[Ben] Your premise is that life and death should not be decided by wealth. I disagree, though I know at one point I would have agreed. Allow me to attempt to explain what changed my mind.
[Arlo] Your thoughtful comments are appreciated, Ben. [Ben] For starters, wealth's effect on life expectancy extends beyond the realm of health care. Poor people tend to work riskier jobs. They live in more dangerous neighborhoods. Often, they eat less healthy foods. So the tie between wealth and life expectancy would continue even if health care was allotted with no regard to wealth. [Arlo] This is a difficult and tangled issue. The poor only buy what foods they can afford, and often that means substituting orange soda for orange juice, french fries for "real" potatoes. Partly this is due to a consumerist culture that has associated "making it" with certain consumer choices. Partly it is a failing in education in promoting healthy eating habits. Partly it is a result of the degeneration of the family hearth. So while what you say is true, I see it as more of an issue to be addressed rather than supportive of social Darwinism. [Ben] I recall reading studies showing that even when they have equal health care packages, poor people tend to receive worse care--they don't pester their doctors enough; they don't know the right questions to ask, etc. [Arlo] Again, failings in education and community. [Ben] So my feeling is that if you wanted to eliminate the link between wealth and life expectancy, you'd have to eliminate wealth inequality altogether. [Arlo] Japan, Canada and Britain, and the rest of the "Western" world prove this is false. [Ben] The problem I have with left-wing arguments is that they focus too much on inequality and not enough on poverty. Poverty is a problem. Poverty kills people and leads people to live horrible lives. [Arlo] Yes, it does. [Ben] But poverty is not caused by the wealth of others; it has existed throughout mankind. If you could eliminate wealth inequality in medieval France, you'd still incredible poverty by any modern standards. Life expectancy even of French nobles was considerably lower than that of poor Americans today. [Arlo] While poverty is not caused by the wealth of others, wealth is gravitational. It has been a long standing myth in this country that people move up and down based on merit and ability. Our hardest workers are often our poorest, and many who have achieved familial wealth can spend generations living like aristocrats without working or achieving anything. I don't think we can eliminate poverty, nor do I think we should try. But I deplore the idea that basic health care needs to all is "redistribution of wealth", a fear-phrase that often means nothing other than "boo". These are real people, so let's consider some real examples. You tell me what you think should happen. A father with a daughter who has cancer looses his job (and hence his health insurance). He can't afford the more than $2000/mo private insurance would cost for his family. When he does get rehired, he is denied coverage on the basis of the cancer being a "pre-existing" condition. What should happen to the girl? A single mother in West Virginia (say a mine widow) needs bypass surgery or else she will die, but she has no insurance. Do we let her die? What do we do with the kids? A man starts coughing up blood. He has no idea whats wrong with him, but his job doesn't provide insurance, and he only earns $17k/year, and between rent, food and utilities, can't afford the $800/month he would have to pay for private insurance. What do you think should happen to him? [Ben] There are two ways to combat poverty; one is to redistribute wealth within a society and the other is to create greater wealth. The problem is that these two objectives often conflict. Redistributing wealth requires raising tax rates. Higher tax rates create a reduced incentive for innovation and hard work. [Arlo] I reject the idea that basic health care is "redistribution of wealth". In essence, it is a society buying into a system that values human life, in the same way public education is buying a system that values giving opportunity to all rather than the already privileged. [Ben] The Canadian policy of preventing rich people from buying more health care--which your position seems to support--reduces the incentive on Canadians to work hard or to choose particularly demanding jobs. [Arlo] I don't know what your point is here. Many "particularly demanding jobs" in America come sans insurance benefits. And where Unions have fought for insurance benefits, the right attacks this too. My grandfather, and all nine of his brothers, labored 12 hours a day, 6 days a week, in mines and never had insurance. What was their "incentive"? In the end, I don't measure a nation by economics. When we are in recession, we don't blame "private" health care, but whenever Canada goes through economic troubles, the right-wingers roll out their health care as the issue. It isn't. As pointed out, the American government already spends more per capita per person for health care than Canada, and this is compounded by the fact that America's also pay almost 5x more out of pocket for health care. [Ben] My position is not as extreme as Platt's; I support some amount of wealth redistribution, ideally through an Earned Income Tax Credit. But I don't think we can, or should, arrive at a situation where wealth does not affect life expectancy. I'm more interested in seeing poor people live longer than I am in seeing a narrowing of the gap between rich and poor's life spans. [Arlo] And again I dispute that health care is "wealth redistribution", any more than schooling, libraries, roads, public parks, fire and EMT services and police are. "Wealth' may always impact life expectancy, but it shouldn't be the basis for determining who does and who does not receive medical care. Social Darwinism, Platt's position, is that "poverty" is nature's way of weeding out the riff-raff. The poor are simply our nation's lazy, slothful vermin, so letting them die off makes the nation better. But there are many, many, many "working poor" and otherwise impoverished who bust their asses everyday, or are struggling to find work, and can still not afford basic health insurance. Letting them "die off" may protect the wallets of the wealthy, but I find grossly immoral. Even private health care, as I said to Platt, is taking money from others. Everytime someone makes a claim, especially for serious conditions, everyone else's premiums and deductibles go up. I am, in reality, paying for the medical treatments of others. If you use more than you pay in (to insurance) you are, in reality, "stealing" from others. What if I don't want to pay for the cancer treatments of others? Why should my insurance go up because someone else's treatments exceeds their payments? Now, since even people like Platt have used more via private insurance than they paid in, I have proposed before requiring health insurance to be based on a reasonable percentage of income for everyone, rather than out and out rates. So when a poor family uses more services than they have paid in, they are doing nothing even people like Platt haven't done. But even then I don't think society should simply let the uninsured "die off". A while back, Platt and I talked about the Terri Shiavo case. I repose the question, should she have lived or died based on whether or not her family had insurance? Or based on the value of life? moq_discuss mailing list Listinfo, Unsubscribing etc. http://lists.moqtalk.org/listinfo.cgi/moq_discuss-moqtalk.org Archives: http://lists.moqtalk.org/pipermail/moq_discuss-moqtalk.org/ http://moq.org.uk/pipermail/moq_discuss_archive/
