A reply to Consi on the issue of national health care.

This is a first. I’m actually offended by something Consi wrote…

If you don’t have the talent or the willingness to move to where there is a job that provides health care, well then, that is a bed of one’s own making.

Comments like that are why I laugh bitterly every time I hear some Republican use the phrase “Compassionate Conservatism” as though it wasn’t a complete oxymoron. What the fuck? Only talented people are allowed to have decent health care?

Apparently I’m not talented enough to have a job that provides decent health care. Oh wait, I am that talented as I’ve had those jobs in the past. Shame I got laid off because the company decided to make the position a direct hire and had an arbitrary requirement that direct hires have a four year degree — in nothing in particular — to be considered for employment.

Technically my current job and the Meijer’s job I held previously both offer health care. Of course at Meijers I was earning a mere $7 an hour which came out to around $245 a week after taxes. Insurance for me and my family would’ve cost around $600 a month. How’s your math, Consi?

At this point I’m working for a company that’s paying me $15 an hour which is considered a pretty good wage by some folks. They also offer insurance after 90 days, but from what I’m told the entire cost of said insurance would come out of my pay. When I asked the recruiter about it she said in utmost candor that “It really isn’t worth it unless you’re single, and even then not really.” I’ve not hit the three month mark yet so I don’t know what the actual costs are, but I’m not filled with optimism after being told something like the above. The fact that every single guy on my team hasn’t signed up for the health insurance either is another bad sign about the cost.

So that leaves moving, which Consi suggests as a possible solution. I’m reluctant to move because I have roots here. My family is here, my friends are here, and, I realize this is quaint, I love this stupid state even if its economy is completely screwed up at the moment. I’d rather stay and try to be a part of the state’s comeback and be close to my family and friends. Consi seems to think that means I shouldn’t expect to be able to get reasonable and affordable health care.

In essence, Consi’s position seems to be one of: “Sucks to be you. I got mine and that’s all that matters to me.” The thing that kills me about that line of thinking is that you’d think conservatives would realize that if people didn’t have to worry about health care they could focus on working and improving their situation.

Since I was first laid off from Ford in February of 2005, with the exception of my brief return to Ford last year before a second lay off after just two and a half months, I’ve been without health care for me and my family. In two years we’ve been to the doctor’s a total of three times paying for the office visits out of pocket and one trip to the dentist we managed to squeeze in during my brief stint last year. We’ve been pretty lucky so far, but it’s starting to catch up with us. I lost one of my fillings last year and haven’t been able to afford getting it replaced. That’s come back to haunt me as I’ve been suffering from minor tooth and ear aches on that side of my head so I’m going to have to address it, out of pocket, sometime this week. My left hip is giving me problems which I mentioned in passing during one of the office visits with our doctor last year and the doctor said that if I had insurance she’d have some tests done, but I can’t afford that at the moment so I just keep trudging on hoping that my hip doesn’t have a major problem. Additionally, Anne’s been having some gastrointestinal problems and Courtney injured her foot in dance class at school that still seems to be bothering her.

I’m not trying to drum up sympathy here, just pointing out that back when we had health care we’d have addressed these issues as soon as we noticed them and could get back to being productive members of society in short order. Now it’s a daily question of: Has the problem gotten so bad that we have to find a way to pay for, at a minimum, an office visit. With my tooth I’ll probably end up having to have the dentist just yank the damned thing out as it tends to be cheaper than anything else they can do, my sister has had to do that in the past as has my wife. I suppose given my redneck heritage it’s somewhat appropriate, but that doesn’t make me feel any better about it.

Compared to a lot of people in the same boat as us, our problems are somewhat minor. It was just one month prior to my first lay off that I wrote this entry about my cousin who died from friggin’ pneumonia because she didn’t have health care and couldn’t afford an office visit to find out that she was that seriously sick. Every time one of us gets the sniffles I can’t help but wonder in the back of my head is it just a cold or something more serious?

I said it then and I’ll say it again now: In the richest country on the planet it’s simply ridiculous that we can’t find a way to have a national health care system. But hey, according to Consi, it’s my own damn fault that I’m not talented enough or living in the right place to have a job with decent health care. Spending trillions of taxpayer money on a war started on lies that the vast majority of people don’t want to be in is A-OK, but holy fucking Christ on a stick you’re a communist if you think folks should be entitled to health care. Fortunately it looks like national health care is going to be a big issue in the next election. With any luck perhaps something will actually come out of it once Bush is gone.

67 thoughts on “A reply to Consi on the issue of national health care.

  1. How million of unhealthy people does there need to be for you to consider it a crisis?

    Again, it is not a number.  However, if the more vulnerable populations, the very young and very old were uninsured, then I would have a problem.  Those populations don’t have the means to protect themselves.  That is why we insure them. 

    Your solution does nothing to cover folks who don’t go to college…

    I wasn’t representing that it did.  I was offering up a way to cover more folks, as you want to do.  That was one way to accomplish that.

    …the one thing it does accomplish is to ensure that even fewer people can afford to go to school as it is.

    I know of nobody that can’t afford to go to school between Pell grants and student loans.  Nobody. 

    For the same reason that I’m burdened with paying for an illegitimate war: For the greater good. That’s the part you apparently didn’t bother to read.

    I did read it Les.

    You said:

    You can argue that my taxes go to pay for the military to benefit the greater good and that’s exactly the same argument I’d use in defense of universal health care.

    That told me nothing.  Well, that isn’t fair.  In fairness you did say greater good.  Nonetheless, I’m still at a loss as to what that greater good is.  So, let me follow up if I may and ask you about the greater good that you believe exists by hoisting onto others a responsibility to pay for my health care.

    What is the greater good that benefits the couple in North Dakota on a fixed income that has their taxes raised and health care rationed by foisting onto them responsibility for providing me with health care? 

    Either we treat you like an infant or you don’t want any help at all?

    No. It is not.  However, the position I outlined about food and shelter is entirely an outgrowth of your logic about

    help them continue to be healthy — that whole preventative versus reactive thing —

    The most preventative thing you could do would be to provide proper food, shelter and exercise facilities.  Do you disagree that those things would be preventative?

    Regardless I never said having health care makes you productive, I said it allows you to concentrate on being a productive part of society.

    So increased concentration about productivity, not actual increased productivity is the benefit?  Folks have an ability to think about being more productive folks?  If they aren’t going to be more productive, and that has always been the obvious implication from those in favor of a move to socialized medicine, I again ask, what is the greater good?

    You seem to mistakenly think…that I would if I were to move to another state. For a lot of people there isn’t a lot of choice regardless of what job the end up with.

    You are not one of those folks Les.  I have no doubt that if you were willing to relocate that there are more than enough computer geeks who read these boards that you would have several work opportunities.

    That’s the only real distinction to be made here.

    I made another distinction.  I understand that you and GM don’t have an appreciation for the distinction, but that doesn’t viciate the existence of that distinction.

    Who says it has to be one size fits all?

    I certainly implied it, because that seems to be what most proposals consist of when offered.  Further, you had said that you could not:

    figure out what a universal health care system should look like or how it should be implemented

    So, I made an assumption that you were working from the same framework that I was.

    Bad people send their kids to publicly funded schools…

    They don’t personally benefit from that though, their kids do.

  2. Consi writes…

    Again, it is not a number.  However, if the more vulnerable populations, the very young and very old were uninsured, then I would have a problem.  Those populations don’t have the means to protect themselves.  That is why we insure them.

    So if you don’t have a number then what are you basing your conclusion that there isn’t a problem on?

    As for the very young being insured, you seem to be implying that they are. Again according to The National Coalition on Health Care:The number of uninsured children in 2005 was 8.3 million – or 11.2 percent of all children in the U.S. (1). The number of children who are uninsured increased by nearly 400,000 in 2005, breaking a trend of steady declines over the last five years.

    As for the very old it is true that the majority of them are covered by Medicare, but not all of them and even with Medicare too many had unmet needs according to this CDC report: In 1993, over 3.3 million (11 percent) of elderly persons in the United States had an unmet health need, and over 1.4 million delayed medical care because of cost. Those with unmet needs included almost 1.4 million elderly people who were unable to get needed dental care, 1 million who were unable to get glasses, 500,000 elderly people who were unable to get medical care, and 600,000 older persons who were unable to get prescription medicine. Although the majority of elderly people had a regular source of health care, many did not get routine preventive services such as immunizations or Pap smears.

    I wasn’t representing that it did.  I was offering up a way to cover more folks, as you want to do.  That was one way to accomplish that.

    Apparently I didn’t make myself clear: I want to cover everyone. Not just a the ones who can go to college and not by making their college loans more inflated than they already are.

    I know of nobody that can’t afford to go to school between Pell grants and student loans.  Nobody.

    Then you don’t know enough people.

    That told me nothing.  Well, that isn’t fair.  In fairness you did say greater good.  Nonetheless, I’m still at a loss as to what that greater good is.  So, let me follow up if I may and ask you about the greater good that you believe exists by hoisting onto others a responsibility to pay for my health care.

    What is the greater good that benefits the couple in North Dakota on a fixed income that has their taxes raised and health care rationed by foisting onto them responsibility for providing me with health care?

    I’ve already explained all that already, if you’re not capable of understanding it based on what beens presented so far then I can only assume you’re incapable of grasping the concepts put forth.

    The most preventative thing you could do would be to provide proper food, shelter and exercise facilities.  Do you disagree that those things would be preventative?

    Not at all, but unlike yourself, I’m not afraid to draw a line and say: This is how far I think we should help each other.

    So increased concentration about productivity, not actual increased productivity is the benefit?  Folks have an ability to think about being more productive folks?  If they aren’t going to be more productive, and that has always been the obvious implication from those in favor of a move to socialized medicine, I again ask, what is the greater good?

    Already been laid out for you.

    You are not one of those folks Les.  I have no doubt that if you were willing to relocate that there are more than enough computer geeks who read these boards that you would have several work opportunities.

    I think you overestimate my marketability, but even so if that were true then I am fortunate. Not everyone is so fortunate.

    I made another distinction.  I understand that you and GM don’t have an appreciation for the distinction, but that doesn’t viciate the existence of that distinction.

    I saw no additional distinction, just an admission of your unwillingness to accept one over the other.

    They don’t personally benefit from that though, their kids do.

    Sure they do, they would’ve had to pay for their kid’s education otherwise. Just because they’re “bad people” doesn’t mean they wouldn’t value an education. Not all bad people are gang bangers after all.

  3. Then you don’t know enough people.

    I doubt this to be true.  There are rare circumstances that would prevent a high school senior from going to college.  Those circumstances don’t involve finances, but rather other unforeseen responsibilities. 

    I’ve already explained all that already, if you’re not capable of understanding it based on what beens presented so far then I can only assume you’re incapable of grasping the concepts put forth.

      I honestly don’t know what you mean when you say greater good.  I can imagine some amorphous concept, but that may or may not be what you mean.  I’m not going to make assumptions about your position though.  So it seems I’ve reached the depth of my understanding about what you are communicating at this point.

    In any event, I hope that my responses, while poorly crafted and not all that persuasive to you, shed some additional light on how some of us approach the discussion and the questions and issues that we have when the issue is raised.

  4. There are rare circumstances that would prevent a high school senior from going to college.  Those circumstances don’t involve finances, but rather other unforeseen responsibilities.

    I was going to stay out of this thread, but this just pissed me off. You really do lead a sheltered life, don’t you, Consi?

    I personally know at least six kids who aren’t in college for financial reasons. They have to work full time so they can afford to fucking eat and keep a roof over their heads (one of them to keep a roof over his mom’s head). Student loans and grants only cover so much and they work real well for someone who doesn’t already have bills to pay and mouths to feed. No so much for those that do.

    I live in a very small community. If I know six people here who fit that description, how many are there spread out over the country? Millions?

  5. KPG, the range of my experiences would surprise my friend.  It pisses me off to hear the excuse that school is too expensive though.  So, I guess we are both pissed.  The economics of going to school have their pay off on the back-end so taking out loans is not an issue.  It makes sense.

    They have to work full time so they can afford to fucking eat and keep a roof over their heads

    Yes, so?  Folks work full-time and obtain degrees all the time. There are colleges and universities filled with these folks.  Full-time status at school is 16 hours a week.  If one has a full-time job, tag 16 hours on and that is less than 60 hours a week.  That is no impediment to going to school.

    Need to work to feed yourself?  Work to feed yourself. Take out loans to go to school.  It is a only a matter of focus.  The reason you mention KPG is not financial.  The reason is time management. 

    (one of them to keep a roof over his mom’s head)

    This is the example of unforeseen responsibilities that I mentioned.

  6. Consi, what you are talking about is so far beyond the realm of reasonable in these cases that you obviously don’t have any comprehension.

    Let me explain just a little to you. The state of Michigan is in deep shit, financially speaking. Jobs are hard to find. People are working for much less than they’re worth, because that’s all they work they can find.

    Moving somewhere else may not be possible. See, moving takes money. You’ve got security deposits and first months rent to come up with. And you need a way to get there. Lots of folks around here don’t have a vehicle. Can’t afford one.

    Many people are working full time and taking side work in their off time, trying to get just a little ahead. School? That’s in Traverse, about an hour away. We’ve already covered the no vehicle thing? Public transport? Nope. It’s another county, Benzie County public transport won’t leave Benzie County.

    Don’t assume that just because you’ve never been in a dead end situation that they don’t exist. Your personal range of experience is not even close to all-inclusive…..

  7. At this point anyone else who wants to jump in may do so. Perhaps someone else can get the idea I’m trying to communicate across more clearly, but I somehow doubt it.

  8. As far as defining the greater good, I tend to want to look at

    a) total cost expended on health care as per what is available for testing and measurement, and

    b) the efficiency of the system.

    The latter is hard because, while costs expended are qualified by what is available to test, the efficiency of the system is not wholely open to testing (because it’s impossible to consider all the extended costs of a policy).

    I find myself in the peculiar position where I’m not recieving health-care without paying about $480/year in costs (edit: this is before the bills come in, because this is not comprehensive; this also does not account for money paid in taxes and through social deductions from pay), plus union dues through the University which provide the majority of my insurance. Certainly, I can imagine better positions to be in (edit: being that I’m dirt poor). Most of them involve me having more money to go around.

    We have a lot of heated arguments in Canada about having a two-tier health system (public/private) because, on one side, those who do not support the public system help it decay, but on the other, as you say, we don’t want to see the line drawn in the sand. The reality is, the line is always drawn – it depends on the policy you draft, but it’s always there.

    The question to consider, in the end, is how can you provide for more of America’s citizens while lessening the expenditure. I don’t argue for the complete removal of private medical service – having worked for your coin should entitle you to health-care too, without having your chain jerked and being put on large waiting lists, being given lesser service and accomodation, or whatever. But I do not doubt that an appropriate policy can be crafted. We would do well to give it attention, however, and not dismiss it on “moral” grounds.

  9. I wanted to briefly chime in on the college thing, being a college student myself.  I think the college analogy is entirely inappropriate for this discussion.  College funding, government and personal, is an issue way too complex to even come remotely close to being fairly treated in that short brush stroke analogy.

    You said 16 hours is a full-time load.  At my university that is the average course load a student that wants out in four years will take.  16 credits does not typically equal 16 hours of class a week.  Depending on the field of study 16 credits could equal 14 hours in one field to 22 in another.  And this is just class time, you forgot to include homework.  My second semester I was an engineering major (by far the most popular major at my university) included the following classes:

    (cr=credits chr=class hours hhr=homework hours per week)
    Circuit Modeling 1 = 2cr/3chr/8hhr
    Freshman Composition 2 = 3cr/3chr/2hhr
    Intro to Engineering = 1cr/1chr/.1hhr
    Engineering Drafting = 2cr/4chr/0hhr
    Calculus 2 = 4cr/4chr/5hhr
    Physics = 3cr/3chr/4hhr
    Physics Lab = 1cr/2chr/1hhr
    Total = 16cr/20hr/20.1hhr

    Those estimations are based on my own experiences in those classes as well as my observations of classmates.  I consider myself an average student and ended up with Bs and Cs across the board.  Expect an average student to spend more time than that to get straight As and kids with ADD or ADHD need not apply.

    This is only the tip of the iceberg when it comes to the complexities of this issue.  Throw in the economic state of the particular field of study (whether it’s in demand, pays well, has opportunities for progress, etc.), potential for further education (competition for grad school spots, placement of grad school grads, cost of education, etc.) as examples of a couple of larger issues involved and we begin down a path of seeing the full monstrosity of this iceberg.  Bad analogy.

  10. Perhaps someone else can get the idea I’m trying to communicate across more clearly, but I somehow doubt it.

    As do I. 

    Consi, you’re quite the International Man Of Mystery, aren’t you?  It doesn’t take a rocket scientist to guess you’ve either had severe health problems or been responsible for someone who did.  How it worked out financially you’ve given no hint – maybe you had good insurance or maybe you’re in debt up to your eyeballs.  But if you’re determined to misunderstand the concept of compassion, that’s a bed of your own making.

    What I don’t get is your determination to support the tangled bureaucracy and vast inefficiency and waste that is the US system. According to The Economist we’re 40th in life expectancy, and we didn’t even make the best 20 in infant mortality. Yet we’re #1 in per-capita health care spending.  We’re paying more, getting less, and the “health-care” and insurance companies are getting rich.  I don’t know if that qualifies as a “market failure” but it certainly sounds like a market f*something.

    And in the bargain, our hospitals are in endless crisis, and there are a lot of people sick who should be well, at work, and paying taxes.  You seem to be making a deliberate effort not to understand.  It’s weird.

  11. Interesting comment from Paul Krugman’s column in today’s New York Times (behind the subscription curtain, unfortunately):

    “We have always known that heedless self-interest was bad morals; we know now that it is bad economics.” So declared F.D.R. in 1937, in words that apply perfectly to health care today. This isn’t one of those cases where we face painful tradeoffs — here, doing the right thing is also cost-efficient. Universal health care would save thousands of American lives each year, while actually saving money.

    Here in CT there is a growing movement for universal health care—even our Republican governor is pushing for it, as I’ve mentioned before. And before you libertarians or whatever the hell you claim to be (Consi?) take a look at it and say the stories are made up, etc. etc.—they’re not. Our story is there (along with our photo—even our dog’s photo is there!) They managed to pull it off in Massachusetts (under another Republican governor) and are working out the ways to implement it.

    I just hope it happens throughout the country in my lifetime.

  12. This will have to be brief, as I’m headed out to Südtirol early tomorrow morning for two weeks in the mountains (luckily, it doesn’t suck to be me at the moment).  Have a wonderful and happy summer, everyone!

    As usual, GM and DoF have already stated what is also my position very well.  I’ll just try to back up a little and say what I see as being behind the disagreements here.

    What these issues, like many others, boil down to is: how do we balance the wealth of individuals with the wealth of society?  If we tip the balance all the way to individuals, we have no society: we have sharks.  If we go all the way to society, we have no freedom:  we have ants.  Human societies are always somewhere in between, and there is no absolute truth about the best place to set the balance.  There are advantages and disadvantages that can be claimed for robber-baron capitalism and communist dictatorships, or the more usual colorful mixtures we have in the West.

    As far as I understand consi and other conservatives, the fact that American health care is so poor and so expensive is beside the fact: the important thing is that the poor shouldn’t be subsidized.  If they are poor it’s their own fault, and they should pull themselves up by their own bootstraps like I did.

    Now, there is a lot to be said for self-enterprise, and having spent a fair amount of time in communist countries, I can voucher for the deadening effect excessive state coddling has on societies.  And programs of welfare in capitalist countries that don’t also help get jobs for the unemployed lead to cycles of hopelessness.  But going too far in the other direction, with too little sharing of the fruits of civilization, sharpens the classes of haves and havenots.  If you’re a have, then it’s easy to say “sucks to be you” to the havenots, and you get people pulling out their own teeth with pliers because they can’t afford a dentist.

    Imho, it’s artificial, and fruitless, to decide who is responsible, and who is not responsible, for getting the short end of the stick.  We should rather see what kinds of programs, governmental or private, work to get people jobs and schools and health care that the society can afford.

    And the current American health care system sucks.  It’s certainly no easy task to design a workable universal health care system, but it’s been done.  As I said, I pay about $275 a month here in Austria, and that takes care of everything for my family.  Employees pay even less, and the quality of care is far better than in the States (not that that means much nowadays).  Why the fuck can’t something like this be made to work in America?

  13. Yet we’re #1 in per-capita health care spending

    Thanks for this DoF. I’ve seen/heard this quoted as a reason to dismantle the NHS.  Now I can come back with

    According to The Economist we’re 40th in life expectancy, and we didn’t even make the best 20 in infant mortality

    This is from UK newspaper “The Independent”

    DEATH RATES

    Ten worst states in the OECD for mortality in children under five

    FRANCE 5.5 (deaths per 1,000)
    NETHERLANDS 5.50
    PORTUGAL 5.50
    SWITZERLAND 5.50
    AUSTRALIA 6.00
    IRELAND 6.00
    NEW ZEALAND 6.00
    CANADA 6.50
    UNITED KINGDOM 6.50
    UNITED STATES 8.00

    It is bemoaning the high rate in the UK.  Now look at the country with privitised health care.  It’s a good job you god botherers are breeding quicker than us nasty secular liberal Europeans.

  14. Zilch: Why the fuck can’t something like this be made to work in America?

    Why the fuck indeed?  Could it be … Money?  Americas for-profit HMOs have a monopoly on health care provision, and they maximize shareholder value by withholding medical care and denying claims.  On top of that, they spend a great deal buying support in Congress to keep the gravy train rolling.  Just about the only force that could possibly counter that might be a popular revolt, which is generally frowned upon by the DHS in our scarily Orwellian, post 9/11 US of A.

    If there’s a position outlined in Consigliere’s conversation with Les, it was this:

    However, if the more vulnerable populations, the very young and very old were uninsured, then I would have a problem.  Those populations don’t have the means to protect themselves.  That is why we insure them.

    I think many Americans share this idea: We’re OK with insuring vulnerable portions of the population, such as the very young and the very old, but everyone else has to pay one way or the other.

    The obvious problems with this is, of course, that we don’t do a very good job insuring the very young, nor the very old.  You don’t get an infant mortality rate like ours when your healthcare system is hitting on all cylinders.  One would also suspect that the average life expectancy   would be higher if you really took care of your elderly.  A more telling problem with Consi’s argument is that the whole population is vulnerable.  It doesn’t matter, for example, whether Consi thinks:

    I don’t have the right to hoist onto others financial responsibility for that which is mine.

    because, it’s not about his rights or his choices  It’s about every citizen’s duty in a free society to help to one another when (not if) they need it. In terms of health care – we all need it at some point, regardless of how healthy we are now. 

    I don’t advocate making health care into an entitlement, because I believe it’s already one of those inalienable human rights that the American founders spoke about back in the 18th century.

    While I’d be more than happy to pay my share to make sure Consi gets the care he’s going to need, I’m in a fairly small minority.  Instead, I think that there are more Americans that, like Consi, appear to believe that not having adequate health care is a logical consequence of being unfortunate enough to be born in the US.

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