Many liberals now want to kill the healthcare bill. At Talking Points Memo here is a dissent from an individual who is obviously going to get screwed if the bill is not passed:
If I feel abandoned, it’s not by Obama and the Democratic party, it’s by those on the left advocating to kill the bill.
I am unemployed and have a pre-existing condition that requires daily medicines, quarterly doctors visits and an annual test. I am on COBRA, which runs out mid-2010, when I will have to find new health insurance. I will need to purchase some kind of health insurance, assuming I can find provider who will insure me
I don’t pretend to understand all the intricacies of the health care reform bill, but I do read a lot. From what I can glean, if the bill passed, I would be able to find health insurance because I could not to be turned down due to my pre-exisiting condition. And based on my income at the moment, my premuims would be subsidized.
Am I disappointed in the reform effort? Yes. I believe in single payer. I was terribly disappointed the Medicare buy-in for 55 and older was dropped, not because I give a rat’s ass about Lieberman or the political wrangling involved, but because I am two years shy of 55 and I would have loved to be able to tough it out on the private market for a little while longer knowing Medicare coverage was just around the corner. Believe me, it’s scary being 52 and unemployed with a medical condition. Any form of security is vital.My case is not unique or unusual. In fact, it is common. I am one of thousands if not millions with the same issues that this bill would affect. And when I read or hear people from the left arguing against the bill that would likely provide me and people like me with some modicum of security because the bill doesn’t accomplish everything they had hoped it would or it doesn’t help every last person or the insurance industry will benefit, I do feel abandoned.
Do liberals want these people to suffer? No. But, their working supposition now is that passing the bill and ameliorating the distress in this individual’s life (and many like them) will have negative long term consequences. So in a cost vs. benefit they now believe that this short-term injustice is something that must be accepted for the greater good; i.e., The Perfect Bill. So now liberals are in a position where they believe that they must accept that people will die because of lack of healthcare because the compromises necessitated will cause even more misery down the road. I find this all interesting because this is the exact same general framework that many moderate libertarians, such as Megan McArdle, are operating under. Megan et al. do not think that the current regime is optimal, but, they believe that just doing something, anything, is not necessarily superior to the status quo. Liberals may not accept the same ends as libertarian critics of the status quo, but the same cost vs. benefit analysis is compelling to them as well. They only make recourse to moralistic language bereft of a broader utilitarian context as a tactical measure. They too believe that sometimes you need to break a few eggs to make an omelette. Though this is always clear when those without political careers in the future openly admit the need for technoratic rationing. Some must die so that others may live. Thus it has always been.
That’s fine as far as it goes, but so what?
I’m also not sure how penetrating it is to observe that we’re all utilitarians or whatever. Given the analytical frame we’re a lot of different things at some level. Are we essentially utilitarians in any way? How does grasping the utiltarian aspect of liberalism give is a better handle on things overall?
I feel for this individual. I mean, there but for the grace of… genetics? luck? broccoli?… go I. If I were suddenly unemployed, I’d be screwed. I could be self-employed if I could just get all of you to subsidize my health insurance and guarantee me coverage.
But utilitarianism aside, this reform looks awful for all the reasons conservatives and libertarians state: more government control; less R & D (yes, less); rationing delivery of services; raising the costs; taking more from those who work and produce.
And we have a president who says “pass this or we all go broke.” Thanks, dude. You’re making Jimmy Carter look smart. Yeesh.
The deep issues with “socialized medicine” are whether some people don’t deserve medical care and whether the state should take steps to provide it. This is not a utilitarian argument about how to get people the best medical care. It’s a principled argument about the role of the state, taxing one person to pay for a different person’s health needs, etc. there are no utilitarian medical justifications for denying medical care on the basis of ability to pay.
Anyone making big decisions for large groups will be impelled toward generalized utilitarian formulae, since it’s not possible to deal with nuances of individual cases and, by and large, the issues dealt with are not obvious moral choices. The setting of the overall goal can be moralistic wile the details of execution are utilitarian.
I wonder if the premise of this post is wrong. Is something utilitarian because it contains a cost-benefit aspect? I think instead that the term “utilitarianism” should be reserved to arrangements where measurable or observable social calculation is treated as a basic, overriding, organizing principle of things.
@Evan
“Consequentialism” would be a little more precise than “utilitarianism” here, it’s true. But you could figure out what he meant from context, right? Anyway it’s typical of progressive rhetoric to condemn any hint of consequentialism or even trade-offs between absolute goods (see Sowell’s Conflict of Visions for many quotations illustrating that worldview), so it’s a little interesting to see the change in rhetoric. If Razib is implying that liberalism is fundamentally consequentialist or deeply interested in trade-off analysis, well, that would be quite the assertion.
Though of course as a practical mater each person is, as Theodore Dalrymple observed recently, entirely comfortable mixing consequentialist and deontological reasoning in his daily life. I recently read Theological Incorrectness, after Razib recommended it, and it’s making me wonder if there isn’t a related Ethical Incorrectness that would be interesting to explore. Various creeds claim substantially different roles for principles and consequences in morality, but I can’t say that it seems like the people who adhere to those creeds morally reason very differently in every day matters, i.e. when employing “online thinking.”
Madisonian conservatives and Chicago School economists (I’m thinking especially of James Buchanan, PhD, Nobelist, who is both) are also adamantly anti-consequentialist.
in *libertarianism: a primer* david boaz claims that the chicago school is consequentialist.
I’ve found that liberals often use Benthamite utilitarian arguments:
“So what if the rich are taxed 60%? They don’t need the extra money anyway. Give it to people who really need it.”
“He only lied about sex. He’s a good president. Don’t be such a stickler for the letter of the law.”
Utilitarianism assumes that everyone deserves happiness equally. If you can give person A 2 “utils” of happiness by doing something to person B who will lose only one “util”, the action is always worth doing. Conservatives are more likely to think that some people deserve happiness more: that a person who works is more entitled to what he produces than someone else, that an guilty person deserves punishment more than an innocent person, ect.
Recently, a study came out showing how happy people were in each state:
http://www.livescience.com/culture/091217-happy-state-list.html
The data made one person remark, “This suggests that life-satisfaction survey data might be very useful for governments to use in the design of economic and social policies.” I’m guessing he is a liberal. As someone who is definitely not a consequentialist, the idea of government policy based on total happiness scares me to death.
PS: The “red” states were almost all happier than the “blue” states. The authors of the study missed this entirely. Apparently even when liberals try to do the utilitarian thing, they foul it up. They’d be better off leaving people alone.
This is an enormous question, but my conclusion is that consequentialist and moralistic arguments are both indispensable and neither can be reduced to the other, and that furthermore, while hybrid ethics combining both can be concocted, they won’t be powerful, persuasive, or robust.
I’d say that for individuals moral behavior is the rule and consequentialism is a kind of check, whereas for administrators consequentialism is the rule and moralism a kind of check.
Having spent the past ten hours in penitent prayer that I be granted the enlightenment contained in this post I… am apparently still not worthy. It seems to me however that Razib is saying that because Howard Dean won’t sell all of his assets in order to save the life of little Zambian Sambo, Stalin’s “To The Gulags!” health plan ought to be accepted by the body politic. Am I close?
mnuez, no. mind reading isn’t your thing, that’s for sure. stick to the day job! and least you didn’t take your inference of my inner thoughts as definitive and start constructing a rebuttal like many commenters have done over the years 😉
Gov’t run health care is the best way to destroy America and Obama is going to destroy your country. What a tragedy!
I know better than to assume understanding of thine inscrutable ways. Closer to thee I pray… I should be honest in saying though that were I not forever bedazzled by your awesomeness I would think that you pointed out some obvious and wholly irrelevant thing but I know better than that! And so my prayers shall continue until my knees beg for the relief of death…
You can get insurance even if you have a pre existing condition. The condition usually is not covered for the first two years. It is expensive. No surprise there. I have never in any given year used as much health care as I paid in premiums. So, depending on the cost of treatment of course, the cash discount could be less than buying insurance. Maybe she could buy accident insurance that just covers injuries.
It is possible to spend a lot of money on treatments without benefitting the patient. I think gov’t single payer reduces such treatments effectively. However, it then takes it a step further by not covering needed treatments promptly. That may in itself increase costs in other areas. The worst part of gov’t single payer is the giant bureaucracy of incompetent paper pushers who can’t be fired and will get full gov’t pensions. The clerks at insurance companies can be fired and I don’t have to pay their pensions. Democrats see gov’t programs as jobs programs for their constituents.
The worst part of gov’t single payer is the giant bureaucracy of incompetent paper pushers who can’t be fired and will get full gov’t pensions.
Overhead costs for private insurance are much higher than opverhead costs for medicare. This is an ignorant criticism, nothing more than a worn-out one-size-fites-all slogan. Reducing overhead costs would be one of the big advantages of single payer — which we’re not getting, however. Americans pay more per capita for healthcare than any countyr in the world, even though many Americans don’t get good healthcare.
The amount of illusion and disinformation in the healthcare debate makes it almost a waste of time.