When it comes to economics, the general position of the current Republican party seems to be this: if most of the money flow ends up going to the top 1 percent of the population, that’s good and evidence of a healthy “free market”; if some of the money flow ends up going to help the other 99 percent of the population (which, in turn, ends up helping them live better lives), that’s bad and evidence of socialism and, just maybe, fascism. (This claim is made despite the fact that government intervention is complicit in either of these outcomes.)

Regardless of general political philosophy—conservative, progressive, libertarian, whatever—how can anyone reasonably think this position is worth supporting (unless you are among, or are a direct beneficiary of, the 1 percent)? Even if you don’t object to this in principle, how can you support this position while standing in opposition to improvements for public services such as education, infrastructure, environmental protection, and healthcare?

The current Republican agenda is focused on protecting the rich and elevating selfishness at the expense of the rest of the country. And this gives them the right to make an exclusive claim on patriotism, denouncing opponents as anti-American threats to democracy?

I’m just baffled …

Common Ground

From what I’ve seen so far, most rational, compassionate people on all sides of the issue seem to agree that some method of health insurance reform is necessary. The reasons are many, from the inefficiency of the system and its negative impact on the national deficit to the inhumane decisions made by insurance executives to preserve the company’s bottom line at the cost of lives.

I recommend these resources for explanations and verifications of these claims:

• Video: Why We Need Government-Run Universal Socialized Health Insurance
• Video: John Green’s Thought Bubble: Health Care Overhaul
• Video: Bill Moyers interview with Wendell Potter detailing CIGNA abuses
• Article (Washington Post): 5 Myths about Health Care around the World
• Article (Media Matters Action Network): “Obamacare”: Debunking the Myths of Health Insurance Reform
• PDF (The American Journal of Medicine): Medical Bankruptcy in the United States, 2007: Results of a National Study
• Article (Rolling Stone): Sick and Wrong: How Washington is screwing up health care reform – and why it may take a revolt to fix it
• Article (New York Times): The Uninsured
• Article (Washington Post): Doctors Support the Public Option
• Appeal: a “physicians’ appeal” to Congress, organized through Sermo, an online community of physicians
• Site: Sick for Profit
• Site: Health Care for America Now

I also outlined my reasons for supporting health insurance reform in an earlier post.

The Goals of Reform

Most people can also agree on some common goals, such as:

• Reduce and better manage the cost of health care.
• Prevent insurance companies from denying coverage based on pre-existing conditions.
• Prevent insurance companies from dropping their coverage when a person becomes seriously ill.
• Remove caps on the amount of coverage insurance companies will provide.
• Find ways to make health insurance accessible to more (some say all) people.
• Reduce unnecessary tests and procedures through tort and malpractice reform.
• Streamline the system to reduce waste and make billing more transparent.

The Solution is the Problem

The problem starts when people begin proposing specific solutions and methods for achieving those goals.

Thankfully, the Kaiser Family Foundation has put together a fairly comprehensive overview of the various proposed solutions to these problems and has even created a tool that allows side-by-side comparison of the proposals on specific topics.

Collaboration

I am passionate and confident about the need for reform. However, I’m not a physician, a lawyer, or an economist, so when it comes to the details about “how,” I feel less confident (as I suspect most people do). This leads to a position of humility with which I hope everyone, particularly our politicians and media, will approach the subject. So far, that’s not proving to be the case.

I will continue to collect resources in my online bookmarks tagged #healthcare and will continue to share some of those resources on my Tumblr account (which are also re-posted to Facebook and Twitter). In addition, one of the best ways I’ve found to stay informed about various bills and to keep track of your Congressional representatives is through OpenCongress.org. Once you register, you can begin tracking bills and representatives. For each representative, you can view contact information, voting history and patterns, contributions received, and mentions in various media.

If you read this and you’re also collecting and sharing ideas and resources, please leave a link to them in the comments. I hope that, regardless of the politics, we will end up with a better health insurance system for everyone.

Still, charges of “socialism” are both hyperbolic and hypocritical in the midst of other social services that no one seems to mind: Medicare, Tricare, education, fire, police, water-treatment, libraries, postal service, etc. When we’re talking about essential needs (as health care certainly is), placing profit motives in the middle is potentially much more problematic and dehumanizing than a government-run system (or at least, a government-run option). Yet, that’s the system we currently have: CEOs and investors are making decisions about our health, and they’re unquestionably motivated by profit. How can anyone see this system as something worth fighting to protect while accusing the proposed changes of being fascist and comparing them with Nazi policies?

Consider this simple, clear argument in support of government-run health insurance:

Then remember that this isn’t even what’s being proposed. The current proposals will be much less effective comprehensive, even with a public option.

I’ve been reading and thinking about this issue quite a bit and have attempted to collect my reasons for wanting serious health-insurance reform. Where possible, I’ve also supplied sources. If you read this, I hope you’ll consider these points and then provide your own thoughts and resources. I welcome: additional reasons; additional sources; critiques of the reasons and sources provided; reasons and sources that argue against substantive reform. However, I ask that all claims be backed up with sources if at all possible … it just helps to keep the debate honest.

We’re paying too much:

Total spending on health care, per person, 2007:

• United States: $7290
• United Kingdom: $2992
• Average of OECD developed nations: $2964
• Japan: $2581

[source]

For all this extra money, we’re not doing so great:

At last ranking (in 2000), the U.S. is ranked #27 in the current World Health Organization’s rankings (below France, Italy, Spain, Japan, the UK, Ireland, Switzerland, Germany, Saudi Arabia, Israel, Canada, Australia, Chile, and Costa Rica)

[source]

The current system isn’t helping enough Americans:

• Over 44,000 Americans lose their health insurance every week
• 46 million Americans (18% of the population under 65) don’t have health insurance
• 10% of children don’t have health insurance

[source]

It doesn’t help us precisely when we need it most:

• The proportion of all bankruptcies attributable to medical problems has increased 50% since 2001
• Medical debt contributed to 62% of personal bankruptcies in 2007; For 92%, high medical bills directly contributed to the bankruptcy
• 78% of bankruptcy filers burdened by healthcare expenses did have health insurance
• Many end up bankrupt due to medical problems because they are under-insured (and usually don’t realize it until it’s too late), lose their insurance because they became too sick to work (which means they’re also losing their income), or are denied because of "pre-existing conditions"
• Nationally, 1/4 of all firms cancel coverage immediately when an employee suffers a disabling illness; another 1/4 do so within a year.

[source]

The debate is being unfairly influenced:

• The industry uses much of its profit to "pay off" members of congress for "protection" (at the rate of nearly $4 million in 2008) [source]
• The most influential Congressional reps in this debate together represent only 13 million people, meaning those speaking for just 4 percent of America are attempting to control the debate for the other 96 percent. [source]

Many arguments against the current proposals are based in misunderstandings:

• Misunderstanding: it will pay for illegal immigrants. To the contrary, the House bill specifically forbids federal dollars from going to the health insurance policies of undocumented workers residing in the United States.
• Misunderstanding: it will create “death panels.” To the contrary, the initial proposal (now gone, sadly) merely ensured that those who wanted end-of-life counseling would be able to receive it for free.
• Misunderstanding: it will pay for abortions. To the contrary, the only types of abortions that would be covered under any public plan would be for cases of rape, incest, or or life-endangerment, as was mandated in the 1976 Hyde Amendment and is already the case with private insurance companies. Abortions for any other reason would be paid solely through the premiums of the insured. In addition, insurers would not be required to offer, or prohibited from offering, abortion services. [additional source]
• Misunderstanding: a public option will force people out of their current plan. To the contrary, the House bill allows for existing plans to be grandfathered in. However, should the public option prove to be a better choice than those privately available, why wouldn’t you want that plan? On the other hand, if government-run programs are as inefficient as critics claim, then private insurers should be able to compete easily and provide better choices at a better price. At any rate, why are we so concerned about protecting insurance companies?
• Misunderstanding: it will result in healthcare rationing and/or put a bureaucrat between patient and doctor. In reality, this already exists and is managed by insurance companies who, as businesses, have profit as their primary motivation.

For sources to these claims, as well as corrections to additional misunderstanding, please see this source.

What is your understanding of this debate? What are your reasons for opposing or supporting health insurance reform? What arguments or resources can you offer to help clarify the relevant issues?

Also, I’ll continue to share related articles I find interesting on my Tumblr account, tagged healthcare (most of which end up in my public bookmarks, also tagged healthcare).

I’ve known that he opposes insurance reform for a while now, but hadn’t yet heard any specific reasons from him, so I asked: “In all seriousness: can you outline your reasons for opposing insurance reform?”

His reply: “Simple: Selfishness. I have a job that provides health insurance. What’s to stop private companies from eliminating this option if there’s a govt.-run, socialized system? People have the ability in life to do what I did, and many others: Rise from a modest past, get educated, get a good job or two, and get health insurance as a result. I’m tired of the whiners who think the feds should run their life for them. Suck it up, and stop making excuses. Everyone has the ability to success…their messiah, Obama, has proven it. Plus, I don’t want my tax dollars to pay for health care for illegals, and we KNOW this will happen even if the liberals claim otherwise. My question: Why would you want federalized health care, besides it’s what Obama wants and you voted for him?”

To which I reply …

First, you have me backwards. I don’t support insurance reform (and this is about insurance reform, not health care reform) because Obama wants it. I voted for Obama because he ran on a platform that was in line with many of the things that concern me, including insurance reform, and because McCain was too in line with the previous administration on most of those issues. Obama is just another elected politician, and I hope he holds to his campaign promises, but my support of insurance reform has nothing to do with him personally. However, I suspect that many are now opposing insurance reform precisely because, and mainly because, he supports it.

Second, that your support can be summarized by “selfishness” doesn’t speak well of your position, though it does highlight the ironic pairing of conservatives and Christians that I mentioned a while back.

You say that your job provides you with insurance and you’re afraid that it will go away if there’s a public option. However, a major element of the current proposals is a requirement that all employers provide health insurance. But further, one of the primary goals of all of this is to significantly reduce the number of uninsured. Still, there are genuine economic and health care implications of the various proposals. No serious analysis of those concerns are occurring publicly, though, because they’re being drowned out by lunacy and paranoia. I’m not saying: “trust Obama, go big government!” I’m saying: “insurance reform is vitally important and the current system is unacceptable.” I’d like to hear more serious, grown-up-people discussions about the options. Instead, I mostly hear shouts of “No!” and hypocritical fear mongering.

I have to say, though, I don’t get why big-corporate insurance is afraid of competition. We have plenty of examples of private and public options living side-by-side and doing just fine.

To me, it seems like, on the one hand, conservatives support competition. On the other, they don’t want anything that could bring serious competition. One the one hand, government can’t run anything well. On the other, a government-run insurance plan would be too good and would drive out the private sector. Sheesh.

The bottom line is this: insurance reform has nothing to do with the feds trying to run other peoples’ lives for them. It’s about the stranglehold current insurance companies have on our health care system. We need to find effective ways to create competition, regulate corporate abuses, and ensure that all citizens can receive adequate health care. I don’t see how anyone can argue with these goals. Approaches? Sure. Goals? No.

You currently have a decent job, and therefore have insurance, and that’s great. However, I think you vastly over-estimate the ease with which your status is attainable by others and under-estimate how easily that position could be taken from you. If you were lucky enough not not get laid off during this recession, then you’re probably OK. Otherwise, you’re screwed, and it may not have anything to do with your work ethic. Many people work multiple jobs and still have no coverage at all. How does this fit with your “earn it” stance? Have people only earned it if they’re working white-collar jobs?

And Obama is no model for the “everyone can do it” myth. He came from a privileged background and had advantages that the vast majority can only dream of.

Also, there are no proposals to provide free insurance for illegals. However, from a purely selfish perspective, you should realize that you’re ALREADY paying for the health care of illegal immigrants and the uninsured, whether you like it or not. Whenever anyone without insurance, legal or illegal, arrives in an emergency room and can’t pay, you (the taxpayer) foot the bill. And these costs get rolled back into your insurance premium, driving it higher and higher.

And finally, I don’t want federalized health care. I want insurance reform. Those are not the same things, and no proposal being seriously discussed anywhere in Congress is seeking Federalized health care. Even the public option is merely a public insurance option. But your health care is already regulated … by insurance companies.

Moving beyond the issue of the uninsured, the self-insured are only somewhat better off. If you’ve ever tried to buy your own insurance, which many people have to do because their jobs don’t, then you realize how difficult it is to afford, how selective the companies are, how often the companies try to deny coverage, and how big a role “pre-existing conditions” can play.

And regardless of whether you’re self-insured or insured through your job, corporate greed stands between you and your doctor, and this greed will find any means possible to deny you coverage, not least of which is the pre-existing-condition excuse. And given the current setup, there’s no true “free market” in place to bring genuine competition, nor is there enough government regulation to control abuses or prevent people from being denied necessary treatment. I’m sure you’ve already heard the statistics: we pay more than any other advanced country and get less. And we don’t even bother to help ourselves by revising our unhealthy lifestyles.

So, selfishly, I don’t want to keep making insurance CEO’s rich by over-paying for sub-standard insurance. And unselfishly, I don’t want to support those that would deny making health insurance easier for others to obtain simply because I’m lucky enough to be in a position of privilege.

There’s a long list of reasons to support insurance reform (scroll through the links I’ve been posting for a few). For me, none of the reasons have anything to do with Obama or the Democrats. There are also a number of issues worth serious, considerate debate. However, very little of that is happening in the public sphere because of the disinformation being spread out of hate, fear, racism, and corporate greed … which make up the majority of all arguments “against health care reform” that I’ve heard. I really wish we could get to the necessary and serious parts of the debate, but I fear that won’t happen until it’s too late and we’re all stuck with a compromised bill that won’t do much to help anyone at all. Then who will we blame? Well, surely not ourselves …

If you want to play a constructive role in an ongoing cultural conversation, the sizable majority of your disputational effort should be spent engaging with the best people out there with whom you disagree — confronting the strongest possible arguments against your own view, and doing so with a respectful and sincere attitude.

He’s writing in the context of the atheist/religious argument, but the point (and grid) applies to all cultural arguments. I wish this approach were followed by the media and by politicians, particularly surrounding such important issues as insurance reform and economic stimulus. Here’s the grid Carroll developed:

Of course, the cheapest move in any argument is to label your opponent as "crazy" regardless of their actual sensibility. If you can discredit "the other side" through this tactic, then you can win even if your arguments are unsound. So, while in general I agree with the grid, I would revise it to the following:

Where "rational" is defined as adhering to logic and based on evidence. I would hope it goes without saying that an argument must always be open to differing views when presented rationally. It is the job of the media and of our politicians to keep national arguments in the lower-right quadrant as much as possible and to follow the guidelines of respectful debate. Sadly, they seem to be mostly failing in these regards.

So, I’m confused, but I am genuinely trying to understand. I hope that some people will bother to read this whole thing, trust that my intentions are what I say they are, and help me out by sharing their thoughts and resources.

I do want to say a few things up front, though…

First: I’m confused … which means I’m admitting that there are many things I don’t know and don’t understand related to the issues I’ll be raising. I’m hoping to get some responses that help clear things up for me.

Second: I have no definite party affiliation, and I don’t blindly vote on party lines. There are plenty of Republicans and plenty of Democrats who are driven by corporate corruption and strange ideas, and I don’t believe any party, political movement, or political figure is beyond reproach. Case in point: Obama’s appointment of Arne Duncan infuriated me and sadly confirmed my suspicion that neither one of them knows anything about education.

Third: I’m raising concerns about issues and problems, but not backing any one approach to addressing those issues or solving those problems. In other words, I feel strongly about “good and bad” results for each of the issues below, but I’m not sure about the best way to remedy bad results or achieve good ones.

Also note that “the best way” is not even the point of this post. I’m trying to understand the thinking behind two groups in relation to a few big issues … nothing more.

Fourth: I’ll be talking about “right-wing conservatives” and “Christians” throughout the post, but I’m trying to pick on anyone. I realize that I’m making generalizations and that my points won’t apply to all people in all situations. However, I don’t want to keep repeating things like “on average” or “broadly speaking” or “as a generalization.” I also recognize that I’m talking about popular conceptions of both. I’m trying to get a handle on the big picture, not trying to pin entire groups to their stereotypes.

The Confusion

The simplest way to express my confusion is this: I don’t understand why Christians and right-wing conservatives are friends. From my perspective, the teachings of Christianity seem to be more in conflict with current conservative political views (typically mapped with the Republican party) than with current liberal political views (typically mapped to the Democratic party).

Sure, I can understand lining up under issues like abortion, but on many of the large issues dominating our national discussion right now, I just don’t get it.

The Environment

For example, I don’t get why so many Christians seem so opposed to concerns about the environment or the idea of climate change. I won’t even go into the merits of the argument for climate change … I’ll leave that to scientists who study this for a living and who, with an amazing level of agreement, believe that climate change is occurring and is impacted by human activity. But even if 97% of climatologists are wrong, I still don’t understand the opposition to a more careful approach to our environment.

The Christian attitude toward the earth can be summed up in the word “caretaker.” The environmental movement supports exactly that attitude. And even if there is no climate change, why would anyone fight against creating new jobs (through alternate forms of sustainable energy), securing the future of the planet through careful management and cultivation of resources, saving money by reducing wastefulness, striving for cleaner air and water, supporting biodiversity, supporting local farmers, holding corporations accountable for their impact on the environment, etc.? What am I missing? And why wouldn’t Christians want concern for the environment to triumph over corporate greed? Because that’s the popular perception that results from aligning with right-wing conservatives on this issue.

The Market

Right-wing conservatives don’t want any government intervention with the market (unless it’s protecting the profits of their supporters, of course), and certainly don’t want any “redistributing” of wealth going on. Never mind that wealth is being redistributed all the time, and for the past 20 years or so, it’s been redistributed from the poor to the wealthy at an increasing rate. Why would Christians be in support of this? Or put differently, why wouldn’t Christians want a government that takes an active role in preventing corruption and the pooling of wealth among the very few? (I’m not taking political sides here: there are corrupt politicians on both sides of the aisle.)

Now, I can see all kinds of dangers when we start talking about how this is to be done. But that’s not what I hear people arguing about … not really. The argument starts and stops at whether or not there should be any government involvement at all … and the answer from Christians and conservatives alike is mostly “no,” followed quickly by accusations of socialism. Yet, isn’t one of the tenants of Christianity that we should help those less fortunate than ourselves? And wouldn’t creating a government that played a role in making that happen be a more-Christian government by extension?

I’ve heard the argument that the government should stay out and self-regulation should rule, but the past 20 years has demonstrated that self-regulation doesn’t work. And Christianity would seem to suggest that self-regulation is a bad idea, given its pessimistic view of human nature. I mean, the love of money is still the root of all evil, right?

I’m not talking socialism or communism here … I’m mostly talking about more regulation, and I’m condemning the complaints from the wealthiest 2% of the nation (who are orders of magnitude more wealthy than even the “middle” class) when they’re asked to contribute more to the general welfare of the nation.

Again, the “how” is certainly a difficult issue, and I don’t have any grand ideas there. But I have a hard time understanding people who think regulation of some sort isn’t necessary, particularly in light of what we’ve just experienced during the last year, or who see injustice in asking those who benefit the most from society to also be the ones who give the most in return.

Health Care

Related to this is the issue of providing health care for everyone. How any Christian can be opposed to this is completely beyond me. Again, we can argue a lot about the best way to achieve this, but I don’t understand why Christians wouldn’t see it as a worthy goal. Currently, we have an industry driven by greed that does whatever it can to protect its wallet … concerns for the patient are far down the list. Yet, the Christian value of caring for others is central to the faith … so why wouldn’t Christians want a government that makes provisions to ensure that all people can receive care? And isn’t the moral of the story of the good Samaritan that aid and kindness should be given to all, regardless of their standing in society (or, dare I say it: legal status)?

Once again: I’m not arguing that the current proposal is the best way to achieve this, I just can’t believe that we can’t get consensus that it’s a goal worth achieving.

Private Liberties

Now, on moral issues, the friendship between Christians and right-wing conservatives seems to make more sense, but the real question for me is: why are conservatives in agreement with Christians on this? Typically, conservatives are concerned with the individual’s rights and, in general, oppose government intervention in how an individual chooses to exercise those rights. (This is true historically and in theory, though with the Patriot Act, illegal wire-tapping, etc., that stance has been greatly eroded.) So, at least historically and theoretically, a true conservative wouldn’t want the government to have any say at all in how one chooses to conduct his/her private life (you know, things like sexual preference …) provided basic prohibitions against things like theft, murder, and so on. So why do conservatives align themselves with a religious group who are very much interested in not only telling others how they should live but in employing the government to enforce the kinds of lifestyles they condone? This seems backwards to me.

In fact, with many of these issues, the issue doesn’t seem to be that one side doesn’t want the government to intervene and the other side does, it seems to be that each side wants the government to intervene for them but not for others, pointing fingers and placing blame hypocritically at every turn, depending on who has the upper hand at the moment. Which is why I think finding some common agreement about which goals are important must be the first step before any talk about how to achieve those goals can happen. I don’t hear that discussion happening, though.

And also … guns!?

The love for guns among the religious right completely baffles me. If you take a minute to think about it, it should baffle you, too.

Conclusion

Now, if I take an historical approach to these issues, I can make some sense of them, but it’s usually a very unflattering kind of sense, which is why I’m trying to take a step back and point out that the two schools of thought don’t really seem to belong together, despite their historical entanglement.

So, I ask this sincerely: why do Christians and right-wing conservatives so often appear on the same side? What am I missing? Or is my perception actually off and the two are more opposed than I realize? It would seem to me that they should be in opposition on some of our major issues. Can you help me understand why they’re friends?

If you know me, you know that I’ve been a long-time admirer of Whedon as a creator, thinker, and activist as well as a fan of his work, particularly Firefly/Serenity and Buffy the Vampire Slayer.

He sees education as humanity’s greatest hope. Stay around for the final quote:

The enemy of humanism is not faith. The enemy of humanism is hate, is fear, is ignorance, is the darker part of man that is in every humanist, every person in the world. That is the thing we have to fight.

He also offers some insightful comments on gender in his Equality Now acceptance speech from 2006.

His vision is inspiring, as is his message: "We will lose our economy right after we’ve lost our morality."

Ultimately, Doctorow argues against DRM altogether, and this speech is a concise and convincing presentation of that argument. His message for publishers in particular is that, whether or not they decide to use DRM, it should be the publishing house that makes that decision, not the distribution platform (i.e., Amazon).

Somewhat jokingly, Doctorow gives us his “law” related to DRM: “Anytime someone puts a lock on something you own, against your wishes, and doesn’t give you the key, they’re not doing it for your benefit.” Sadly, not a joke.

Here’s the link to the the speech on blip.tv. Also see EFF.org’s write-up about this speech²

1. A great site with videos and resources from the conference
2. You might also be interested in checking out my “copyright” tag on the blog and on Delicious

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