Thursday, October 03, 2013

Endovelicus

Granting the general political ineptitude of Republican pols and the continual creep of executive power at the expense of congressional restraint, why isn't the riposte to the assertion that the 2012 presidential election was a referendum on Obamacare that the GOP won the house? Every congressional district in the country had an election on the same night, and Republicans came out 33 bodies ahead, the vast majority of the victors having incorporated opposition to Obamacare as part of their campaign platforms (is there a single one who did not?).

Obamacare was passed by a Democratically-controlled House and Senate, but by the time the question of funding had come around, the public's dissatisfaction with the law had served as a catalyst for a return to divided government. The stupid party would be able to strike an oh so sought after moderate pose by claiming that the American people are divided on the question, and consequently the law should be put to a national referendum, or, in a more republican style, people should be allowed to opt out entirely for the first year or something similar.

I'd love a red pill review of Obamacare, and of the state of health care in the US more generally (this is a solicitation--please feel free to oblige in the comments). Much like our mutually exclusive national ideals of liberty and equality, our simultaneous insistence upon providing everyone access to the best health care available and also on making health care affordable for all tells me the whole enterprise is hopelessly saturated in a thick paste of contradictory, quixotic nonsense that conceals the perpetual, mendacious special interest plundering that is taking place on the inside.

I attempt to take a citizenist perspective on the issues of the day, but I scarcely feel like I can make out the top letter of the chart when it comes to this byzantine subject. Thus handicapped, I'm reduced to free market utilitarian analogies and firsthand experiences. Regarding the former, imagine how expensive and inefficient auto insurance, care, and usage would be if insurance companies footed the bill for every driver's flat tire, fuel up, and rim upgrade, or, even more profligately, if private auto insurance was abolished and instead all a person had to do was provide a driver's license to have these services performed, or if a home insurance provider was required to indiscriminately sell a home insurance policy to a home owner whose house had just burned down.

As far as personal experience goes, the head of my company's benefits department has earnestly told me that if one of our employees requests reimbursement for a pack of condoms, the affordable care act requires us to pay up. With a doc in the box that completely covers me and my family without my having to (directly!) pay a dime, I'm sensitive to concerns over--outright hostility to, really--the law's implementation among our corporate brain trust. I've been fortunate not to have ever fallen ill in the decade I've been an employee, but with a baby on the way, I've finally started trying to get to work on some long overdue homework.

Other questions linger. Will other companies follow the lead of Walgreens, UPS, and IBM and begin dumping their employees onto the public exchanges in the future, bringing about an effective socialization of health care in the US? Will the seemingly inexorable trend away from a national norm of working for a living necessitate the separation of health insurance and employment?

12 comments:

JayMan said...

Well, every developed country in the world has a system of universal health care, and it works fine for them. The United States would be no different. Sure, how Obamacare implements it is far from ideal, but it's a step in the right direction.

As HBD Chick might note, the more clannish elements that make up red state White Americans would be naturally viscerally uneasy with any system that redistributes assets from kin to non-kin (especially those of different races). That doesn't mean that that objection is well-founded from a national interest point-of-view.

Universal health care is indeed a system the redistributes goods from the healthy and productive to the sick and less productive. In many ways, this means from the high-IQ to the low-IQ. But, then again, so are the police, and many other basic functions of government. I think we can agree society is better off with these things.

In a nutshell, that's the "red pill" analysis of the topic. The question of whether market forces are necessary to control costs is unclear. I will say that doesn't seem to be an issue for anyone else in the world.

Audacious Epigone said...

Jayman,

Are black Americans more or less clannish than whites in red state America? Consang.net shows South Africa at negligible levels, but blacks in Sudan at 45.7%. Somalians in the US vote heavily Democratic, too, and so presumably support this sort of redistribution.

My point is the inbred/outbred conservative/liberal needs to be qualified to be explanatory in a multiracial society like the US--inbred groups that benefit from it are happy to vote inline with the universalists if it means they get theirs. The opposition, then, is made up of groups a bit more clannish than the racial-majority universalists, but less clannish than a lot of other members in the redistributive coalition.

In a nutshell, it's a somewhat helpful framework in understanding how whites act, but not necessarily how others do. In a majority-minority future, how explanatory is it going to be?

JayMan said...

@Audacious Epigone:

"Are black Americans more or less clannish than whites in red state America? Consang.net shows South Africa at negligible levels, but blacks in Sudan at 45.7%. Somalians in the US vote heavily Democratic, too, and so presumably support this sort of redistribution.

My point is the inbred/outbred conservative/liberal needs to be qualified to be explanatory in a multiracial society like the US--inbred groups that benefit from it are happy to vote inline with the universalists if it means they get theirs."


Precisely. Indeed, HBD Chick said much the same once:

"i think this is one of the fundamental problems with ... clannish societies, and that is that, while they generally do not want to contribute to the common pool (to varying degrees), they are VERY happy to TAKE from the common pool as much as possible to the benefit of themselves and their extended family members.

thus you get ridiculous scenarios like those being played out in the piigs these days: in places like italy and greece, everyone tries to avoid paying taxes, but at the same time they all want to retire when they’re 58 on a full state pension."


Most of the non-Whites in America are far more clannish than the Whites themselves, so they are generally happy to vote with the "inclusive" party to be on the receiving end of the social welfare goodies. The clannish Whites that see themselves on the giving end, that is, White conservatives, naturally oppose such measures.

Hence, I wouldn't quite say:

"In a nutshell, it's a somewhat helpful framework in understanding how whites act, but not necessarily how others do."

I think it is, so long as you understand the role everyone plays in the equation.

As a minor aside, one complication is the role of Asian Americans (both South and East Asians). In general, while they may be on the "giving" end of the revenue in these services, and while they are certainly quite clannish, as fairly recent immigrants, I think they see themselves as overall standing to gain (partly at the expense of Whites) from universalist policies. Hence, they generally vote Democratic.

Audacious Epigone said...

Jayman,

Thanks for the chickadee refresher, that had fallen out of my mind.

Re: the framework, I was referring in particular to the left/right political divide, not clannishness in general. I didn't articulate it very well, though.

Asians are definitely a big question mark going forward. They voted Republican as recently as the nineties, and I think (though I've not seen confirming quantitative evidence of as much) the Rand Paul variety of the Republican brand has the potential to make that motley category a lot more competitive than Hispanics or, obviously, blacks.

asdf said...

"it's a step in the right direction."

While I agree on universal healthcare, I disagree on this statement. I've worked directly on Obamacare quite closely and I don't think its a net good. People who believe that just want their team to "win".

JayMan said...

If you believe universal health care is a good thing, then you should agree that virtually any step towards it is a step in the right direction, considering the political climate. This is true even if that step is a far less than perfect thing (which I'll totally agree that Obamacare is, because of the fact that it was built to placate insurance companies).

vinteuil said...

Obamacare absolutely is NOT a "step in the right direction." It doubles down on the worst and stupidest aspect of the current system: the disproportionate role of third-party payment. Using "insurance" to cover routine expenses and pre-existing conditions is simply insane.

Besides: if the USG is capable of delivering healthcare of, say, French quality at French prices, then why isn't it already doing so? Per capita public spending on healthcare in the U.S. is already HIGHER than in France.

vinteuil said...

Addendum I: routine expenses should be paid out of pocket. Insurance should be confined to its proper role: improbable but expensive (i.e., "catastrophic") situations. Pre-existing conditions should be covered by private or public charity and not foisted off on for-profit enterprises.

If you're libertarian, you'll want catastrophic insurance to be optional; if you're statist, you'll want it to be mandatory.

Whatever.

vinteuil said...

Addendum II: In case there's any misunderstanding, let me explain this point: "Per capita public spending on healthcare in the U.S. is already HIGHER than in France."

I'm not talking about total public + private spending, here. I'm talking about public spending alone.

And I'm not talking about spending per *patient covered.* I'm talking about spending per *person in the country.*

Capisce?

If you add up all of the USA's PUBLIC healthcare spending and divide it by the population of the USA, the resulting figure is HIGHER, not LOWER, than the one you will get if you repeat the same exercise for France.

So why isn't the USG already doing at least as good a job as the French at providing universal healthcare?

If you've got any thoughts about this, I'd honestly be interested.

Red said...

It's much more expensive because our system is fully socialized with 4 separate levels of graft(Government, Insurgence, Drug companies, and medical facility). Most universal healthcare systems treat their patents worse and worse until the people with money travel to another country buy their healthcare on a market rate and they only have 2 levels of graft. Americans have a difficult time doing this because of who our neighbors are.

vinteuil said...

Red - interesting suggestion, though a little under-described: I'd like to hear more.

I think a couple of other factors are (1) the extraordinarily high compensation for American doctors & nurses and (2) American insistence on mostly pointless end-of-life interventions regardless of cost.

Anonymous said...

Obamacare is evil masquerading as good, and since this is an evil world it could only be defeated by countervailing evil on the order of civil insurrection.