Party of 1

The “tea party” activists think they are getting a raw deal from the media these days.  Fair enough: one, two or a dozen instances of incendiary rhetoric do not necessarily make for a trend.

A more serious vein of criticism is suggested by remarks contained in a Washington Post article from this past Thursday. The piece focused upon Tennessee farmer and Republican Congressional hopeful Stephen Fincher, who “could be a perfect ‘tea party’ candidate: a gospel-singing cotton farmer … seeking to right the listing ship of Washington with a commitment to lower taxes and smaller government.”

There’s just one problem: “Fincher accepts roughly $200,000 in farm subsidies each year.”

One supporter of Fincher sees no problem. “He is for getting the budget balanced. He does not want this health care. He is right in line with the views we are holding true to.” Another says: “I don’t see the agricultural subsidy thing as an issue at all … If it were an issue, then we would never elect a farmer to Congress at all. Because basically, most farmers get agriculture subsidies. If they didn’t, they’d be broke, and we’d be buying our food from China.” In his own defense, the candidate says: “People are quick to say with their mouth full, ‘Well, the American farmer is on the dole.’… But a loaf of bread is two bucks when it could be 10 bucks. I know what it is with the government in my business. We would be all for not having government in our business, but we need a fair system.”

These people represent themselves as tribunes of the oppressed masses, but what they really are, are affulent voters who haven’t thought through the implications of their own libertarianism. They’re not being oppressed. Their opposition to the health-care reform legislation borders on the hysterical. In their own detached and disinterested opinion, they’re overtaxed.

Somewhere in a trailer park, there’s a family with a kid on a respirator, and no health insurance. They’d like a “fair system” in health care, just as Mr. Fincher wants a “fair system” in agriculture.  I wonder whether he is aware that libertarians will belittle the invocation of “fairness” in either case.  What’s good for the goose is good for the gander….

David Frum believes that Republicans overplayed their hand on health care. “We followed the most radical voices in the party and the movement, and they led us to abject and irreversible defeat.”

This is too good to pass up: “When Rush Limbaugh said that he wanted President Obama to fail, he was intelligently explaining his own interests. What he omitted to say – but what is equally true – is that he also wants Republicans to fail. If Republicans succeed – if they govern successfully in office and negotiate attractive compromises out of office – Rush’s listeners get less angry. And if they are less angry, they listen to the radio less, and hear fewer ads for Sleepnumber beds.”

The takeaway: “So today’s defeat for free-market economics and Republican values is a huge win for the conservative entertainment industry….”

It looks like we’re headed for The Mother of All Health-Care Reform Battles this week, as it appears there actually will be a vote or series of votes this weekend, by which time the whole thing should be settled, one way or another. As the denouement approaches, it’s to be expected that the polemic will grow more heated.

Generally, I find Robert Samuelson to be pretty reliable, but I see that in Monday’s column he continues to push the we-can’t-afford-reform line.  The opening salvo of the column is aimed at debunking the argument that reform would relieve emergency rooms of the burden of caring for the destitute — as though it were normative or self-justifying for the poor to rely on emergency rooms as their primary providers. (I’ll be he doesn’t do that….) “If universal coverage makes appointments harder to get, emergency-room use may increase.” I suppose that therefore we just have to keep poor people from making doctor’s appointments.

Even more reliable may be David Brooks in the New York Times, who appeared on NBC’s “Meet the Press” on Sunday (transcript here). “I understand why people would be fervently for [the reform legislation]. This will cover 30 million people.  That is a serious moral accomplishment…. [But] I’m really worried about the cost, and that’s why I lean against right now.”

Fair enough.  This website, for its part, concentrates on broad questions of political justification rather than “wonkery” — and there are plenty of “wonkish” claims and counterclaims in circulation with regard to the costs of the pending legislation. I notice that Samuelson thinks it simply would be ruinous to cover the uninsured. “Obama claims his proposal checks spending. Just the opposite. When people get insurance, they use more health services. Spending rises.”  So we’ll just have to leave them uninsured, and liable to being ruined — we can’t afford to do otherwise.

More from Samuelson: It’s no problem that so many are uninsured, because “many uninsured are fairly healthy — about two-fifths are age 18 to 34.”  Funny thing — I always thought that to be insured was the responsible thing to do, if you possibly can afford it. Much of the polemic I run across reads like a recommendation that “twentysomethings” remain uninsured.  Hey, not to worry — you’re ten feet tall and bulletproof, you’ll never get sick! By the way, if you’re looking for entertainment this weekend — why not meet your buddies at a nearby vacant parking lot for an exciting game of “chicken”?

I also notice that Samuelson rehashes a recent column by Megan McArdle in the Atlantic Monthly which purports to find no relation between health insurance coverage and health benefits in terms of (for instance) decreased rates of mortality. He doesn’t acknowledge that Ezra Klein mounted a vigorous debunking effort against the McArdle column. “At its base, [McArdle's column] takes a methodological difficulty (it’s hard to measure mortality) and blows it into something approximating a conclusion (insurance coverage has no effect on mortality). It gives an accurate impression of one of the problems bedeviling efforts to answer this question, but an inaccurate impression of the conclusions the best researchers draw from the best research.” (See Klein’s response to McArdle’s original column here, and a summary of the subsequent exchange between the two here.) An audacious critic might speculate that, since McArdle is a laissez-faire ideologue, a lack of relationship here would have been just what she was determined to find….

Klein has had some interesting exchanges on health reform with Rep. Paul Ryan (R-WI), whose budgetary proposals at least have served as a springboard to further discussion. (Click here to see two earlier blog posts of mine, with links to these exchanges.) With a vote pending in Congress this week, I notice that Rep. Ryan has an op-ed in Monday’s Washington Post. He writes in opposition to the bills before Congress, under which health care purportedly “would be dominated by government programs and the largest insurance companies, operating as de facto government utilities.”

“Government utilities” — that’s interesting.  I suppose his polemical purposes dictated that he coin this term, rather than employing the more familiar “public utilities.” Are we now going to see a movement for the privatization of any and all “public utilities” as quasi-socialistic and therefore sinister? Haven’t we always had public utilities, for the sake of such public facilities as convention centers, stadiums and sports arenas, water works, sewerage systems, even electric power generation in some cases? Wait a minute, we’ve already had the movement to privatization — for waste collection, operation of corrections facilities, even public schools in some cases.

Nevertheless, the thought occurs — if health insurance companies have the power of life and death over people, why shouldn’t they be treated like public utilities? Just asking….

Without doubt, everyone is getting weary from the drawn-out battle over health-care reform legislation, which by all appearances will be resolved one way or the other sometime this month or next. Here are just a couple of links to pieces that provide important talking points down the stretch.

I am far from a policy “wonk,” preferring instead to focus on broader questions of political justification. Ezra Klein, for his part, is about as adept a “wonk” as you will find, and on his Washington Post blog (going back almost a week now) you will find his take on the critique of the economics of the Democrats’ legislation offered by Rep. Paul Ryan (R-WI), which has gotten so much attention. The takeaway: “To sum up, then, Ryan makes some good points about the true cost of the bill and realities of the federal budget. But he purposefully omits any mention of the bill’s expected savings, disingenuously attaches the price tag of a broken Republican policy onto the health-care reform bill, and selectively stops extrapolating trends when they don’t fit his points. It’s a presentation designed to make the bill look less fiscally responsible than it really is.”

Klein and Ryan have conducted some interesting exchanges in Klein’s WaPo-sponsored blog. Click here and here, for instance.

Also worth a look is a piece from last week by Jonathan Chiat, available on the New Republic site. It’s a valuable piece because of the fashion in which it summarizes the issues at hand so concisely. Highlights:

“Health insurance, if you think about it, is a redistribution scheme. It transfers money from the winners (people who don’t need much medical care) to the losers (people who do)…. The problem with this system is that, while you can’t be certain who will win and who will lose in the medical lottery of life, you can make some educated guesses. The health insurance industry is good at making those guesses, and getting better all the time…. Left to their own devices, millions of Americans could not afford to buy health insurance, because their expected medical costs are too high–they’re the losers of the medical lottery–or their incomes are too low. Obviously, many Americans are left to their own devices, with horrifying results.”

“Republicans have long championed Health Savings Accounts, which give individuals who buy insurance a tax deduction for money they set aside for a high-deductible plan. Since tax deductions are worth more to people in higher tax brackets, and since high-deductible plans appeal more to those with lower medical expenses, the plans attract the rich and healthy, leaving the poor and sick behind…. Republicans boast that the CBO says their plan would reduce insurance premiums. This is true. The CBO predicted this would happen because the GOP plan would reduce premiums for healthy people, bringing more of them into the insurance pool, and raise premiums for sicker people, driving more of them out.”

“Liberals have reacted with astonishment to conservative accusations of socialism against Obama, whose plan relies mostly on private insurance and closely resembles proposals put forward by Senate Republicans in 1993 and Mitt Romney in 2005. It is, however, socialistic in the broad sense of spreading the risk of medical misfortune. This is a goal that Republicans increasingly abhor.”

Back during the presidential campaign, Joe the Plumber was up in arms over plans for “redistribution of wealth,” and the “tea-partiers” now are at the ready, with pitchforks and torches as it were, to the same end. The problem is that if you pursue “American exceptionalism” to its logical end, and prohibit any and all measures that smack of so-called “socialism,” you will end up with a medical system that does not treat the sick….

Here’s the “Party of 1″ joke of the day: If you count yourself as a diehard American conservative and defender of “American exceptionalism,” try climbing to the top of an American skyscraper and jumping out the window — and see if you can make yourself an exception to the law of gravity.

That might seem harsh, but I offer it up with reference to the lead article in the March 8 issue of National Review, which came over the electronic transom a few days ago. The piece by Rich Lowry and Ramesh Ponnuru is entitled “An Exceptional Debate” — and those familiar with the concept of “American exceptionalism” can anticipate the argument.  The two worthies are concerned to demonstrate that Barack Obama is a threat to this vaunted “exceptionalism.” More broadly, the polemical pressure is in the direction of the view that fealty to “American exceptionalism” absolutely prohibits any social-democratic measures. “Lowry and Ponnuru aim for comprehensiveness, and they maintain a measured, thoughtful tone throughout their essay, marshalling a wide range of historical evidence for their thesis and making well-timed concessions to contrary arguments,” concedes Damon Linker of the University of Pennsylvania in a reply on the New Republic website (I note that Linker formerly was associated with Richard John Neuhaus’s publication, First Things). Readers can try the above links  and peruse both articles for themselves. For the moment, I am going to concern myself in the main with Linker’s reply.

Despite his generous concessions, Linker finds the Lowry/Ponnuru essay to be “either a string of American banalities and clichés—or an abstract of the Republican Party platform.” That’s the point, of course — to equate “Americanism” with one party’s line — and, under current conditions, I suppose you have to hew to the line or else individuals of conservative inclination will come after you with torches and pitchforks, as it were. I wonder what the future holds for political competitiveness in such a country, where the very essence of the country is equated with one side of the partisan divide. You might as well declare a dictatorship for the sake of enforcing unlimited corporate prerogative — not so different from what they have now in Singapore or even in China.

As Linker notes, the invocation of “American exceptionalism” is supposed to serve as an inoculation against any “foreign” or — for heaven’s sake — European infection. With that in mind, it’s most interesting to peruse a “Review & Outlook” feature from last week, from National Review’s fellow travelers, the Wall Street Journal editorial board. It seems that Russian politicians Dmitry Medvedev and Vladimir Putin were disappointed in their country’s performance at the recent Winter Olympics. I understand that, in the meantime, several Russian sports bureaucrats have stepped down. The editorial board notes: “This thought runs against centuries of Russian tradition, but why not try to measure Russia’s greatness by its ability to build a free and prosperous country, a good global citizen at peace with its neighbors?” Well, no one should take exception to that, as far as it goes. The board further notes: “The four leading medals winners in Vancouver are free-market democracies.”

Actually, it was five leading medals winners by the time the Games were over: Germany, Canada, Norway and Austria in addition to the United States. I would simply note that for the purposes of this commentary, it suited the editorial board to christen the three European winter-sports powers, not to mention Canada, as “free-market democracies.” But if you pointed out that the other four have more extensive social-democratic measures than the United States, it would suit the purposes of polemicists of this ilk to portray them as quasi-totalitarian. Linder: “Jane Addams, Herbert Croly, New Deal economist Stuart Chase—all of them, and many more, failed to understand and appreciate America’s exceptional character and sought to replace it with ‘the best innovations of the modern dictatorial movements taking over in Europe’ during the 1920s and ‘30s. That’s America for you: Members of the modern conservative movement squared off against the European-inspired liberal fascists, forever searching in desperation for ‘a foreign template to graft onto America.’ If only the latter could be convinced not to hate—let alone to like or love—their country. But alas….”

All those countries are, of course,  “free-market democracies.” They are marked far more by their commonalities with this country than by their differences. All are part of a larger North Atlantic civilization which had its beginnings in Britain and Europe — of which this country basically is an offshoot, and from which all the components of “American exceptionalism” come. As Linker notes, such countries are described as “sclerotic welfare states” in contemporary polemic — but all of them exhibited plenty of innovation and dynamism. That, of course, can be inhibited by social-democratic programs — but these polities arrived at the conclusion that it is indeed possible to have too much of a good thing. Just ask the residents of Flint, Youngstown, or Buffalo.

Linker: Lowry and Ponnuru seek “to relegate contrary voices in our national narrative to the periphery of our history, and perhaps even to read them out of our history altogether.” Indeed, polemic of this genre often comes down to innuendo. In that connection, the March 8 National Review makes interesting reading indeed. It includes a book review by Matthew Scully, former speechwriter for the likes of Bush, Palin, and McCain. It may be regarded as something of a quirk, given his politics, but Scully has become an outspoken opponent of animal cruelty, and his book on the matter, Dominion: The Power of Man, the Suffering of Animals, and the Call to Mercy, attracted  critical acclaim. Scully nevertheless found himself under attack from one Wesley J. Smith, author of the book under review, A Rat Is a Pig Is a Dog Is a Boy: The Human Cost of the Animal Rights Movement. Scully apparently has been lumped in with those who “had ‘fallen for the deception’ of animal-welfare advocacy and ‘its true animal rights ideological agenda” — along with Rush Limbaugh, who, playing against type, offered some kind remarks on the radio about the activities of the Humane Society. In this polemical genre, offenses against the essential verities of Western civilization are never hard to find, and I suppose it could be a sort of just desserts for Scully, who may be  experiencing blowback from the innuendo he might have crafted on the half of the aforementioned Republican politicians. I see that the letters section of the same magazine (difficult if not impossible to find online, apparently) contains an exchange of letters from the authors of dueling books about John Dewey, whose thinking supposedly “rests upon a denial of the first principle of the American founding.”  Not that I have any beef to make on behalf of John Dewey, at least not for present purposes. From my perusal of newspaper editorial pages decades ago, I recall that Russell Kirk didn’t think much of Dewey.

Lowry and Ponnuru want to portray Barack Obama as a threat to “American exceptionalism.” As I have noted elsewhere on this site, such people hold it against the President that he was at one time a community organizer. Somebody who would work to remove asbestos from a housing project full of poor people, they deem a troublemaker. They hold it against him, as Lindner notes, that his allegiance is “to a hypothetical, pure country that is coming into being.” As an Aristotelian, I would say that the Stagirite would have held that all living things are “coming into being,” and that to forestall such a process would be tantamount to killing them.

Indeed, dogged pursuit of the party-line version of “American exceptionalism” may have a deadly effect, not least in the area of health-care reform, which probably occasioned the polemical exchange under consideration herein. Such a dogged pursuit is indeed something like jumping out of the top floor of a skyscraper — although contemporary affluent Americans do not see it that way, because the victims are out of sight and out of mind, in the ghetto, the barrio and the trailer park.

Limbaugh, for his part, declared that poor people do not deserve health care. By so doing, he thought he was upholding the verities of “American exceptionalism,” I suppose. The country will always be exceptional, even if it adopts more social-democratic measures — and, if it does not, we may find that its creed will come to be associated with kicking people while they are down, or rubbing their noses in the dirt. I recall that, at one of the vaunted “town hall meetings,” a senator was confronted by the sort of woman who is sometimes described as “poor white trash,” who was being ruined by her medical expenses. Essentially, his advice to her was to go around to her neighbors with a tin cup in hand. It’s the gorgon’s face of “American exceptionalism….”

Canadian native Christopher Flavelle describes the hysterics in Saskatchewan upon the implementation of universal health care in 1962. The American Medical Association took a hand in the campaign, which at one point involved a three-week doctors’ strike. The governing left-wing CCF party (Co-operative Commonwealth Federation) was denounced as “a dictatorial, power-mad, ruthless group of politicians who would rather see people die for lack of medical care than back down.” The plan, which proved to be a precursor for the remainder of the country, was implemented nevertheless.

Also of interest is the exchange of “dueling anecdotes” following the article in the comments section….

Timothy Noah at Slate.com: “Health reforms favored by Republicans tend to accelerate the market’s natural tendency to segregate healthy people from sick people, thereby lowering insurance premiums for the healthy majority while raising them sky-high for the sick minority. That’s true of the GOP scheme to sell health insurance across state lines (which, because insurance is regulated at the state level, would cause companies to stampede to states offering the fewest protections to the sick). It’s also true of the GOP’s urge to expand choice-oriented health savings accounts (which allow healthy people to minimize contributions).”

Most of this article concerns proposals to expand state risk pools, which Noah describes as “an idiotic idea on its face. Create a special government-sponsored insurance pool consisting entirely of people who don’t qualify for a private insurance policy because they’re too likely to need medical attention. Have them share the risk, on the theory that, hey, at least they probably won’t all need medical attention at exactly the same time…. Thirty-four states operate them, serving (a relatively scant) 200,000 people….”

Ezra Klein of the Washington Post got right to the point with readers who submitted questions to an online chat on the paper’s website Thursday. “Republicans have done a lot of polling on [health care] and have learned two things. 1) Americans want reform. 2) If Americans like the reform Democrats have proposed, and it gets enacted, Democrats will benefit electorally. So what Republicans are trying to do is make Americans dislike the reform Democrats have proposed while not positioning themselves against the general concept.”

Here is a fascinating exchange from earlier this week on the Washington Post website.

Ezra Klein: “I’m a big Wyden-Bennett guy, frankly.”

Rep. Paul Ryan (R-WI): “I have a lot of respect for that plan. If I were a Democrat, it’s the bill I’d be on. He’s got more mandates than I’d like. But if Ron Wyden and I were in a room, we could hammer out a deal by tomorrow.”

I know people who object to the Wyden-Bennett bill as too much of a giveaway to the insurance companies. However, that’s true to some degree of just about any bill that might pass.

If this is the kind of bill that can pass, why don’t we pass it? If the point is to keep people from being bankrupted, this should do the job in most cases. It bears the name of one Democrat and one Republican — members of both parties can take credit for it. That will make everybody happy — or, at least, some people on both sides of the aisle. So, why not pass it and forget about it?

The right side of the blogosphere is excited because the premier of Newfoundland, Danny Williams, has traveled to the United States to have heart surgery. This is supposed to be evidence of the inferiority of the Canadian single-payer system. I question seriously whether these commentators know what they are talking about.

A look at the website of the local paper in St. John’s, Newfoundland reveals that the exact nature of Premier Williams ‘ illness has not been disclosed, nor has the exact United States location to which he has traveled. He is expected to be laid up for anywhere from 3 to 12 weeks.

I wonder whether the commentators on the right side of the blogosphere even know where Newfoundland is. It is, as a matter of fact, a remote island with a population of a half-million, practically in the middle of the North Atlantic Ocean. Transatlantic flights stop at the airport in Gander, Newfoundland for refueling; you might remember hearing reports of passengers being stranded there after 9/11. I understand that Newfoundland has suffered economic hardship, like the other Atlantic provinces, due to the decline of the North Atlantic fisheries. Remote though it may be, I am sure the local population loves the place, which I understand is known as “The Rock.” Nevertheless, not every specialized medical procedure will be available in such a place — no matter the details of the health-care system.

The right-of-center National Post in Toronto says that there is no reason Premier Williams could not have had his procedure there.

The National Post reports: “Long wait times for cardiac surgery were a problem 15 years ago but are generally ‘a thing of the past’ in most parts of Canada, physicians insist. Where queues develop for elective operations, patients are routinely sent to other provinces for speedy care, with their own government’s medicare plan picking up the tab, they say.”

The paper spoke to Dr. Chris Feindel, a cardiac surgeon at Toronto’s University Health Network: “”Virtually all forms of cardiac surgery are looked after in Canada, and I would say extremely well…. Personally … I would have my cardiac surgery done in Canada, no matter what resources I had at my disposal.”

And, get a load of this: “In fact, [Dr. Feindel] said, patients from the United States and other countries come to the UHN’s Peter Munk Cardiac Centre for valve repairs, a procedure developed by Toronto surgeons. Meanwhile, the death rate after bypass surgery in Ontario is among the lowest in North America, reports the province’s Cardiac Care Network.”

Nevertheless, I suppose that on this side of the 49th parallel, the denizens of the right side of the blogosphere think themselves competent to say that the hospitals in Toronto are no good. You know, I heard something about some Americans traveling to Mexico for surgery….