healthcare reform and the appeal to emotion

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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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45 Responses

  1. Avatar Freddie says:

    I’m actually much less interested in pointing out that there are people who don’t care– which I hope is common knowledge– and much more interested in pointing out that people who say they care banish what they are supposed to be caring about entirely from their posts. Megan McArdle, for example, actually admits that there are people who suffer and die under our current system in a laughably small percentage of her posts on the issue. The effect is that you have an argument prosecuted against nothing. Ignoring the human costs of the status quo, or acting as if talking about them is some sort of trick or unfair is to shut the debate down entirely.

    What I would like is more arguments that start by acknowledging what we’re fighting about, rather than eliding such concerns, which inevitably handicap people arguing for reform, even if all sides understand what is unsaid.Report

    • Avatar Freddie in reply to Freddie says:

      And that is an argument that has nothing to do with emotion, as well you know.Report

    • Avatar Sam M in reply to Freddie says:

      “What I would like is more arguments that start by acknowledging what we’re fighting about, rather than eliding such concerns”

      What would this look like? Every one of McArdle’s posts about health care ought to start out with a personal anecdote about friends with cancer or something? Or a disclaimer: “I am about to address the issue of healthcare in America. But before I get started, just let me say that I am hugely concerned about the human costs. The current system sucks. Wait, no… it really sucks. A lot. Here is a link to a story about a baby that died because of a greedy insurance company. Now that that’s out of the way, today the CBE released a report suggesting that….”

      I don;t really see how that makes any of her positions more or less plausible. In fact, it would strike me incredibly distracting.Report

    • Avatar Kyle in reply to Freddie says:

      Not to be disrespectful Freddie, but I think this criticism is beneath you. You’re an older hand than I in the blogosphere that it can’t have escaped your notice that people edit and focus their posts. A post on the ineffectiveness of the Cuba travel ban need not delve into it’s contextual history or contemporary sentiments in the same way that we expect longer academic papers or journalistic articles to.

      By the same token, major blogging voices are all about niche appeal. McArdle does libertarian leaning, snark-infused, cold commentary. Wonkette’s Ken Layne does hyperbole and sarcasm. Media Matters and Malkin alike do aggrieved/”look they’re at it again” like few others.

      If you want to criticize the rhetorical/argumentative shortcomings of bloggers who handicap their opponents well you might as well not stop with naming McArdle, just about anyone with a blog should be named, including yourself.

      When we talk about public education, your comments aren’t consistently infused with anecdotes about the horrors of the status quo as perpetuated by the institutions you support. On illegal immigration, no discussion of the preventable murders made by illegal immigrants. On abortion, what about discussion of the anguish caused to barren women, those killed during the procedure, or even of would-be fathers. Which isn’t to say, “oh look you’re a hypocrite and nothing you say matters.” Quite the opposite. I’ve really enjoyed reading posts here and older ones at L’Hote. I think you make good points, insightful comments, and ask provocative questions.

      At no point, however, do I find your writing or arguments compromised by a insufficient discussion of costs. Perhaps that’s because your posts tend to be more open-ended and conversational. If a discussion of the casus foederis of reform is missing, I think that means we need more voices that can communicate the missing aspect of our discussions rather than criticizing people for not meeting artificially imposed standards that have as much to do with style as substance.Report

  2. Avatar Scott says:

    After reading Freddie’s appeal to our heart strings I can only think of him paraphrasing Jane Fonda on Communism. If only americans understood what health care reform was, you would hope, you would pray on your knees that one day we would get Obamacare.Report

  3. Avatar Madrocketscientist says:

    SO Freddie has takes issue with any pundit who fails to regularly acknowledge the human cost of the current system? Now, if he was complaining about a pundit who went on & on about how our system is great, nearly flawless, and this is all a big todo about nothing, then I’d agree, he has a point. But the likes of Megan McArdle aren’t claiming the system is perfect, what they are arguing is that the proposed fix may wind up being worse than the problem because it doesn’t address the underlying causes of the problems with our current system.

    Which is a task that requires logic, which would discourage using appeals to emotion.Report

  4. Avatar Jaybird says:

    Additionally, there are perspectives that see this as a solvable problem.

    “Health care costs too much and the price keeps going up. Well, looking at basic economics, we see that price is a function of supply and demand. When demand grows larger at a rate greater than the rate of growth of supply, we see that we will have price increasing. Which brings us to a discussion of what the supply consists of, what the demand consists of, and what can be done to bring the rates of growth into a relationship where price is lowered and can remain lowered sustainably.”

    “CHILDREN ARE DYING.”

    “I beg your pardon?”

    “YOU SIT THERE AND TALK ABOUT ECONOMICS WHEN CHILDREN ARE DYING? WHAT KIND OF MONSTER RESPONDS TO CHILDREN DYING BY GIVING DEFINITIONS OF ‘PRICE’?”

    “I beg your pardon?”

    “WE WANT HEALTH CARE FOR PEOPLE LIKE JOHN AND JANE AND TOM AND SARAH AND WE WANT TO MAKE SURE THAT NONE OF THEM DIE FOR A REASON THAT IS AVOIDABLE! WE HAVE TOO MANY PEOPLE SOBBING AT TOO MANY GRAVESIDES!!!”

    “I beg your pardon?”

    And so on.

    From my perspective, the problems with health care are problems that are solvable. It requires a debate that will be somewhat wonky and will not be helped by a tendency to, here let me look up a quotation: “…grab hold of some of the saddest and most terrible moments of human history, and squeeze out importance and pathos like juice from an orange– and the only cost is that you are reducing human loss to fuel for careerism.”Report

  5. Healthcare and education are two areas I think need to be totally separated from government. E.D.’s attempt to be a centrist is exactly what fuels statism. Statists aren’t interested in being a secondary support player — they are interested in control. By compromisng with progressives, progressives win, because all they need is a foot in the door. We can argue about this back and forth until next Tuesday, but the proof is evident, and if this bill passes, you’ll see conclusive proof. A revolutionary change like the healthcare reform being proposed is nothing to be soft with — it needs to opposed with every free fiber our being. This is a change comparable to the 16th Amendment, it just won’t be as gradual.Report

    • Avatar E.D. Kain in reply to mike farmer says:

      Mike, that’s such a predictable response. I’m not trying to be a centrist, by the way. I think positions like yours – railing against “statism” for all its worth – are simply short-sighted and even more importantly far too easy. For one thing, comfortable in your knowledge that you’ll never actually have to experience or prove any of the actual implications of this oh-so-pure ideology, you can say whatever you please, however ludicrous or unlikely. Taking a more reasoned and reasonable approach (gasp! centrist!) is harder because it forces you to seek common ground on some things and make the system work. For instance, I think government should be involved in education, but not the federal government. But you can just say “No Government!” and leave it at that, knowing full well that your position will never be tested.

      Easy way out. Boring. Ho-hum. Why even bother?Report

  6. Your response is even more predictable. Make a caricature of me as a “no goverment” simpleton who hasn’t made a case against statism, or made a case for an efficient limited government. That’s all I do is make a case against statism, and neither of us have to wait to see the negative effects of statism — we’re living them. It’s just that your starting point for judging statism is a lot closer to the present, so it seems more normal. For you to cry statism, we’d have to have absolutely no freedom.

    But don’t get all out of sorts, it’s only a disagreement. You should support your centrist position if you think that’s the way to go — I don’t think it is. That’s what makes horse races.Report

  7. Avatar Bob Cheeks says:

    Mike’s right E.D. we are, indeed, “living” the effects of statism and the statists laugh at your reasonable and considerate approach. I believe Bro Lenin referred to centrists as “useful idiots.”Report

  8. Thanks, Bob — Anyone who respects human dignity and values liberty should be fighting against statist growth. It’s incredible to me that well-educated people can’t see what’s being taken from us, and what we’re leaving our children if we let it happen.Report

    • Avatar Jaybird in reply to mike farmer says:

      I will say that there is also precious little upside to posting one’s own plan for reform. It inevitably results in having it pointed out that one’s opposition does nothing except yell “no” without suggesting anything at all.Report

    • Avatar Bob Cheeks in reply to mike farmer says:

      Mike, my visits here to LOOG are singularly illuminating. I had no idea people think the way they do on this site. You’re right, it’s almost as if they have no concept of the pernicious effects of consolidated gummint, no history to analyize that reveals the inherent dangers of statism. It’s a phenomenon that springs from how people “feel” about things. These kids demand that the state cover the risks of existence…fascinating stuff! And, they are more than willing to give up liberty…liberty has no meaning for them, it’s an abstraction. Keep up the good work, dude!Report

  9. Avatar 62across says:

    E.D. –

    “Perhaps expanding Medicaid would have been more sensible and providing catastrophic coverage on a means-tested basis through vouchers or direct government insurance.”

    These are interesting ideas and worthy to be debated, but they aren’t alternatives to the health insurance reforms now being considered. There is the House bill as passed, the Senate bill as now written, there are some provisions being discussed that could still end up in the Senate bill or the reconciled bill and there is no reform at all. This is how it works when the leadership of the right behaves as it has.

    Freddie’s emotional entreaties notwithstanding, an honest opponent can validly argue that the current reform is bad policy, but they should also acknowledge that the only alternative on the table is the status quo. At that point, honest opponents can argue whether the current reforms enacted would get us to a better place from which to pursue the additional cost containment that I agree is needed or whether it is better to start again from scratch.

    With folks like Mike arguing that the modest government involvement called for in the current bills is a foot in the grave of the totalitarian state, I would argue that the incremental approach is the only one that is tenable.Report

    • Avatar Mike Farmer in reply to 62across says:

      I will state, unequivocably, that the status quo is better than the healthcare bills proposed. It’s not a matter of saying I’m right, you’re wrong — it’s a matter of looking at what government has done so far with healthcare and then asking them to do much more — that’s insanity. The mandate by itself is a violation of property rights. A free country doesn’t force it’s citizens to give money to private companies. Once you say that’s okay, then property rights mean nothing. There is more at stake than just healthcare. People give their freedom away through emotional appeals like Freddie’s — we have to find another way, or live with the fact that we’ve screwed future generations. One day there will be a backlash, and those who stood by compromising with power-mongers will not be considered favorably.Report

      • Avatar 62across in reply to Mike Farmer says:

        I realized just the other day that my willing obeisance to my state’s mandatory auto insurance rendered all my other property rights meaningless, so I’ve got all my stuff out on the curb by my house. Come check it out.

        I gave away my freedom to spend that $1200 a year on whatever I want, just to ensure that schmuck who texts while driving has the means to compensate me should he run me over on my motorcycle. Patrick Henry would be appalled. My freedom of speech and assembly are hanging by a thread.Report

        • Avatar Mike Farmer in reply to 62across says:

          The modern apathy of someone who doesn’t understand, or doesn’t appreciate, what he’s losing. You really have no idea, do you? It’s a shame.Report

          • Avatar 62across in reply to Mike Farmer says:

            You go ahead and tell yourself that you are the enlightened one and all who disagree with you are either apathetic or clueless, if it helps you sleep at night. If it makes you happy, continue to conflate the regulatory environment of the US with genuine oppression and hunker down for that impending backlash. I’ll be over here in the real world where I’m free to no longer engage with myopic ideologues like you.Report

  10. Avatar Art Deco says:

    There are plenty of good arguments for containing healthcare costs, and the concern that bringing in more government and more coverage will lead to higher costs is not only valid but logical and consistent.

    As households grow more affluent, the distribution of their consumption between various goods and services changes. Ditto whole societies. There is nothing necessarily pathological about changes in the consumption mix in this country in favor of a greater share to medicine and surgery, most particularly if the marginal utility of such services has improved over the last eight decades. What is problematic is the placement of such expenditures on autopilot by rendering them politically determined and subject to the troublesome forces of patron-client politics. We might construct a general public insurance program that obviates this problem. That would, however, public acceptance of high deductibles and the dismantling of extant patron-client relations already established between characters like Henry Waxman and sundry constituency groups. So it will not happen.

    About means tests: no more, please. They generate perverse incentives and administrative costs.Report

    • Avatar 62across in reply to Art Deco says:

      Honest question… what are you claiming as the perverse incentives of a means test?Report

      • Avatar Art Deco in reply to 62across says:

        If you separate the population into nominal categories and declare one set eligible and one not, you generate an incentive for people to liquidate their assets and abstain from earning. Universal benefits financed through proportionate assessments obviate this problem.

        The typical relationship that ensues between state and household will differ according to social strata. This is unavoidable, because criminality is correllated with impecuniousness (perhaps because impetuous people tend to commit crimes and perform poorly on worksites), so the poor will have more contacts with the public defender, legal aid bureaux, the child protection apparat, the sheriff, &c). That aside, I myself would prefer that the relationship between the state and households be a similar as possible across all social strata, and that the functions of mothers and fathers among the class of struggling wage earners not be partially absorbed by the educational or social work apparat. A welfare state that has a quite circumscribed menu of benefits but whose benefits apply to the whole populace (medical insurance, insurance for custodial care [nursing homes, asylums, &c.], school vouchers, and subsidzed tram service) would be a way from here to there.Report

  11. Avatar Bo says:

    Oh the (Alanis-style) irony: E.D. accuses Freddie of arguing against a caricature instead of the ‘real debate’; in response, various conservative and libertarian internet commenters show up to reaffirm that Freddie’s ‘caricature’ is the real debate.Report

    • Avatar Jaybird in reply to Bo says:

      No, not exactly.

      Freddie posted something about the meta-debate and people engaged Freddie about the meta-debate and Freddie was upset that they were meta-debating him rather than going back down to the real debate. This post was a discussion of the meta-debate and dealt with it as a meta-debate topic. The comments ought to be read as meta-meta-debate, at the very least.

      This comment brings us to meta-meta-meta-debate. If you would, instead, like a policy paper on how to fix health care, I’ll try to write one tomorrow. (Then I can keep it in a text file! When people complain about meta-debate or meta-meta-debate, I can post my policy paper. If people say that they dealt with this assumption I made or this assertion I forgot to give foundation for in previous threads, I can ignore them entirely.)Report

  12. Yes, then Bo shows up and says hardly anything at all — that reminds me of a caricature I met in 1987 — man, was he a caricature! Of course I had seen his reality many times before and knew what he was going to say before he said it, but he was some kinda caricature. We drank Wild Turkey ’til 2 in the morning, and not once did he say or do anything original, but he was a good enough fella — what else can a caricature do? At least there were no unpleasant surprises like one night in Kansa City when I met this orginalist who kept me so off-guard I was disoriented for days.Report

    • Avatar Bo in reply to Mike Farmer says:

      There’s a talent to saying hardly anything. I’d recommend trying to accomplish it in a couple short sentences rather than your current paragraph upon paragraph.

      I’ll start: Statiststatiststatist. Statist? Statist!Report

      • Avatar Mike Farmer in reply to Bo says:

        Sorry, dude, I have a lot of important shit to say. Does the word “statist” bother you? It’s funny how some people react to that word. It’s like — “Don’t be so harsh, man!”Report

        • Avatar Bo in reply to Mike Farmer says:

          I love the word statist. Mostly I love how by learning that one word people can completely skip learning anything about political science, philosophy, or health care, and still think they’ve got important shit to say about them. It’s a word that’s almost relevant to any subject one might encounter.Report

          • Avatar Mike Farmer in reply to Bo says:

            You have no idea how much I’ve learned about those subjects, sport. Shoot, I’ve even read big books all the way through. And, because I have learned, I’m a hardcore anti-statist. I mean hard- hard-core. You’ll figure it out one day.Report

  13. Avatar Cascadian says:

    I think I’m probably closest to E.D.’s position. I don’t want national health care. I want more freedom to develop State solutions without interference. Going for a national system requires too many compromises with too many interests. Now Freddy can cry, “Sure, in the NW, you’ll have a great program but what about all those people in Georgia?” Well, being true to Freddies sorrows, I don’t care. Let Texas try the free market. Let Cheeks demand that his doctors be educated at Bob Jones. Let everyone find their personal hell and then figure it out from there. Yes, there will be casualties, but the end solution will be better. I’m willing to admit to accepting those casualties.Report

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