Today’s Paul Krugman column connects the S-chip controversy and public school education, and wonders why one is bad but the other acceptable.
The truth is that there’s no difference in principle between saying that every American child is entitled to an education and saying that every American child is entitled to adequate health care. It’s just a matter of historical accident that we think of access to free K-12 education as a basic right, but consider having the government pay children’s medical bills “welfare,” with all the negative connotations that go with that term.
And conservative opposition to giving every child in this country access to health care is, in a fundamental sense, un-American.
Here’s what I mean: The great majority of Americans believe that everyone is entitled to a chance to make the most of his or her life. Even conservatives usually claim to believe that. For example, N. Gregory Mankiw, the former chairman of the Bush Council of Economic Advisers, contrasts the position of liberals, who he says believe in equality of outcomes, with that of conservatives, who he says believe that the goal of policy should be “to give everyone the same shot and not be surprised or concerned when outcomes differ wildly.”
But a child who doesn’t receive adequate health care, like a child who doesn’t receive an adequate education, doesn’t have the same shot – he or she doesn’t have the same chances in life as children who get both these things.
Actually, much of the Right wants to dismantle public education also — for our own good, of course. But let’s stick to health care.
Krugman may have a point about a “historical accident.” People are comfortable with the familiar, “the way we’ve always one things.” It’s like the “reefer madness” phenomenon. Liquor is legal and marijuana is not, even though liquor is the more dangerous of the two substances — people do become physiologically addicted to alcohol, and it is possible to die of an overdose of alcohol, which is not true of marijuana. But we’re used to liquor, so it’s OK. And we’re used to universal public school education, but not universal health care for children (or the rest of us), so the first is acceptable but the second is scary.
This blogger argues for the status quo:
Where in the Constitution does it say that every one has the right to health care?
Where in the Constitution does it say that every one has the right to an education? Or the right to call the fire department if your house catches fire? What’s the big bleeping deal with allowing We, the People, to use the federal government to solve national problems that aren’t being solved any other way? Isn’t that what bleeping government is for?
Besides, I bet you most people think that everyone should have access to affordable health care, but that is not the same as making it the responsibility of the federal government to provide it.
Well, yes, and if the U.S. health care system were providing at least basic health care to everyone who needs it, at an affordable cost, then we wouldn’t have a “health care crisis,” would we?
Certain conservatives may, for instance, think that it is unconstitutional to get the government (too much) involved or they may think that private companies can deal with the problem… or (shocker to people like Krugman who seem to believe that States in the US are not much different that provinces in the Netherlands) that States could and should deal with it.
Certain conservatives think that universal health care is unconstitutional, but that suspending habeas corpus or warrantless surveillance of U.S. citizens isn’t. This is why I don’t give a bleep about what certain conservatives think.
And states are not going to come up with anything but band-aid solutions; Ezra Klein explains why.
The blogger continues,
This issue is not between conservatives who do not want children to have a health care insurance on the one hand, and progressives who do want that on the other, it is about what solutions / plans actually work and the power of the federal government. Krugman, then, does not approach this subject from the perspective of someone who tries to bring people together to join forces on an issue, he approaches this subject from the perspective of a partisan liberal.
Krugman has written a ton of columns about possible solutions to the health care crisis. Here’s just one of them. But today’s column was not about solutions. This column is about why we haven’t been able to have a sensible national discussion about these solutions, much less put any of these solutions into practice.
Part of the reason is that politicians — and I’m not just talking about Republicans — are in the pockets of the health insurance industry. But the larger reason is that the American Right is in deep denial about the true dimensions of the crisis and what it will take to correct it. In fact, I have yet to see a substantive discussion about health care in mass media. What I’ve seen by way of “discussion” are right-wingers screeching about waiting lines in Canada. Thus, the United States remains the only industrialized democracy on the planet without universal health care for its citizens, and the only thing most Americans know about health care in other countries is that there are waiting lines in Canada.
Are there any conservatives out there who say that children should, quite simply, never see a doctor? Of course not. This is not what the debate is about.
I’m sorry, but that is what the debate is about. Children are being denied medical care. This is really happening. It is not imaginary. It does those children no good to say that, in principle, we’re fine with all children seeing a doctor. We’re just not going to do anything to make it possible.
I write about health care a lot, and I’ve written several posts that look at various solutions. And I don’t much care which party or which politician comes up with a workable solution. In fact, so far none of the Democratic presidential candidates has come up with a plan that I’m all that excited about.
But the Right is coming up with nothing. Less than nothing. For example, I’m certain that Health Savings Accounts would make the problem worse, for reasons Kevin Drum explains. As he says, “solutions” coming from the Right don’t even rise to the level of band-aids; they’re more of a papering-over.
If by some miracle someone comes up with a workable plan that does not involve a federal program, I’d be thrilled. I am not advocating or a federal solution just for the sake of a federal solution. I’m advocating for a federal solution because I haven’t seen any other plans that would come even close to solving the problem.
The first step in finding a solution is understanding the problem. I see no indication that anyone on the Right has made that step.
We’re back to “lead, follow, or get out of the way.” On health care, the Right won’t lead, they won’t follow, and they won’t get out of the way. They just obstruct and deny.
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What’s the big bleeping deal with allowing We, the People, to use the federal government to solve national problems that aren’t being solved any other way?
The great mass of Americans thought this was a great idea after WWII when the Great American Middle Class was created, largely by federal government programs. It became a big bleeping deal in the late 60s when white Americans realized that these benefits would be extended to black people. It was then that Americans discovered how government assistance was destructive to the American soul. Funny how it didn’t seem to have that affect on large corporations.
James — exactly. A point I make frequently. But the hard-core Right also (hysterically) associates any govern program involving social services with socialism.
Bravo for what you suggested – an objective look at the problem.
Here’s a couple of opinions to chew on. The insurance industry and the profit motive are a BIG part of the problem. A real solution will cut them out of the game in a big way, and they have a lot of money to spread around to prevent any proposals from seeing the light of day – if those plans don’t include profits for business.
There really are NOT enough doctors to go around. Do the math. A long-term solution has to provide a greater supply of doctors, and a short-term solution probably required a clinic approach with trained nurses seeing patients and referring cases up to doctors when the scope exceeds the training and authority of the RN.
Yes, this means that patient care for people with ‘gold-plated’ insurance like the BCBS I have – will be superior to the ‘free’ care I would gladly pay higher taxes to provide. But doctors don’t grow on trees; it takes 6 years of college plus residency training. The NEED is NOW, but the logistics of a comprehensive plan require more than money. Politicians need to get grounded in reality in proposing plans.
Hi Mahabarb,
I seem to vaguely recall that Thomas Paine and Ben Franklin believed we should have universal healthcare. Of course, I think one of the problems single payer proponents have had in the past is an unwillingness not so much to address how we’ll pay for it but their unwillingness to
1.emphasize that American companies would become more competitive, especially the auto industry that is carrying a lot of retirees on their healthcare rolls, relative to the Japanese companies building cars here,
and
2.lefties generally fail to discuss what will happen to investors with healthcare stocks, which is practically like inviting blowhard righty pundits to scare old folks who are depending on their IRAs and such. It would be so much simpler to actually talk about converting healthcare stocks to public healthcare bonds, but I’ve never heard anyone do this. have you?
Access to medical care in the United States is a privilege of the wealthy, the employed, the elderly, and the incarcerated. God help you get sick if you a low paid worker or a child living with working poor parents. There is no room or money in the health care system for these hard working souls.
These downtrodden are shunned by all who are privileged. Why should they have medicine or access to doctors if they only cut our grass, clean our dishes or mop the floors in our offices? Why should their children have pediatric care? The nerve of them! If they get sick and can’t pay, they should pray. Pray to recover before they lose their job and their car. But they could always commit a crime and end up in prison.
Logic dictates the only solution would be to eliminate these people from our society. Make poverty a crime and put them in prison therefore granting them free healthcare. The problem would be solved. No more health care crisis.
Tell that to the people who remained behind in New Orleans. The good life the affluent lived in the Big Easy was assisted by these wonderful hard working people. They did the things that no one else wanted to do. They served at restaurants, the hauled away the trash, and they manicured the lawns in addition to their fingernails. They simply make our lives richer. It is a symbiotic relationship. Take out these people who are the foundation of society and our lives would not be as comfortable. Make health accessible to everyone now.
Posted by Dr. Michael Esposito M.D.
Radiologist and Author of “Locked In,†a new medical thriller.
http://www.mikeespositomd.com
Perspective of an outsider (I don’t get to vote in your country, only observe it)…
The right as a general rule wants to avoid anything that will lead to greater taxation. The richer portion of the voting right don’t want the government to take their money away from them. The poorer portion of the voting right can’t afford to lose any more money. This seems to me the root of opposition to universal health care.
Much of the right’s reluctance to pay higher taxes is the belief that the money raised through taxation will be wasted, which I must say is a legitimate concern with any government spending.
Coming from Europe, where everyone has universal health care, I just can’t quite work out why the US can’t get this one through other than power politics blocking it in legislation.
Make it a sufficient priority and it can be made to happen – but it will take lobbying to get there; you need a large enough group who form a consensus on the issue, which means isolating the issue and committing to resolve it.
A possible back door… if the bill for healthcare under a proposed universal scheme is cheaper for employers than provision of health insurance is now, it becomes easier to pass the bill because companies will be better off, and companies wield considerable influence. It may be necessary to take some of the funding from personal taxation to make this happen.
Are the US people open to “a few cents in tax for universal health care?”
Best wishes!
Chris (#7) asks: Are the US people open to “a few cents in tax for universal health care?â€
The question reminds me of something a Canadian friend now living in Florida told me a few years ago. Apparently voters refused to allow a 1-cent increase in the mill-rate (used to calculate property taxes), thus preventing the city from installing property street lighting.
I may have the details wrong, but the moral of the story is clear: a significant portion of voters so believes that government and taxes (at any level) are evil that they would rather cut off their noses to spite their faces than give up a cent of their income for the common good (as indirectly, their own personal benefit…but try to explain that to a brain-washed rightie).
Just a personal note: Yesterday, I got the annual letter from my kids’ pediatrician asking for 75$/child or $150/2 kids or more to cover fees not included in OHIP (the Ontario Health Insurance Plan) such as consultations on the phone, etc. The form had three boxes: fee enclosed, will pay for each service separately if needed, request the fee be waived. The letter specifically stated that those who cannot pay will not be turned away nor will they be charged. I paid the fee and felt reassured for those who are not as well-off as my family.
I am following the debate on universal health care in the States with great interest from up here in Canada, where yes, the waiting lines can sometimes be atrocious, but where EVERYONE gets health care. Judging by comments I see on the boards of two medical self-help groups that I belong to, the fight for universal health care in your country is far, far from being won. A visceral fear that choice will be lost, that old canard about health care not being in the Constitution, the frontier mentality that says you take care of your own and leave the others to fend for themselves, the idea that U.S. medicine is the best in the world are all arguments I see frequently expressed by otherwise intelligent, hard-working and sometimes extremely well-educated people. One person I know (he of the “not in the Constitution” argument) pays $14,000 a year in premiums and still firmly believes that the U.S. system should not be changed. Go figure…
Good luck, guys. I’m not being facetious. You really, really need it!
I may have the details wrong, but the moral of the story is clear: a significant portion of voters so believes that government and taxes (at any level) are evil that they would rather cut off their noses to spite their faces than give up a cent of their income for the common good (as indirectly, their own personal benefit…but try to explain that to a brain-washed rightie).
Absolutely right. One still finds people who resent paying for public schools because they don’t have any children in them. They actually cannot grasp that having an educated population benefits all of us.
The bulk of public school funding in most communities is from property taxes, and I’ve met plenty of people who’d rather have disgraceful local schools than raise their taxes to pay for them. But since the quality of local schools impacts home values, such people often are depriving themselves of considerably home equity.
On the flip side, years ago New Jersey tried to improve quality of schools in property-poor districts via a modest and progressive income tax increase, plus a 1 cent sales tax increase, and the entire state went ballistic. And one of the leaders of the tax protest had kids in a school that would have benefited considerably. He didn’t realize that until someone pointed it out to him.
The next governor, a Republican, made a big deal of cutting taxes. But then many districts had to raise property taxes to make up the difference in money they weren’t getting from the state.
Excellent analysis and discussion. I’d add only one thing, which is the “not in the constitution” argument is fundamentally wrongheaded anyway. That perspective seems to assume that the constitution is what grants people their rights, but it isn’t. The constitution recognizes the people’s inherent rights, that is, the rights that they already have simply by virtue of being the people. That’s why the constitution actually specifies that just because a right is not listed there, that doesn’t mean that the people don’t have it.
This, I think, is the most important thing to remember in the health care debate, and for that matter in any kind of democratic debate: the people’s rights are inherent in the people, not in any document.
the platform should never be “health insurance for every american”; it should be “health care for every american”.
My 80 year old mother fell last month and broke her pelvis, landing her in the hospital with an infection they can’t find and incredible pain. She has her home, and a little money in the bank, and medicare and blue cross supplemental. When she can come home from the hospital, she will need round the clock care, which my brother (who lives in another state) and I will be unable to do all or even most of–and still support ourselves. So we are looking at her losing her home and posessions, in order to live.
Where in the bleeping constitution does it say that’s right? If she were a Canadian citizen, she would have the health care and get to keep her home, and my brother and I could focus on helping her get well, not be frantic to find someone to help her we can afford, while losing our jobs in the process.
Where in the constitution does it say the insurance companies have the right to hold my mother’s health care hostage to them getting her home away from her?
Health care is not a right. Neither is driving a car, having an education or having sidewalks. They are priviledges. The question of health care from the perspective of the right (which I am a part of) is that whenever you get goverment involved in commercial matters (and I am sorry, the high quality of health care that we have is a commerical matter) the quality of that service diminishes. Goverment has no competition. Thus they set a certain bar and that bar continues. Incentives are key. Government intervention would create bureaucratic layers that would retard advances in health care. Right now we have more cures for ailments than ever before. Why? Because drug and medical companies compete for the consumer dollar. We do have the highest quality of care in the world. Right now England has one Dentist for every 6,000 people. British Dr.s make less than lawyers and work 40 hr schedules. If you cannot get an appoinment, you are out of luck. I have a friend in Canada that had to wait 18 months to have a cyst removed on his stomache and had to wear elastic waistband pants for 6 months until the cyst was removed. When it was removed, it was found to be cancerous. If they had removed it within a month period this could have been avoided. Do you really want a world with long wait lines and less medications to choose?
Karl — I’ve written exhaustively about health care. Click on the “health care” tag at the top of the post to read more and to find the documentation for what I am about to write:. Everything you say is wrong. We do not have the best health care system in the world, just the most expensive. If there were a free market solution for the health care crisis, the free market would have found it already. It hasn’t.
I’m sure you’ll continue to believe the crap the Right has fed you until some unfortunate day when the health care industry lets you down. Good luck.