The Costs of Ideological Correctness
In the United States, slavish adherence to “moderate” positions is often construed as exhibited “pragmatism” that’s in distinction to the more “ideological” views of people with less centrist views. In fact, moderation can reflect ideology ever bit as much as extremism can. I’ve had occasion to observe in the past that they best model for recapitalizing distressed financial institutions is provided by Sweden’s response to the early-1990s Nordic banking crisis. And nobody seems to seriously dispute that the Swedish model worked very well. But it’s too left-wing for the United States for basically reasons of ideological correctness.
Similarly, the Commonwealth Fund has a write-up of some Lewin Group analyses of different congressional health care bills. Here’s how much they do to expand coverage:
Pete Stark’s bill, the most left-wing of the lot (it’s sort of a “Medicare for many more” proposal) covers the most people. And here’s their impact on health care costs:
Stark’s is the best again. And yet there’s no chance whatsoever that we’ll actually do this because his plan, though the most practical, is also the most left-wing. Far too left-wing for the United States of America
Some folks, of course, will oppose the Stark plan because they’re right-wingers who don’t want to expand health care coverage. And some folks, will want to focus their energies on other, worse, plans because those plans have a better chance of passing. But what’s incredibly frustrating is that a lot of people who claim to want to change public policy to expand health care coverage and better control health care costs will nonetheless fail to embrace Stark’s plan or anything similar for no real reason other than ideological posturing. It just can’t be the case, as a matter of centrist dogma, that the best solution is actually the most left-wing solution. It’s a far more ideological stance than anything you’ll ever hear from Pete Stark or from me. But the people hewing to it will insist on being called pragmatists.
95 Responses to “The Costs of Ideological Correctness”
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January 9th, 2009 at 6:17 pm
I can’t help but feel that it’s not just that Stark is a left-winger; it’s the particular WAY he presents himself. For one thing, he’s very unpleasant to his adversaries (he makes Biden’s gaffes look like those of Blanche Lincoln), which makes it harder for him to construct the sort of reputation and bipartisan coalitions that you need in Washington.
Also: the atheist thing. Which is to say, he gets caricatured as this far-out-there left-winger with totally unrealistic and crazy views because of the aforementioned atheism, a perspective still widely disliked and mistrusted by many Americans.
January 9th, 2009 at 6:18 pm
Matt’s hot today.
January 9th, 2009 at 6:22 pm
Can someone detail how Stark plans to dramatically expand costs while cutting tens of billions of dollars from the budget? Sounds too good to be true.
And yes, Matt’s hot today.
January 9th, 2009 at 6:22 pm
Sorry, I meant “dramatically expand coverage”. kthx.
January 9th, 2009 at 6:24 pm
A big part of becoming a “leftist” is to be continually told that the policies and analyses you think simply make sense are “leftist”, and typically meaning ‘unacceptable in the American / Third Way / etc’ context.
It’s only later that you go through the whole routine of sacrificing infants on a candle-lit alter in front of giant portraits of Lenin, Mao, Che Guevara, and Bill Ayers.
January 9th, 2009 at 6:25 pm
Yes, if Stark were just more charming, like Grover Norquist or Tom DeLay or Mitch McConnell, he’d be effective.
January 9th, 2009 at 6:26 pm
Spit hot fire son.
As much as I like Obama, his “we’ll do the best idea” rhetoric doesn’t mesh with the “we want to work across party lines” talk. Something will have to give and it will almost always be the former
January 9th, 2009 at 6:26 pm
Which is another way of saying the entire political economy is broken, brain dead, corrupt.
Really, step back and look. Everywhere you look is disaster and every possible response that our elites will make is either wrong, badly wrong, terribly wrong, horrendously wrong, or worse. Disaster piles upon disaster and compounds and what? Nothing.
There are several hundred trillion dollars worth of financial losses now explicitly or implicitly backed the the US Treasury. Ho Hum. It will all work out.
January 9th, 2009 at 6:27 pm
This all relies on one groups analysis. I am sure the sponsors of each bill can perform their own analysis and come up with dramatic results too by changing the scope and assumptions. You never know until the proposals actually get done though because there will of course be unintended consequences of all bills.
January 9th, 2009 at 6:27 pm
My guess is that Stark’s plan cuts out a lot of middlemen and private bureaucracy and that that explains everything.
January 9th, 2009 at 6:31 pm
Alarmists are going to become increasingly mainstream during the next 5-10 years. Hopefully the people who made the mess won’t all profit from it.
January 9th, 2009 at 6:39 pm
I am very curious as to how those cost numbers were derived as well. “Too good to be true” usually is. How were these projections derived? What was not included or what was finagled around the costs? Of course, many will say that ideological purity to left wing ideas is the only way to solve all the problems of the world, but that is the exact same the the right-wingers say and I am leery of them as well.
January 9th, 2009 at 6:52 pm
Yes, if Stark were just more charming, like Grover Norquist or Tom DeLay or Mitch McConnell, he’d be effective.
Why do you assume that Norquist, DeLay, and McConnell are any more effective than Stark is? Yes, they have gotten some of what they want, but so have people with views more like Stark. If you judge their effectiveness by how well they achieve their actual goals, none of them fair too well (e.g. Norquist has not gotten the income tax eliminated). It’s just that because your positions are closer to Stark’s, you see a partial success by him as a failure and a partial success by Norquist as a success (that is, as a success for Norquist).
January 9th, 2009 at 6:56 pm
When people call themselves pragmatists, they mean political pragmatists–that is, they are willing to intentionally accept worse plans which are easier to pass–or else they don’t mean anything. Pretty much every ideologue thinks that following their ideology will lead to pragmatically more effective results, otherwise they wouldn’t hold that ideology.
January 9th, 2009 at 6:56 pm
Looking at the link, the “costs” was a net, based on an increase in federal spending and employer spending and decreases in state, local, and private spending. Federal spending would go up a lot.
If the Feds are the insurers it would cut out a lot of the private insurers. The ones who could would convert to hospital-clinic complexes.
Maybe a closer look will see the flaws. #13 is about as cogent and penetrating as everything else Al-bot has ever done.
Did I mention that I was the Al-bot for awhile? Easy!
January 9th, 2009 at 7:02 pm
Glaivester, I’ll take your cockamamie theory that Norquist, DeLay, and McConnell have been ineffectual under advisement, while granting that the charming Senator McConnell doesn’t have a long track record..
No one with views like Stark’s has had any success in this country for 40 years or so.
January 9th, 2009 at 7:03 pm
This slavish adherence to moderation occurred during the nineteen fifties with the rejection of any type of ideological positions by a large percentage of American public intellectuals due to the stigmas of Communisn and Nazism. I believe that the American political class needs to get out of this fifties mindset and embrace some European ideas such as universal healthcare and a free college education for those who qualify.
January 9th, 2009 at 7:27 pm
The American polity seems to have a unique gift for vicious cycle-style self-fulfilling prophecies. If enough people keep repeating the meme that such and such sensible, efficacious proposal is excessively socialist — and therefore politically non-feasible — the meme becomes the reality. Why this is I don’t know. Civil War legacy and all that, I guess, although I also think our non-Westminster-style division of powers plays a role.
January 9th, 2009 at 7:31 pm
Of course, what MattY “forgot” to tell everyone is that – in addition to the very good possibility that the figures were cooked to achieve the result they wanted – is that millions of those newly-insured would be foreign citizens who are here illegally. I’m sure the MexicanGovernment would thank the Dems for their generosity… by sending even more of their people here.
Until hacks like MattY start telling the truth and the whole truth, I suggest not trusting anything they tell you.
January 9th, 2009 at 7:53 pm
I’d think those numbers were too good to be true if it weren’t already true that we spend more money than anybody else and get less for it than most. Given that basis, it seems completely reasonable to improve health care and make it cheaper – it’s better and cheaper for everybody else already.
January 9th, 2009 at 7:55 pm
Conyers-Kucinich plan actually is the most cost-effective and left wing.
January 9th, 2009 at 8:12 pm
This is quite timely, as I finally got around to watching Sicko. Not that Moore’s some dispassionate, objective person, but he’s definitely got some points.
My friends’ aversion to social health is usually caused by an ideological rejection of anything government-run, buttressed by random articles from the UK about people complaining about health care.
Nevermind all the ways in which US healthcare fails against many other countries.
January 9th, 2009 at 8:28 pm
I see two problems with the Stark proposal. First, it raises federal expenditures more than and of the other plans. And second, from the report Matt links to:
Savings are also accrued by paying all providers at Medicare reimbursement rates.
In other words, Stark saves money by lowering both administrative overhead (good!) as well as doctors’ compensation (bad!). Any plan that fixes doctors’ pay to Congressional mandates needs a more nuanced critique than Matt has given us, especially considering the enormous educational barrier to entry in the medical field.
January 9th, 2009 at 8:46 pm
Lower the educational barrier.
Reducing doctors’ pay is not a bad thing. The HMOs have already done it some.
January 9th, 2009 at 8:50 pm
But it’s too left-wing for the United States for basically reasons of ideological correctness.
It’s kind of weird to watch in real time as Matt figures things out that most people learned when they were teenagers, and evolves from somebody who supported the invasion of Iraq solely because he didn’t like the left-wing campus hippies who opposed it into someone who realizes that in a wide array of situations the “radical” or “leftist” approach is the prudent course of action.
Don’t get me wrong, it’s a good thing. It’s just weird.
January 9th, 2009 at 8:51 pm
We need more Mattist evolution.
January 9th, 2009 at 8:52 pm
If we could get the best health care system in the world for a hundredth of the current costs plus a pony but some Mexican somewhere gets a penny out of it I’m against it!
January 9th, 2009 at 9:02 pm
“Generally, I don’t think rhetoric about moderation is the holdup–it is the aforementioned fears of rationing, denial of choice, and so o”
I see poll after poll supporting single payer and very little support outside of the 90 or so House members on Conyers’ bill.
January 9th, 2009 at 9:21 pm
It’s kind of weird to watch in real time as Matt figures things out that most people learned when they were teenagers
Wildly OT: I must admit I’m a bit envious sometimes that he gets paid to do it. He can’t come around on IP/copyright issues too soon for my liking.
January 9th, 2009 at 9:29 pm
Fair enough, DTM, but all the polling I’ve seeing as far as putting the single payer option on the table — meaning offering a medicare-style public alternative to private insurance — is decidedly positive, including 59% of USd octors in the last annals of medicine study.
Let’s stop beating around the bush. This is about HMO dollars and special interests, not public opinion.
Tom Daschle and John Podesta spent time as lobbyists for the insurance industry. That’s a problem.
January 9th, 2009 at 9:43 pm
@24AheadDotCom
“Of course, what MattY “forgot” to tell everyone is that – in addition to the very good possibility that the figures were cooked to achieve the result they wanted – is that millions of those newly-insured would be foreign citizens who are here illegally. I’m sure the MexicanGovernment would thank the Dems for their generosity… by sending even more of their people here.”
As opposed to now, where they already effectively get free medical care by going to emergency rooms and not being able to pay, which causes the state govt or other agencies to have to bail out the hospitals rather than see them go bankrupt?
Might actually save some money if they were treated before the health problems became “emergency room grade”.
But than again, your whole purpose here is to prove Matt’s point–that some ideas are beyond the ideological ken of the United States because we’re not really serious about choosing the “best” solutions.
January 9th, 2009 at 9:46 pm
I think there can be two forms of centrism. One that is concerned with doing things very slowly and one that is simply a melding of ideological values. Our system favors the former, where as long as an idea doesn’t accomplish anything, it must be moderate…and anything that does accomplish something is suspicious.
I’m partial to health vouchers, an idea that Ezra Klein looked at and blessed, yet an idea that I have sold effectively to two staunch Republicans that I know. It is an idea that is centrist in that it takes on preferences of both sides of the debate, but it is unworkable because it changes too much at once to be seen as centrist in our system.
January 9th, 2009 at 9:47 pm
It’s kind of weird to watch in real time as Matt figures things out that most people learned when they were teenagers
MY consumed too much John Rawls in his youth.
January 9th, 2009 at 9:49 pm
Steny Hoyer was on the southern MD station Star 98.3 this morning, quoting LBJ about how doing the right thing was easy; knowing what was the right thing was the hard part. While he was talking about how to get us out of our economic crisis, I was thinking of health care, and how everyone who’d ever looked at it knew single-payer was the right thing. But can they do it? Not on your life.
January 9th, 2009 at 10:02 pm
I had used Canadian single-payer healthcare for some time, and frankly , the (government-mandated) absence any private alternatives just means more wait times for everybody. Under the single-payer system, you are not allowed to purchase private care, or even if you were to be able to do so, not allowed to (quoting the gov’t) “jump ahead of the queue” for follow-ups even though it makes sense for everybody, even the ones who cannot afford private care, because in aggregate less public care capacity is being used up. People regularly wait months for routine operations.
I think this is exactly why “moderation” is good: why the hell can’t one purchase private care with his own money and reduce the congestion on the public system at the time time, helping everybody? This alone makes single-payer is pretty awful in some respects.
January 9th, 2009 at 10:02 pm
MY’s point is a great one, and healthcare is just one good illustration. The pretense that what is called ‘moderation’ is not idealogical is a lot like the one which says that there is no class structure in the US. It’s pure nostalgia (pure idealization), and nostalgia is not merely misleading – it’s actually pernicious, since it precludes grappling with the actual problem at hand.
January 9th, 2009 at 10:09 pm
Brandon Says: As opposed to now, where they already effectively get free medical care by going to emergency rooms and not being able to pay
Brandon – yet another sockpuppet – is, as almost everyone should know, engaging in a false choice. There are other alternatives, such as encouraging foreign governments to take back – and take care of – their own people. You know, the natural order of things.
January 9th, 2009 at 10:12 pm
By the way, under current Canadian single-payer, there is currently no private delivery of publicly-funded care, although thankfully some provincial gov’ts are working on gradually allowing private delivery of publicly-funded care
January 9th, 2009 at 10:30 pm
What I don’t get though is that if countries that provide universal health coverage spend less on health care why do these countries have such high taxes?
Those tax dollars aren’t going to military or law enforcement spending (as they do here). They tend to have nicer parks and museums but those things don’t cost that much. They tend to have more generous benefits for the long-term unemployed but even that doesn’t cost so much (especially compared with America’s massive Pentagon budget).
You wonder if the Canadian middle class (as an example) isn’t paying more than its fair share to attract foreign (as in American) companies. It isn’t as though people in Seattle or Bellingham go to Vancouver to shop (for much more than codeine-laced tylenol); at last check the sales tax rate there was nutty.
January 9th, 2009 at 10:32 pm
Uh oh, look out!
January 9th, 2009 at 10:34 pm
They are paying in taxes what us stupid Americans pay for health insurance, or have our employer take out of our checks for health insurance instead of giving to us.
They live longer and better, and are more productive. But oh no! taxes!!!
January 9th, 2009 at 10:46 pm
My brother, sister-in-law, and cousin who have lived in Canada for ten years or more all love the system there.
Myles has no credibility about anything, based on his typical comment here.
January 9th, 2009 at 10:53 pm
There are other alternatives, such as encouraging foreign governments to take back – and take care of – their own people.
Three generations to turn from dangerous immigrants sapping the nation’s moral character to sad nativist shut-ins complaining about those damn immigrants. It’s the American Dream! Kelly the ladder-pulling paranoid, leaving a puddle of piss whenever a brown person comes into view!
What I don’t get though is that if countries that provide universal health coverage spend less on health care why do these countries have such high taxes?
That’s a fantastic non sequitur. Try reading that sentence out loud and working out where logic packs its bags and runs away.
January 9th, 2009 at 10:55 pm
By the way, under current Canadian single-payer, there is currently no private delivery of publicly-funded care…
Miles: you don’t know what you’re talking about. In fact, nearly all “publicly-funded care” in Canada is delivered by private sector providers such as hospitals and physicians practices. Perhaps you’re thinking of the British NHS.
January 9th, 2009 at 11:03 pm
I am talking about private delivery of publicly-covered surgical operations.
January 9th, 2009 at 11:10 pm
The free market, anti-socialist propaganda we have been fed for decades has ruined us.
I have a sneaking suspicion that, rather than offer the American people solutions to job losses and lack of healthcare, Congress is training Blackwater mercenaries in domestic mob control. Anything to keep the campaign coffers and kickbacks bulging.
When Reason Sleeps, Nightmares are Possible- (from a Goya plate)
January 9th, 2009 at 11:21 pm
If Canada had the only universal-coverage healthcare system in the world, you might have a point (even if your point is demonstrably wrong, at least in B.C., I haven’t spent much time anywhere else). But there are other healthcare systems, some of which have virtually no waitlists, less so in practice than the U.S. (France, Germany, Japan come to mind). Those three countries’ systems are very divergent in their implementation. Anecdotal strawmen get tiresome after a while.
January 10th, 2009 at 12:41 am
You’re assuming the plan is great, which I guess is reasonable for someone on the left. A Centerist will probably have some sort of complaints about it. If you find such complaints reasonable or not is how you decide if you’re on the left, right, or center. There’s people in all 3 categories who will reject a plan out of hand because it’s from the left/right.
January 10th, 2009 at 1:07 am
Perhaps it’s also because getting something like universal coverage would be a huge coup for “the Democratic wing of the Democratic party” and is, of course, completely out of the question.
January 10th, 2009 at 1:08 am
Patience, Matt. The winds are already shifting. We’re just coming out of eight years of right wing nonsense that would make Dwight Eisenhower and Barry Goldwater throw up their hands in disgust. I just watched a clip of Obama saying that we’ll use whatever ideas work best, despite where they come from ideologically. This could be interpreted as an olive branch to conservatives, but remember…he said the ideas that work best. And if the left wing Swedish model works best…
January 10th, 2009 at 1:09 am
55: I should note of course that this sort of thing is entirely possible on the left vs. some agenda that the right may have. I just honestly can’t think of one.
January 10th, 2009 at 1:11 am
”
Zaid,
With all due respect, I think you are wrong. I think it is about people not wanting to repeat the mistakes of the Clinton Administation, and pushing the reset button on serious health care reform for another 16 years.”
You mean the Clintons that rejectd single payer for an HMO scheme and failed miserably?
Oh right.
January 10th, 2009 at 1:16 am
“I just watched a clip of Obama saying that we’ll use whatever ideas work best, despite where they come from ideologically.”
That’s code for, “We’ll use ideas that come from corporate America, and if you complain you’re a far left loon.”
I’m serious, they’re using this exact same meme every time progressives criticize them. That’s exactly what it means.
January 10th, 2009 at 1:28 am
What I don’t get though is that if countries that provide universal health coverage spend less on health care why do these countries have such high taxes?
There’s a difference between taxes and cost of living.
Someone else can give a more detailed answer, but basically there are a few factors. For one thing, not every country which has national health care is the same (is not Canada, for example). It’s probably useful to compare the EU as a whole with the US, rather than to isolate, say, France or Italy, when talking about healthcare. Also, equating every kind of tax muddies things up. If you live in a reasonably nice suburb or urban neighborhood in the US, you may not pay any VAT or high gas taxes, and your marginal income tax rate may be relatively low, but your total tax bill is actually pretty high, providing you include property tax, local sales tax, State sales tax, State income tax, fees, etc., as well as Federal payroll tax and FICA (or self-employment tax). The US is a low tax country for wealthy people. For the middle class…not really. And of course, after paying all of the above, you still have to pay for your own healthcare (and your employer’s share of it is coming out of your pocket in the end). And you have to pay for college. And if you lose your job, you’re probably fucked.
The US is hardly a low cost-of-living country anymore, and if you’re middle class (or upper middle class but not rich), it’s not really even a low tax country, either. The Federalism Dodge!
The US spends twice as much on healthcare as do OECD countries, to ensure fewer people. AND we spend over half a trillion per year on the military. How do we do it? Ever heard of the National Debt? $10 trillion and counting fast.
It’s also a mistake to think of OECD social policy as just universal healthcare, unemployment insurance (in the stingy American sense of the concept), and nice parks. It’s much more than that, and it costs a lot of money. Other OECD countries (mostly) simply don’t tolerate some things we take for granted here, like high rates of child poverty (as MY rightly points out), malnutrition, high rates of infant mortality, and a spotty (locally controlled via property taxes) public education system.
Oh, I forgot – in 90% of this country, you also *have* to own and maintain a car and pay taxes and insurance on it. As far as I’m concerned, a car is a tax, since you have no choice in the matter.
Do liberal technocrats who think they know everything scare me? Occasionally, yes, they do, including some of my favorite bloggers. Is the American Republican party a countervailing force to that? No! The GOP has sold out – for a degradingly cheap price – a once-noble political insight. They no longer do their essential and vital job, which is insisting on the technocrats’ having a sense of humor. Now liberals and conservatives are just two poles of a stubbornly persistant feedback loop, with the conservatives in the driver’s seat keeping it persistant. Conservatives need periodic spankings, and when they don’t get spanked – knowing they deserve it – it disorients them and they freak out and wreck everything.
Due to my marriage, I’ve come to know a lot about Argentina. In the Bush Years, people have started to widely throw around phrases like ‘Banana Republic’ or even ‘Banana Republicans’, but they never name the country! It’s Argentina, our doppleganger – big, naturally-rich country of immigrants, which devolved into a total mess, due to the unfulfilled need for competent politics; it’s easy to muddle through if you’re relatively rich. You can make a lot of mistakes and things sort of work out anyway – if you’re rich. It catches up wth you eventually, though. You piss away your wealth and then wonder what happened. Ideology is everything in Argentinian politics, and is therefore nothing. Left and Right are basically meaningless. Alas, that same thing has happened here in the US. Nice work.
January 10th, 2009 at 1:51 am
jonnybutter, I am presuming you know more about Argentina than I do, but surely you must agree that it is the misguided protectionism and heavy-handed Peronism being practised way past its sell-by date that killed the country. Just look at who the president is; Cristina Kirchner. She just snatched the pension fund, against the express wishes of most of the beneficiaries, to tide her through the debt maturation. The stock market in Buenos Aires dropped a third immediately after.
It is not just any ideology that killed Argentina; it is socialistic ideology.
January 10th, 2009 at 2:28 am
It is not just any ideology that killed Argentina; it is socialistic ideology.
And once more, Miley Stevus shows why he has become the dancing donkey of this blog’s comments section in double-quick time.
January 10th, 2009 at 5:53 am
Jonnybutter is right about taxes. I live in Sweden and although I pay 30% income tax and a high VAT. My tax bill is essentially the same as when I lived in the U.S. Plus, I only pay about $120 a year for complete medical care and everything is free for kids under 18, including dental. Not to mention all education is free. I don’t have to drive a car to get around so I never buy gas and I can travel at least 50 kilometers in every direction using my monthly travel card (subway, commuter trains, buses) for about $90 a month. Good stuff.
January 10th, 2009 at 5:59 am
“It just can’t be the case, as a matter of centrist dogma, that the best solution is actually the most left-wing solution.”
I think Matt meant to write “the least left-wing-solution”.
Actually the sentence is pretty terrible drafting. I think MY means to say that there seems to be a centrist dogma etc and it’s obviously wrong.
Right.
January 10th, 2009 at 6:37 am
Do you suppose Obamanian thought is more centrist for centrist aka political sake or centrist for a pragmatic reason…so far I’m worried that he is leaning towards what you discuss here. http://tinyurl.com/8×7leu
January 10th, 2009 at 7:57 am
@64 – no, I think he meant ‘most left-wing’
What I don’t like about this analysis of the Stark plan is that it doesn’t consider the unintended & long-term consequences of lowering doctor pay. Will we end up with a shortage of doctors? Based on the historical results from other countries and other places, what other negative effects might we see from price controls of this kind?
Because if we’re not looking at long-term consequences of the plans, we could just have all 49.6 million people executed. That would cost a lot less and result in virtually no new federal expenditures, reduced demand at hospitals for emergency services, fix the immigration problem, increase the GDP-per-capita of the survivors, reduce demand for government services, reduce congestion, reduce demand for gas and food, reduce crime, increase school performance (on average) and so on and so forth. Plus it would ensure that no new illegal immigrants would come to America, and that everyone from now on would have health insurance.
I mean, as long as you don’t look at the long-term consequences, the my plan (AmeriDead) would manifestly be the best plan in terms of costs and effectiveness (0 uninsured, one time expenditure of 49.6 billion and no other expenses, and big net savings in other areas)
But I bet you’d object to this plan… probably on ideological grounds.
January 10th, 2009 at 7:57 am
Clearly, the solution is to make leftier proposals.
January 10th, 2009 at 8:02 am
Re: Oh, I forgot – in 90% of this country, you
In most other developed countries car ownership is pretty general too. Too many Americans visit only major cities when they travel abroad and thus may be fooled by the excellent public transportation that they find there, forgetting that only some small fraction of the people actually live right in Paris, Tokyo or Toronto. Foreigners who didn’t know any better could make a similar misjudgment about the US if all they saw was NYC or DC.
Re: And if you lose your job, you’re probably fucked.
Not really, Usually you just have to get another job. Right now that’s easier to say than do, but usually it’s not too particularly difficult. I’ve been through three layoffs in my life, and the longest it took me to land a new job was nine weeks. In 2006 when the company I worked for went belly up I was back to work in less than a week.
January 10th, 2009 at 8:19 am
JonF, do you have any preexisting conditions?
January 10th, 2009 at 9:40 am
JonF Says:
In France 75% of the population lives in urban areas:
January 10th, 2009 at 9:42 am
Sorry. Here’s the link:
http://globalis.gvu.unu.edu/indicator_detail.cfm?IndicatorID=30&Country=FR
January 10th, 2009 at 10:00 am
great post. nothing more to be said.
January 10th, 2009 at 10:08 am
Re: JonF, do you have any preexisting conditions?
I have asthma. Not sure what that has to do with my post about car ownership rates or employment prospects. If your point is that we need universal health coverage then you needn’t preach at me, because you are preaching to the choir on that one.
Re: In France 75% of the population lives in urban areas:
Another non sequitur. Most of the US population lives in some manner of city too, not in a small town or rural farmland. My point was that American tourists tend to see touruisty areas of foreign countries and that’s not where the bulk of the population lives,just as most Americans are not to be found in Manhattan or DC. Also, my larger point was that in other developed nations car ownership is general throughout the population, as anyone who has beheld a German autobahn, Roman traffic jams, or the freeways around Toronto should know. See http://www.cfit.gov.uk/docs/2001/ebp/ebp/stage1/02.htm for EU car wonership ates (granted the data is ten years old, but it’s the best I could find with a quick Google search). The figure for France is just slightly over 1 car per household.
January 10th, 2009 at 11:46 am
Alarmists are going to become increasingly mainstream during the next 5-10 years. Hopefully the people who made the mess won’t all profit from it.
January 10th, 2009 at 12:28 pm
“It just can’t be the case, as a matter of centrist dogma, that the best solution is actually the most left-wing solution.”
That sentence is pretty mangled but here is what I think it means:
“From the perspective of dogmatic centrism, it is an a priori truth that the most left-wing solution will not be the best solution.”
January 10th, 2009 at 1:32 pm
in other developed nations car ownership is general throughout the population,
The chart you cite shows car ownership to have been lower in the in the aggregate-EU than the US, actually (e.g. more cars in Luxembourg, fewer in Greece). But my point wasn’t that only Americans own cars, but rather that most Americans *have* to drive cars – in most of the country you can’t work or shop without a car. Surely there are places in the non US OECD where you must drive, but it’s not the iron rule almost everywhere, as it is in the US. Having lived in more than one OECD country (other than the US), I also noticed that people often use cars for specialized things, like trips, outings, special shopping trips, etc. rather than for commuting and absolutely everything else, the way we have to here.
A car is a tax, and it’s a regressive one.
January 10th, 2009 at 1:34 pm
Will we end up with a shortage of doctors? We already have a shortage of doctors because in the 1980s the AMA decided we might have too many, and shut down admissions to med schools.
The situation you see today is the result of letting the oldest doctors in the AMA (not the younger docs, who are over-ruled by the ‘leadership’) make our healthcare policy.
January 10th, 2009 at 2:05 pm
Unless you are haute-bourgeois, you are not going to be able to afford any sort of a reasonably-sized family dwelling in Paris proper, say in the 16th arrondissement. It is far more affordable to live in the suburbs (i.e., car) and Parisians respond accordingly.
January 10th, 2009 at 2:13 pm
Re: But my point wasn’t that only Americans own cars, but rather that most Americans *have* to drive cars
And that is true in most folks of Europe, as well as in Canada and Australia. Look, I live in the inner city of Baltimore, and until the weather turned bad I rode my bike to work. But I still find a car is a necessity for shopping, taking a cat to the vet, errands to out of the way places, and road trips to places like (say) Monticello or mountain ski hills. That’s going to be just as true for the people in Europe, Canada, Australia and Japan: groceries, pets and children are no easier to lug on public transportation; and such transportation will not serve oddball destinations very efficiently if at all. I realize this website is ground zero for people who feel about cars the way Fred Phelps feels about gays, and I am foot-stomping in favor of improved public transportation– I rode a train to work in Florida and I bike when I can here. But we need to be realistic about the limits of the possible and quit positing there’s some transportation Utopia overseas: for the majority of people in the developed world an automobile is a necessary adjunct of middle class life.
Re: A car is a tax, and it’s a regressive one.
No. Taxes are, by definition, paid to government at some level. Let’s not do violence to language! I hate it when the Right does that, and the Left should be ashamed to follow suit there! Would you say “food is a tax” or “electricity is a tax”? Both are pretty necessary too. But that doesn’t make them taxes. And yes, people abroad need cars too (as I think you admitted). Yes, they have smaller, more efficient cars, and may use them less, but they have them and need them just the same.
January 10th, 2009 at 2:59 pm
I still find a car is a necessity for shopping, taking a cat to the vet, errands to out of the way places, and road trips to places like (say) Monticello or mountain ski hills.
You’re arguing with yourself, for some reason. I never suggested that the rest of the world is a non-car utopia (you said that, not me). And of course use of a car is often a necessity, both here and abroad. What I was saying is not complicated, but you insist on throwing up strawmen. Why?
Look, I’m under no illusion that cars are going to vanish from our world. But there ought to be more alternatives to driving a private vehicle every single place you ever go, than there are in the US. And of course calling a car a ‘tax’ is a figure of speech, and I don’t care if you approve of it or not.
January 10th, 2009 at 3:16 pm
Yes, [people abroad] have smaller, more efficient cars, and may use them less, but they have them and need them just the same.
No, they *don’t* need them ‘just the same’! Using them less is precisely what I’m talking about which is different! I keep talking about car usage, and you keep responding about car ownership. You do not need a car to *survive* in most of the EU/Japan, but you do in most of the US – you can’t work without a car. Get it? That’s why I call it a ‘tax’.
Funny that you scold me about that latter by asking if I would call food a ‘tax’. You can’t survive without food, so of course it’s not the same thing. You can physically survive without a car, but not in most of the US, which is my point! Circular reasoning, doctor.
January 10th, 2009 at 4:06 pm
If your point is that we need universal health coverage then you needn’t preach at me, because you are preaching to the choir on that one.
Excellent. I was just thinking about preexisting conditions because I’ve been given to understand that they can cause trouble even for someone who succeeds at your plan — even if you get a new job before COBRA runs out, if the insurance at your new job doesn’t cover the care for your preexisting condition, you’re SOL. But I’ve never changed jobs with a preexisting condition, so I don’t have any firsthand experience with it. I don’t know how asthma compares to other conditions. And I believe some states like NY force insurers to cover preexisting conditions when the patient has had continuous coverage (though this also depends on getting new insurance not long after COBRA runs out).
More relevantly, not everyone can find a new job quickly, and as you observed it’s especially hard now.
January 10th, 2009 at 4:32 pm
Re: Using them less is precisely what I’m talking about which is different!
No matter how little you use a car, the cost of buying it, of titling and registering it, and to some extent the cost of periodic maintenance and insurance, is the same. Fuel will be the main use-based difference. But the higher fuel taxes (which really are taxes) in Europe and (to a lesser extent) Canada cancels out the lower fuel consumption.
Re: You do not need a car to *survive* in most of the EU/Japan, but you do in most of the US
Any one of us could *survive* without a car. You do not need a car to live– humankind existed for tens of millenia without them. You do need a car (generally) to enjoy a middle class standard of living, and that tends to be true both here and abroad.
Re: you can’t work without a car.
I know people who don’t have drivers licenses, either because of too many DUIs, or in one case medical reasons (epilesy). These people work. If you don’t have a car then you need to live close to your job, or close to public transport that can get you to your job. Public transport in the US generally sucks (no argument from me there!) but it does exist and people do use it. You are way overstating your case. Living without a car is a major pain in the ass in the US, more so than in Europe (though in Canada it’s about the same). But its not an impossibility. In fact I believe our host here manages without a car and has not been reduced to singing for his supper at the Salvation Army.
Re: if the insurance at your new job doesn’t cover the care for your preexisting condition, you’re SOL.
Under 1996 HIPAA law insurers can’t exclude pre-existing conditions in either group or individual policies* assuming the individual was previously covered for that condition with no more than a 62 day break in coverage. Job changing (assuming the new job has coverage of course) is no longer a problem for people with preexisting conditions. (Note: I have a friend with HIV who was laid off with me in 2006 and changed jobs, and coverages, quite seamlessly) That was one reform the GOP was happy to put in place back in the 90s since they knew it would dampen down the outcry for more serious reform.
* They can still charge more for preexisting conditions in individual policies– group policies of course gave group rates, the same for everyone in the group.
Re: And I believe some states like NY force insurers to cover preexisting conditions when the patient has had continuous coverage
See above. This has been a federal law since 1996.
January 14th, 2009 at 8:22 pm
OH NO!!! The people who harvest our groceries, wait our tables, clean our office buildings, and all sorts of other menial labour might get HEALTH CARE!! That would be the END OF THE WORLD!! EVEN WORSE THAN 2012!!
January 20th, 2009 at 2:52 am
The most rational non-idealogic plan, the kind that can actually cover everybody and save money is… the one closest to single payer.
And you could have learned about this a week ago, here:
http://www.dailykos.com/story/2009/1/13/8135/23887/977/683458
1. Stark, is actually the most rational non-idealogic plan, the kind that can actually cover everybody and save money is… the one closest to single payer.
2. Others, including Wyden and Baucus/Obama/Hacker don’t/aren’t. Wyden is all about saving Congress and the Federal government money, while exploding costs overall and for everybody else. Well except for the insurance companies. They do well.
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