Wednesday, September 16, 2009

Jimmy Carter, the sage of Plains

This one is great. Now, I'm no defender of Rep. Joe Wilson (R-SC), for two reasons: first, what he did during Obama's speech was rude, boorish, and silly; second, he's from South Carolina, which contains the most annoying stretch of interstate highway in all the land -- and it's annoying not because of the road, but because the SC drivers make it so intolerably miserable.

Anyhow, here's Jimmy Carter, adding his own folksy wisdom to the debate over health care:
ATLANTA (AP) - Former President Jimmy Carter said Tuesday that U.S. Rep. Joe Wilson's outburst to President Barack Obama during a speech to Congress last week was an act "based on racism" and rooted in fears of a black president.

"I think it's based on racism," Carter said in response to an audience question at a town hall held at his presidential center in Atlanta. "There is an inherent feeling among many in this country that an African-American should not be president."

I'm unclear how Jimmy has determined that the "inherent feeling" that "many in this country" believe Obama shouldn't be president this based upon evidence? Is this based upon the statements of people in power? How many people are the "many" to which he refers? Is it the 60 million or so who didn't vote for Obama? Is it six dudes in south Georgia sitting on a porch drinking Dixie Beer? Or is it based in Jimmy's wisdom of the ages (i.e. he's just making shit up)?

The point, dear reader, is this: saying that people, including elected representatives, who oppose the policies of the Obama administration are doing so because they are racist is, essentially, and invocation of Godwin's Law on racial terms. If you can assign racist motives to the speaker, you don't have to engage the substance of his argument. Joe Wilson's point, poorly made as it was, was that the administration's proposed health care plan likely would cover illegal/undocumented aliens. There is considerable debate over this issue -- the plan says it won't cover anyone other than Americans, but apparently does not require proof of citizenship, nor is there any discernable enforcement mechanism. I'm sure that will change as the bill winds its way through the House and the Senate -- it may have already.

Now, whether it's kosher to shout "You Lie!!" during the President's address is one question (Wilson has received an official rebuke for it). Whether the health care bill in its current form would end up with taxpayer funded coverage for illegal aliens is another question, and one that clearly deserves a fair debate -- and there is a debate going on, so let's have it.

But for a former president to come out and say your opposition to Obama's health care plan is due to your being a racist, based upon nothing other than an "inherent feeling" and your opposition to the policies being debated is nothing short of astonishing. Set aside the supposed dignity of the office of ex-president--Carter just called those of us who disagree with Obama's policies racists!! And the best part -- because these "racist" outbursts are an "aftershock" of America's racist past, you may not even know you're being racist when you speak! And who gets to decide if you're racist? Jimmy Carter, that's who!

Are there racists out there? Sure there are. However, there are waaaaay more of us non-racists out here, struggling with notions of freedom vs. the concentration of power in the federal government, struggling with how best to remedy the problems of our health care system, struggling to determine how best to vindicate the rights we have under our constitution, and much more. So before you call people "racist" for opposing Obama's policies, you better be prepared to debate on the substance of the issue.

Friday, September 04, 2009

The Great Health Care Debate goes to kindergarten

So I'm on Facebook, and I've noticed a number of my friends have updated their status to say the following:
[Name] believes that no one should die because they cannot afford health care, and no one should go broke because they get sick.
Another friend of mine posted this most excellent question:
[Name] understands why libs are dumbing down their message of healthcare reform, but I don't agree with it. It's not that simple.

I'll be the first to admit our health care system, as it is currently operating, is fraught with problems. I will also state that all those who opposed the administration's efforts to create a "public option" by screaming "it's socialism!" need to wake up and see that the system is already largely socialized. Medicare, Medicaid, S-Chip, etc., are government-run health care programs, and they cover a significant percentage of the population.

The problem with making the debate about emotionalism/sentimentalism, which is what the "no one should die" statement is all about, completely misses the point of why there is a debate in the first place. This form of argument is juvenile -- nobody involved in the debate would disagree with the sentiment of the statement. However, it certainly does not follow automatically that to agree with that sentiment means you are evil and bad if you don't support the health care reform efforts of the administration or congress.

For example, we can all agree that "no one should die because of domestic violence." That is an obvious truth. However, because that sentiment is an obvious truth, do we completely dismantle the criminal justice system to handle this subset of cases? Do we start giving wife-beaters life in prison? Do we change the burden of proof?

It seems to me that, if you support a public option, single payer system, complete free market approach, whatever, you should be able to back up why with something other than sentimental arguments a 5 year old could make. Take a listen to John Hunt, a doctor at UVA, who has some interesting thoughts on the matter (scroll down to the podcasts, look for John Hunt). You may disagree with him, but he at least makes sense.

So to get back to the facebook status updates, the point is that argument, when taken down to the level of sentimentality, becomes completely meaningless. "What do you mean, you don't support health care reform? That means you want people to die because they don't have health insurance! Meanie!" Think about it this many people have you heard about who have died in the last 20 years from not having insurance? Apparently, folks are arguing that something like 60 people per day are dying from not having health insurance. They apparently get this information from this article. Of course, actually reading the article would help, so I did so.
"Health insurance really matters in how people make their health care decisions," said Ron Pollack, executive director of Families USA. "We know that people without insurance often forgo checkups, screenings and other preventive care."

But one can't conclude that being uninsured alone killed people, said Kim Bailey, Families USA senior health policy analyst. Instead, not having health insurance is associated with mortality-increasing behavior. "We can't actually attribute any individual deaths," Bailey said.
After hearing several minutes of background on the patient, Dr. Nielsen eventually asked when the woman's last Pap smear was. The answer: 10 years ago. The woman had developed uterine cancer, a curable disease if caught early. She died a few months after the initial diagnosis.

"You can dance around it all you want, but people who do not have health insurance delay the kinds of preventive care that everybody acknowledges are critical," Dr. Nielsen said. "That woman had a preventable, curable disease, and as a society we failed her because we have not made affordable health care available to all Americans."

So what can we divine from studies and articles like these? That folks who are uninsured (a) engage in riskier behavior, or (b) are more likely to delay preventative care that could prolong their lives. Is there a direct link between the lack of health insurance and these behaviors? Maybe so, because the common factor in folks like this is, of course, poverty. I represent folks in this cohort in court all the time. They engage in risky behavior not because they don't have health insurance, but because that's just how they roll. I'm pretty sure most of my 19-25 year old criminal clients, which demographic makes up a sizable chunk of people, are eligible for Medicare already. They don't have insurance because they never signed up. They don't get preventative care not because they don't have insurance, but because they just don't give a shit about it. Why is that? There are hundreds of reasons, no doubt, but I'm pretty sure "because I don't have insurance" is not high on the list.


UPDATE: and astute commenter reminds me that I meant to say "Medicaid" instead of Medicare for my young clients. Sorry about the error.