$? Because you see the doctor for 15 minutes, and it takes an additional 1.5 hours of work to get the claim paid. And, it's almost always for profit. So every dime the insurance company can take and not pay out, goes into a golden bucket for the CEOs, whose greed is usually limitless and guilt-free. It is therefore not in their own best interest to pay your claims, it is in their best interest to cancel your policy if you are *too* sick. Once you are retroactively canceled on a technicality, you are well and truly screwed, because your hospital stay was twenty thousand dollars and since you weren't technically insured to begin with, now a pre-existing clause applies on any new policy you try to purchase - meaning they will not cover any future expenses for your illness. Now, you must claim bankruptcy, assuming you are alive, and the burden of that cost goes back to the hospital who passes it on in a never game of hot potato. All I'm saying is that since we are shouldering the cost anyway, and since it isn't truly a free market, but is instead nearing a monopoly, we may as well have it regulated and standardized. Besides, there is medicare and social security and the ER but if you are not old enough and neither sick enough nor poor enough, you fall between the cracks because these programs do not cover everyone. I'm looking out for my own best interests, when I say let's get a public option in place before the potato lands on me.


AmericanAntitheist

I'm not a tea bagger in that I've never been to one of the tea parties, but I am an Objectivist, which means that I hold that the responsibility of the government is to protect individual liberty and little else. The notion that somehow the government has the ability to magic health care to every body at no cost is ridiculous. Health care is not a right. Insurance is not a right. We cannot be entitled to services which require a living being to bestow them. We can only negotiate terms to mutual advantage. The notion that somehow we will be saving money by having the government handle it for us ignores the reality that every single government entitlement program adds a the burden of running a new bureaucracy to the real cost of all the services involved. It also ignores that evry single government move into the provate sector has had negative repurcutions across the economy. Is the current system corrupt? Yes. But the reason is not the unfettered greed of private corporations, the reason is the stinking cronyism of corporations propped up by government bailouts who are endorsed and subsidized into continuing unprofitable activities and who then pass that loss onto the consumer. Just as public education drives up the cost of private education and provides a mediocre product, you can expect the presence of a public insurance program to drive up the costs of private insurance even more and to manifest itself in all sorts of hidden taxes (i.e. the value of our currency, inflation, and the other possibilities I stated previously.) Is reform needed? Certainly. But the reform we need is to move away from the statism socialist society into which we seem to be slipping and back towards our laissez-faire roots.

Sis

I'm not going to go into the objectivism thing with you, I already know that you vehemently believe whatever you believe.

It is not by virtue of it being government run that makes the public option magic. It is by virtue of having the burden of the sick, which I firmly believe we are already paying for indirectly, spread more evenly across the population. All insurance is by nature already socialist - it's just socialist on a per company scale. Short version is that as a healthy worker you are likely to pay more into the insurance program via premiums per year than you are to withdraw via claims (and the employer often subsidizes this to help keep it affordable). But, if an employee has a severely ill child, they are likely to take out more than they put in, and if it's a small company, may take out more than the entire company puts in. If at any time insuring a company is costing more than they are bringing in, then the insurance simply says - pay a higher premium or cut your benefits. Paying a higher premium just distributes the costs across everyone, however, if a company cannot afford to do that, then they may just cut benefits. Cutting the benefits is great because in addition to the $2400 premium each year, a healthy worker now cannot see any payout until they've met the $1000 deductible. If you are relatively healthy, you may not meet the deductible at all. Meaning, that you are paying into a system which does not benefit you one dime on a yearly basis - but we all do it because we fear being the one who is sick. Where the burden of one sick child can astronomically increase the cost of insurance for a small company, larger companies are able to shoulder this burden better because they have more people paying in to the system. A larger base to draw from, means a lower expense to everyone. If said system were nationwide, the base to draw from would be much larger. Hence, why a public option would help small businesses (and sick children with little puppies). The current system is already socialist, it's just uneven in it's distribution, placing a higher cost on small business and a lower cost to conglomerates. Bureaucratic costs will always exist - the question is, do the costs outweigh the benefits of having a public option? No, I don't think they do.

AmericanAntitheist

It's curious to suggest that more of a bad thing will somehow make it better. As for the nationwide economy of scale, that could be realized through free-market principles as well, were it not made illegal by the very same government that you suppose will make it all work out. I am well aware of how insurance works. Insurance is not socialist by definition. There are free-market solutions to these problems. I don't see how you can support further government control of these systems when you already concede that the system (which is already heavily government controlled) is contradictory and wasteful. I have never seen a government organization which was not so. Do you seriously think that an insurance company simply run under the government's name will be more respectable, trustworthy and less prone to abuse and "unfettered greed" than a private company? If you haven't noticed, the government doesn't seem to have a lot of money left to fund these things. Perhaps you didn' notice that the very greed mongers that you berate are those companies propped up by the government already. Remember AIG? How much money did we sink into floating that organization and for what?


Sis

Now, now, don't get angry just because I'm challenging your assumptions. I'm only discussing a public option, not whatever other stupid things the government has been doing lately. I'm expecting you to counter me with logic. Try to educate me as to why your path is better, rather than just saying blanket statements that a free market would solve everything and that the government is evil.

Insurance is socialist on a small scale because it is a system where a bunch of people pay into it and only those who need it withdraw out.

A free-market does not work in this instance because it is not in the insurance industry's best interest to insure everyone on thier own, even if they did compete accross state lines.

You are very quick to try to shoot down the public option, but haven't told me your solution. I mean, a practical solution that could get through Congress and make improvements in the lives of the uninsured or underinsured. Obviously you aren't going to overthrow our existing governmental system any time soon, so what solution do you support? Keeping the devil you know vs the devil you don't?

AmericanAntitheist

Well, I did say. Withdraw governmental controls on the insurance and banking industry, stop bailing out failing businesses and financial institutions, allow insurance companies to market across state lines thus developing the same economy of scale, dismantle the FED and return interest rates and currency to a real standard rather than arbitrary political manipulation. (For starters...) All of these things have been changes mandated by government which created the problems we are now experiencing. It is just as simple to unmandate them.

Insurance is a VOLUNTARY enterprise. This is not socialist. Socialism is by definition "a theory or system of social organization that advocates the vesting of the ownership and control of the means of production and distribution, of capital, land, etc., in the community as a whole."

Insurance companies are private businesses which set the terms of coverage and collect premiums to fund that coverage in the event it is needed. It is funded by voluntary contributions to the whole and is paid out along the terms mandated in the insurance contract. If insurance companies are not meeting the terms of those contracts, then it is within the province of governmental authority to hold those companies accountable to the terms of their contract under existing fraud laws. Insurance prices are driven by the risk and reward generated by market, legal, and political conditions. It is the presence of government guarantees to failing megacorporations which incentivizes unprofitable activities. It is the support of those corporations which pass the costs onto the taxpayers.

A socialist insurance system would be one where the insurance is owned and managed by the government, where it is funded or at least partially supported by government through taxes on the people and the government establishes the terms of payment. Interestingly enough, social security and medicare were intended to be socialist insurance paradigms and they're going bankrupt. I wonder what is to keep this new mandate from following the same path? It seems very noble to suggest that a socialized insurance option will somehow make healthcare available and affordable to all, but it doesn't explain how it will be paid for, and it fails to make an accounting of the numerous side-effects that the introduction of such a program will have on the cost of health-care and private insurance.

Also, since the government is in the business of enforcing contracts, it seems like a conflict of interest to have the government so tightly entwined with the insurance industry. The reason being is that if the government decided to change the terms of the coverage due to fiscal insolvency or political maneuvering, who will enforce the contract? It will be exactly like social security where the government can shift the terms at will with impunity, after of course it has already collected all the payments and spent the funds. When an insurance company goes bankrupt, there are legal procedures in place to dissolve the assets and pay back the investors (as well as the aforementioned legal procedures for determining fraud). At least that was until Obama decided that bondholders don't have any rights and that the taxpayers should be burdened with propping up zombie corporations.

It is not the business of insurance companies to ensure 100% of the people. They offer insurance on the terms of risk they are willing to accept. It is unprofitable to insure high risk cases, just as it is unprofitable to make loans to high risk clients. Incidentally it was exactly for this reason that the housing crisis occurred which started this whole mess. A complex tangle of government regulation mandated that banks lend to high risk borrowers. Obviously they couldn't pay back and it sparked a chain-reaction throughout the financial system. The same thing happens when you insure regardless of risk, too many inevitable payouts and before you know it the system is bankrupt. You may think that worrying about how we are supposed to pay for this is incidental but I insist that it is fundamental.

Inevitably, those who produce more, who have less need of insurance will be burdened with maintaining the depleted reservoirs of the needy. The disincentive to productivity this will incur is profoundly socialist and flies in the face of everything a society based on individual choice and responsibility stands for.

You seem very quick to shoot down the free-market option, and yet you have not explained how this public option will be maintained. You also seem to resist the challenging of your assumptions. I have explained that I do not assume that it is the obligation of insurance companies to insure everyone regardless of risk and in spite of taking a loss. And yet you seem to assert that the public option will guarantee coverage of everyone regardless of risk. I think that makes it incumbent upon you to explain how this principle can be maintained in reality. You are after all supporting a large fiscal commitment on the part of the government, which btw is an imposition on all of us who pay taxes. I am simply advocating that people pay their own way.

Sis

Your "free market option" isn't an option at all. It doesn't insure everyone, which is what we're discussing, and no amount of deregulation and free competition would make them. So, your way of insuring everyone, is to... not. It costs too much.

I think healthcare IS a right. Surely "life" is one of our unalienable rights. What you fail to understand is that no man is an island, we all live within a community of people, not all of whom can afford healthcare. The bus boy(/self employed designer/ recent college graduate/ homeless person in the bus/ fast food worker/ etc)'s health is very much my own issue if only because of physical proximity. One sneeze and I get swine-flu.

I refuse to believe the money doesn't already exist - we all know about government pork, which could be eliminated to pay for healthcare. Even if not, I wouldn't mind paying a little more on taxes if I felt I was getting a tangible benefit from it, like healthcare for all (of course adding a commuter train system locally would also be nice). I definitely wouldn't mind a tax on those earning over 250,000 a year to pay for it - even if some day I earn that much.

"It takes a neighbor to raise a barn", no one is completely self-sufficient, and no matter how much you'd like to believe otherwise, we are all in this together. The common good doesn't just benefit someone else, if benefits me, too. Someone who is in good health is less likely to burden other programs which already exist (welfare) and is more likely to work for a living - a better life for them, means more income into the program. I fail to see how healthcare for all does not benefit us all.

American Anitheist

(I'm copying my reply to this last bit here just in the interest of keeping this fair)

[Note: At this point she had decided to repost this discussion as a note where she would have the ability to delete the entire conversation at her sole discretion]

AmericanAntitheist

Well, at least you're being a little more honest now. You DO advocate a socialist state then. You think it is fine to appropriate the labor and productivity of all to give to a few. You see doctors,bankers. insurance providers, not as humans with the right to the fruits of their own productivity but as reservoirs to be tapped to fulfill your wishes... See More. I am interested to see how you would feel, were someone lower on the food chain to propose that your freedoms should be sacrificed to provide them with more. But at least I think we understand each other. Don't pretend to want to live in a free society and then suggest that "other" people are resources to be stolen from at will (taking without consent is stealing) and distributed as you wish. I maintain that social rights cannot exist in the absence of individual rights--a society is simply a group of individuals, if individuals have no rights to their earnings, then the society doesn't either. And that is socialism.

This is why it is impossible to debate this without getting into the deeper moral issues--and that would mean getting much deeper into Objectivist morality. If you are sincerely interested in learning more about it, then I would be glad to talk with you on it. If not, then there's not much more to be said. I believe that socialism is immoral. We could get into a deeper discussion on why if you're game, but it would require a sincere interest in reading some of Ayn Rand's philosophical work to get a full and honest picture.

PS: The fact that you wouldn't mind pitching in to help others is not the point at issue. The problem is that you're taking that as moral vindication to steal from others to support your goals. How do you justify stealing from people? You claim the greater good as your justification. So did Stalin, so did Hitler. How is this any different?

Sis

Who is stealing? If we voted Obama in on a platform of healthcare reform, that means that most of us want it. If we are consenting, then how is it stealing? We all knew what we were getting in for during the election, and I'm sorry, but one side has to loose. If you don't like the electoral process as created by the framers, leave. Go somewhere where your ideals are being upheld. Where everyone must work for every single service they have and any random chance accident or illness could mean failure, starvation, and death. Let's call it Isla de You, current population 1.

Thankyou for your kind remarks upon my character, they were perfectly logical and not incendiary at all. Why I sure hope the cops aren't coming for me! You don't seem to understand that a person can be both free and conscientous. Just as you don't understand that a person can be moral and disagree with you. You are an extremeist, yes, every bit as extreme as the far right, the anti-abortionists or the al Quaeda. There is no middle ground for you. And because of that... Have you ever gotten a book from the Library? Surely a free and public library would not exist in your philosophy since there is no financial incentive to running a service like that. Have you gotten a free and public education? It may have been mediocre, but at least you got an education adequate enough to get you elsewhere. Have you driven on a public highway or ridden on a public transit system? Have you been to a public park? Have you received mail? When you retire, if social security is still available, will you take that money and live off it? Will you take medicare, too? For all of these things that you have recieved by your own definition, you, yourself, are a theif for you took them from the pool of available socialist resources, and then you went to Isla De You from whence there is no return.

Yes there is government waste, yes there are problems with our current government, and yes, I do want a free society. I think perhaps our definitions of freedom may differ. You seem to like a sheriff-less laissez-faire (from the french meaning do nothing) wild west town where everyone can be free to exploit each other at will. You see I'd like to be free to do what I want within the law (which I currently can) and not live in fear of loosing my insurance (which I currently cannot). The way I see it, we are being held hostage by the insurance companies, because there is no alternative to them. It's either insurance or steep debt. Isn't the public option in that sense providing much needed competition into the market? If the insurance companies then go under, wouldn't that be because they failed to offer a better product at a better price?

You have found an excellent way of writing off all personal responsibility towards your friends, neighbors, colleages, and yes, strangers. But luckily you live in a place where your freedom to be an ass is protected. So quit whining about stalin and hitler - there is simply no comparison there. Adding healthcare to the list of currently available services would free people from the unrelenting weight of private insurance coverage. It would not turn the country into a fascist regieme. Or is Canada fascist now? It's so hard to tell.

And, finally, you know you have a problem when you find yourself on the side of Glen Beck.

AmericanAntitheist

I didn't vote for Obama, a lot of people didn't either. Simply having a majority of people decide to steal from a few isn't rule of law, and isn't consent. Unfettered democracy was not intended by the framers of the constitution. They understood it leads to exactly one thing...mob rule. That is why we are a Constitutional Republic and not a Democracy.

Why were my remarks incendiary? If you believe that socialized healthcare should be enacted regardless of opposition because you have the "might" to make "right" then I don't see my remarks as anything other than stating the facts of your viewpoint as you present them. You ARE advocating stealing from people. You simply don't want to use just those words. You are entitled to your belief, but at least let's be honest about what socialism in any form means.

I do not advocate for socialism. I am not asking for socialist programs. Simply because they force them on me does not make me an active participant in their realization. That is why I actively oppose these programs (including public education, public welfare, public ownership of property), because I realize that if I were actively involved in creating these programs then I would be morally responsible for their effects on other human beings. You ARE actively advocating for these programs so you ARE morally responsible for their outcomes.

Some things do not have a middle ground...like mathematics. Like life and death. When we are talking about life and death it is a very black and white issue. Any amount of death injected into the social system is bad. Period. Every penny that the government takes from people makes it that much harder for those very same people to improve their lives. The government is less efficient than the market at providing services for an appropriate cost. But beyond that, the government (i.e. any mass of people) does not have the moral right to take by force the earned product of a person's labor.

I do not advocate anarchy. And I am not a fan of Glenn Beck (he is far too religious). I advocate the terms of a Constitutional republic wherein are guaranteed the rights to life, liberty and the pursuit of happiness. But the right to life is not a guarantee of life itself and cannot exist without the right to liberty and property. By surrendering the latter you do, indeed, surrender the former. They are inseparable.

And no, I do not write-off helping people who need it, whom I am within my power to help and who I deem worthy of such help. But it is MY choice who to support with my labor, not yours. It is MY choice how much to give and when and under what conditions. If you presume to suggest that you have any right to dictate by force of government how any other person should dispose of their assets then you ARE in point of fact and by DEFINITION advocating thievery. The responsibility of social reformers in a free society is that of argument, of convincing people to donate their assets to a given cause. It does not entitle anyone to just take them by force or fiat.

If you are upset with the label, then perhaps you are the one who should reassess their values more closely. You haven't demonstrated at all how my assertions are in error. If you remember, YOU were the one who started attacking my beliefs in this matter. I have shown just what the systems you support lead to. If any of this is in error, please address the point in question. And no, Stalin and Hitler are very much still relevant. They ruled on the basis of imposing government controls and appropriating private assets for the "greater good". Simply because that is what statists assert will happen, it doesn't make it so. You tell me how I am supposed to trust our government with the same powers and ill-fated philosophy of those other regimes. If the philosophy is different, then tell me where. Are you suggesting "it can't happen here?" I would remind you that Hitler was elected. The suggestion that America must be free by definition is naive in the extreme. People can be legislated into slavery just as surely as they can be conquered into it. Are you suggesting that "but this time it'll be different?"

Sis

Sorry, are you still talking? cause I stopped listening once you called me a thief. Sorry, not even gonna read your post, nope. Don't care, you're an ass. Your opinion is meaningless because you can't even discuss it with civility. So, bite me.

[An interesting addendum, is that Sis couldn't calmly defend her views in our discussion, had an emotional fit, and then severed all contact...only to then write a scathing bit of character assassination on her personal blog where I presume any defense of mine will also be ignored. It's interesting that she accuses me of refusing to see things from anyone else's standpoint, but I am actually the one trying to explain my views and asking her to defend hers. She's the one who has cut off contact so that she can villify me with impunity. I'd link to her blog entry, but she also doesn't have the courtesy to anonymize personal conflicts in public. In the interest of protecting my family from potential wackos who may take umbrage at my anti-theist views I cannot publish my identity openly like that. Too bad, it's some really one-sided stuff, published in a venue where I cannot debate or defend myself. It's just like I've always said, it's very difficult for liberals not to resort to ad hominem and character assassination, because they really don't have a logical, rational argument to support their stance.]