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McCain's health care plan is a 5k tax credit.
My question is this:
How does this help families who are so poor they already don't pay taxes?
Seriously. Why hasn't one single reporter asked him or Palin this question? A five thousand dollar tax credit isn't going to give them the money to buy health insurance. We're talking about people who just worry about making rent and eating. And are the folks most likely to end up sick.
If someone has, and I missed it, what was the answer?
The rich stay healthy and the sick stay poor...
U2
My question is this:
How does this help families who are so poor they already don't pay taxes?
Seriously. Why hasn't one single reporter asked him or Palin this question? A five thousand dollar tax credit isn't going to give them the money to buy health insurance. We're talking about people who just worry about making rent and eating. And are the folks most likely to end up sick.
If someone has, and I missed it, what was the answer?
The rich stay healthy and the sick stay poor...
U2
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Here's the thing: there are a lot of people -- a lot of pundits and policy makers -- who think that if you can't afford health insurance or health care, you don't "deserve" it. Like any other consumer good. Or, put another way, if you have enough value to society to be able to afford health care, your life is worth saving. Otherwise, not -- and the people "worth" saving ought not be asked to shell out their money to save those "not worth saving".
And there are plenty of health care systems like that. America in the Gilded Age was like that. Much of Latin America, Africa and the Middle East is like that. Now, granted, no other industrialized nation is like that -- in fact, every other industrialized nation has a radically different health care model than that, and all of them to the liberal side of ours -- but that's a whole different kettle of fish. Just because every other industrialized nation assumes that delivery of basic health care to all citizens is a inherent function of government -- and that the wealthy should pay so that the poor can get it -- doesn't mean America has to. And many in America think it shouldn't.
This is *the* central debate at the heart of all the other health care reform questions. The central question of whether access to basic health care should be a strict market good -- given to those who can afford it, appropriately denied those who can't -- or a "right", with everything else that flows by implication from that second point (like, for example, why physicians in other nations make as much as astronauts, FBI agents, or career commissioned military officers in this country. Which is to say, about 1/2 of what physicians do now). Right now in America we have this crazy, impossible attempt to straddle the fence, and it simply is neither stable nor viable. The economics, studied to death by legions of health care policy experts and economists, are inexorable. There's a *reason* (several reasons) why every single other industrialized nation, once they decided health care was a right, ended up doing it roughly the same way. Either health care is a market good or it's not, with all the implications therof. You can't have it both ways in the long term.
You're right -- a five-thousand dollar tax credit isn't going to help the huge and growing number of Americans who would still be thousands of dollars short buying even the most rudiamentary health care plan. But you're assuming McCain and his backers give a shit.
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Oh, bullshit.
Shorter but much more accurate "right-wing" argument:
1. Everything's a "market good"; anyone who tells you otherwise is lying.
2. Stealing and slaving are, ipso facto, wrong.
3. Pure Fucking Magic doesn't exist.
4. Life is hard, get a fucking helmet.
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Don't ask me; it's a damn silly tinker-round-the-edges policy whose only merit so far as I'm concerned is that it doesn't create some Godawful nationalized healthcare system that doesn't, by virtue of being ours, have the convenient props that the current ones depend on.
You want sensible healthcare reform? Decouple routine/chronic/elective from acute care (this in itself should greatly reduce insurance premiums, not to mention reducing the paperwork load at physician offices sufficiently as to lower the cost of basic health care in the process), shift routine/chronic/elective over to a pay-as-you-go/health savings account model rather than an insurance model, deregulate in all the places where regulation inhibits this (like that pus-awful New Jersey law that charges you extra if you want to pay cash rather than rely on insurance) - in fact, revise insurance regulation heavily to concentrate on ensuring that health insurers deliver on their promises, and throw out a lot of the market-impeding crap and regulatory burden, including most of the regulation that fights actuarial reality, and lastly, do something to inform foreign monopsony pharmaceutical purchasers that they are actively harming American patients by driving prices up, and that they can either knock it the hell off, or we'll make their lives not so easy, too.
And admit that in the absence of Pure Fucking Magic, it is not possible to have a perfect system. Everyone rations. Let's not pretend we're doing anything but arguing over how we do it.
For a start.
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(Except for the words "value to society", which are potentially loaded.)
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He's saying he wants it made a "right", not a "market good", because everyone "deserves" it. Well, yeah, but everyone deserves a lot of things, but here's the problem:
We live in the real universe, and so it, along with everything else that we deserve and which would be nice to have, is a market good. It is a good or service, it has non-zero value to the recipient, and non-zero cost to the provider. That's the definition of a market good.
And making it a right is going to change exactly nothing. It's not going to magically create more healthcare out of thin air. Congress can make it a right, they can write it into the Constitution, they can stand on street corners and shout about it, and it's not going to do so much as heal a goddamned bruise. The only way to get more healthcare is to (a) produce it for yourself, or (b) buy it.
"Right" versus "market good" is therefore a bullshit dichotomy.
Because you can't buy it or produce it with nothing, you have to obtain the means to do so somehow.
So, you can either take money away from people to give it, or the market good bought with it, to other people. Where I come from, taking money from Peter and giving it to Paul is called theft.
Or you can insist that people produce the good for you for free (or, combining it with the latter, at well below the market rate; in many of the countries with nationalized healthcare systems, for example, this is enforced by making it illegal to practice medicine outside the system). Where I come from, requiring people to work for you on terms other than a mutually agreed wage is called slavery. It may not be chattel slavery, but it fits the broader concept.
Jeff's argument is predicated on the notion that the property of the wealthy and the labor of the doctors and other healthcare workers is an asset of society that he can allocate as he sees fit to produce an optimal outcome. "From each according to his abilities, to each according to their needs^W^Wwhat they deserve".
Those of us over here in libertarian-conservative land point out that the whole "deserves" argument is so much irrelevant bullshit, because said property and labor are not social assets because of real, old, fundamental and inalienable rights like life, liberty, and property; appropriating them is, therefore, ipso facto wrong; and that while the People and/or Congress can make theft and slavery legal, they cannot make it right.
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Of course, there are also other factors - like that we are perhaps the only country in the world that buys pharmaceuticals at the market price, since most nationalized healthcare nations have monopsonic purchasing organizations, and that price is inflated by that very monopsony.
And, of course, minor things such as being able to get the result of the pathology on your suspected-cancer biopsy overnight, instead of three months later, your MRI in good time, and so on and so forth, but while that is more expensive to achieve, I think the poor bugger with the cancer doesn't mind so much, eh?
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This is dramatically different than the analogue situation one hundred years ago where, for example, when the wealthy had a child kidnapped they hired Pinkertons and the poor... sucked it up. By my own read, the idea was that, at some point, it was decided that some minimum level of justice should be available to all citizens, regardless of their ability to pay. In other words, justice and it's pursuit largely -- and effectively -- no longer became a strict (or even mostly) market good. Where do things like crime investigation, civilian rescue, and other services provided by the government indistinguishably between poor and rich fit in? I mean, it's not like the FBI or the Coast Guard leave people behind because they can't possibly afford the service they're recieving...
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For one, per Warren vs. District of Columbia, et. al., law enforcement is not a general protective service handed out to the citizens. The government specifically has no affirmative duty whatsoever to protect or rescue anyone. Law enforcement is the government's instrumentality of punishing the people who defy it after the fact, not protecting its citizens from crime before the fact, and any rescuing of hostages, recovering of kidnappees, et. al. are, well, nice to have, but not their core mission. So it's fundamentally different on that point.
Nevertheless, let's play with it. Obviously, it remains a market good. It's an odd case of a market good, but it still is one, since it has a value to its recipient and a cost to its supplier - even though it's both monopolistic (it has one supplier; the government, which has a legal monopoly on the use of force) and monopsonic (it has one purchaser; the government, which pays all the costs and determines how much you get).
And so, there is necessarily rationing. You don't get all the searching you may think is justified for your kidnapped child for as long as there's any possible hope. You don't get air-sea rescue teams searching everywhere possible for as long as possible. You get what the government deems is cost-effective. (And if you honestly believe that the kidnapping of the son of J. Random Prole and the kidnapping of the son of, say, Bill Gates receive exactly equivalent attention from the FBI, well, that's kind of naive, I would have to say. Even if only on the purely triagic grounds that the latter is much more likely to be found alive.) If you're wealthy, you get to work around this - because you're able to hire as many modern Pinkertons and search helicopters as money will buy to do things your way.
((Which is exactly analogous to, by the way, what you see happening when a bunch of Canadians or Englishmen or assorted other foreign chaps and chapesses turn up in hospitals in this country, because they happen to think that their valuation of their own lives is more valid than the one assigned to them by the Secretary of Health and Human Services, Minister of Health, or some other random bod who isn't them.))
Additional: Leaving aside the moral argument, for the moment - which, incidentally, is not in the least affected by what other people happen to be doing now either in other areas, or in other countries; you might as well argue that healthcare ought to be fully private because food is, and everybody needs food even more than they need healthcare - there is also the pragmatic point that both of these things are orders of magnitude cheaper than healthcare. We could throw lots more money at both of them and they'd be lost in the decimals by comparison.
Additional additional: Why shouldn't ship and yacht owners repay the Coast Guard for rescue operations and carry some sort of 'sinking insurance' to do so? And for that matter, drivers repay car owners for, say, the fire department cutting them out of their vehicles, carrying their insurance to do so? This would be a much better system, both because it avoids moral hazard, and because it ensures that risk is borne by, and risk information is available to, the people who have the power to minimize or maximize risk.
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Obama's not immune, here-- he's got the an expansion of the child and dependent care tax credit on his platform, for instance. (More than that, but that's the only one I know of targetted specifically at the poor.) Clinton, if memory serves, monkeyed around with child tax credits, too, but I don't remember the details. Even attempts to expand the pool of people who benefit by this tend to affect relatively small numbers of people, and not the people at the bottom who aren't paying taxes.
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Our right wing coalition had to lie blatantly and say they were in favour of the welfare system ("The _New_ Worker's Party", the biggest party in the coalition called themselves) to have a chance in the last election, so we do have pseudo-left and more left. Our political discourse is one where the concepts from the left are seen as good, but our right still manages to present traditional righty concepts (like lower taxes) in a positive light. The Social Democrats are the conservatives here, though some of the right, especially the Christian Democrats, are reactionaries.
Your political discourse is one where both parties use concepts and language from the right. (You even use the term liberal to mean left.)
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Or to take a more recent example, compare Eisenhower's administration with the administrations from Reagan forward.
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What I don't get is the people who say that a universal healthcare program will make our healthcare system worse. Our hospital system can do incredible things on a case by case basis, but overall, we are number 42 when it comes to infant mortality, which is a nice handy stat you can use to compare the results of a healthcare system. We don't do much better on any other comparison. It would take some work to make our healthcare system worse, but our doctors do very well when you compare their personal income levels.
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In re infant mortality, for example, in the US, we treat neonates born prematurely to a much greater extent than virtually all other countries. Our infant mortality statistics look bad because what we record as infant mortality after attempted treatment, they record as stillbirths without ever treating.
Flaws in other common statistical comparisons and/or relevant demographic reasons for statistical differences are left as an exercise for the reader.
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This information is readily available. Go look it up.
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"Stillborn" is defined in clinical praxis at "not having responded to 20 minutes of resuscitation". (And while I haven't been there for resuscitation of extreme prematures, I've seen the training nurses in just the regular, non-specialist labour wards get, and it's good training. I've also seen resuscitation of full term infants.) In the new law since July 2008, stillborns are legally defined according to the WHO definition (500 grams, 22 weeks or 25 cm). Before that, the law said 28 weeks and not breathing at birth, which meant that all premies who took a breath were registered. (It was a bad and fuzzy law, though, and obstetricians have complained since 1994.)