It’s all well and good to say personal responsibility is the bedrock of liberty, but even the hardest of libertarians has always understood that there are places where your person ends and mine begins. Generally, we think of this in terms of violent intrusion or property transgressions. But in health care, it has to do with compassion.Actually the reason no one looks in a wallet is because emergency ambulance service is generally provided by government. I don't see how looking in a wallet of a person having a heart attack has anything to do with decency. To me it sounds pretty damn reasonable, if we lived in a free market society, to look into a person's wallet at such time of emergency to see if the person has made any plans for emergencies. If there are specific directions as to what ambulance service to call or which hospital to be taken to, why wouldn't we want to honor those thought out requests on how to be treated in an emergency? And, if there is no plan, I do not see how it would be possible for a charitable organization to not develop in our society to service those during emergencies.
We are a decent society, and we do not want to look in people’s pockets for an insurance card when they fall to the floor with chest pains.
I resent Klein's implication that people are not charitable enough to create such organizations on their own and that therefore government must force people to "be charitable". Klein writes:
If we’re not going to look in their pockets, however, we need some answer for who pays when they wake up — or, God forbid, after they stop breathing — in the hospital. And though it sounds nice to say that charities will pick up the slack, any hospital system in America will tell you that even with Medicare and Medicaid assuming much of the burden for the most intractable and expensive cases, charities are not capable of or interested in fully compensating the medical system for the services needed by the un- or underinsuredFirst, as I argue above, looking into a person's wallet has zero to do with whether service will be delivered under a free market medical system. Second, charities have been downgraded in the mind's of most people because of the impression that government pays for the medical care of the poor. Klein is some character. He has a very low opinion of Americans, if he thinks private medical-related charity wouldn't boom again, if the state stopped providing healthcare.
I say phooey to you, Ezra. Speak for yourself. Government has been playing on the charitable nature of Americans to justify its growth, for decades. It's time we end the propaganda that Americans will be charitable only at the point of government guns. It's a damn evil implication to create about Americans.
I am not discounting the impression that Wenzel references, but it is hard to give to charity when the government has already taken a significant portion of your income. Furthermore, charities do not need as much money in a free market economy to provide services for the needy. Free health care is VERY expensive. Just like any other "free" service provided by gunverment.
ReplyDeleteIt's not Ezra Klein's (or anyome else's) job to tell me when or how to be compassionate.
ReplyDeleteNor is it Ezra Kleins (or anyone else's) job to force me (steal from) to be compassionate when I am not meeting their definition of what it means to be compassionate.
It's moments like this that show precisely why there is so little virtue left in society. One must be left to freely choose for virtue to have any real meaning.
The most important question is: is it right to make someone the slave of the heart attack victim?
ReplyDeleteThat's the ethical quandry. Not, "Do we have enough compassion for people who are of little means?" The question is, "Do we live by the principle of slavery, or free commerce?"
There will be accidents. There will be acts of little to no compassion. It won't be perfect. Nothing in life ever is-- life is full of uncertainty, due to the laws of nature and human action.
The response of people like Ezra Klein is, "Slavery can make this situation better."
my god, next thing you know ppl will check someone for bracelets or necklaces to see if they have medical allergies paramedics should know about. the horror!
ReplyDeleteEver hear of "Patient Stacking"? That's a British term for what happens when a "Compassionate Law" meets "Reality". Ya' see, the people over there in charge of spending other people's money thought it would be "Compassionate" if everyone who came into an Emergency Room had to be seen within 4 hours.
ReplyDeleteSo, when the British Hospital's emergency rooms filled up, the doctors simply would not let anyone in an ambulance into the hospital. The ambulances waited...and waited...until the patient could be seen within "4 hours".
It's like the coming election: "Republicans want to destroy social Security!!!" If, however, you decrease the purchasing power of the dollar by 35%, haven't you already "Destroyed" Social Security? 'N without even passing a Law.
Where can I buy a "Smash the State" bumper sticker?
CW
right on brother
ReplyDeleteI've found that in the end, almost all arguments I've have with liberals boil down to "people simply aren't charitable enough" and then the onus is on me to prove they are. One girl told me that if I could show her a poll saying that 80% of Americans said they would be willing to donate what they pay in medicare to health organizations (if they didn't have to pay for medicare anymore), she would be a libertarian.
ReplyDeleteIf you could cover "charity" stories (any numbers regarding donations to anything or people mobilizing to take care of others) that wind up in your inbox, that'd be awesome. It's a good topic.
Honestly, I've found most liberals secretly believe the market can do all these things better when you boil it down - they just don't think people are charitable.
Everyone here has presented some good counter-points and observations but you're still all missing the true absurdity of what EK is implying, which is either:
ReplyDelete1.) That doctors (and EMTs) are heartless people lacking compassion, so they can't be counted on to help people with heart attacks who can't afford treatment, THEREFORE, it's right to steal from others to provide the victims with tax-subsidized health services
-OR-
2.) Doctors and EMTs are a special class of people, and they shouldn't be expected to work for free, but everyone else is subject to the Law of Forcible Compassion, THEREFORE, it's right to steal from others to provide heart attack victims with tax-subsidized health services.
Do you see it now? Do you see what twisted, absurd logic this is masquerading as heart felt common sense?
Either doctors and EMTs are jerks, or they're super special and shouldn't be expected to work for no pay, but either way, everyone else should be expected to work for no pay to compensate for this situation.
Why?
Because Ezra Klein says so.
That's called "dictatorship mentality" and the kid's got it in spades.
Taylor,
ReplyDeleteWith all due respect, I don't believe we all missed the true absurdity of what Klein is saying.
You're zealousness and spirit is appreciated nonetheless.
Why are liberals, who claim to be compassionate, ultimately such hateful people who reject claims that their fellow man can be compassionate? Yet these same liberals contradict themselves because they themselves claim to be highly compassionate people. If it were true that without government, no one would care enough to contribute to charity, then why would any government "charity" programs exist? Obviously, for such programs to exist, someone somewhere must have supported the premise on which they are based. Finally, and most important, a truly free market in health care would ultimately make health care so inexpensive and would result in such innovation that many now-deadly, highly expensive medical problems would be easily treated for low prices.
ReplyDeleteTaylor, (dammit, sometimes when I see your post my blood boils because I read it as Tyler Cowen...sorry) but I agree- most of us see the absurdity, but explaining in detail the absurdity, without breaking it down to the fundamentals the way you did, would leave many non-libertarians "room to wiggle".
ReplyDeleteYou are 100% right, as are most of the posters- explaining just how stupid the idea is hard to do to someone who is just as stupid (ignorant) as Klein.
To them slavery is freedom, as long as the majority votes to be slaves. F*ck the people who vote to be free- they don't count.
I have a family friend in the U.S. who was afflicted with a serious illness. It was treatable, but treatment was very expensive and her health insurer denied her claim. Her family and friends desperately tried to raise money to pay out-of-pocket for the procedure. Ultimately, her life was saved with the help of a donation from the Ronald McDonald Foundation. In this instance, the heavily-regulated and mandated private insurance provision failed. Government provision failed. Private charity succeeded.
ReplyDeleteIn the 1950's, before Medicare and Medicaid, most of the hospitals in the US were completely private. Many of these were not even for-profit institutions, but religious or teaching hospitals. People would purchase health insurance for catastrophic injury or illness as well as hospital stays, but pay out of pocket for all other medical needs. Even back then the medical system was far from laissez faire with government regulations, licensing and the cartelization of health care providers, but it functioned far better than the modern US nightmare of government mandates and intervention.
There is no doubt the US system is broken and bankrupt, but overhauling it and emulating a system in another country is not a solution either.
Besides, what's with this obsession of "everybody must have health insurance!" Of course proponents never mean insurance in the sense of pooling resources to hedge risk; they mean a convoluted government-mandated private entitlement program where someone else should pay for the government-inflated costs.
EK said:
ReplyDelete"charities are not capable of or interested in fully compensating the medical system for the services needed by the un- or underinsured"
Because Medicare and Medicaid ARE interested in that compensation? The same programs that only pay a percentage of doctor costs on principle? Those who deny procedures on principle?
No, Mr. Klein, I think charities are a MUCH better way to go. Better still if folks like EK took a step back and let the system work, free of government meddling.
And by god, we are such a decent society, that if you refuse to meet our definition of decent, then we'll kill you (after we confiscate your property and liberty, and make an example of you to anybody else who might be thinking about not being decent).
ReplyDeleteMr. Klein is indeed a fine example of a modern moralist.
So many good comments here! A true reflection of the consistent quality of posts.
ReplyDeleteI'd like to echo some of those fantastic comments in a slightly different way:
Per Ezra Klein,
---"But in health care, it has to do with compassion.
We are a decent society..."
I agree. I believe We are a decent and compassionate society. Therefore we don't need to be FORCED to pay for the medical care of others.
I don't see how Mr. Klein comes to his conclusion that we need cops and guns and jails to coerce such caring and compassionate people into helping others.
Anon @ 1007: regarding your argument with liberals over compassionate libertarianism...
ReplyDeleteNathan @1225 made a great point that "free market in health care would ultimately make health care so inexpensive...medical problems would be easily treated for low prices."
When arguing with statists, it is very difficult to get them to recognize that the problems they see aren't isolated in a box on an island. If you fall into their trap of arguing the singe point of "people simply aren't charitable enough" so the govt. needs to step in and "provide", the argument goes nowhere--it becomes a "yes-they-are", no-they're-not" argument. But, if you shift the focus of the debate to the root cause of the problem and show them clearly that all of the symptom issues are linked to that root cause, then you're getting somewhere. The problem with the health care system is NOT that people aren't insured, or that charity isn't enough; it's that medical costs are too high. If you can get them to see this, then you can steer the debate towards the reasons why they're so high and what the possible solutions are to reducing medical costs.
My 3 point plan:
1.) Eliminate the influence of the AMA and their barriers to entry into the medical profession and their obdurate adherence to "Modern Medicine". More doctors with more ideas=more competition=lower prices.
2.) Eliminate the FDA and their barriers to market entry for new and innovative, or even old and tried and true (see homeopathic) treatments. More options=more competition=lower prices.
3.) No Intellectual Property rights for medical devices, pharmaceuticals, (or anything for that matter). More manufacturers=more competition=lower prices.
Note that none of these solutions has anything to do with insurance and that none require any new bureaucracy or oversight--in fact it only eliminates bureaucracies gone horribly wrong but no one will admit to.
There are two sides to charity. The obligation to be charitable applies to everyone not just the rich, even if the only form of charity one can afford is generosity of spirit. Why is it charitable or ethical to rely on the effort of others for your support? Why is it charitable or ethical to believe that you have a stronger claim on property than those to whom the property belongs? Why is it greedy to wish to benefit from one's own efforts but not greedy to demand access to the property of others?
ReplyDeleteThe problem with the ethics of "intellectuals" like Klein is that they believe that ethical obligations apply only to the self-reliant.