A Philosopher's Blog

Health Care Rhetoric II

Posted in Medicine/Health, Politics by Michael LaBossiere on July 22, 2009

As CNN pointed out in a recent online article, Bill Clinton tried his hand at health care reform and failed in this attempt. Now that Obama is pushing his own health care reform, certain folks are hoping to make sure that he suffers the same fate as Bill Clinton.

One tactic that is being employed is the use of advertisements calculated to make people fear government based health care. One such ad claims that the health care plan will put a government bureaucrat between the patient and the doctor. The ad includes the nice visual touch of a bureaucratic geek menacing the doctor and patient in a dire nerdly manner. This nicely taps into the fear of some folks of geeks and, of course, bow ties.

It is, of course, reasonable to be concerned that the government will act in ways that would interfere with health care. As Thoreau argued, governments have a tendency to get in the way of things and sometimes it is best to have a government that governs less.

The approach of the ad does, however, have some serious flaws. The first is that it is unsupported rhetoric (hyperbole), scare tactics and most likely a straw man attack. After all, no plan has been formalized and hence the ad is attacking a plan that does not even exist yet.

One concern about the ad is that it presumably is intended to imply that the current system does not put a bureaucrat between the patient and the doctor. This is hardly the case. Insurance companies are bureaucratic entities and they obviously decide what will and will not be covered. This clearly impacts the sort of care that a patient is able to receive. For example, when I had my quadriceps tendon repair, I was informed that my insurance (Blue Cross/Blue Shield) stopped covering adjustable leg braces shortly before I had my surgery. So, I had two choices: I could do without something essential to my treatment and recovery or I could pay for it out of my own pocket. While no geek came to menace my doctor, a bureaucrat did try to come between me and my treatment. I was clearly told that the brace was essential to my recovery-it was not an optional thing. Yet, my insurance company had effectively told my doctor that it was optional and not worthy of coverage.

This is, of course, just one example. Unfortunately, a little research will easily turn up many cases of insurance companies decisions affecting treatment (or lack thereof).  Insurance companies decide what they will cover and how they will cover it. As such, to imply that the government presents a special menace in this area is hardly accurate. True, the government might stick in a government bureaucrat to screw things up, but this would merely be replacing an insurance company bureaucrat. Whether the government bureaucrats would do a worse job or not is something that is worth considering, of course.

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11 Responses

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  1. T. J. Babson said, on July 22, 2009 at 7:56 pm

    Above this race of men stands an immense and tutelary power, which takes upon itself alone to secure their gratifications and to match over their fate. That power is absolute, minute, regular, provident, and mild. It would be like the authority of a parent if, like that authority, its object was to prepare men for manhood; but it seeks, on the contrary, to keep them in perpetual childhood: it is well content that the people should rejoice, provided they think of nothing but rejoicing. For their happiness such a government willingly labours, but it chooses to be the sole agent and the only arbiter of that happiness; it provides for their security, foresees and supplies their necessities, facilitates their pleasures, manages their principal concerns, directs their industry, regulates the descent of property, and subdivides their inheritances; what remains, but to spare them all care of thinking and all the trouble of living?

    Alexis de Tocqueville, quoted in The Constitution of Liberty, by FA Hayek, page 251.

    • biomass2 said, on July 22, 2009 at 9:45 pm

      What does A de T mean by this?
      “What is most important for democracy is not that great fortunes should not exist, but that great fortunes should not remain in the same hands. In that way there are rich men, but they do not form a class.”
      Does anyone know the context that might explain it accurately?

      I like this one.
      “It is easy to see that, even in the freedom of early youth, an American girl never quite loses control of herself; she enjoys all permitted pleasures without losing her head about any of them, and her reason never lets the reins go, though it may often seem to let them flap.”

      • T. J. Babson said, on July 23, 2009 at 7:11 am

        Sure, he is saying that inherited wealth is inimical to democracy.

  2. T. J. Babson said, on July 22, 2009 at 9:00 pm

    Once the government takes over health care it will give it a justification to micromanage and regulate every aspect of our lives that bears on our health.

    Just the other day I was reading that the military was thinking about banning smoking by the troops–justification was that it would save health care money.

    • T. J. Babson said, on July 22, 2009 at 9:22 pm

      Health officials to military: Ban smoking

      By Kelly Kennedy – Staff writer
      Posted : Tuesday Jun 30, 2009 16:53:16 EDT

      Medical experts say they have a solution for the military’s increasing smoking rates:

      Ban it.

      And not just in basic training — stop selling cigarettes and chewing tobacco on post, stop with the discounts at the PX, don’t allow it in hospitals, and come up with a deadline when everyone should be smoke-free.

      Why? It cost the Veterans Affairs Department $5 billion to treat smoking-related emphysema in 2008, and in 2006, the Military Health System spent about $564 million on tobacco-related costs.

      That’s almost as much as the $611 million worth of tobacco military stores sold in 2005.

      http://www.navytimes.com/news/2009/06/military_smoking_063009w/

    • Michael LaBossiere said, on July 24, 2009 at 8:46 am

      The state already micromanages many things. In some cases this is good (I’m fine with the state regulating what can go in my food), but in some cases it is paternalism of the worst sort.

      As far as soldiers smoking, they shouldn’t smoke…but they should be allowed to make that choice. But, they need to stay healthy enough to meet the physical requirements.

      • T. J. Babson said, on July 24, 2009 at 3:24 pm

        Mike, what if the government said: “You injured your leg while running, and it cost us a lot of money to fix it. We think it is too risky for you to run again, so we won’t pay for your health care if you injure your leg again while running.”

        • Michael LaBossiere said, on July 27, 2009 at 5:10 pm

          Well, laying aside that my injury was not caused by running, I’d counter that the health benefits of running far outweigh any costs that would arise from typical running injuries. So, it would cost more to have me not run than it would to allow me to run. So, I would argue that they would be mistaken.

  3. biomass2 said, on July 23, 2009 at 10:09 am

    “Sure, he is saying that inherited wealth is inimical to democracy.”

    As I understand it, most states do not have an inheritance tax. And at the federal level, a certain group stands in staunch opposition to the estate tax*.

    So, I have an idea. For the sake of our democracy–our constitutional republic based on a representative democracy, that is–let’s not eliminate the Federal estate tax as some on Capitol Hlll demand. Let’s streamline it, “increase” it, and use the resulting funds for health care. That’s much better than having the massive wealth from unrealized stock capital gains, for example, pass on untaxed to the next generation. Yet currently the step up in basis allows such untaxed transfer of wealth.

    The wealthy elite in this country—a growing number— are like unto aristocrats. Toqueville would not praise us for that.

    *Unless someone can argue a “meaningful” difference between estate tax and inheritance tax, I’ll treat them as similar enough to ignore the difference.

    • Michael LaBossiere said, on July 24, 2009 at 8:52 am

      Taxing inheritance heavily does seem like a good idea. The concentration of wealth via inheritance does seem to have various negative consequences. Wollstonecraft nicely argues about the negative impact of hereditary wealth and the evidence seems to support her claims.

      Also, the folks who would complain about not getting the inheritance would have no real basis for complaint. After all, they did not earn a penny of it.

      Of course, there is the concern that the state would be interfering with choice-why shouldn’t people be allowed to dispose of their property as they wish?

      • biomass2 said, on July 24, 2009 at 3:07 pm

        “. . .why shouldn’t people be allowed to dispose of their property as they wish?”

        Unless you’re among the crowd that believes that government doesn’t have the right or the need to tax us (The same crowd apparently also believes that services such as highway construction, defense, etc. can be provided at no cost :( ) the question almost answers itself. The money that goes to pay taxes, a member of the anti-tax crowd will claim, is “my money”–and money is, I assume, property. . .in that money is considered part of an individual’s estate, and an estate is considered one’s property. . .

        So we already pay taxes on “our” money/property. We don’t get to dispose of that 5%, 15%, 25%, 35% “as we wish”, because it’s needed to run government and provide government services. Much better that we get control of the growing aristocracy in this country—the aristocracy that Tocqueville considers dangerous to democracy—and, perhaps use an increased tax on estates to fund health care reform.


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