[Unfortunately, the GOP went and had another debate where they booed kittens or something in between the time I wrote this and got around to posting it, so I’m referring to old faux-outrage now. But it’s relevant to my situation, so up it goes]
So, I’ll bite.
I don’t watch political debates. I don’t like them. I don’t really care for politicians in general and I don’t really care to hear anybody's views on anything condensed into 30 second soundbytes. And I figure I’ll catch anything meaningful in my RSS feed or through Twitter or Facebook. So this exchange made it to me in about 20 different ways the other week:
BLITZER: Thank you, Governor. Before I get to Michele Bachmann, I want to just -- you're a physician, Ron Paul, so you're a doctor. You know something about this subject. Let me ask you this hypothetical question.
A healthy 30-year-old young man has a good job, makes a good living, but decides, you know what? I'm not going to spend $200 or $300 a month for health insurance because I'm healthy, I don't need it. But something terrible happens, all of a sudden he needs it.
Who's going to pay if he goes into a coma, for example? Who pays for that?
PAUL: Well, in a society that you accept welfarism and socialism, he expects the government to take care of him.
BLITZER: Well, what do you want?
PAUL: But what he should do is whatever he wants to do, and assume responsibility for himself. My advice to him would have a major medical policy, but not be forced --
BLITZER: But he doesn't have that. He doesn't have it, and he needs intensive care for six months. Who pays?
PAUL: That's what freedom is all about, taking your own risks. This whole idea that you have to prepare and take care of everybody --
BLITZER: But Congressman, are you saying that society should just let him die?
Well I’m not quite 30, and fortunately, I do have health insurance. But I guess you could say that things were going along swimmingly until “something terrible” happened, and then I started racking up the medical bills. So this exchange got me thinking.
First, the primary reason I even heard about this exchange was because the Tea Party audience allegedly cheered when Wolf Blitzer asked if society should just let him die. That…didn’t happen.
Seriously. Like two people yelled "yeah.” Just stop with the whole cheer thing. It’s silly.
Paul gave a characteristically rambling response, but I think the Congressman believes this: if somebody is uninsured by choice, the government should not force others to pay for his care should something catastrophic happen. I think that’s at least a defensible, not insane position.
But the reaction has been a little nuts. Paul Krugman, who seems to be approaching parody status these days:
So would people on the right be willing to let those who are uninsured through no fault of their own die from lack of care? The answer, based on recent history, is a resounding “Yeah!”
Think, in particular, of the children.
Cue Simpsons clip. And how did we get from an explicit question about an individual with a job who makes a deliberate choice not to obtain health insurance to “those who are uninsured through no fault of their own”?
The Washington Post’s Eugene Robinson:
According to the Gospel of Matthew, Jesus told the Pharisees that God commands us to “love thy neighbor as thyself.” There is no asterisk making this obligation null and void if circumstances require its fulfillment via government.
I’m going to go out on a limb and say that Mr. Robinson – and those who share his political leanings – doesn’t really support government enforcement of cherry-picked bits of scripture.
Both men play up compassion. Robinson’s column is titled, “Where are the compassionate conservatives?” Krugman writes, “Now, however, compassion is out of fashion — indeed, lack of compassion has become a matter of principle, at least among the G.O.P.’s base.”
But let me be clear about this: Coerced compassion is not compassion. Forcing others to pay for something your moral obligations is exactly the same as prohibiting others from violating your moral sensibilities. If you want to contribute to makes sure “society” doesn’t “let him die,” that’s fantastic. And worthy of moral praise. But if you want to employ force and violence to make others contribute, you do not get to hop up on the moral high ground and sneer at the rest of us.
I know compassion because I experienced incredible amounts of it over the past year. The cards, the gifts, the religious tokens, the work of the doctors and nurses and administrators at various hospitals, the phone calls and the e-mails and the letters and the postcards and on and on…all of that was voluntary human compassion expressed to me by society.
But my illness is not yours. My medical bills are not yours. My student loans are not yours. It really sucks that I got cancer and now have to pay off a bunch of stuff – to be clear, much, much less than I otherwise would have – and have to deal with all sorts of problems and concerns. And if you choose – as many, many people have – to help me out any way you can, from reviewing my case and rendering an opinion without charge, as Dr. Zelenetz of Sloan-Kettering and Dr. Advani of Stanford did, to writing me a short e-mail, you have my respect and appreciation. And you have shown exponentially more compassion than the hack who tries to claim some sort of moral superiority over people who do not feel the need to enshrine “society’s compassion” in law.
I don’t know what to do about health care and I don’t want to debate that here. I’ve had enough experience with the system to know that it is very, very messed up. But I’m not God. I had a hard enough time figuring out how to manage my own care. This pretty much precludes me from offering up a credible plan to manage the care of a couple hundred million folks.
But I do know that it is wrong, given the exchange that prompted this whole game of moral football, to equate “society” to “the federal government.” And it is wrong to equate government coercion with “compassion.” I’m very, very thankful for the compassion society has shown me. But those who would force society to show me compassion or pay my bills do not get to look down on others with condescension.
Plus, given the outrage in the aftermath of this ordeal, I would think this is a pretty self-remedying problem. Let’s say we accept both general premises here: that the federal government should not force one party to pay for the care of another party who fails to obtain medical insurance by choice, and that a significant chunk of the country – say, 40%, although I’m probably low-balling – finds this position abhorrent.
Well, there you go: That’s about 120 million Americans who think it’s horrible, terrible, and unthinkable to “let him die.” That’s 120 million people who presumably feel some strong moral obligation to help out. To show compassion through financial means. That is a significant chunk of the US population that will help a brother out. That will chip in to cover that 30-year-olds care. That will not, to put it bluntly, “let him die.”
So while I don’t really know what I would have done without health insurance, I feel pretty confident with hundreds of millions of my fellow Americans apparently willing to chip in for my care. Unless, of course, these people aren’t exactly putting their money where their mouths are, and are instead using this incident to take another childish swipe at a group of people they just don’t like.
But I’m willing to give these people the benefit of the doubt. In the meantime, though, I’m choosing to cancel my health insurance. I trust society will pick up the tab.
With respect: you seem to think that people who cannot afford and currently do not have health insurance should, essentially, have to rely on the impromptu charity of others. At least, that is what I take from your insistence that others "should not be forced to pay your bills" (paraphrasing).
ReplyDeleteI find this stance particularly hard to swallow in light of your medical odyssey that you've chronicled extensively on this blog. You write sarcastically at the end of your post that you're choosing to cancel your health insurance, trusting that your fellow Americans will chip in for your healthcare. From your tone, I take it that you don't in fact think that this would be a good idea, and you DON'T trust the 120 million Americans (to whom you impute a liberal view on the matter of, hm, not letting people die) to pay for your health care on an ad hoc, individualized basis. In this case, I don't understand how on earth you can take a stance that effectively would place others - including other young cancer patients - in this very circumstance...of potentially relying on ad hoc charity to treat serious, life-threatening medical conditions that come with six-figure treatment bills.
See, I am perfectly willing to chip in for your - or anyone else's care - via my taxes. I support universal health care and am willing to put my money where my mouth is - via payroll deduction. However, I am ill-situated, as are most of my fellow middle-class Americans, to go around funding the treatment of seriously ill people on an ad hoc, voluntary donation basis. Even more to the point, I suspect that many seriously ill people without health insurance are ill-situated to go on publicity campaigns to raise the charitable funds they need to cover their treatments. This is all the more true if they are homeless, mentally ill, immigrants with limited English ability, etc.
Finally, I have a bit of difficulty with your sarcastic reference to "show[ing] compassion through financial means" - particularly as you write in a tone that suggests that we supporters of universal health care are not all that compassionate and are just sitting around "taking childish swipes at people we don't like" (paraphrase). I have only a very, VERY limited ability to show the "financial compassion" you champion -- because I left biglaw and took a six-figure paycut to do postconviction work on behalf of indigent death row prisoners harmed by the overzealous prosecutors you like to rant about. So that's another group of people I'm busily trying to help, hm, "not die"...and the financial sacrifices involved in doing this work mean that I simply don't have the resources to come to the financial rescue of indigent cancer patients... beyond the modest amount that I can do through a slightly elevated tax burden.
(Note: you seem to switch back and forth in your post between the debate hypothetical of a young, healthy person who chooses to forgo health insurance voluntarily and turns out to have made a bad gamble...and your use of more general language suggesting that people should not be coerced by the government into paying for others' health care, period. My comments are mostly directed towards your latter arguments.)