This blog recently posted about Jimmy Kimmel and the near-death of his newborn son. Kimmel made the point that nobody should be put in the position of having to decide if they can afford to save their child, and scolds Trump and the Republicans for being heartless.
Well, conservative Jonah Goldberg decided to respond to Kimmel in National Review. His response is ironic in that it actually confirms Kimmel’s arguments. Goldberg’s article is titled “The Dangers of Empathy”, and it argues that empathy makes it “very difficult to have a rational discussion about the trade-offs inherent to any health-care system.”
Goldberg even falls for Godwin’s law, claiming “Adolf Hitler was a master of empathy”. Seriously. Is he really comparing Jimmy Kimmel to Hitler?
Who will Goldberg complain about next? Jesus for having empathy for the poor (and even for prostitutes)?
UPDATE: A reader found this graph showing life expectancy compared to expenditures on health. Note that US health expenditures really started taking off in the mid-1980s, which is when Ronald Reagan was president. Does anyone have a guess as to why?
Also published on Medium.
I have long ago made in my own mind the difference between liberals and conservatives.
Liberals believe that no one chooses to be born so we provide sustenance, clothing, shelter, medical care, and education.
Conservatives: OK, you are born, make the best of it.
The “having empathy” is obviously a liberal thing totally lacking in conservatives.
I watched my conservative tax clients help their children get college loans rather than provide the money themselves. I knew from their returns that they had the money to provide.
I empathize with poor. My religion has mandated 2.5% charity (certain criteria, and not on income but rather untouched wealth, details beyond scope now). Also it has encouraged us to help needy other than mandatory one, and it is one of means of pleasing God Almighty.
The problem with Obamacare (the new republican plan is worst piece of shit though) is that while empathizing with poor, it is not empathizing with me the middle class guy. The insurance is neither affordable nor reasonable. I am not saying I can’t manage it, but I do not find it fair to burden me in a way that I have to cancel legitimate expenses to balance it out.
As everyone on this site know, I am for universal healthcare. Not because of ideological standpoint that “free” healthcare is right (like right of habeas corpus), rather it may be a solution worth trying. I can go with complete market based system or universal healthcare, as long as we kick insurance companies out in both picture. They add no value whatsoever.
Which leads to my point of people voting/demanding unreasonable stuff. There will be many congressmen representing districts that heavily employed by insurance companies. And they will not let insurance companies die. Also of course more than people, the congressmen will be bought and paid for these companies.
I have some reservations of universal healthcare. Like how to control cost from increasing (paid by taxes). Hospitals/doctors will start charging higher (and unnecessary work) amount knowing that these things will be paid. If government controls the price, that will be unfair for doctors and hospitals. It will become political and lobbied matter.
Hassan, the ACA had several provisions on controlling costs (which actually worked), like basing payment not on procedures performed but on outcomes. Also, penalizing hospitals if patients had to be readmitted for the same problem.
In 2014, the first full year of the ACA, health care spending grew at the slowest rate and inflation of health care prices was the lowest in 50 years. The same things (and more) can be used to control costs in a single-payer system.
[Full disclosure: I was one of the founders of a company that was working on the hospital readmittance problem, so I’m pretty familiar with some of these measures.]
A couple of points. Ebdoug, I live in a very conservative county in far northern CA. Rarely a day or two goes by without hearing of some friend of a friend getting involved to raise money for a family in need. Their house burned, their car was destroyed in a crash, they have large medical bills (there is another story in that one about not buying insurance). Cake sales, auctions, barbecues. I’m thinking these events come with some level of empathy attached.
Hassan, I don’t know where on the economic ladder you reside, but many friends here who are lower middle class have greatly benefited from improved health care as a result of the ACA. Most would lose their insurance or have to take far inferior plans if the Publican’s in the House get their way.
Goldberg’s flippant parsing of definitions (empathy v. sympathy v. compassion) is a difference without a distinction. His argument, that compassion is sympathy in action while empathy is ultimately a plunge into darkness, even to Hitlerian depths, sounds like so much mental masturbation. Even more confounding, he recruits Bloom as a proxy to seal his preconceived notions (“Oh look Democrats, even this flaming liberal agrees with me, using Science!”). The underlying assumption being that, whether healthcare or anything that involves a dollar, the holy writ of free and unfettered market capitalism is the only conceivable solution to any and every social issue. In Goldberg’s and the GOP’s world, if there’s no profit there’s no point. Anything less is Socialism (re. “socialized medicine”). As if the practice of medicine is distinct and apart from the society in which it practices.
He then falls back on the old canard that even people without insurance still get plenty of essential healthcare as needed, because…oh I don’t know, compassionate conservatism? noting “…when their parents are uninsured, doctors don’t just let the baby die on the table”. True enough as far as it goes, but apparently he didn’t hear the whole Kimmel monologue, where we learn that his son will require a second operation before long, another into adolescence and who knows what level of treatment before and after those major interventions. I’m sure the Kimmels have platinum level insurance under his contract, but what kind of continuing coverage would a similarly stricken child with less affluent parents have access to under the AHCA, which seeks to impose strict lifetime (and guessing not so generous) caps, meager subsidies and gives other broad discretionary freedom to the states, including what they consider a pre-existing condition, leading to a patchwork crazy quilt of options and restrictions depending on where you happen to park your wagon. Perhaps once you hit your state mandated cap you’ll still be eligible for free aspirin, a box of Band-Aids and a puppy. How do you define “freedom”? Of course, the latest House version of the bill is on life support and essentially DOA at the Senate, but the point remains. And does anyone believe the Senate version will be demonstrably better?
Frankly, I don’t give a flying fig how you define your feelings or your freedoms. I do know that this is one country which, ostensibly, gives us the freedom to move, live, love and work within or across any one of its 50 freedom loving states. But that freedom rings hollow if you’re tied to a job you hate because you’re afraid of losing health insurance (if the job even offers it) or live in a state that decides behind closed doors what level of healthcare their residents minimally deserve, and screw the federal subsidies whether or not any strings are attached.
This country has rarely experienced the level of income disparity that presently exists and it’s questionable that a representative democracy (however you want to define it) can even survive, let alone thrive, under such conditions. The healthcare debate we are presently engaged in is our litmus test of just how representative and truly compassionate/sympathetic/empathetic (pick one) we still are as a collection of United States. The GOP’s worst nightmare is the growing realization that, even within its own constituency, people are finally beginning to see healthcare as a human right and social compact rather than a mere commodity within the cold calculus of profit-driven capitalism. Despite the flaws and limitations of the ACA, this may be one of Obama’s greatest legacies.
“If you can learn a simple trick, Scout, you’ll get along a lot better with all kinds of folks. You never really understand a person until you consider things from his point of view, until you climb inside of his skin and walk around in it.”
– Atticus Finch in To Kill A Mockingbird by Harper Lee
I don’t see any of those three Goldberg keywords in Atticus’ lesson to Scout, but it’s about the best definition I’ve heard yet for Humanity.
FYI, thought I’d share this graph I recently came across comparing the growth in average lifespans vs. per capita health expenditures for countries in the OECD from 1970-2014, according the World Bank. The disparity between the US and the others, beginning around 1980 and still growing, is striking. What the hell happened around then? Clearly, we’re not getting our money’s worth!
Interesting graph, Ralph. Thx.
NOTYCOON, I am in economic scale where I do not get any benefits from government, but get burdened enough that I wish it was not the case. I would certainly welcome tax cuts and lower healthcare costs. That is why I am fine for Universal healthcare. I know it would be paid by my taxes for not-for-profit government. I am sure getting rid of insurance companies will decrease costs by 30% if not more. Also it will help small businesses compete and grow bigger.
I’m with Hassan on his important point about getting rid of insurance companies, “They add no value whatsoever”. This is a simple enough fact that conservatives and liberals should agree on. My wife is a pediatrician and she spends at least 20% of her time wrestling with insurance companies. Staff spends even more.
In my area, Medicare is handled by the Insurance companies. I think the companies are more efficient than if government employees handled claims. I know if I have a question, I pick up the phone and get right through to someone. In New York state, the administration cost % are fixed. I think they can’t exceed 16% of total costs.
What I see is the waste. “come back in a year” for no reason except it lines their pockets. And my big one are the cost of inhalators for asthma where the same cost by nebulizer is negligible. One certainly can’t carry a nebulizer around for emergencies but for retinue use a nebulizer does fine.
Medicine prices could be brought down considerably. I take a large dose of aspirin daily. (2) Then I read that chocolate (which I live on) and aspirin cause veins and arteries to stay clean. My ultra sounds for various stuff show I have totally unclogged systems. aspirin has been around forever. Such a simple solution. Cost is negligible.
Two other things on that graph:
Exercise: I found when I was moving, I lost 15 pounds just exercising. Exercise, not diet is the answer to good health. I know someone who used to run around on stilts with his friends. He stayed very slim that way :). Heat in the south (growing all the time) keeps people from exercise. You just can’t move in that kind of heat.
Guns: What country has more guns than we have? NRA loves guns. Guns are very not good for our health. If you live in the inner city, are you going to get out and walk with bullets flying everywhere? And if you can’t afford exercise in your apartment, what are you going to do? I know I can’t take walks in the woods during a great part of the year for fear of bullets flying.
Point being is that other countries exercise more. The daily walk to get “le Pain” and have less guns so they can exercise; hence they have better health.
I take my car to be inspected once a year, then walk the mile to the dentist. I’m amazed at the offers for rides to go one mile. Excuse me? I hope everyone walks a mile a day.
Prevention is indeed great to improve people’s health; exercise,a diet with lots of veggies and fish and clean environment has made the difference for Japan, Spain and France compared to Belgium, Denmark and Germany. Michelle Obama used to to a lot for prevention, before the President put the chainsaw into social programs. However, the US is in a totally different class. A good way to filibuster the next Trumpcare bill would be to name all the Americans who died of a totally curable disease because of this difference.
Noty, compassion for many, only goes as far as people they know, or people that people they know know. In other words, people like themselves. They will have that bake sale for the neighbors kid who was hit by a car, for the person from work who is seriously ill, but five miles away and of a different background or ethnicity and that compassion might not exist. I think it also is determined by what caused the need for compassion. Neighbor’s kid, dying of aids, maybe not so much as neighbor’s kid dying of a brain tumor.
Note that US health expenditures really started taking off in the mid-1980s, which is when Ronald Reagan was president. Does anyone have a guess as to why?
This is not a guess:
Reagan signed legislation into law requiring that people NOT be refused emergency treatment regardless of their ability to pay… effectively socializing the full cost of emergency care.
Redjon – thanks for that insight, it’s a great point I hadn’t been aware of and could go a long way towards explaining that graph. There’s a good Wiki article on what I believe is the law you’re referring to, The Emergency Medical Treatment and Active Labor Act of 1986, requiring ER’s in hospitals who receive Medicare funding (practically all of them) to provide emergency treatment regardless of the individual’s ability to pay. Though it originally may have been well intentioned as a way to eliminate the practice of patient dumping, being an unfunded mandate made it inevitable that the uncompensated costs would be passed on to those who could pay. In other words, higher premiums, deductibles and co-pays for everyone else and the infamous $20 aspirins.
The article, however, wasn’t clear on just how much those added expenses were relative to overall healthcare costs, but seems to be at least in the tens of billions of dollars annually and perhaps more. At any rate, there’s no question ER care as a primary provider is the most expensive and least efficient way to run a healthcare system. Financial pressures have even forced many ERs to consolidate or shut down their operations altogether.
Here’s another sobering statistic that also adds in to this overall cost trend. Rx drug prices rose almost 9% in 2016, the fourth consecutive year of overall price hikes that exceeded 8%. Meanwhile, the consumer price index rose just 2.1% in 2016 and I don’t believe it was any higher the previous four years either. So what’s driving this drug price inflation, besides profiteering and the enormous growth of advertising and marketing? I can’t turn on my TV for five minutes anymore or open a magazine without seeing a bunch of drug ads.
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