would Megan McArdle have saved Deamonte Driver’s life if it meant expanding government?

When I say that we have a moral obligation to provide people with adequate health care when their employment or financial situation prevents them from having it, I am usually told that “no one argues” the opposite. No one, I am led to believe, genuinely opposes universal access to health care. They just disagree with me and others about how to go about delivering that access in a fiscally responsible way.

Now, I could argue, and have, that saying “I support universal health care,” but opposing any and all actual attempts to get there, is a particularly cruel bit of rhetoric. But okay. Fair enough. A lot of people opposed to currently debated reforms favor universal coverage generally. If only we could afford it, let’s keep the changes iterative, free market pixie dust and libertarian magic beans, etc. etc. OK. I have been told, though, that no prominent pundit or commentator actually opposes government-guaranteed universal access to health care.

Well, here’s Megan McArdle.

She says, “I was writing about my deeper opposition to the entire project of providing, paying for, or otherwise guaranteeing health care…. [F]or most people on the left, this is akin to declaring that I would like to take up killing orphans in my spare time….”

I don’t know anything about orphans. I do know, though, that Megan McArdle’s ideal America has some senseless, preventable deaths. Because here is a fact that anyone concerned with our health care system and its reform should admit: our system leaves many people without adequate health care, and that this lack of adequate health care sometimes leads to death. Prevention and early detection are the foundations of American medicine. And the lack of same does indeed kill people. At the top of this post is a picture Deamonte Driver, the young man who died of a toothache two years ago and caused, for the briefest moment, our country to consider exactly what is at stake when we talk about health care reform.

How many people actually die because of our health care system? Impossible to say. Probably not that many, all things considered. One would be too many. And die they do. Those opposed to health care reform point out again and again that emergency rooms are forced to provide emergency care regardless of insurance. That, actually, is part of the problem, not an argument against reform. Misuse of emergency room facilities because of a lack of adequate coverage is an enormous strain on our system and a terrible misallocation of our resources. What’s more, emergency room medicine is much more expensive, and those who go to the ER because they have literally no other options for care are saddled with incredibly debilitating medical debts. And these debts lead to all the usual ails that we associate with financial catastrophe, bankruptcy, inability to lease an apartment and have a place to live, failure to provide for children, collapsing marriages, and all the rest. That is not a situation that a humane society looks at as an acceptable alternative. Nor would a rational, fiscally prudent society look at the use of emergency medical facilities as someone’s only avenue to medical care as a sane, workable system.

Our system, as you know, leaves people financially ruined; it leaves them in great pain, unable to stop it; it leaves them prey to conditions and diseases that have no place going untreated in the context of the miracle of Western medicine. Yes, I know someone who literally had teeth rot out of his mouth because he had no medical or dental coverage and couldn’t afford to pay out of pocket. Yes, I’ve heard from someone who helped care for a woman who delayed treatment of pain due to a lack of health insurance only to discover that she had cancer, and that her prospects were materially damaged because she didn’t receive proper early detection and care. Yes, I personally know people who have suddenly been denied the extension of their benefits because they got sick, which is a little like a car insurance company denying you benefits because you were in an accident. And yes, a 12 year old boy who committed the crimes of getting a cavity and being born poor died an absurdly preventable and tragic death because of this system, because of a lack of a guarantee from government that everyone will have access to adequate health care at a cost that doesn’t unfairly burden them. These things are happening, this is our system, this is real. Real human lives, real human costs, real human suffering, every day.

And there are millions so suffering. This is not a fact that can be seriously disputed. Those opposed to health care reform have made a cottage industry of assaulting figures for those uninsured and those underinsured (an equally large problem). They complain about dubious statistics while the assemble dubious statistics of their own, they question the methodology of studies they don’t like while reading with utter credulity those they do, they scream about faulty assumptions while never thinking to question their own. You will be as amazed to learn as I was, dear reader, that those in favor of health care reform are all in possession of terribly politicized numbers, but those opposed to such reform are all stoically unbiased champions of objectivity. Even in the context of resistance to reform that borders on religion, none are so blinkered as to suggest that the number of uninsured and underinsured in this country does not number in the many millions. Zealot that I am, I insist on coverage for anyone and everyone, whether the number be 4 or 40 million. But I don’t have to pretend that the number is low, no matter how desperately conservatives insist I do, when mountains of evidence say otherwise.

There is nothing illegitimate about Megan opposing guaranteed health care for all. It’s an opinion. I prefer her candor to a fake commitment to universal health care. But she has to confront the whole story. [Fixed, sorry.=- Fd.]

This is why that “killing orphans” line above is important. It’s important because it’s the only time Megan actually mentions death at all, the closest she comes in the entire post to reflecting, on the human cost that our system wrecks on our people, on what we are allowing as a civil society to go on in the midst of this incredible affluence. She is not alone in this selective blindness, in purporting to consider an issue while largely ignoring the real costs, and the real reason we ask for reform in the first place. That tendency to fail to adequately acknowledge the genuine impetus for reform is, I find, a common failing. The petulance and grievance that arises when I insist on talking about it demonstrates, to me, an implicit acknowledgment of this failure, from those who would prefer not to talk about the uninsured at all. It is for this reason that I insist, against all criticism, on continuing to bring up, again and again, the very real, non-theoretical, non-hypothetical people who are crushed by our system. To not do so would be a malpractice of argument in a democracy that requires, again and again, that we argue in full throat and with full power.

Now then. Megan is receiving kudos from her libertarian commenters, thanking her for her bravery. And Megan has said, now, explicitly and without reservation, that she doesn’t think the citizens of the country with the most powerful economy in the history of the world should be guaranteed health care. She is, in fact, certain that providing that health care to those who desperately need it on the government dime is immoral. (Read the post.) And she’s not afraid to say it.

So– Megan works for the Atlantic Monthly, a powerful old-media/new media crossoever entity. The Atlantic provides her with the resources and the imprimatur to contact Deamonte Driver’s mother, the woman in the background of the above picture, a woman who had to endure something that I could never imagine and don’t want to. So if Megan could go back in time and ensure that Deamonte Driver have his medical and dental care provided by the government, would she do so? If she could have saved Deamonte Driver’s life, if in doing so she involved government more deeply in the business of dispensing medical care, would she have done it? And would she tell Deamonte’s mother, to her face, that she would not? Would she continue to oppose health care for all when her audience is not faceless commenters applauding her, but rather the human face of someone who has paid far too high a price for existing in our corrupt, brutal, insane system? This is where the rubber meets the road, ladies and gentlemen, this is where the courage of one’s convictions becomes not a matter of convincing your  ideological fellow travelers but of looking at the actual reality of human pain.

If the issue is that Driver was a child, then Megan could hypothetically find one of thousands and thousands of adults who have stories of pain, hopelessness, financial crisis, and despair. Perhaps she could talk to one of the people in these videos. She doesn’t need to look far. She just needs to find someone who has had their life disrupted and damaged by a lack of health insurance and tell him, to his face, that it is right and proper for him to to have his life so disrupted, if the alternative is government intervention. She just needs to say that she would not change our system so that government would ensure that such disruption, such damage, such suffering not occur.

Some, no doubt, will tell me that this is illegitimate. But why? Why would a political position, freely chosen and unapologetically endorsed, be something to hide from those who are most affected? Holding a political position has a simple consequence; you must really hold it, and you must stand up for it. Megan– and you, if you are opposed to universal health care access, guaranteed by government–should be willing to tell it to the people who will be most hurt by that opinion, if you were in a position to confront them. And Megan, meanwhile, is a professional pundit and vocal opponent of universal health care access. No, we don’t all have to tell our opinions to everyone on the street. But due to her profession, and her certitude, and her lack of apology, I think such a challenge is legitimate. So would she say such things to the victims of the American health care system? Would you?