It’s my party, and I’ll vie if I want to
By BRAD WARTHEN
Editorial Page Editor
INSPIRED BY Ariel Sharon’s decision to abandon the Likud Party he helped build and start another, more centrist one — one that immediately began to catch on to the extent that it looks as though it will propel him past the established factions and into another term in office — I posted a blog item last week that asked, “Why can’t we do this here?”
Excited at the idea of “giving those of us in the sensible middle an actual alternative to the mutually exclusive, mutually loathing Democrats and Republicans,” I got right to the business of setting up my own faction, posing such questions as: What would be the precepts of such a party? What should we call it? Who would be some good candidates? What animal should be our mascot?
My respondents quickly brought me down to Earth. I heard from both sides of the partisan divide, and the more ardent were soon ignoring my questions and clawing each other. But both sides seemed to agree that those of us who eschew the current phony ideologies don’t believe in anything ardently enough to get things done.
What a relief when “David” spoke for me by writing, “I am always intrigued by this argument that moderates aren’t passionate about anything…. I take every issue on its own merits and when I make up my mind, I am as passionate and diehard about that position as any conservative or liberal could ever be.”
Exactly. Why is it so hard for partisans and ideologues to understand that we might hold our own values and positions even more passionately than they hold theirs, for the simple fact that they are ours. We didn’t do what they did, which was to buy an entire set of attitudes off the rack, preselected and packaged by someone else, and chosen based on nothing deeper than brand name.
Is there anything wishy-washy about the stands taken by such “moderates” as John McCain and our own Lindsey Graham? Was Joe Lieberman being a fence-sitter when he helped push through the Iraq Liberation Act, which way back in 1998 made the overthrow of Saddam Hussein the official policy of this country?
These are the people who take the independent risks that make things happen, from campaign finance reform to banning torture. Without them as pivots, giving ideas credibility by virtue of their own independence, we’d be forever in a state of stalemate, unable to settle any difficult issue.
And those of us who support their like are the ones who decide elections
— not the partisans, who can be taken for granted.
The best thing is to have no parties. But it’s still fun to imagine what kind of party we who despise them would create if we were so inclined. Let’s give it a go.
Right off, I’m stumped as to a name. So for now, let’s just call it the “Unparty.” (After all, the “Uncola” caught on for a while.)
Are there any fundamental, nonnegotiable tenets? Sure:
- First, unwavering opposition to fundamental, nonnegotiable tenets. Within our party would be many ideas, and in each situation we would sift through them to find the smartest possible approach to the challenge at hand. Another day, a completely different approach might be best.
- Respect for any good idea, even if it comes from Democrats or Republicans.
- Contempt for any stupid idea, even if it comes from our own party leaders.
- Utter freedom to vote however one’s conscience dictates, without condemnation or ostracism from fellow party members.
Every Unpartisan would have his or her own set of positions on issues, having worked them out independently. But to banish the thought that Unpartisans don’t take strong stands, here would be some positions I would bring to the party table (and remember, this is just me, not the editorial board of The State):
- Respect for life. Opposition to abortion, the death penalty and torture of prisoners.
- Belief in just war theory, and in America’s obligation to use its strength for good. (Sort of like the Democrats before Vietnam.)
- A single-payer national health care system — for the sake of business and the workers. If liberals and conservatives could stop driving a wedge between labor and capital for about five minutes, we could make this a reality.
- Universal education — as a state, not a national, responsibility. Go ahead and shut down the U.S. Department of Education, and make sure you provide equal educational opportunity for all on the state level.
- A rational, nonideological energy policy that will make us independent of despotic foreign regimes: Drill in the ANWR. Impose strict efficiency standards on Detroit. Build more refineries. Since we are at war and they are helping the enemy, build internment camps for Hummer drivers. (OK, scratch that; just make the Humvee like automatic weapons — banned for all but military use. In fact, what was wrong with the Jeep?) Launch a Manhattan Project to find something better than fossil fuels. Take the advice of Charles Krauthammer and set gasoline permanently at $3 a gallon — when the price of crude drops, raise the tax to keep the pump price at $3. Unlike Mr. Krauthammer (who’d use the proceeds for tax cuts), I’d make like a real conservative and balance the budget.
Such ideas are not left, right or wishy-washy. Admittedly, in my zeal to debunk the myth that we “moderates” (an inadequate word, really, for independents) don’t take strong stands, I’ve deliberately chosen some ideas that are attractive to me but are too out there for my own editorial board. (Although the issues they address are similar to some set out by potential Unpartisan Paul DeMarco in comments on my blog.) But wouldn’t that make for some lively Unparty conventions? And wouldn’t they be more worth watching than those scripted, stultifying pep rallies that the Democrats and Republicans hold every four years?
I certainly think so. In fact, that’s one point on which most of us Unpartisans could agree.
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Brad, with few exceptions I think you have a workable, supportable, and realistic platform. Pro-life, strong military, energy independence, high quality education, and a balanced budget are all excellent goals. The single payer health administration smacks of a medical version of the USPS which concerns me. That would depend on how it is set up. Overall though you surprised me with these good ideas. Issues that would also need to be addressed are immigration control and border security and the ultimate bankruptcy of Social Security and Medicare. As for Hum-Vees, if the scientific community ever discovers the energy breakthrough you noted, then why should we ride around in Coopers?
I almost want to say, “Brad Warthen for President!” If you lead this party, I will join it! Even the health administration idea is good. This could work well, if it stays lean and (to a certain extent) mean. Having lived in Germany for 28 years, I saw national health work well. Unfortunately, it isn’t working so well anymore, as people and politicians have the continual tendency to pad entitlements in order to get votes. But keep up the good ideas! And I hope The State and your editorial column stay around for awhile.
Brad,
I’ll admit, I liked most of your positions, but the “single payer healthcare” system has to go. That is simply code for socialized medicine, which has worked out pretty well for, well, nobody. What we need for health care is the following:
1-Tort reform so that juries don’t act as lottery commissions for those who sue hospitals and doctors. For that record, the state should have a review board to ensure that an expert panel reviews cases before they go to court.
2-Large tax benefits for health savings accounts to urge people to use thier insurance wisely.
3-Remove elective surgeries like stomach stapling and nose jobs from covered procedures for medical insurance. These increase the fees that all of us have to pay.
4-Fund Medicaid at the state level only and make it a temporary program for adults. It should be a safety net, not a crutch. Children should be able to stay on it till thier parents can financially pay for it, but parents should be held accountable. If they can buy a new car, they can pay for insurance.
5-Lastly, educate the public on how to stay healthy and ensure that children do when they are at school. PE is very important because many kids will be allowed to sit at a video game for the rest of the day when they get home. Meals at school should be healthy and wholesome.
If you take care of those items, you won’t need a government system. You will need government oversight, just like you have for banking, but my tax dollars won’t have to underwrite the plastic surgery that my neighbor wants.
One last comment on your editorial though. Why can’t one look at each issue and still come to a conclusion similar to that of a party? While I am against the death penalty, and hate that the GOP appears to be turning into the party of torture, I see few times that I would vote for a Democrat because I am both a social conservative and fiscal conservative. Does that make me a Kool-aid drinker, or does it just mean that I have principles that line me up with a particular party most of the time? Unless you are socially conservative and fiscally liberal, there is a party for you already. And doesn’t starting a party take away your independence?
Nathan,
I’ll respond to your last paragraph.
I think you can come to a conclusion similiar to that of a party. One thing I have found interesting about the Repub and Dem party is they are far from consistent. Repubs use to blister Bill Clinton for his spending and his long laundry list of “wants” in his state of the Union addresses. Rush and others like him would talk about all the money it would take.
Yet – President Bush has been the biggest spender in the history of our government even when you take out military related spending. Never hear Rush talking about what a big spender President Bush is though. Of course not, he has to be loyal even if he is being totally hypocritical.
The problem comes in when Republicans or Democrats won’t allow their members to vote for a perfectly good bill because of
1) A congressman from the other party sponsored the bill
2)you can’t change your mind – ever – even if come to know you were wrong. If you do you are seen as “the weak link” in your party and you get blistered and blackballed from the leadership of either the Repubs or Dems.
I also have seen few times I could vote for a Democrat recently. But I have done so – even if I didn’t agree with them on every social issue.
I voted for Inez Tennenbaum when she first ran for Sec. of Education because her opponent (now sadly deceased) spent all of his time talking about vouchers. That was his issue- that was basically all he had to talk about. That issue wasn’t going to get through the legislature – as we know now even Mark Sanford couldn’t get it through right after he won election.
I didn’t want to vote for someone – who I probably agreed with on social issues- because I knew he would spend his entire term talking about one subject that would never – EVER pass.
Oooh, the best of the French and Canadian systems! More on that perhaps later.
But every time I hear or read “Manhattan Project” I cringe. That project succeeded beyond its creators’ wildest dreams mainly because there was a clear vision, no outside scrutiny or interference (it was highly classified, so only the dirty Commies had a clear picture), and a virtually unlimited budget – about $20 billion in 2004 dollars. What united those involved was a war-time attitude to defeat the enemy, allowing 130,000 people to build three nuclear bombs in four years.
How about Project Apollo? Eight years, $135-billion (in 2005 dollars) for a dozen or so folks to walk on the moon and almost 841.5 pounds of rocks. Don’t get me wrong, I supported it and still think it was a great idea, but we were then in a race too, to beat the Russkies, and we won. Behind the bucks was a drive and devotion that’s impossible to re-create today.
Take environmentalists. Please. Try doing Apollo today, and don’t even think about a Manhattan with anything but bourbon – we can’t even test a nuke or two, not even on the Fourth of July, with or without barbecue and beer.
Few readers of this blog have been engaged in a large project development and don’t appreciate how tough, challenging, and complex it all is. It’s especially hard for a governmental entity to do because of the politics, disparate goals of the stakeholders, budgetary uncertainties, etc. Even if everybody can agree, it’s quite hard to overcome bureaucratic inertia.
Exhibit A is Jimmy Carter’s Synfuels Corp. (PDF link), stillborn. Exhibit B is the Human Genome Project, something only the government could do, no? No. This thirteen-year project would have taken a lot longer, were it not for private enterprise. A crazy guy — Craig Venter — jumped in with a different approach to start a neat race between the governments and his company, Celera, a race that we all won.
Your party and Mayor Coble fail to take into account proven economic theory. The government spurs economic development when it supports economic multipliers, things like interstate highway systems, the GI Bill, land-grant colleges, and radio spectrum management. It screws things up by failing to revere private enterprises or plays favorites by chartering the US Synfuels or imposing ex post facto tax on the oil industry.
I’d suggest that what you really want is another crazy guy like Craig Venter to jump in to spur energy development, but I don’t have to because he already has:
So, instead of a Manhattan Project, how about capital-gains and dividend tax cuts along with an investment tax credit?
Brad,
Enjoyed your column today-the headline was terrific.
In thinking about which issues a new party might tackle that would attract a significant following, two come to mind-energy and health care. Perhaps our trademark should be issues that the Republicans and Democrats have failed to address/solve for which our party might offer a “third way. Surely with energy and health care we can do better than we are now. Our party could become a party characterized by “doers” (rathers than simply being a party of “believers”).
I like your idea of a Manhattan project to find legitimate alternative sources of energy (unlikely to be a high priority of a president who has such a strong allegiance to the oil industry).
As for health care, those of you who worry about a “socialist” system-I’ve got news for you-we are already there. I practice general internal medicine in Marion and the majority of my patients have government insurance (Medicare or Medicaid). Private insurance offers few advantages to me. The reimbursements are similar (or less) than Medicare and the private companies have strong motivation to try to deny or delay claims.
It’s easy to advocate cuts for Medicare and Medicaid in the abstract but for those who do so (I’m thinking about Lee here) let me suggest a bedside test. Imagine your neighbor is sick and in the hospital. You can only cut services that you would be able to sit down at his bedside, look him in the eye and tell him he is not going to receive.
It’s one thing to glibly advocate cuts but its another to say to a 70 year old indigent woman who has just fallen and broken her hip, “I’m sorry M’am but since you are unable to pay $20,000 for hip replacement surgery and rehab we can’t do it. Unfortunately, that means you’ll never walk again and any movement of that leg will be severely painful.”
Certainly, we will have to make tough choices about which procedures and drugs to allow if we adopt universal health care (a toughness that was not evident in the Medicare drug bill in which Congress caved in to the pharmaceutical lobby) but I believe it can be done. One need only look at the recent GM layoffs, which were in part motivated by rising employee health care costs, to understand just how severe the health care crisis has become.
Nathan, I’m afraid that even if your five point plan was adopted it would make only a small dent in the problem. What we need is comprehensive health care reform.
So lets be a party of doers, taking on the nation’s most pressing problems and finding a new way that’s best for the people of this country rather than those who pay the lobbyists. Which brings up the question of accepting PAC money, etc. Surely our party would be better problem solvers without the influence of PACs, but could a low budget party really have any impact?
Brad: I enjoyed “It’s my party…” and can agree with most of it (I hate the current political gridlock on being able to talk out problems toward compromise that would help the majority). I’m afraid of taking the competitiveness out of the medical field if it were socialized. If I only have a job under a massive beaurocracy, I’m afraid that I’d clock in and out on time, do as well as I can while at work, and never think of problem solutions outside of the workplace. Can you point me to a URL with a succint web discussion of “single-payer national health system”…are you really talking about socialized medicine?
David,
I can’t really speak of what Rush has to say about anything, since I prefer Bill O’Reilly in that time slot (more independent view). I will say that Sean Hannity (or Rush Jr.) has consistently blasted President Bush for spending too much, the terrible Medicare prescription plan, weak enforcement on the border, and spending way too much on entitlements. Oh yeah, and did I mention that Bush spends too much?
Even those committed to an ideology, conservative or liberal, can call out those in thier party for issues that they disagree on. (See Lindsey Graham, John McCain) Some partisans would rather not do that because they worry it may weaken the party. I think it strengthens the party, by bringing in new ideas and keeping debate strong. But, back to Rush, I am going to assume that he has probably attacked the spending ways of Bush. In fact I may have to check into this.
Nathan.
Rush has a few times but he doesn’t do it with the same passion that he attacks other “liberal” issues. If he did, I would have a beef with him.
Sean Hannity has jumped on Bush a few times. Sean is the perfect definition though of partisan.
A few weeks ago he had Henry McMaster on and called him a liberal (how dumb is that?) because he was concerened about possible price gouging at the pumps in SC after the Hurricanes. The other Conservative guest on his show got to laughing and said he couldn’t help laugh hearing Sean call a diehard Conservative like Henry McMaster a liberal. Sean calls names when he can’t make his argument.
but my larger point is this – calling someone a socialist on these boards is just a method used to discredit someone’s opinion that might be different.
That type of classification might work to end the debate if President Bush was getting the same amount of criticism from his own party people for expanding the federal government faster than any Republican or Democrat in the history of our country.
My argument is this – we have socialism now in many forms and President Bush and his administration have done nothing to stop it- they have increased the role of the Federal government in our lives tremendously.
the end of the first paragraph above shoud say –
“I wouldn’t have a beef with him”
the end of the first paragraph above shoud say –
“I wouldn’t have a beef with him”
Medicare is 200 times the size it was projected to be on this date. Reducing it by 75% would not be much of a cut, to the original authors of the legislation.
The Medicare drug benefit is already 80% over its projection, and it is only one year old. 75% of seniors were already covered, and only 9% wanted it. The GOP passed it to outspend the Democrats and take away (from the media) an issue, by caving in plus ultra.
If my neighbor was sick and needed Medicare, I would want to know why. Maybe the government took so much in income taxes that he was unable to buy medical insurance.
Why not build on the excllent cost-effective health care system we already have in this country for older and disabled Americans–Medicare. It provides good, affordable access to care from doctors and hospitals across the country. It does not penalize people financially if they have a costly condition for which they need ongoing treatment because it allows you to buy supplemental insurance to cover your full costs. It has administrative costs of only 2 percent compared with administrative costs of some 25 percent for private insurers. And,Republicans and Democrats alike value it.
Any private insurance model is going to discriminate against sick people and people with costly conditions. And, as we know, it is going to cost a lot more.
People think of single payer as radical and not feasible but most people love Medicare.
Free market, private healthcare solutions are totally non-discriminatory, because they are neutral mechanisms.
Discrimination comes when people have to ration services, and the worst examples are socialist systems with lower wealth and productivity than the USA. That is why cancer and heart patients are left to die in England, Canada and Europe, unless they buy extra insurance that lets them pay for treatment.
Neutral? I use to work for BC/BS.
Your insurance company can buy another insurance company and dump you if they wish. Not sure what is neutral about that.
Our health insurance system is almost totally backwards and it is very expensive and growing at an incredible rate.
In a large number of states, people who can’t get health insurance are placed into groups of people (pools) and then are forced to pay much higer premiums. The deductibles are often much higher for these plans which that keeps some of the poorest folks from evey going to a doctor because “they don’t want to use their insurance.” Then they get sick because they haven’t went to the doctor in years and the first time they go they are so sick that they are placed into hospitals and run up enourmous bills that they can’t pay for and the state ends up paying for.
I am not sure what the answer to the problem is at this point. We have a complex system and doctors have to hire other companies just to keep up with the paperwork.
When enough companies drop their health coverage altoghter except for very high deductible plans, people will eventually get mad enough that they will demand a change.
some form of universal health care will happen in the near future (10-15 years).
Dave, you don’t understand the difference between arbitrary discrimination by individuals and business decisions.
Insurance companies can drop you, but they cannot refuse to pay your bills as long as you pay your premiums.
American doctors don’t refuse treatment to anyone who really needs it.
Socialism is the rule of men, not law. All all levels, they can deny you treatment because you are a Jew, a black, a political dissident, or as a business decision to ration care. Just ask the survivors of those deliberately killed every year by socialist medical systems.
Lee, that is the exact problem.
I don’t want “business decision” by a company far away to affect the level of health care I receive for me, my wife, if my 2 year old becomes critically ill, etc.
Private business is wonderful. I work for one of the largest companies in the country. We are a multi billion dollar company (I didn’t have anything to do with it). Last year our CEO sent out a letter to every single employee stating how we were quickly becoming uncompetitive in several markets due to the incredible rise in our health insurance premiums. In part it stated that we could only pass along so much of this increase to our customers because we wouldn’t be able to compete in the future. We have good insurance, I wouldn’t say it is great or as good as some I have heard of that basically have everthing covered.
I am willing to pay for my insurance. Glad to do it.
However, I get annoyed at a system in this country that basically hands over your heath care to what company you work for and what insurance they offer.
I want businesses to be free from having to fool around with, mess with, hire people to mess with, be aggravated by, and charged for health insurance premiums.
As a member in good standing of the Unparty, I am taking a position… against positions. Here’s why.
Any time someone takes a position, it automatically creates opportunity for one or more opposing positions, and thereby sets up conditions for polarization. Once polarization has set in, reaching a reasonable solution becomes almost impossible. All sides dig in and the flexibility to seek the creative solution “outside the donut” is lost. The problem becomes fragmented and oversimplified. Reality is swept away by dogmatic rigidity and obfuscation.
A better way exists. One name for it is interest-based politics. All parties to the issue voice their deeper, heart-felt interests, listening respectfully to one another in the realization that all sincere interests are valid for those who hold them. By interests I mean the qualities of the outcome, not some particular features of a position. Try this out on a few of the positions Brad Warthen advanced in his column on the topics of abortion, the death penalty, just war theory, national health care, universal education, or drilling for oil in the ANWR. What are the interests behind such positions? Which interests benefit and which are damaged if any particular position prevails?
When all interests are on the table, the participants then join together in a collaborative effort to find a solution that, to the highest degree feasible, satisfies all interests. Few if any get everything they want. Most get enough of what they want to be satisfied. A few may come up somewhat short, but in the realization it is the best they can expect, and certainly better than what they’d get out of a polarized struggle. Everybody, except for perhaps a few die-hards at the margin, supports the solution.
The result is a robust solution — a solution that is effective in solving the problem — a solution that endures in the face of challenges and threats delivered up by reality. It is robust because it is not based on rigid positions. It is adaptable. It is flexible. It is agile.
The process principles and practices for this collaborative mode of politics exist and are well perfected. I suggest you look at the web site of the National Policy Consensus Center at the University of Portland at http://www.policyconsensus.org, or contact Victoria Taylor Consulting Services Group, vetaylor@adelphia.net.
Making collaboration work requires some shifting in our thinking and habits — away from defending positions, toward a mutual effort to understand and realize the interests of everyone in the game. It requires shifting our ideas of leadership — away from the hero-genius who comes up with the answer — away from the partisan leader who champions one or another position — toward leadership that focuses on engaging all sides in the collaboration, and facilitating the process. If Brad Warthen’s Unparty offers candidates for office, that’s the kind I’d like to see.
Lee,
If your neighbor was sick and needed medical care, it would be most likely that he was one of the working poor or a senior citizen on a fixed income.
It appears from your comments that you have very little first hand knowledge about how medical care is delivered in this country.
The current system (or lack of same) does not serve the working poor or the self-employed well. Health insurance is now too expensive for many people, so they skip preventive care (mammograms, cholesterol checks, etc) gambling that they won’t develop breast cancer or heart disease. Or they postpone care of their diabetes or hypertension until their kidneys are ruined and they need dialysis.
A system that provided simple preventive care for all Americans would likely save money and certainly allow us to be healthier.
As for your statement that “American doctors don’t refuse treatment to anyone who really needs it”-I wish it were true. Many physicians opt out of Medicare or Medicaid so they are inaccessible to that population. I have had dozens of patients who I referred to out of town specialists come back to me saying, “I couldn’t see Dr. X because I didn’t have insurance or he wouldn’t take my insurance and he wanted $200 up front.”
It is true that emergency care is available to all but this is the least efficient, most expensive way to render care.
Lee, your macroscopic, market based approach can be useful, but it is not the right model for medical care. People don’t shop for medical care the way they buy cars and doctors are not car salesmen.
Paul,
Amen. I think Lee operates in the world of “Theory.”
I recently had some medical treatment from a specialist. I was referred by a local doctor. The specialist office quickly told me they only accepted certain insurance and if I didn’t have it, I would have to pay out of pocket at time of service. I got lucky in that my insurance was one they accepted.
The thought that ran through my mind though was what about the people that don’t have that insurance. I probably could have paid the bill. A lot of folks would have simply not went and their bills would be much higer down the road when complications arose because they had delayed treatment. That would have doubled or tripled their costs.
Doctors can refuse treatment to anyone they wish. Happens all the time.
Paul,
In your opinion, why is a market-based approach the wrong model for medical care? What differentiates medical care from other services? I’m curious as to how centrist folks reconcile the apparent contradiction. Thanks.
I like the idea but must make a few comments.
How do you resolve the first tenet, opposition to nonnegotiable tenets, with your Respect for Life stand, three apparently nonnegotiable tenets? I oppose politicizing any position that is inherently unsolvable such as abortion. No law will ever approach making everyone happy. If government can ever just say that this is a personal issue then the people can get on with their lives.
National health care will likely be a mess, why not take Ben Carson’s suggestion and guarantee catastrophic coverage by the government. Then private insurers can offer health insurance at reasonable prices knowing that they won’t get stuck if someone needs a heart/lung transplant. Also health insurance should belong to the individual. Once covered they should be able to quit and change jobs without having to give up insurance. Thomas Friedman discusses this in The World is Flat.
Please shut down the Department of Education and provide equal opportunity. But don’t make education mandatory like we have recently. By making the schools keep students who have no desire to learn we drag down everyone. We should encourage education and help fund higher education for anyone qualified. We especially need to encourage science and engineering like we have done at times in the past. If we do not do this and soon we will soon fall behind other countries like China and India.
Why not set our price for gasoline and diesel fuels at the average of the price in Europe. This way we do not have to keep revisiting the price each time the world market changes and we are always on par with our traditional competitors. Just make sure the profits go to reducing debt, paying for improved roads and such, not into new boondoggles like the “Clyburn Connector”.
I admire both John McCain and Joe Liberman. I am proud that Lindsey Graham is willing to do what he thinks is right regardless of the extremes. The radicals on either side promote hate and discontent, injuring our society.
Paul, You would probably agree that a scarcity of any resource drives up the cost. Example – oceanfront land. We have a real shortage of doctors in this country. But, is it not an artificially created shortage? Doctors who de facto control the boards of med schools are the gatekeepers creating the artificial shortage. People with pre-med degrees and excellent gpa’s are turned down for medicine due to lack of seats. Yet, we import many foreign doctors to supplement the base here. I am not involved in the medical profession but would like to hear your opinions on the above. I would add that doctors deserve a very nice income as several of my friends practice and they work long and hard. Anyway, is this self imposed shortage driving up medical costs?
People who don’t shop for medical care deserve whatever they are handed, and they have no right to complain.
The only thing wrong with medical care in America is the childish attitudes of people who don’t want to take responsibility for their own health.
According to the US Census, a large portion of those without medical insurance are young people with high incomes, who chose to spend the money on nice automobiles and luxury vacations.
America’s Health Care System:”Don’t Get Sick”
Don’t get sick unless you want to accept all the free medical care that is offered, or you bought insurance in order to have more consumer choices.
Lee,
Please provide a link to your statement about the US Census.
“The likelihood of being covered by health insurance rised with income. Among people in households with annual incomes of less than $25,000 in 2004, 75.7 % had health insurance; the level increased with income up to 91.6% for those in households with incomes of $75,000.”
“Children 12-17 were more likely to be uninsured than those under 12 years old – 12.5% compared with 10.5%. About 21.1 % of Hispanic children did not have any health insurance in 2004, compared with 7.6% for non Hispanic children, 12% black children and 9.4% Asian children.”
Source: US Census Bureau. Income, Poverty, and Health Coverage in United States: 2004 (report)
Should we count illegal immigrants in our estimates of poverty, health care, and education programs? Should we not at least break them out from the citizens? The Census does provide the data.
Census Bureau reports welfare use by household based on the nativity of the household head. See for example, Figures 20-1, 20-2 and 21-3 in ?Profile of the Foreign-Born Population: 2000.? P23-206, U.S. Census Bureau, December 2001. http://www.census.gov/prod/2002pubs/p23-206.pdf.
The Census Bureau in 2001 reported that the number of Americans without health insurance fell to around 38.7 million in 2000, down about 600,000 from 1999 and well below the record 44.3 million who were uninsured in 1998. Many can afford insurance:
* From 1993 to 2000 the number of uninsured people in households with annual incomes above $75,000 increased by 63 percent and the number in households with annual incomes from $50,000 to $75,000 increased by 48.2 percent.
* By contrast, the number of uninsured people in households with incomes under $25,000 fell by 25 percent.
* Almost one-third of the uninsured now live in households with annual incomes above $50,000.
Mark,
Most people don’t plan to get sick. For some, a sudden chest pain is their introduction to the health care system. They call 911 and the ambulance takes them to the nearest hospital. If they are having a heart attack they now face at least a five figure expenditure that a few hours ago when they were rolling out of bed they had no inkling they would incur.
What other service do we purchase like that? Most people spend weeks comparison shopping for a car and can walk away from the deal if not satisfied. When you are acutely ill, you don’t have that luxury. Nor does price competition mean much (have your first heart attack at our hospital, get the second at half price?)
I suspect Lee will respond by saying that the luckless dolt that finds himself in an ER having a heart attack without medical insurance deserves what he gets. But, Lee, can you honestly say that if you were making just enough money to get by that you would spend your only bit of discretionary income to buy health insurance for an unanticipated medical emergency? Most people are going to put their money elsewhere.
Dave,
I suspect that the number of physicians has very little effect on medical care costs. I can charge whatever I would like for my services but what I get paid is primarily dictated by insurers (private/Medicare/Medicaid). Perversely, it is only the patients who have no insurance who have to pay full price.
In rural areas, the physician shortage is often because of lifestyle choices on the part of physicians who would rather practice in cities. Often times rural medical care is dispensed by “physician extenders” (physician’s assistants or nurse practitioners) whose salaries are less than MDs so this might actually decrease the cost of care.
You have to take the case of each person who has a medical emergency on its merits. If the person is 500 lbs overweight, could afford insurance, but chose not to buy it and had a heart attack, would “Paul DeMarco” say he is responsible for his situation?
Among Americans with household incomes of $50,000 a year or more = just eight percent are uninsured.
Among those with incomes under $50,000, the number of uninsured swells to one in five.
Among just those with incomes under $20,000, it grows to nearly one in three.
Another issue is that a lot of those people making over $50,000 a year that are uninsured are SMALL BUSINESS OWNERS. They can’t afford health insurance and stay profitable in their business and keep the doors open and their employees half way happy.
Another reason is that some companies just aren’t offering health insurance anymore. They have basically got out of the market. So you have full time workers that aren’t offered coverage at work and they go out and price health insurance and find that the costs have skyrocketed.
The issue has became so complicated that a figure or a statistic doesn’t really tell the story.
I visit businesses every day in South Carolina. Most are small business- under 20 employees and a lot are in fairly rural areas (some aren’t). As part of my job I inquire if the company offers health insurance. I don’t keep statistics myself but I am always fairly taken off guard if I go into a small business and they offer any type of regular health insurance. A precious few offer a basic plan with a deductible in the $1000-$2000 range.
and I can only end with the experience I had that I mentioned above (and this was my first experience with anything like this because I rarely go to any doctor). I have decent insurance but the specialist I was going to go to wouldn’t even let me make the appointment if I hadn’t had the right insurance or paid at the beginning of my visit. I was lucky. I probably could do either. But my wife and I talked about what we would have done if we couldn’t pay for that visit ourself and we had no or limited insurance. I know I would have been in trouble.
I don’t worry so much about myself. But I do worry about a lot of other people that wouldn’t have been able to get that appointment. That, my friend, make me think.
Paul, I agree that doctors don’t truly set the rates but the prices that insurers pay are set by the UCR mode, Usual, Customary, Reasonable that I know you are familiar with. That is basically a form of price fixing to keep all doctors on an even keel as well as the insurers. As to elective type medical treatment, I think doctors and hospitals should be allowed to advertise. Why not?
I know of two recent situations where a person who had no insurance was “given” half price by a doctor and a dentist. Another indication of the mess the government has created with Medicare and Medicaid.
Small business owners are not permitted the same tax deductions as large businesses who can afford the tax lawyers and accounting staff, and setup fees for defined benefit plans.
The best solution is to get rid of all the large corporate benefit systems, and let each person buy their own insurance and own their own retirement plans, with no legal limits on the levels. Big companies don’t want that, because they use their special tax treatment to keep unhappy employees as captives.
I have been arguing something close to that all alone.
It is silly to have your health insurance tied up and depend on who your employer is at the current time.
The system we have now is backwards. It makes little sense.
I won’t try to weigh into this discussion much, since I don’t have the time, nor the expertise. But having lived in Europe for nearly 30 years, I do object to Lee’s characterization of its health care. Yes, I have read some of the stuff on it, but it is interesting that the people I know, whether in England, Canada, or elsewhere, do not have the opinions that Lee represent. (Instead, almost all of them think our system is barbaric.) And I certainly was glad to have raised our kids in Germany, especially with our son spending weeks at a time in the hospital. I wouldn’t want to even calculate what that would have cost here, if the insurance company here would have even let him be in the hospital.
We have to have a system that everybody has to pay into (it’s not going to work if people don’t pay in until they get sick), and it has to stay lean. It is true that people here want to overspend their credit cards instead of paying for a yearly physical, but government needs to protect its people in that respect too. There are ways to to have very basic coverage for everybody without killing the goose that laid the golden egg.
Keeping such a system lean is admittedly the hard part, but at the very least, I would suggest not characterizing the whole of European medicine with “socialist horror,” if one hasn’t seen it first hand.
I am not a socialist, but I do think there needs to be some re-distribution of income, otherwise the gap between rich and poor becomes too large, and the accompanying destabilizing effect on society is dangerous. Coming from a guy who started out in Young Republicans working for Goldwater in ’64, that is quite a statement!
Re Herb’s comments: One principle for success is that everyone must obtain health insurance. Another principle is that the costs of health care administration (including insurance company profits) must be relentlessly monitored. “Socialized medicine” is a dirty phrase, but it also covers a lot of muddleheadedness that could be eliminated without hobbling ourselves economically.
Dealing in the anectodotal opinions of a few Canadians or Europeans who happen to like what little medical treatment they received is worthless, compared to the cold hard facts.
* Until a few years ago, Canada only had 2 CAT scanners in the entire country.
* Socialist medicine has to ration care, and selects retirees and those needing the latest treatments to die, in order to give ordinary care to more people.
The thousands of deaths in each category are published each year, and the UK has had a program for several years now to improve the scandalous treatment.
Lee, I realize that we have had our differences, and for the sake of discussion, I am going to say things that you may not like.
Is it really necessary to keep every person on earth alive forever? The earth is overpopulated as is, and with advances in medical technology the problem only gets worse. Perhaps it will be better for mankind if we revert to a little Darwinism, where only the strong survive. (Sorry to all those worshippers of Pat Robertson’s God.)
Americans have an unhealthy immunity to death because we are able to keep loved ones hanging on for the sake of the survivors rather than the infirm. I have watched firsthand as my Grandfather has withered, yet been kept alive for the last three years following a major stroke (at a huge expense and against the wishes of his living will).
I am healthy, and rarely need/use health care, yet I pay out of the rear for it. I pay the same amount as every other employee at my company for the same coverage, yet I rarely use it. That seems to be rather socialistic to me.
One more question in this rambling post, but is it just me, or do you remember such a profession as health care administration ten years ago? It seems that there are more administrators than doctors in hospitals these days.
Actually, it is impossible to keep anyone alive forever. Free market medicine just makes it possible to keep more people alive for a longer life. Patients get to decide if they want to pay for continuous care, surgery, and drugs to keep them alive.
Under socialism, the average person has no choice. The state has a financial incentive to kill off pensioners and cure young taxpayers.
That’s why all the countries with “universal healthcare” also have expensive medical insurance plans that let the upper echelons buy their way to the head of the waiting list, receive treatment at private clinics, or even out of the country.
Pardon my use of hyperbole. I get angry that I am subsidizing all of the 400 lb. smoking crowds’ health insurance.
I believe that there is a little free-marketism in the fact that the upper eschelon don’t care because they know that they are free to get health care elsewhere. (at a cost of course) To me it is a little bit of financial Darwinism where it is survival of the richest. If you are welthy you have certain advantages in life. Sad, but true.
What is the point of working harder and accumulating more wealth if you cannot use it to purchase a more comfortable, healthy and longer life?
I’ll counter with: what is the purpose of a longer life if you are confined to a wheelchair or bed?
Most people work harder for material comforts, rather than worrying about death by being kept alive by modern medecine at a huge monetary cost.
If your sole purpose in life is to accumulate wealth to “live longer”, then you are fooling yourself, and wasting valuable time dwelling on death.
I work hard to pay the bills, and harder so that I can accumulate wealth, so that I won’t have to work hard forever, and in the end I will be more able to enjoy my life so that I won’t have to extend it unnecessarily because I feel that I have missed something.
These are at least my thoughts on the matter.
can’t speak about Europe or Canada.
I do live in the United States though and our health care system is closer to broke than it is anything.
About the Unparty. Keep pushing it. We need it.
And may I suggest an insignia!? How about a CHAMELEON? It suggests pragmatism, to be able to look at all possibilities, regardless of who propose them – the conservatives or the liberals. And if we fail, we have only to look in the mirror to blame somebody.
Rafael
When I said “lean and mean,” I meant a system that can be tweaked to penalize the 400 lb. smoker. I work for a non-profit and have a very small salary. The only way my wife and I can afford any kind of health insurance in this country is through Christian Care Medishare. Technically, its not insurance, but it requires a commitment to pay one’s share each month. The whole point of it is for the stronger to help the weaker. But if you’re grossly overweight, they won’t let you into it. They won’t let you into it if you smoke, either. Those of us who are healthy (and I belong in that category, too) should be thankful, and realize that could change at any time. I had a good friend who was robustly healthy, too, until he got RLS (Lou Gehrig’s) at age 50.
Preston,
Get your thoughts in order, then come right out and state if you think state employees and politicians should be telling other people that their lives are not worth continuing, so they are going to be killed?
Wow, talk about putting words in my mouth. I in no way endorse killing, although I do think that people should be allowed to die with dignity. These are two different things.
I asked a philosophical question. What does it mean to be “alive”? Are you “living” if you are confined to a wheelchair or bed without the ability to comunicate or take care of yourself?
I think these are valid questions to be discussed.
Where is the dignity in being denied treatment by state medicine, or injected with a lethal dose of narcotic by a state doctor, against your will?
Who does what you say happen to?
According to the official reports of various socialist medical systems, in Europe, they deny treatment to thousands of sick patient as a matter of policy, to save money.
The reality is that there is not enough money in the world to buy all the medical care everyone wants. Even the richest people in the world are unable to buy all the medical they want for themselves.
The market allocates medical care to people based on what they really want to pay for.
Socialism allocates medical care to people based on the whim of bureaucrats operating with even less funding than is available in economies which are more free market. They control costs by setting the pay of physicians and nurses below the free market rates, forcing drug companies to sell to the state a prices too low to justify new research, by witholding expensive treatment, and even killing patients.
Radical Independent Party
http://www.wrisley.com/rip.htm
Brad,
As luck would have it, for your Unparty there is apparently a competing Nonparty with a NonCandidate: The Cackalacky Candidate – The Voter’s Choice for No Office. He or she has an Official NonCampaign Website at http://www.cackalackycandidate.com.
The official Nonparty of the Cackalacky Candidate is the Tender Party (Because politics runs on U.S. Legal Tender.)
Would this Nonparty compete with your Unparty? Or, would the two form a Noncoalition government.
As Unreal as this NonCandidate obviously is, he or she does present some Real Ideas to address Real Problems in South Carolina that probably beat anything we’ve heard coming out of Columbia.
http://and-rapunzel.monplombaprojet.org/rapunzel-wig.html
I had an accident last year. My hip joint was replaced and after some months, i was having some noise in the hip and some tingling feeling. Later on i found out Depuy’s implants were recalled and i had to suffer a lot. I need some legal advice on how can i claim.I live in California.