On One Hand

June 21, 2009

It doesn’t follow!

Filed under: Uncategorized — ononehand @ 12:51 am
Tags: ,

I’m running into a common breakdown when discussing healthcare policy with economic conservatives. They are people who believe that taxation to pay for government programs is unfair or immoral, and because of that belief, argue that any form of government-provided healthcare is bound to fail and dig up a bunch of statistical or factual points about why they think it would. Or to be more accurate, they think adjusting our already-public/private system by creating a government-sponsored public healthcare option is a “step in the wrong direction” and therefore bring up points about why they think it would waste money and lead to worsening health conditions. There are rapid shifts from moral to factual arguments.

This is akin to discussing theology based on someone’s personal interests:

Person A: I know there is a god.
Person B: How do you know?
Person A: Because there should be something to right the wrongs in the world.

There may be a god, or there may not – I’m not trying to get in to that argument – but the above argument is a non-sequiter. Just because you want something to be so doesn’t mean it is.

Similarly, just because you think that taxing income to provide healthcare for low-income people represents what you call an immoral redistribution of wealth – a power that the government has no legitimate claim to – doesn’t mean that using a government program to provide better healthcare to our 50 million uninsured people could only do so by worsening healthcare for everyone else.

I doubt that many economic conservatives are even fully aware that their passionate opposition to a government health insurance provider – that they still oppose to even if it were, for the sake of conversation, completely self-supporting and not require tax dollars – is based on their desire to see society structured in a certain way but not actual facts or interests. But it would be hard to argue that the uninsured’s interest in getting access to better healthcare outweighs a private insurance company’s interest in their profits, or their own asthetic preference for private over public entities – and that their passion in opposing it is really proportional to how destructive they honestly think it would be.

To be fair, there are people on the other side of the aisle who make similar leaps. Some want a public option because they would rather buy in to that option and have their money go into a common public plan than a private entity, which they consider immoral. Others dislike the private sector in general, or just want to stick it to those mean rich guys. But I consider this more of a European-style leftist attitude than one of American liberalism, which, excepting a few hardliners, is open to the market if that’s the best way to solve the issue we want solved.

Also to be fair, I am sure there are some opponents of government-subsidized healthcare who reached that conclusion out of reasoned analysis rather than a need to fit their observations into a predetermined ideology, and there are also liberals who support government healthcare for ideological reasons – one of the main reasons why I and most other liberals want to increase access to healthcare is that we consider 50 million uninsured Americans to be morally unacceptable. So it is a moral argument. But we have sought out, and would consider, any number of a wide variety of plausible solutions to expanding access. Single-payer would be the preferable option for many liberals, but we’d be willing to compromise for a public option in a private market if it were more feasible or more likely to make it through the political process. We’d be willing to consider a variety of options if it could be argued better than how it is working now. I think you could argue that we are operating under a pragmatic concern rather than a moral one – we’d be up for anything if you can convince us that it makes healthcare better for everyone and expands the number of people who have access to it.

The scarcity argument does not work for me – healthcare is a service, and is therefore as scarce as monetary resources spent on healthcare put in the right places. The scarcity argument would only in economies that have no expendable income or economies that aren’t wasting the vast majority of dollars already spend on healthcare – maybe Africa or Southeast Asia, where people have a hard enough time paying for food. We do not need to “ration” healthcare – a buzzword of the Right – when we live in an extremely wealthy society that has as many resources for healthcare as we provide. Putting money into healthcare on behalf of those who currently do not have access could certainly lead to an increase in the number of doctor’s offices, doctors and nurses and other medical staff, medical research and resources. Scarcity is only limited by the number of people employed in the profession and the efficiency with which we use those resources. Furthermore, giving low-income people access to preventative care would reduce the need for delayed care which is more expensive and uses more resources – which is the single most important issue I and most liberal advocates of healthcare reform will talk about. It is perfectly reasonable to believe that shifting the system around and encouraging people to see a doctor sooner would ultimately reduce the scarcity of healthcare in America – and it’s what most economists and experts say anyway.

I’ve heard the scarcity argument from six or seven people now, who insisted that any government intervention in healthcare would mean it is being “rationed,” and it seems to be more of something fed by university economics departments than a real-world analysis, or in some cases even a scare tactic. They have the need to fit the same basic principles to everything because doing so tends to put factual arguments in a framework of their moral philosophy. I didn’t graduate with a degree in economics so I can’t name any philosophy that argues that in some cases, in an industry that is a service rather than a good, scarcity is limited by how much much energy we choose to spend and not a physical property, but if I did know, I’d name that.



  1. scarcity is limited by how much much energy we choose to spend and not a physical property

    Opportunity costs. Although when economists say we have a world of scarcity, they mean all types of resources including human time and energy. Everything has a next best use.

    Comment by jdhenchman — June 21, 2009 @ 3:15 pm | Reply

    • Well of course all things are scarce, but the idea of “rationing” healthcare is a scare tactic. If healthcare is so limited that we cannot provide basic care to everyone, then we need to put more resources into it.

      Comment by ononehand — June 22, 2009 @ 7:41 am | Reply

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