One thing I thought about reading this Hot Air post is that if a lot of the proposed health care funds come from state coffers, we run the risk of not being able to fund our education systems year after year, with that money diverted into bloated health care budgets. The worse our children do in school, the more likely they are to need state-provided health coverage in the future. It’s a vicious cycle.
Erik Kain
Erik writes about video games at Forbes and politics at Mother Jones. He's the contributor of The League though he hasn't written much here lately. He can be found occasionally composing 140 character cultural analysis on Twitter.
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So, fund both.
I’m tired of hearing that our governments can’t afford stuff. We can afford to spend a trillion dollars making war on a two-bit dictator in Iraq, but we can’t afford to educate our kids and provide our population with health care.
Seriously, how do all these European countries do it?
All the objections raised to national health care are ultimately nonsense. There are working systems in every other industrialized Western nation on the planet. If they can do it, surely the “greatest nation on Earth” can do it too.Report
Agreed. ED’s argument is pure nonsense. Nationalize health care and education, stop fighting pointless wars, raise taxes… voila! Everything is paid for. This isn’t rocket science.Report
State budget shortages are a very real problem. The argument that we should “just fund” everything is the same as throwing money on a fire to put it out.Report
They’re a real problem in the sense that they exist. They’re not a real problem in the sense that they’re intractable in any way. More revenue, less spending on stupid things like wars, more federal funds made available, and state budget shortages are no more.
Again, as Travis points out, a lot of major Western democracies pay for all this stuff just fine. It’s only an extreme lack of imagination and a set of rigid ideological hangups that make this a difficult problem for you.Report
I agree that fewer wars might help. But more revenue is not always as easy as all that – with higher taxes you usually see a downturn in economic activity and thus lower revenue (though this is not always the case, of course). Other options need to be put forward. And federal funds are fine, but they often come with strings attached. So while it sounds easy, it often isn’t. I do think that education should always be fully funded, but that there should be real efforts to root out waste (which really does exist according to many educators I’ve spoken with…)
We have to be careful to fund things, yes, but perhaps just continuing to grow the government is not the best approach, and we should look for ways that it can be done by individuals as well. The government has a tendency to continue to grow and grow and that costs more and more money…Report
Evidence of the Laffer Curve is sparse on the ground. And basically no one with a brain thinks that raising taxes from their current rates would fail to raise more revenue. Taxes are far, far, far too low.
I agree that strings attached to federal funds make for a messy arrangement. For my money, that makes it all the more imperative that we simply get the states out of education and health care, and just nationalize the whole process. State government is small and inefficient (both for reasons of scale – health care – and patchwork standards – education). Uniform standards and a single source of funds would be a dramatic improvement over the status quo.Report
Ugh. I have been a staunch defender of public schools but that will all end if they are “nationalized.” I understand the appeal there – I really do – I toyed with the idea myself. But the implications to local autonomy are bleak. And the direction we need to go with our public schools is smaller, more autonomous, and yes, well-funded but also leaner. We don’t need lots of administrators and bureaucrats. We need lots of teachers. Okay – so a federal government that really supported the new nationalized education system would probably fund it well. But what about the next government? Maybe they’d slash funding across the board. And what about the curriculum? What if strong lobbyists pushed for their preferred curriculum or text books or food etc. etc. etc. and it had to be adopted across the board? What if someone managed, God forbid, to push into the mix a mandate to teach ID along with evolution? I mean – when the well is serving the whole camp, the poison in the water kills the whole camp. Much better to keep us all autonomous.Report
Again, Europe. They do this much better than we do, and their students regularly kick our butts on measures of international achievement. The “smaller” and “more autonomous” our schools get, the more kids will grow up learning about silly things like Creationism instead of actual science. The last people who need to be in charge of a school system are local administrators.
It’s hard to make the case for conservatism/”local autonomy” (i.e., doing things wrong) when Europe consistently does better than us at everything except making a very small segment of the population extremely rich. I will gladly trade my “freedom” and all the bankers/mega-CEOs it creates for decent education and health care. What troubles me is that so many conservatives won’t.Report
Actually schools in Massachusetts consistently rank at or above schools in Europe and Asia. Do you think people in Mass. would forsake their autonomy in exchange for a federal system? Even if that system ended up providing only an average overall? In other words, the federal system might lift up some schools in under-performing states like Arizona, but it would lower results in Mass. and Kansas. Is that worth it? Or do you honestly believe that America – which is far, far larger and less culturally homogeneous than any European nation – could achieve similar results across the board simply by the magic of nationalization?
I think you’d have a lot of very nervous teachers and parents out there if we went in this direction.
That said, I’m not against a nationally suggested curriculum…or open-source cooperation between schools.Report
We had total Republican control for six years. Did the government shrink by one iota? Are you kidding? The right wing ran this place into the ground. We ended up with the biggest growth in government intrusion into private lives since the Alien and Sedition Acts, we built unconstitutional internment camps for extrajudicial detention, … and not one thing was done to shrink the federal government. The War on Drugs continued unchecked, our prison population kept exploding, gays were told they didn’t deserve marriage, a giant new useless bureaucracy was created to search air travelers – a job private industry had done just fine… I could go on. In eight years of the Republican White House and six years of complete GOP control, not one significant agency was shut down, not one significant program was abolished. Q.E.D., Republicans don’t really want to shrink the government. When they talk about it, they’re lying.
Nor do I believe any conservative when they talk about fiscal issues. Again, the right wing ran this place unchecked for six years, ran up gigantic deficits, spent a trillion dollars trying to create democracy with troops, tanks and Abu Ghraib… and now they cry poverty when we want to spend money on health care? The disingenuity is stunning.
You want to know why my generation is so overwhelmingly liberal/Democratic? Just look at the results of the George W. Bush presidency and his Republican Congresses. There is no reason any of us should ever trust conservatism. Ever.Report
Yep. Conservatives messed up bad – didn’t really stick to conservative principles either fiscally or, really, in any manner or matter. Epic fail all around.Report
For the record, the crazy Libertarians were saying stuff like “Clinton was the best Republican ever, Dubya is the best Democrat. God only knows why their respective opposition hates them so much.”Report
Yeah, but fighting wars (and we can’t discount the future possibility of fighting an unavoidable [from direct attack] war in the future) have little to nothing to do with state budget deficits.
E.D.’s point deserves more than the callous treatment you’re giving it, Ryan. Education is a huge part of every state’s budget and it’s folly to think that increases in other costs or decreases in revenue won’t affect education. Nor is it a matter to consider in isolation. After all states also fund emergency services, prisons, and services to the poor.
You can’t avoid choices by saying fund it all. That’s exactly what California has done for the past decade and that hasn’t worked out for us so well.Report
No, dude. ED’s point doesn’t deserve that much. Education is only a huge part of every state’s budget because we seem committed to an insane funding model that has individual states paying for schools (somewhat) on their own. Sure, that leads to great outcomes like in Massachusetts – but it also leads to Mississippi. Standardize the curriculum, put schools under the aegis of the Department of Education where they belong, and let the Treasury pay for it. It’s really not that difficult, unless you’re committed to the idea that inefficient, patchwork state-by-state methods make sense. They don’t.Report
It must be nice to have such easy solutions to all the problems we face. But the reality is that will simply NEVER happen. Ever. I’m serious, you’re never going to get all the tens of thousands of schools in this country under the Dept. of Education, and I’d be a lot more troubled than you are about what that would actually mean for our schools and students, etc.
Also – most educators I know of liberal or conservative stripes (as in not wonks or bureaucrats) are terrified by the idea of national curriculum or national bureaucratic control. Thus we see the blossoming of a very robust charter-school movement. And if liberals ever do try to nationalize schools well then there goes all the support I ever had for public schools at all. It will be a disaster – both in terms of funding and administration as well as educator freedom.
Now – are there better, more equitable ways to fund schools? Of course. We can do better, and we should do better – and I worry that this will take a backseat if health care is made into a huge state burden that is nearly impossible to fund.Report
Yes, because as a conservative, you care more about “freedom” than actually getting good results. I honestly don’t care about “educator freedom”. I care about kids getting good educations. Currently we are being schooled (pun intended) by all those socialist countries who do things that could “never work” and that wouldn’t earn the ED Kain stamp of approval.
Referencing the Thatcher quote from below: “The problem with conservatism is that eventually someone asks for evidence and all you have is ideology and Econ 101.”Report
Oh hogwash. Or bullshit. Or whatever you want to call it. that is precisely the reverse of my take on education. I think freedom for educators is entirely vital to the results. Indeed, the more we’ve moved toward nationalizing our schools (think NCLB) the worse things have gotten. Standardized testing and teaching to tests have been horrible for our education system.
What will actually improve our schools is to create lower student-teacher ratios. My own take on this is to create smaller schools with more teachers per student and less administration, less bureaucracy, and fewer standardized tests.
I’ll say this – the educators I’ve spoken with – and I have spoken with many, many educators – all say the #1 issue is student/teacher ratios, and beyond that they want room to be teachers. They are sick and tired of government bureaucrats telling them what or how to teach. And these are often very liberal people I’m talking about. And conservatives, too, who have a deep regard for our local public schools, but who would be appalled at the march toward a national school system.Report
I will grant you one thing. Treating schools like a political football – via things like NCLB – has been uniformly bad. The problem, as I see it, isn’t bureaucrats. The federal bureaucracy in this country, with some exceptions, is full of people who are generally quite well-educated and good at their jobs. It’s Congress that is full of people who are stupid, immoral, and incompetent. To the extent that Congress would be setting a national curriculum rather than leaving it to the actual experts employed by the Department of Education, I would not favor nationalization.Report
E.D., you’re right with class size reduction is – in everything I’ve ever studied/read – the more tried and true method of improving student outcomes. Moreover, nobody and I mean nobody wants more nationalization in education. I mean NCLB is about as federal as it gets in education legislation and it is reviled in the education community.Report
The problem is that what amounts to a “good education” can vary quite a bit depending on the region, person, etc. There are likely to be a rather large number of people who have very legitimate disagreements with the federal government’s definition of a “good education” on any given issue. This isn’t just with regards to things like evolution, math, and science, but also in regards to things like whether history gets as much emphasis as science, whether math gets as much emphasis as reading, whether music classes or PE get any emphasis at all, etc. The thing about local decisionmaking is that it is going to be more responsive to the particularized educational needs of its community.Report
Or, if you look at it another way, local decisionmaking is going to be more responsive the biases and prejudices of its community. Where you might see individualism and a million tiny flowers, I see Creationism, racial animus, and sexual oppression.Report
Ryan – see how this works: you take the local responsiveness of a school board, teachers, etc. and you transfer that out of your local community to your big federal government where voices are barely heard at all. That’s problem #1 with nationalizing. Then – under your plan – you take the responsibility out of the hands of elected officials who are at least nominally beholden to we the people and put it in the hands of “actual experts” (read: bureaucrats and ideologues) and have no accountability left whatsoever.
Who are the actual experts? I’d say the teachers we hire to watch over our children all day. Not the bloody pencil pushing idea-men protecting their jobs in some dim-lit government office in Washington D.C.
I’m sorry, but this is a downright frightening proposal.Report
Though I think it goes without saying, I couldn’t agree more with Mark on this point.Report
Right, I don’t see this as frightening. Local voices are the problem in education. Instead of having people who conduct education research for a living, who are trained in different methodologies, and who can evaluate what works and what doesn’t, we have people who are completely beholden to the local prejudices and the whims of parents making decisions about how to provide a good education. What you see as frightening about my take is precisely what I see as correcting the absolutely terrifying thing about yours. The very last people I want in charge of deciding how to educate children in the 21st century are people who have no scope on a deep and complex issue.Report
The thing about each of those examples is that they are all probably unconstitutional. E.D.’s not proposing the elimination of the 14th Amendment.
The reality is that federalization is very much having the sort of effect I’m worried about above – music, art, and PE are getting cut left and right because of various federal mandates, to say nothing of cutbacks in vo-tech programs (some of which are admittedly driven by the realities of an increasingly service-based economy).
While Creationism in the public schools is a definite problem to be wary of, the number of places where it’s actually managed to wiggle its way into the curriculum are quite few and far between; and I don’t think there’s been much of a push to institute stronger racist and sexist memes into the curriculum – there may be exceptions to this, but they seem to be increasingly few and far between. In fact, these things are now rare enough that when they are tried, they warrant wall-to-wall media coverage.Report
I seem to have lost the ability to see ED’s replies (for some reason). They’re in my email but not showing up on the site. Anyway…
I’m as glad as you are that my kids won’t be forced to go to what passes for schools in some parts of this country. They might actually receive an education, which is an enormous relief to me. As Pat Moynihan once said, the best way to improve schools is to move them closer to Canada. In which case my kids will be sledding to school.
But I’m not exactly ecstatic about all the kids in other parts of the country who have been shuffled aside because we’re so concerned about “local control” that we won’t commit to (a) making sure they’re learning the right things, and (b) paying for them to get what they need. I don’t generally like to impugn my interlocutors’ motives (like I did above :-/ ), but I’m guessing you didn’t go to school in rural Mississippi or urban DC. Those schools need something much more than local control and better student/teacher ratios. Vouchers have been basically useless and charter schools are making a dent, but we need better solutions than we have. I honestly see no evidence that more federal control wouldn’t be helpful. After all, the DoD schools do pretty well, yeah?Report
As a small but crucial style point. I think this is exactly what’s wrong with political discourse today. Amalgamating goals and methods. Ergo, if you don’t support my method, you’re opposed to the goal. Conversely, if you support X method it must be because you’re evil or a socialist or both.
I mean talk about toxic.Report
Ryan – if that’s how you feel, then it’s a good thing you live in a country where you have the freedom to put your kids in whatever school you want. You can live in whatever community suits your tastes, or put them in a private school. (hypothetically, of course, since I have no idea if you have kids)
I have that freedom too. And we can choose different approaches. Hell, I could even home school or “unschool” my kids if I wanted. Lots of choices for lots of different views on what approach is best.
Thank God we live in that country and not the one you propose, where the approach of the very few is dictated to the very many. You might end up with – heaven forfend – creationists in those offices one day. But by then it would be too late…Report
Tabling for a moment just how constitutional your so-called easy fix is, I think there are some points you make that should be addressed.
Arguments should be respected based on how relevant and accurate they are. Not whether we like what the argument is or isn’t. To do otherwise is uncivil. Just because you don’t like what E.D. is saying doesn’t make his point less deserve of credit nor any less true.
The way we have education may have its flaws but its hardly as bad as you say nor, for that matter, would nationalizing everything be a simple or good fix.
First of all, the states contribute a large amount to schools because its a constitutional obligation for most (I think all) of them. No such obligation exists at the federal level, so I think I’m with no small amount of people when I say that’s not just risky but, in fact, downright foolish to assume that education funding would be adequately maintained at the federal level.
Moreover, one size fits all is entirely detrimental to good education. At the curricular level, at the governance level, and at the funding level. It’s unfair to kids, and bad for employees/educators.
You talk about these being liberal ideas. The teachers unions would fight to the death to oppose your “reforms” and you don’t get more liberal than that.Report
I realize conservatives like ED are wedded, for ideological reasons, to the idea that local control is always preferable. But I just think it’s time for liberals to point out that that is false. We do an immense disservice to Americans (especially those who live in the South) by allowing the governments of individual states to continue making decisions for their citizens. The federal government can simply do these things better.Report
Sweet, paternalism. Let’s just take over the south and force them to run things better just like that time we did that in Iraq.Report
Unfortunately we don’t get to choose whether to take over the South. Lincoln already decided they were part of the country. Trust me, I’d have let them go. Those people are my countrymen in name only.Report
They’re like children, really. With the proper governance, we can provide them with meaningful labor, shelter, and decent nutrition.
It’d be a disservice to their culture if we allowed them to remain the backwards folk they are.Report
“We do an immense disservice to Americans “(especially “those who live in the South) by allowing the governments of individual states to continue making decisions for their citizens. The federal government can simply do these things better.”
Especially in the south! This guy is cracking me up. Oh yeah, the federal government is simply splendid at telling everyone what to do, how to do it, when to do it and who to do it to. We need more federal government.Report
I aim to misbehave.Report
Well partially because these European countries
a.) don’t have the military expenditures we do.
b.) don’t have those expenditures in part because they count on us to
c.) whether European countries will be able to sustain their systems in the face of decreasing cultural homogeneity, aging populations, and smaller workforces is an open question.
Pointing to systems that are quite different from our own, built to work with/for people quite different from us, that have their own issues quite different from those that affect us, is a poor comparison and even worse policy.
Finally for you and Ryan, we’re not paying for the wars in Iraq and Afghanistan. Those wars are subsidized by the Chinese, Japanese, Europeans, and the rest of our creditors. We’re unsustainably financing much of our spending so the idea that because we’ve been able to afford things in the past suddenly it means we can avoid choices in the future is an argument out of touch with and devoid of anything resembling reality.Report
Why do we need those military expenditures? Who are we defending Europe from? It’s 2008, not 1958. The Cold War’s over. The Warsaw Pact is no more. The European Union is plenty capable of defending itself from essentially any credible threat.
The United States constitutes approximately 50% of global military spending. Couldn’t we reduce that to, say, 40%, and still have a dominant force that would deter any aggressor?
Our naval battle fleet is equivalent to the next 13 largest battle fleets in the world – COMBINED.Report
I think EVERYONE here agrees with you on that. But good luck getting anyone responsible for making choices to agree.Report
But see, this is the thing that frustrates the hell out of liberals and makes us entirely unwilling to even think about making common ground with fiscal conservatives.
It’s apparently OK to spend these uncounted zillions on national defense. Everyone just shrugs their shoulders and says “we can’t change it.”
Then, when we talk about spending even a fraction of that amount on social programs, or education, or parks, or pollution control… “we have to stop big government spending, we can’t afford this,” yadda yadda yadda.
Basically, the “we need to control spending” argument does not hold a drop of water with me as long as nobody on the right side of the spectrum is seriously addressing the military and drug war spending issues.
Right now, the message being sent is “it’s OK for us to spend billions on tanks and prisons, it’s not OK for you to spend billions on health care and schools.”Report
Yeah, it’s hard. Because of course ED and the conservatives of his ilk don’t actually support all that defense spending. So it’s not like he’s a cheerleader for that kind of thing. Hard to blame him for something he doesn’t support.
THAT SAID… liberals have to put up with a lot of criticism from conservatives (including ED) for the sins of other liberals who have messed things up despite good intentions. So where do we draw the line? Because I support a national curriculum for education, is NCLB my fault? I don’t support that bill, so I don’t think it is, but I understand if people find that thin gruel.Report
Fair points. I just wanted to point out that while we are indeed quite wealthy, there are limits to what we can afford and a simple cut here may turn out – down the road – to be neither simple nor cost-saving.
I just don’t see things as simplistically, but I think we can all agree that our defence appropriations are somewhat bloated.Report
When I was a little kid, I would sometimes ask for a toy or something and mom would say “oh, we can’t afford that” or similar and a response that always got a good laugh was “you don’t have to use money, just use a credit card!”
“Fund both” kind of reminds me of that story, for some reason.Report
No one is contending that we should fund both with deficit spending. The federal government can substantially increase its revenue by raising taxes (on everyone; not just this cockamamie millionaires surtax business). It could also substantially decrease expenditures by slashing the Defense budget, but that’s not likely to happen. Keeping everything purely in the realm of the possible, there is no reason why taxes couldn’t be a bit higher than they are now.Report
“You don’t have the right to more than 40% of my fucking money” isn’t a reason?
Personally, I think 25% is a bit high.
YHWH himself doesn’t ask for more than 10%.Report
It’s certainly not a reason I find compelling. This libertarian idea that you have some “right” to the money you’re paid is more than a little preposterous. Virtually your entire earnings potential is due to the pure accident of being born in the United States rather than elsewhere. Taxing you to provide for the basic functioning of the society that made it possible for you to earn money in the first place is not even plausibly unjust.Report
Yeah – something about the idea of more and more and more government vis-a-vis higher and higher taxes in order for it to intervene even further into our business and decision-making and autonomy (because, of course, the feds know how to spend my money better then me or my local government does, right?) makes me very nervous.
Look – this attitude – let’s just tax and spend and then, if that fails, let’s tax more and then, of course, spend more – is exactly what will bring down the Democrats in the end.
Maybe next time we can get a fiscally sane President (not that McCain would have been). And maybe someday we can get a government together that will actually reduce military spending to reasonable levels.
Oh, and one last point – just because they take your tax money, doesn’t mean they’ll spend it well.Report
It’s certainly not a reason I find compelling. This libertarian idea that you have some “right” to the money you’re paid is more than a little preposterous.
I’m not even sure how to respond. All my initial overly-serious responses to this just don’t seem fitting….Report
Hey, conservatives are the ones who are always complaining about the insane proliferation of rights (right to privacy, right to health care, right to whatever). I’m more than willing to cut off all this rights talk and just get right down to brass tacks: what works, what doesn’t. I think we all agree that a tax rate above a certain level is simply counterproductive (because of the perverse economic incentives it creates). I certainly hope we also agree that we are not currently at that level of taxation. There is room to increase taxes and raise more federal revenue. There are goods and services the federal government can provide (either direct health care or a public option or a cooperative or whatever) that are worth providing. Seems like a solution almost suggests itself, yeah?Report
I am one of those crazy people who believes in a right to privacy.
How much money do I make? You don’t have a right to know.
Am I pregnant? You don’t have a right to know.
Am I reading Harry Potter to my kids after school? Maybe the Bible? Something corrupting, anyway? You don’t have a right to know.
I see a difference between my right to privacy (which pretty much means my right to be left alone by you moral busybodies) and my right to healthcare (which would be my right to your time, effort, and stuff). I see that I have the former. I don’t see that I have the latter.
Moral busybodies, however, don’t believe that I have the former but they believe that they have the latter.
My goodness, it’s frustrating.Report
Unfortunately for this argument, I don’t believe in anything as weird as a “right” to health care. Mostly because I just don’t care that much. Giving more people health care is a good idea, because people dying is a bad thing. Therefore we should give more people health care. No need to use the word “right” at all! It’s neat!
What’s really frustrating is people talking about who has a right to what independent of what actually produces good outcomes. Ideology is incredibly boring.Report
Dying is something that people do.
I hate to break this to you but you are going to die.
I will do everything I can to not pick your pocket in order to keep myself alive. I’d appreciate the same.
If you find ideology “boring”, why in the hell are you here?
Do you merely mean “other people’s ideology”?Report
Dying is also something that can be delayed with often minor expenditures that some people are better able to afford than others. If your contention is that health care is just another market good that we should be willing to exclude some people from having simply because they can’t afford it, we have no common ground. I consider that position deeply immoral and basically sick. As, I think, do a majority of Americans (and people in the world).
What I mean by ideology is this idea that we can solve problems purely be reference to some first principles that no one agrees on. I simply don’t agree that taxation represents any kind of theft and there is no way for you to convince me that it is. So first principles get us nowhere except a screaming match. *That* is boring.Report
Yeah, I always enjoy when moral busybodies call my positions “immoral” and “sick”.
I think I see what you mean when you say ideology is boring.Report
This is what we’re up against, people — buck up!Report
Well then why don’t we just turn over all of our decision making to Google algorithms and robots. Surely they would be able to impartially produce better outcomes?
This is silly. We have rights because they’re things we pay for despite their inefficiencies. It’d be easier to fight crime without the 4th amendment. It’d be easier to prosecute people without the 5th. Without the 1st amendment we could be less permissive of hate speech like the Europeans are – which according to some social psychology studies actually does reduce hate based crimes. We could presume criminals guilty instead of innocent just to be safe. After all if you were a good citizen why would you ever be under suspicion of a crime?
We don’t do those things because we value a set of rights and privileges that – for all their inefficiencies, mistakes, problems – matter more to us than the alternative.
Saying “this produces good outcomes” independent of evidence neither makes it so, nor is terribly convincing when the conversation is about balancing between values, preferences, and funding.Report
No one here has argued for “more and more and more” government. I, for one, have specifically argued for a government that provides education and health care to its citizens. I’m not the least bit interested in an ever-growing government for the sake of having a big government. It needs to do things that are worth doing. Education and health care fit my definition of that.
For my money, fiscal sanity requires knowing when markets don’t work and government action is needed. Health care is a good that cannot be provided satisfactorily by a for-profit market because the primary job of a for-profit health insurer is to make sure people *don’t* get treatment. That is directly contrary to any sane notion of the social good.
Trying to measure justice by reference only to the “size” of government is not helpful.Report
“For my money, fiscal sanity requires knowing when markets don’t work and government action is needed. Health care is a good that cannot be provided satisfactorily by a for-profit market because the primary job of a for-profit health insurer is to make sure people *don’t* get treatment. That is directly contrary to any sane notion of the social good.”
This is true only of a for-profit health insurance company in an employer-based health care market. For-profit insurance companies exist without any real problems in most other countries because there are consequences (both market-based and, I must admit, regulatory) for denial of coverage. The market-based elements of those consequences don’t exist, however, when you have employer-based insurance because denial of coverage has no effect on whether the insurer loses customers (and therefore revenue).Report
“Most” other countries? Really? Quick perusal of some of the usual folks we talk about:
Canada: single payer
France: compulsory insurance, non-profit providers
Germany: compulsory insurance, non-profit providers
UK: the dreaded NHS
Australia: guaranteed service in public hospitals
And so on. Many of these places have private, for-profit insurers in existence alongside their other systems, but basic service simply isn’t provided by a for-profit health care sector. I think the general consensus among the major Western democracies has long been that private health care is, at best, a luxury for those who can afford more coverage than the guaranteed public provision.Report
Well, but I have no problem with a health care safety net. I was just responding to the blanket statement that “the primary job of a for-profit health insurer is to make sure that people *don’t* get treatment.” This is simply not true – an insurer who made this their primary job in a situation where the customer and the consumer were the same person would be an insurer that was quickly without any customers. No customers, no profit. This doesn’t mean there shouldn’t be safety nets or some fairly robust minimal level of care – just that the idea that a health insurer’s primary job, even in an individual-based system, would be to deny coverage is simply incorrect. In reality, in an individual based market, the incentives for denial of coverage of health insurance would be identical to the incentives for denial of coverage of auto, life, homeowners, etc. insurance, none of which has nearly the coverage problems that exist in health insurance.Report
I mean here’s my question for your “let’s just tax more people more” proposal.
Moreover – and I don’t like to keep doing this – but I think California’s example becomes enormously useful. The federal government has no property tax so it relies on income taxes (personal and corporate) along with assorted other methods of revenue collection. In California, partially because of capped property tax rates, the state is enormously reliant upon income taxes (personal and corporate) which makes revenues somewhat unsteady. When times are good, they’re really good. When times are bad the state is taking in very little money at a time when safety net spending skyrockets.
So how is it any kind of fiscal sense to take on more critically necessary spending based on the income tax?
Moreover, the idea that simply cutting the defence budget because it’s so big and unnecessary just seems to me to be penny wise and pound foolish. If you actually look at the federal budget, it’s a huge expenditure but in relative terms it’s only large in terms of discretionary spending. So sure there are savings over the next five years. In ten, those savings are gone and healthcare begins to start crowding out education again.Report
We have a tendency in America to argue for or against a concept based on our own personal philosophy or view of the world, what advances our personal interests, or the interests of our party, family, organization, or region. Perhaps viewing the issue from a management or systemic perspective might result in innovative approaches to the issue. The American national mindset, citizen philosophy, lack of citizen motivation to be proactively healthy, and governance model make the socialization of health care in America very problematic, particularly at this point in time. A country needs to know its limitations.Report
The objection to your argument – “This is a country built on social Darwinism or survival of the fittest,” therefore we won’t accept socialized health care – is that it’s simply not true.
We already have extensive welfare programs that provide food, clothing, shelter and medical care to the nation’s poor. We have comprehensive medical coverage for the aged. We have a free, universal and reasonable-quality public education system, coupled with heavily-subsidized public colleges and universities.
All of these things are uncontroversial and broadly accepted. I’m not sure why an expansion of Medicare to cover all Americans would cause a torch-and-pitchfork revolt.Report
Well, I like your post, E.D. Not to swing too far to the conservative/dark side but I can’t help but think of this Margaret Thatcher quote,
“The problem with Socialism is that eventually you run out of other people’s money.”
Though, I would substitute Socialism (which isn’t all bad) with a perpetual avoidance of making choices premised upon a belief in easy credit, pliant creditors, and captive millionaires and billionaires.
Less pithy but, perhaps, more applicable. I think it’s arguable that we already don’t fully fund education but that the more health care costs the states, the more Medicaid will crowd out other programs. Not just education but services to the disabled, poor, mentally handicapped. Higher education, prisons, emergency services. They all stand to be affected and the problem with prioritizing one to the exclusion of others is you sometimes can make things far, far worse in an attempt to make things better.
This isn’t a reason not to try, but it’s certainly a reason to be more thoughtful, I think.Report
Thanks, Kyle. And very good points. (Though hey, I think we could just lose some prisoners to help fund those over-crowded prisons.)
But that’s another story….Report
So the experts in D.C. can determine what’s best for the rest of us? Our “biases and prejudices” are merely matters to be swept aside and trampled upon? Seriously, Ryan, you’re making a great case for school vouchers and the end of public schools altogether. Nothing will ignite the anti-public-school forces quicker than this sort of argument.Report
Without getting into the vouchers argument and what not, the idea of experts itself isn’t as ironclad/hard science, as one (particularly one from the left) might believe.
You can have experts in curriculum development, lesson planning, teaching strategies, test development, etc…
However, you can’t have an expert decide whether Johnny Lee will benefit from having more science and fewer visual arts classes. Or if Susie Lempkins should have independent P.E. with her fencing tutor or not. What should a school’s policy be on newspapers and free speech? If we’re cutting funding should we cut two English teachers or the head of the Math department. Should we close a campus specializing in the performing arts to keep open one specializing in information technology?
All of these decisions require different metrics to judge and no one rule is going to lead to the best result in all of America’s roughly 14,000 school districts. You couldn’t make the reforms Ryan was talking about and still maintain the level of community input or incorporation of circumstances that we currently allow on all of those issues. They are decided by the states, school districts, cities, towns, and hamlets.
Federalism matters. Federalism doesn’t ensure equality of results but it does allow for a hetergenous society to manage itself quite well. It does allow for experiments, innovation, and success stories to emulate.
It’s easy to point to Mississippi or Detroit as a failure of national commitment to education. But our system also gives us Massachusetts, Connecticut, Suburban Maryland, & NoVa. You can’t fix problems or the the system by only looking at half of what’s going on.
If you straight-jacket the country with education reform, I think you’re more likely to get 50 states all like Mississippi than you are to get 50 like Massachusetts. Which is why I think solutions need to focus on how we’re going to help kids in Mississippi, New Orleans, Detroit, Oakland, etc… rather than taking the Great Leap Forward approach to education reform.
To come back to E.D.’s original point, it’s worth considering the trade offs we’re making. Maybe by lowering health care costs (or at least transferring them to the federal government), we’ll make some room to raise taxes at the state level and all will be right in the world. Then again, maybe not. The point is, we can’t pretend that health care reform is all ups and no downs. To look at the current system and suggest that we can’t lose by reforming it, is folly. We can and with attitude it seems all the more likely.
The article E.D. links to matters because its highlighting a trade off of enormous significance. That down the road we may have to choose between funding health care and funding education. Or worse, it won’t even be a choice.
We can all disagree on what should be done and by whom, however, recognition that we can’t have our cake and eat it too isn’t liberal or conservative, it’s realistic or ideological at this point.Report
Ryan – I’m going to start a new subthread to respond to you. All the posts up above are getting mixed up.
Anyways – first of all, I’ve been to school in the states and Canada, personally, and there was nothing even remotely better about schools there. It really depends on where you go – there as much as here. I ended up in Catholic school there because the first public school I went to was so bad. Here in my hometown schools range a great deal in quality. There are many options – and a growing charter school movement.
The DoD schools are very good – but that is a small system compared to what we’d need for the entire country – and it is funded via the Defense budget which is untouchable, unlike education budgets (and I realize the irony and the tragedy in that, but it is what it is).
What works in smaller, insulated systems (like the DoD or Finland) cannot work at the national level. It is simply not the same culture – and certainly the military has a very, very different culture than the nation writ large.
Just some thoughts.Report