Month: April 2009

Many readers seem to believe there is no difference between equality of opportunity and equality of outcomes. I favor the former, not the latter unless it's a result of the former. It staggers me to realize that so many do not even grasp the difference. But the critique of private sector healthcare rationing is real and worth airing:

I'm one of the 40+ million Americas that the market has efficiently removed from health care rolls. I was laid off from a corporate job and make ends meet with freelance work while I job hunt in this rather difficult job market.

I bought a private policy — because COBRA was twice as expensive — a year or so ago from the company that held my employer-sponsored plan (rhymes with Clue Loss / Rue Field). I figured this would make continuity of prescriptions and care pretty straightforward, and instead found, when I went to the pharmacy, that those carry-over prescriptions were no longer covered, because my seasonal allergies were now a pre-existing condition. Yes, it's true that leaving health care in private hands reduces political corruption, but there's one thing that I've seen happen with long term political corruption: indictments. You don't see that too much with corporate corruption, do you?

As for me, I'm in this 18 month window where I can't get health insurance, because the forms all ask for medications that have been prescribed over the last 18 months. I've come to believe that America's official health care policy is "Don't get sick," and I'm sure as hell hoping not to in the meantime.

As for the "innovation at the top end" that you cite in our current arrangement, that's a really exciting piece of the puzzle for those of us who can't see a doctor unless things have gotten really bad. And I'm a single, healthy person. God knows what happens when there are kids in the mix, or if, for instance, I had a long term chronic condition like, say, HIV. That would really suck — whatever the joys of innovation at the top end might be for those lucky enough to access it.

Here's the truth Andrew: our system is already rationed. Our government already provides health insurance to large numbers of Americans eligible because of age, civil service, military service, or disability. Since the market has efficiently excluded so many working Americans, I vote that the market face some competition. If its offerings really are superior, then I'll have ghetto government insurance until I'm eligible for these supposedly better products, but we all know it's better than nothing. And people with families to think about — my God, there's a reason that in other countries they call these things safety nets. It's dangerous to be without insurance, and frankly, my views of the "free market" are pretty dim by 2009. And I don't think I'm alone.

It’s here:

Jack Shafer investigates.

David Link finds Dreher’s response to Damon and me underwhelming:

His second post asks whether gay marriage will strengthen same-sex unions or undermine the concept of marriage – a binary formulation that leaves unexamined the possibility that it might strengthen same-sex unions and strengthen marriage as well; or leave marriage unchanged in the minds and relationships of most heterosexuals.

Ta-Nehisi compares what can only be called Rod’s Manichean panic to the racial-sexual panic that once defined opposition to African-American equality:

So you’d have some black dude who’d been born a slave, in some one room shack, but had risen to become a lawyer, arguing for, say, school funding for black kids in rural Alabama. And then you’d see some bigot responding with, essentially, the following, “If we give the nigras school funding, they’ll take our women! Do you want a nigra marrying yer daughter?!?!?” I would read that and think, “What? The dude just wants some textbooks, WTF??”

There’s this great riff in Wattstax where Richard Pryor talks about Southern whites accusing a black dude of raping some white guy’s wife. The guy brings out his wife and says something like, “The nigger raped her!” The assembled black folks look at the guy’s wife who, let’s just say is not Scarlett O’Hara, and go, “You sure??” But in the white male paranoid mind, the deepest ambition of all black men lay between the two legs of some white woman–any white woman. And white women, of course lacking any real agency in the narrative, joyfully go along. Or are forcibly carried along. From that perspective, white racism really is a fear of a black planet–and (paradoxically) of white women.

Or to put it another way:

One could even argue that being black is queer. You’re subject to arbitrary violence, you are over-sexualized, and there are legal structures put in place to deny you equal rights. That sounds like gay folks to me.”

I’m working on my response to Rod. Stay tuned.

Josh Marshall finds an old Enron ad.

Free Exchange wonders if the tobacco tax is a false revenue generator.

Jay Z – a man of many words:

A reader writes:

Beck, and all these guys, Hannity, Rush, Ingram, all of them, what are they going to do for four years? Or, as is likely eight years? They are talking non-stop about socialism and fascism and communism and Obama has been President for about 20 minutes. Do they think even Republicans are going to want to hear this for years? Can you really go around shouting the sky is falling for eight years?

Roger Ailes is interested in the ratings for the next six months. Once you realize that an accurate account of reality is not in his in-tray, it helps makes sense of it all.

Ezra Klein looks closer at that GOP budget and how they make the red line go down:

Currently, Medicare's costs rise as the demand, and price, of care rises. No rationing. Under Ryan's proposal, its costs will rise by whatever the federal government says its costs will rise by. The question will simply be how quickly the subsidy grows. And if subsidy growth slows, we'll have…Rationing! It will take the form of individuals being unable to pay for treatments rather than the government making people wait for treatments, but it'll largely be the same thing. And it's nearly the exact same mechanism.

But rationing is the only way to bring down healthcare costs. And, frankly, I prefer market rationing to government rationing. It's more efficient, less ridden with political corruption and would allow for more innovation at the top end. Yes, healthcare inequality would continue. But I'm not a believer that inequality is the worst of all social outcomes.

Jason Zengerle previews the next act in Minnesota's longest senatorial election.