THE OTHER WHITE MEAT! Next time around, progressives should push the other moral argument: // link // print // previous // next //
THURSDAY, JANUARY 7, 2010
Dorgans departure: Ha ha ha ha ha ha ha ha ha ha ha! Were always amazed by the insouciance pervading the halls of Versailles:
Ha ha ha ha ha ha ha! That sally came after the lady mused about the race to replace Chris Dodd:
Wonderful good solid time-killing fun! Splendid sound strong entertainment!
Might we add a point about Dorgan? Many people know that he warned against the repeal of Glass-Steagall, back in 1999. (For Wikipedias account, click this.) Ed Schultz briefly discussed this matter with Dorgan on last evenings Ed Show:
Like you, we dont really understand this critical history. Our lords and ladies, smirking and smiling, are much too grand to go there.
The durum wheat growers once honored this man! Beyond that, matters get hazy.
Read each thrilling installment: After health care reform, well need health care reform! Why not read each installment:
In todays installment, T. R Reid praises one moral argument. Next time, we should go with another:
PART 3THE OTHER WHITE MEAT: Lets say it again: Despite its shortcomings, T. R. Reids The Healing of America is very much worth reading. Reid tours the world, describing the ways developed nations deliver health careand Reid is a very good raconteur.
We reread Reids book over the Christmas break. As health care starts to move off center stage, his book provides a good debriefing about the subject our nation pretended to discuss all through the last year.
That said, the book has several weaknesses. We think Reid does a very poor job explaining Americas vast over-spending (see THE DAILY HOWLER, 1/6/10). In our view, he fails to explain where all the money goes, as we spend two to three times as much on health care, per person, as the rest of the developed world. Most Americans simply dont understand the size of this apparent looting. The mainstream press did little to address or explain this problem this year. Reid fails to do the job too.
Reid fails to explain where the money goesa groaning problem in American health care. This brings us to a second problem we found on rereading his valuable book:
Throughout The Healing of America, Reid moralizes mightily about what he calls the central ethical/moral argument concerning national health care. But we think he has a limited view of the moral problems which characterize our own American health care system. In our view, he focuses so hard on one moral problem that he fails to see the rest.
Health care reform will be debated again, some number of years in the future. If progressives want to win wider reform at that time, we ought to get clear, starting now, about where our vision is limited.
In chapter 10, Reid starts discussing the basic moral question that should drive [health care] reform. He visits two countriesSwitzerland and Taiwanwhich achieved health reform in 1994, successfully negotiating this central moral question. Reid focuses on this basic moral question in chapters 10 and 12, as he ends his book. And alas! As is so often the case in our political journalism, he leans on a familiar old crutchhe complains a bit about Bill Clinton and his driven wife.
Alas! As president, Bill Clinton didnt emphasize the basic moral question enough, Reid says:
Reviewing the failure of the Clinton health plan, Reid notes the added opposition of the hospital industry, the drug industry, and many physicians groupsgroups whose contributions to our massive over-spending tend to get underplayed in his book. He notes the opposition of major Republicansand the unhelpful antics of major Democrats, people like Pat Moynihan. And alas! Apparently because President Clinton and his driven wife chose to emphasize economics, their health plan failed in 1994, with the central ethical argument...nowhere to be heard:
According to Reids (fascinating) account in chapter 10, the notion that a wealthy country ought to prove medical treatment for all was the moral issue that drove major change in Taiwan and Switzerland. But this central ethical argument has always gotten short shrift in this country, he says. In his chapter 12 (The First Question), Reid complains that Americans have never really carried on an ethical debate about health care as a rightand he states this complaint all through this penultimate chapter. The ethical questionwhat Professor [William] Hsiao calls the first question in the design of any national health care systemhas generally not been part of the conversation in the United States, Reid says.
Were not sure that we agree with Reids overall assessment. In our view, several talking-points have emerged from progressive discussions of health care over the past few decades. One of the most familiar points reflects what Reid calls the basic moral question: 47 million Americans lack health insurance, progressives (and Democrats) have always asserted. (The number jumps around, of course.) Were also not sure that Reids account of the Clintons approach is fair; as President Obama would later do, the Clintons spoke about economics, but they spoke about the moral need to expand health coverage too. Has this country ever really carried on an ethical debate about health care as a right? Were not sure how to answer that question. But there may be reasons why major pols diversify their discussion of health care, and progressives would do well to keep that in mind if we start to prepare, right now, for future health care reform.
Why might major pols move beyond the central moral argument? Why might they discuss economics too? We can think of several reasons:
First, the United States isnt Taiwan, and it isnt Switzerland. More specifically, it isnt an island nation of 23 million Chinese people with a deep commitment to Confucian traditions (Taiwan, page 164), and it isnt a nation of 8 million people who constantly talk about solidarity (Switzerland, page 176). Alas! The United States has a brutal, tragic racial historyand a recent political history in which a major politician got quite fat on talk about welfare queens. Talk of national solidarity may play better in some other lands than it plays around here. That said, this country has agreed to offer health coverage to many of the poor (through Medicaid), to children (through CHIPs) and to the elderly and the disabled (through Medicare). But high-minded talk about solidarity may not play as well in this country as elsewhere. High-minded ethical discussion may appeal to a type of liberal intellectual. But when major pols avoid or downplay such approaches, they may have sensible reasons.
Second, big pols may discuss economics for a second, very sensible reasonbecause its a major problem! No other country has ever had to confront so much over-spending on health care; this would include both Switzerland and Taiwan, according to Reids fascinating accounts. And heres where Reids big error occurs, as least if youre going to listen to us: That massive over-spendingthat matter of economicsis a central ethical issue too! Sorry: When the average shlub spends two to three times what everybody else is spending, wed have to say that hes getting looted! Until somebody shows us different, wed say hes getting looted by the big, upper-end interests Reid tends to pass by in his book.
And thats an ethical issue too! Its an ethical issue progressives should stress in future reform debates.
Have Americans ever really carried on an ethical debate about health care as a right? Were not sure how to judge that. But if the current health reform passes, Americans will have extended coverage to 94 percent of the populationincluding much of the pooreven in the absence of such a sweeping debate. Our system will be a crazy-quilt hodge-podgebut tens of millions will be subsidized in their health care coverage, whether in whole or in part. Unfortunately, average citizens and their employers will still be paying massive amounts for health careamounts which will likely remain comically high when judged by international norms. Example: The Swiss are the biggest spenders in Europeand they spend only about 60 percent what we spend, per person! Wheres all that extra money going? Thats an ethical question too! In our view, Reid, like so much of the mainstream press, gives it short shrift in his book.
Health reform will come round again. Will our side be ready next time? In many ways, our effort was pathetic this yearunless you want to live in a world where industry and corporate groups are allowed to loot average people, to an extent which is comically awful.
In many ways, the progressive effort was weak this year. Tomorrow, a glorious future.
Tomorrow: A glorious future