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Thu, Apr. 15th, 2010, 02:57 pm
Yes, This is Really what I Believe about the Opponents of Healthcare Reform

We've gone over the suffering that people without access to health insurance face.

We've gone over how expanding access to healthcare can save costs.

We've gone over countless plans at making access to healthcare universal, with minimal impact on those who already have health insurance.

We've gone over countless plans at making access to healthcare universal that would actually benefit most of those who already have health insurance.

And for many Americans, the answer is still, no. We don't want that. It's too expensive, it's "too much government," it's too big, it's too fast; those are the arguments that generally rise to the surface in the news. You hear polls indicating that people continue to believe that the uninsured still have reasonable access to healthcare even though this is clearly not true. People seem to be willing themselves into denial.

But if you listen closer to ordinary Americans who oppose healthcare reform, you hear things like "healthcare should be a privilege, not a right," and "I don't think everyone deserves healthcare."

It's time to admit what's really at play here.

The opponents of healthcare reform, or anything that expands access, are not really concerned with compassion, cost, with the role of government or even with taxes.

It's about protecting their privilege. "What good is my health plan," they ask, "if people without my health plan can actually see a doctor too?" You don't want to win a coupon to pay $2 for a sandwich and get to the stand and find out that the sandwiches are free anyway. If another country were to come in to the United States offering "foreign aid," saying "we will pay for your uninsured to have healthcare at absolutely no cost to you," I believe that many Americans who oppose healthcare reform would see even this as a negative.

The history of humanity is full of undeniable cruelty, and undeniable persecution based on constructs of class, race, or other identifiers. Think about American segregation, where white southerners overtly perpetrated their cruelty towards Black Americans for decades, to no benefit of their own. Think about the American Civil War, where poor white Southerners who did not own slaves or personally benefit from slavery still fought and died to protect slavery as an institution.

Look at Roman society, where people of all kinds derived immense pleasure from watching poorer people be tortured and killed in the arena. Look at Greek and Roman slavery, look at South African oppression of blacks, and look at the American genocide of the Native Americans, where white Americans actually overtly stated that extermination of another group of people was the goal. Look at the Holocaust, the irrational hatred so many Germans had for Jewish people, and the cruelties enacted that were of no tangible benefit to their perpetrators.

Look at every school yard where bullies taunt and persecute the outcasts, and you'll see that even in Suburban America humans continue to exhibit a natural enjoyment of cruelty before they reach the self-criticism and maturity of adulthood.

It seems to be quite an audacious accusation to say that class cruelty is at play today; it is a thought that has been more or less banished from the general rhetoric. But if humanity is so wrought with unnecessary suffering, and even our own history is wrought with it, why do we think that we, modern America, are exempt, uniquely enlightened, and suddenly the only motivation of American Conservatism is economic pragmatism?

It's not that rich or middle-class Americans don't want to pay for universal healthcare, it's that they think that limiting access is a good thing, that privilege is something to be enjoyed when you have it, and that one's wealth or advantages are discernibly less enjoyable when they are given to others. Classism still exists. Americans feel good thinking the United States is the richest country in the world. Americans feel good thinking that their neighborhood is wealthier than another neighborhood, and that their home is bigger than another home. Americans, in a tendency that all human beings are prone to, feel good knowing how bad others have it. In other words, when you are not suffering, you see others' suffering as deserved or even good.

The idea that this is what motivates American politics is cringeworthy. It suggests that the views of some on the Right come damned near being definable as hatred; it paints Tea Partiers or other status-quo groups clearly unethical, while we all like to see ourselves as moral and kind. That is why we come up with all kinds of rationalizations to explain the causes we support or oppose: Americans will argue that the uninsured don't suffer that much, they'll say fixing the problem would be nice but is too expensive, or they'll say that they don't believe it is a realistic goal. Most of these arguments are tacitly false, as demonstrated by many successful programs in other countries that make access to healthcare universal, but it is impossible to win the debate over healthcare by pointing out the falsehood of those arguments when those arguments are not what is actually motivating their proponents.

If you listen closely to Right-wing rhetoric, to the Tea Party protesters and to Conservatives who are not in public office who explain their views on healthcare, you will catch this - many people see universal access to medicine as a NEGATIVE thing. In other words, they'd pay extra to maintain their privilege and others' suffering. They derive joy from a stratified world in which others are disadvantaged.

If you open up the New Testament, you see Jesus talking quite a bit about the Kingdom of God, and Heaven and Hell. When he talks about who is going where, the conversation is not about "sin." It's about how you view the structure of society. The rich and powerful are condemned. The poor and destitute are lifted up. Jesus forgives countless sinners, be they sexual deviants or tax collectors or adulterers. He does not forgive authorities who neglect the poor.

In the many parables in which Jesus discusses someone who is not forgiven, there stories of people literally entering Hell. The Rich Man from the parable of Lazarus and the Rich Man is an example. They are people who hoard their wealth and enjoy their privilege so that others may suffer; they are people who refuse to share their table scraps with a beggar. Jesus says that your treatment in the hereafter will be determined on how you treated "the least of these," the poorest and most reviled in your society.

I am not a Christian, and am not advocating the view that rich or conservative Americans are going to Hell. I don't believe that the Bible is literally true nor do I think it is free of countless distortions favored by the early Church. But of the reasons I will likely never be a Christian again (aside from lack of evidence and some absurdities in Christian theology) is that the modern church continues to be so self-damningly silent on the issue of privilege, which Jesus opposed more than anything else. The Church condemns homosexuals and birth control, to the extent that it advocates against the election of pro-choice Democrats, yet it allows the persecution of immigrants and uninsured people? The hypocrisy is palpable, and so is the hypocrisy of those who think our current stratification is a good thing.

But that is, ultimately, why people opposing universal healthcare are so careful to couch their sentiments in other arguments, to claim their opposition to reform is simply selfishness and not overt hate, or to claim it is pragmatism and that the bleeding-hearts are the ones who are irrational. Conservative Americans overwhelmingly identify as Christian, and don't want to position themselves as the one group the Bible condemns more vehemently than any other. What intellectual acrobatics they'll go through to claim other motives for supporting the same general consequence, of concentrating human suffering on one class of people: look to the last 18 months of healthcare reform to find the answer.

Fri, Apr. 16th, 2010 07:50 pm (UTC)

The "anti-obamacare" side isn't so much presenting an attitude of "I don't want to share my privelege" as much as one of "I'm afraid that this will ultimately, indirectly, take my privelege away."

For all the doctors who have refused to take Medicaid because it doesn't pay them enough, there are lots of doctors who will not take this new system of government insurance for the same reason. And in my experience, those are often the most experienced, highly skilled doctors in their individual fields.

The kind of flexible insurance policies that let you pick and chose and even see doctors out of network will become increasingly expensive as people opt for the new free option and private insurance companies will have to raise their prices to stay afloat. As insurance becomes more expensive, it obviously becomes harder to afford. Combined with their increases in income tax, a large upper-middle-class population will lose access to this particular privelege.

There will still be plenty of even more wealthy patients such that those doctors who don't want to sacrifice income and see patients on federal aid don't have to. And that level of personal, specialized care will become unavailable to an even larger percentage of our country's population.

Now, imagine you had grown up being able to see whatever doctor you wanted and knowing your insurance would at least help cover part of the cost. Would you be willing to risk losing that so that someone you don't know could be guaranteed a level of health care you consider sub-standard in the first place? Probably not. So, yes it's selfish. But it's not so malicious as you want to believe.

Fri, Apr. 16th, 2010 08:30 pm (UTC)

There is no "system of government insurance" in Obama care or any legislation that has passed.

There is no free option. The Public Option failed.

Either I am grossly misinterpreting what you are saying, or you are talking about a different healthcare proposal from the one that actually passed.

At its core, the healthcare law that passed says that

1) everyone must buy health insurance from an existing private health insurance company
2) the government will help pay the costs for people who cannot otherwise afford it
3) health insurance companies are no longer allowed to cancel plans for patients who get sick or refuse to cover someone who is sick already; they must take everyone who wants it

Again, there is no public plan.

Fri, Apr. 16th, 2010 08:43 pm (UTC)

Right. I know the public option failed this time. But 1) the paranoia I'm seeing around me is that the passing of this bill is a stepping stone toward not just a public option but an ultimate intended goal of single-payer. and 2) your third point just reinforces that private insurance costs WILL go up out of the necessity to cover pre-existing conditions.

Fri, Apr. 16th, 2010 09:39 pm (UTC)

Under a single-payer system, Americans would actually be paying a lower percentage of their incomes towards healthcare than they do now, so I'm not sure if the "slippery slope toward single-payer" argument is compelling.

Americans spend, on average, 16% of their wealth generated (not necessarily "income" because their healthcare payments are usually outside income) on healthcare, versus 10% in Canada and 8% in the U.K.

In fact, those worrying that their care would degrade under single-payer would be able to go ahead and chip in an extra 4% of their incomes on premium healthcare and easily get back every luxury they have under this system, and it would still be at at lower cost. That's what they do in the U.K. and even if the myth of ridiculous long lines were true, people can still supplement their government-paid healthcare with their own payments and get additional benefits, still at a lower cost than American healthcare.

I think that is a perfect example of how people would rather pay more for privilege than pay less for something everyone gets in equal amounts.

As to my third point, I don't know if you are aware but we actually already pay for the uninsured to get healthcare, and pay for many other unnecessary costs as a result. It is illegal for a hospital or emergency rooms to turn a sick person away - and it is much more expensive for people to visit emergency rooms than it would be had they been receiving routine care and caught the condition early. Even for the exact same treatment, emergency room care is up to 10 times more expensive.

This is actually one of the main reasons American healthcare costs are inflated - it's not that so much of our health bills go to corporate profits (though that is a factor), it's that the only care that poor people have access to is the most expensive possible care.

And you'd be mistaken if you don't think that lack of health insurance stresses the public system in other instances. Lack of access to healthcare has been clearly tied to higher crime rates, homelessness and unemployment. Over half of all bankruptcies are healthcare cost related, and banks and others absorb those costs. Being uninsured can lead to more paid sick days needed, reduced work productivity even on good days, higher rates of employment loss and use of welfare, and more acute manifestations of mental illness, which in turn leads to higher rates of hospitalization and incarceration.

Ultimately, it is VERY expensive to allow 15% of the population to be uninsured. It is expensive to have other people insured inadequately. Everyone across the board benefits from improving access. I don't see any evidence anywhere that middle-class or upper-middle-class people somehow benefit financially, via profits or via not having to pay through taxes, from the current system.

Fri, Apr. 16th, 2010 10:40 pm (UTC)

Matt, I wasn't arguing the importance of a health care initiative from a social perspective. I agree that some form of this bill is important.

To be completely honest, I'd have rather seen the states do it themselves. NY has actually been doing a pretty great job of this on its own for a while now. But I don't disagree with the fundamental notion that our constitution grants all people a right to LIFE, and subsequently, health.

I was simply trying to clarify a misperception of where the teaparty attitude was coming from. Since my parents are firmly in that camp and I discuss it with them daily, clarifying the essence of their perspective.

As far as the economic factors, I agree the business of healthcare is currently sloppy and expensive for a lot of stupid reasons. I agree a lot of that burden is put on the people. I disagree it should be put on the federal government. The dollar is already getting weaker and weaker and this has the potential to do some real damage to us in the global market unless the money can be re-budgeted from something else (such as this war that Obama doesn't seem interested in actually getting us out of).

Fri, Apr. 16th, 2010 11:05 pm (UTC)

I'm sure there are people who are totally selfishly motivated. I know some pseudo-moderates and even left-leaning people in my family who are "nervous" about healthcare reform but think that everyone still deserves healthcare.

But, I don't think tea party protesters care about the "unintended consequences." I think they disagree with the objective. That's my view.

How I arrived at this view: Canvassing for Obama full-time for four months leading up to the 2008 election, going door to door, saying that healthcare was my #1 reason for supporting Obama (which is the truth) and hearing there responses. Leading response in opposition: "I don't think everyone deserves healthcare." Followed by: "healthcare is a privilege, not a right," followed by: "if they can't pay for it they shouldn't have it." I talked with these people extensively. They were pretty explicit in stating that this was their view.

Follow the Tea Party protests, and again, this is what you here. Sarah Palin and other leaders sugar-coat it a little with "in a perfect world everyone would have healthcare but in this world we can't have that." Uh, yeah, so I suppose Europe is their "perfect world?!" I also hear a lot of "That's not the American way."

I'm sure your kitchen table conversations are accurate to what your parents believe - but my comments are straight from the horse's mouth. When someone's core argument is "they shouldn't have healthcare" and their auxiliary arguments are "it's too expensive anyway," you can't trust the auxiliary argument as the true motivation.

I'm not sure how states would accomplish your objective, btw. Are you saying the federal government should mandate that the states come up with a way to make healthcare universal? I don't know if that's Constitutional. The fact is that most states haven't bothered with doing it, and the states with LOWEST and worst healthcare coverage (Texas leads, followed Florida and then the rest of the South) are never gonna deal with the issue at all.

Fri, Apr. 16th, 2010 09:41 pm (UTC)

Also, insurance companies recover the costs of being forced to absorb more sick patients by the fact that all Americans are now required to buy health insurance. That is the reason for the (controversial) individual mandate. That is why the stock market actually rallied on the day that HCR passed, boosted by huge gains in the insurance market.

The public option would have been bad for them, but the current plan increases their profits because it expands the pool of people buying health insurance, including many healthy people who will not need it until later.

Fri, Apr. 16th, 2010 08:33 pm (UTC)

Also, there is no increase in income tax associated with healthcare reform!

I'm not sure where you're getting your information about this.

Fri, Apr. 16th, 2010 08:46 pm (UTC)

There are very significant increases in capital gains tax that were passed this year. But no, they weren't bundled into the health bill, it's just an exacerbating problem.

Fri, Apr. 16th, 2010 10:13 pm (UTC)

From what I can find, Obama let a tax break expire that had pushed the tax on capital gains from 20% down to 15%. They'll be taxed at 10% for those in the 15% tax bracket.

(Source here: http://www.money-zine.com/Financial-Planning/Tax-Shelter/Capital-Gains-Tax/)

So as far as I can tell, everyone still pays less on money they earn from stocks, etc. than they do for money they earn as wages and salary.

Fri, Apr. 16th, 2010 10:51 pm (UTC)

He let a bunch of things expire. Some really interesting estate tax issues going on right now. Die this year and your descendants can keep more of your money!

Right, obviously it's not just a matter of capital gains. It's a lot of little changes across the board. I can get more specific details for you later but suffice it to say, I come from 3 generations of tax attorneys, learned in all the loopholes they can apply. It looks like my dad's income tax is increasing by 10s of thousands of dollars.

Fri, Apr. 16th, 2010 11:21 pm (UTC)

Do you think that capital gains should be taxed lower (as they still are) than earned income? If so, why?
(Deleted comment)

Mon, Apr. 19th, 2010 01:34 pm (UTC)

I totally agree with you. IMO it's an indication of who writes the tax code.

If you lose the money, it's a loss, not a gain. Capital losses are helpful if you want to pay less in taxes.

Sat, Apr. 17th, 2010 12:07 pm (UTC)
poimen: Too Close to Reality

Matt, you've hit it so close to the mark that it blows away the fascist cravings of Limbaugh, Henney, and Beck

Sun, Apr. 18th, 2010 07:12 pm (UTC)

Thanks, Matt- and the others for the forum.