Frankly, all though I strongly oppose the current efforts at “healthcare reform”, this line of criticism seems like a red herring. We already have publicly provided healthcare for the elderly- Medicare. A big part of the problem with exploding healthcare costs is that the kind of rationing of end of life care that’s being forecast here has NOT happened. This article explains why- it’s because older Americans are a formidable, well financed, political bloc.

Now, I suppose one could argue that if we commit to financing more and more people’s healthcare through taxation and federal administration, the costs will continue increasing exponentially until there is eventually enough pressure pushing back against the AARP and other senior’s advocacy groups. But that’s not what is being said here- instead there’s a complaint that ‘Obamacare’ will directly bring these changes to the provision of healthcare for the elderly (which, again, is not going to be administered through the new program but will continue to be through Medicare.)

My guess is that part of the issue with high costs for end of life care in the US is cultural. Michael, I’d be interested, for instance, on a comparison between US and the Netherlands since my understanding is that euthanasia of the elderly is not uncommon there and that while there’s not a direct mandate for it, there is a cultural tendency to accept it. There seems to be a very large disparity between what we think is appropriate for eldercare here vs. virtually every European nation, and without restricting freedom of choice I’m not sure how we could get there from here (and without changing it, there’s no way we’re going to see the cost reductions that the proponents of universal coverage or single payer are claiming.)

CStanley :
Frankly, all though I strongly oppose the current efforts at “healthcare reform”, this line of criticism seems like a red herring. We already have publicly provided healthcare for the elderly- Medicare. A big part of the problem with exploding healthcare costs is that the kind of rationing of end of life care that’s being forecast here has NOT happened. This article explains why- it’s because older Americans are a formidable, well financed, political bloc.

Mute point if the Majority Legislative votes it in and the Far Left Liberal President signs it into law.

Liberalism has no soul. Only an ideology with no soul, no moral compass, can advocate such a plan.

and

I agree, Michael. The “progressive” vision of government run health care is rooted in an ideology that not only lacks a moral compass. It contributes to a cycle of state-sanctioned immorality.

No, the moral compass of the left and the moral compass are simply different. Shockingly enough the disparate political groups have different priorities. Demonizing the other side may score you political points with the hard right or hard left and gain you the occasional guest post in one of the fever swamps, but it is not honest and takes the debate nowhere constructive.

In other words, faceless bureaucrats in Washington — not your family — will decide whether your grandparents live or die.

and

Obama means that, ultimately, federal health bureaucrats would decide which grandmothers get hip replacements.

For the vast majority in America it is already a faceless bureaucrat that makes that determination, though they don’t generally live in DC.

Some people would say that morality in western Europe (and the United States) has continued to deteriorate under social democracy

and some in every generation say that about the generations that follow for as long as man has been man. One of my favorites,

Children today are tyrants. They contradict their parents, gobble their food, and tyrannize their teachers.
S-

This term end-of-life care is important. My family just went through this issue. Mom, 78 yo w/bad heart, had a sudden illness and could no longer breathe on her own. And we totally had the option to keep Mom alive, on a respirator, unable to speak for as long as she could be sustained. Quality of life would have been zip compared to how she had been living. I could see some choosing life no matter what–no matter what suffering was imposed on her. But luckily Dad was not one of those and let her go peacefully. In this situation, when suffering outweighs quality of life isn’t it just selfishness to keep them around? I think if a family wants to fork over the money on their own go for it. But why should the rest of us contribute to someone’s suffering.

“Regardless of what moral philosphy they ascribe to, the vast majority of leftists are not evil people, just misguided.”

Yeah, very open-minded of you to be so precise in your sweeping and insulting generalizations.

I’m not responding to the rest of your post. If you are going to voice your concerns about left-wing agendas this way, then I am going to continue supporting them nevertheless as if your criticism was never raised, and so should all left-wingers. I’m not bothering to address any claims or accusations that are not only laughably open-ended and sweeping, but also in bad faith. I’m not discussing anything within such parameters.

Kastanj: If I remeber correctly, I think this the second time that you’ve reacted very strongly to me calling progressives misguided. You’d think that misguided was a a dirty word, when it’s just another way of saying that I think progressives are wrong about so many things. That doesn’t mean that I think they’re wrong about everything. Oftentimes, progressives have really great ideas. Many progressives are smart, talented, dedicated people. I have progressive relatives and friends. Some progressives are even Ohio State football fans, so they can’t be all bad.

But I do think they tend to be fundamentally wrong about the most important questions of the day. If that’s sweeping, we were talking about a sweeping topic: the connection between ideodology and moral philosophy. On more specific topics, I’m happy to credit progressives for the valid and convincing arguments they make.

My political orientation would probably be best described as classically liberal, which is quite far removed from contemporary progressivism. If I thought that progressives were right even close to half the time, I wouldn’t be a classical liberal. I’d probably be a DNC member.

Patrick,

On what basis would the different political priorities be based?

For many and sundry reasons, and those differ by individual. For some they are religiously based, for some philosophically based, for many based on what their parents taught them, there are simply too many to list them all. I have seen no evidence of difference in this based on politics. What I have seen is someone making sweeping generalizations about how the political opposition chooses its priorities (one with morals and the other without).

if you acknowledge that political priorities are (or should be) rooted in moral philosophy, then your emphasis on priorities is a distraction

Our priorities are informed by our ethics.

In some respects, elements of the Left really did attempt to demonize GW Bush…

True enough and the same was done/is being done to Clinton and as you noted is being done to Obama.

The first point would suggest that liberal/progressive ideology tends to be amoral, not necessarily immoral (or evil).

I fail to see how painting your political opponents as amoral is any better than painting them as immoral.

Regardless of what moral philosphy they ascribe to, the vast majority of leftists are not evil people, just misguided.

and

The 19th, early 20th century German social democrats had no intention of laying the groundwork for Nazism, but they did

Only by failing against very long odds. The level of punitive measures taken against Germany following WWI played a much greater role in laying the groundwork for Nazism than did anything else.

So, is it a good thing, a bad thing, or does it depend, when bureaucrats — whether they work for insurance companies or the government – make life & death decisions for individuals and families?

It is not a distinction between our current system and any proposed system and so is not a reason to prefer one over the other. Pretending that it is present in one and not in another is not honest.

Anyway, I was not born in France in 1921.

Nor were you born in 5th century BCE Greece, but the message still holds.
Ethical change ≠ ethical degeneration.
Our ethics in the US and Europe have indeed changed since WWII. In many (IMO most) respects these changes are for the better, particularly if you are female or a minority. For instance it is no longer permissible to beat your wife or to have sex with her if she declines, both big changes from 1950s America and I would say an improvement in our nation’s moral/ethical character.
I can’t speak for you but from my experience what most people mean when they talk about moral decay is movement away from religious ethics toward secular ethics and in their calculus secular ethics = no ethics (or at best inferior ethics). I can in no way agree with this proposition.

Of course, they think my compass is lacking (or broken).

Or, like me, they simply think that your compass is different and that we should debate the issues on their merits without impugning the character of the opposition.
Christine

I have to agree with Patrick, that the use of the word misguided certainly shouldn’t be offensive.

How about amoral?

An example in application would be sex education for teens which focuses heavily on contraception instruction and leaves out or glosses over abstinence as a preferred option. Many people advocate that approach, but I’d criticize the ‘amorality’ of it because this is a case where I think morality actually helps promote the best outcomes

I disagree that the example you give is an example of amoral policy. It is an example of a policy with different moral foundations. It is not the same moral grounding as ’sex outside of marriage’ = bad, but it is not amoral. The moral grounding in this approach is responsibility. Young adults (and adults) should be responsible in their sexual decisions. In this case responsible means using protection when you have sex in order to minimize unwanted pregnancy and disease.
BTW, I think that most sex ed programs cover abstinence it is contraception that is more often glossed over (to the detriment of those taught).

Jeb wrote, “For some they [political priorities] are religiously based, for some philosophically based, for many based on what their parents taught them, there are simply too many to list them all.”

You’re agreeing that people’s underlying moral philosophies (or ethical orientations) often play a significant role in defining their political priorities, but then you take a very neutral stance toward different moral outlooks/philosophies: “I have seen no evidence of difference in this based on politics” and “No, the moral compass of the left and the moral compass [of the right] are simply different.” Your relativism would seem to extend pretty far, to the point that certain moral foundational tendencies work for the left while other moral foundational tendencies work for the right – both are just fine, to each their own.

That’s fine, but I don’t subscribe to that degree of moral relativism. I was pretty clear that progressives usually think of themselves as moral persons (not as amoral), but that I see classical liberalism as being guided by a better moral compass, not just a different one. For those progressives who are not heavily oriented toward relativism, many of them would question my moral compass. I don’t see that as impugning someone’s character, either way. It’s a philosophical disagreement. Pretending that it is present in one and not in another is not honest.

Jeb wrote, “It is not a distinction between our current system and any proposed system and so is not a reason to prefer one over the other.” Either I’m confused, or you’re just avoiding the issue. Yes, the need for rationing of government-provided health services is very much part of the Obama plan. Why did Obama make the point about “society” making health care decisions in the “aggregate”? Then you wrote, “Pretending that it is present in one and not in another is not honest.” Okay, presumably that applies to you, too. So, is it good, bad, or it depends, when bureaucrats make life and death health care decisions for families?

“What I have seen is someone making sweeping generalizations about how the political opposition chooses its priorities (one with morals and the other without).” I’ll plead guilty to making generalizations. It’s hard to avoid when talking about moral/political philosophy in a blog comment.

Jeb wrote, “The level of punitive measures taken against Germany following WWI played a much greater role in laying the groundwork for Nazism than did anything else.” Many countries have suffered worse economic conditions than did Weimar Germany, yet did not degenerate into collectivist totalitarian states, so we would need to look for other causes besides economic-related causes. If you’re suggesting, for example, that the punitive measures injured German pride, etc., that point would not be inconsistent with Hayek’s thesis that 19th, early 20th century German collectivism laid the groundwork for Nazism, including by contributing to German militarism.

I agree with you that moral evils like racism and violence against women have thankfully ebbed in many respects, but I don’t give much credit for that to the Left. If anything, social welfare partonage politics has not only failed to deliver on its promises to African Americans. They have been moral hindrances. I also do not think it was ever morally “permissible to beat your wife or to have sex with her if she declines, both big changes from 1950s America.” Of course, there’s a lot of other factors besides race and sexual relations we’d need to tally on the moral scorecards to gauge whether Americans/Europeans are more or less moral than they were in the past.

Yes, post-WWII crime rates in W. Europe have been relatively low. Yet, given post-WWII prosperity (also in spite of social democracy), I’m not sure that these societies were really put to the test like were previous generations. Social welfare policies can contribute to dependency cycles. What happens when the flow from the spigot is reduced?

Another way to look at morality: Is the society reinvigorating itself? Birth rates, family structure, cultural confidence. If Western European societies decline and are overrun in the future, that is a form of moral failure.

Jeb, the moral debates are often paramount. A society in moral decline cannot survive, at which point “debating the issues on the merits” (i.e. the detail-oriented policy discussions which you seem to prefer) becomes moot.

Your relativism would seem to extend pretty far, to the point that certain moral foundational tendencies work for the left while other moral foundational tendencies work for the right – both are just fine, to each their own.

It doesn’t take much moral relativism to navigate the mainstream American political spectrum without defining political opponents as either immoral or amoral. I disagree with much of your politics that I have seen and perhaps disagree with the ethical underpinnings and we should be able to discuss that openly and honestly without dismissing the other as either immoral or amoral.

but that I see classical liberalism as being guided by a better moral compass

Fine. That is far different than labeling your opposition amoral.

Many countries have suffered worse economic conditions than did Weimar Germany, yet did not degenerate into collectivist totalitarian states

and many countries have adopted Social Democracy also without degenerating into Nazism or anything close. Without the punitive measures that virtually guaranteed the failure of Weimar Germany and fanned German nationalism it does not seem likely the Nazi party would have risen.

I agree with you that moral evils like racism and violence against women have thankfully ebbed in many respects, but I don’t give much credit for that to the Left.

Who then do you credit?
Who led the struggles for civil rights for minorities and women?
Whose words and deeds changed societal opinions on the rights of women and minorities?
In the political context of their day were they progressives or conservatives?

I also do not think it was ever morally “permissible to beat your wife or to have sex with her if she declines

Both were legally permissible in the US in the 50s. You could not be prosecuted for raping your wife in the US through much of the 70s. It is still a lesser crime than raping a stranger in most states.

Yes, post-WWII crime rates in W. Europe have been relatively low. Yet, given post-WWII prosperity (also in spite of social democracy)

How can you separate their economic success from their form of government and then use that prosperity to minimize their low crime rate?
All of the world’s most powerful economies, the nations with the highest living standards in the world are all mixed economies (several of them Social Democracies). It seems to be a rather successful model in terms of economy, health, and crime.

Another way to look at morality: Is the society reinvigorating itself? Birth rates, family structure, cultural confidence.

Birth rates tend to drop with increases in wealth and education making it a tenuous ethical compass.
Family structure as judged by whom?
How is cultural confidence a compass for morality? If you believe something strongly enough is it more right?

A society in moral decline cannot survive

Setting aside the veracity of that statement, you have not shown us to be a society in moral decline.

Of course, there’s a lot of other factors besides race and sexual relations we’d need to tally on the moral scorecards to gauge whether Americans/Europeans are more or less moral than they were in the past.

Lay it out then, in what ways are we a less moral society now than we were in the 1950s?

“It doesn’t take much moral relativism to navigate the mainstream American political spectrum without defining political opponents as either immoral or amoral. I disagree with much of your politics that I have seen and perhaps disagree with the ethical underpinnings and we should be able to discuss that openly and honestly without dismissing the other as either immoral or amoral” and “‘but that I see classical liberalism as being guided by a better moral compass’ Fine. That is far different than labeling your opposition amoral.”

I’ve clarified above that it is too strong to say that progressivism has no moral compass. That is partially an emotional reaction to hearing about possibilities like the government making life & death health care decisions for families, a precedent which I would consider to be immoral (not just amoral) on any level – emotional, rational, or otherwise. Sometimes when writers are trying to grab the reader’s attention, they will use bold declaratory statements. These more “sweeping” statements often require much less verbiage and sound better to the ear than more precise statements that have to be qualified a dozen different ways. Also, writing something like “progressives have no moral compass,” is like aiming for the sun to reach the moon, whereas writing, “progressives tend to be guided by a faulty moral compass,” is so cautious it is easy to ignore.

Jeb wrote, “and many countries have adopted Social Democracy also without degenerating into Nazism or anything close. Without the punitive measures that virtually guaranteed the failure of Weimar Germany and fanned German nationalism it does not seem likely the Nazi party would have risen.” German society in the late 19th, early 20th century became increasingly more hostile to liberal capitalism, in the process going further down the road of collectivist economic planning, muscular scientism, etc., than other Western European powers. Hayek argued that Germany was 2-3 decades ahead of most of Europe. After WWII, the trend toward heavily centralized economic planning slowed down and was eventually reversed in the UK and elsewhere (although social democracy still ruled), but things might have been different if the Cold War had not changed the dynamics (for exmaple, Kruschev’s “secret speech”).

Likewise, we do not know how prosperous the U.S. and Western European economies would have been with less social democracy. As you said, “all of the world’s most powerful economies, the nations with the highest living standards in the world are all mixed economies (several of them Social Democracies).” The post-WWII U.S. political-economy has leaned more toward liberal capitalism than has most Western European versions, and the U.S. has had by far the most successful, dynamic economy in the world. I don’t separate the economic success of the U.S. and European social democracies from their forms of government. I say that the elements of liberal capitalism that they did preserve were very beneficial, while the social welfare policies have tended to be net negatives. I did concede the possibility that higher degrees of social welfare MIGHT contribute to lower crime rates, but at what cost?

Here’s an analogy: a 28 year old still lives in his parents’ nice house in the suburbs and regularly receives generous allowances from those parents, while working on and off part-time jobs. I agree that this fellow is less likely to commit a crime than if he were forced to fend for himself, but how do look at this arrangement in moral terms?

I think part of our disagreement relates to the etymological separation between morality and moral. At one time, these words were closely linked (in the French, le moral and la morale), but not so much anymore. One of my points is that they should be seen as closely linked. I agree that there does not appear to be much evidence that social democracy tends to generate greater immorality in the sense of individual property and violent crimes; but I do think that it erodes the moral fabric (or morale) of a society.

You wrote that “birth rates tend to drop with increases in wealth and education making it a tenuous ethical compass.” It is true that economic prosperity can be correlated with declines bith rates in the U.S. and Western Europe in the 19th and 20th centuries, but we’d need to isolate the variable to really evaluate it. Some countries with very low birth rates today include Greece, Hungary, Bulgaria, Ukraine, Belarus, Russia, and Poland–not exactly models of prosperous post-WWII social democracies. Historically, even advanced industrial economies like the United States needed higher birth rates than they need today to produce a certain number of persons who would survive to adulthood, etc., so we would expect these numbers to decline as health conditions improved, but the extent to which they have declined over time varies widely among the richest economies. For example, the U.S. has relatively high birth rates compared to the E.U. Those states with very low birth rates will have to rely on massive immigration to make up the difference, which has the potential to fundamentally transform their societies; or they will have to deal with a very nasty inverted demographic pyramid, prior to becoming depopulated and eventually colonized. Yes, I would consider that a grave moral (or morale) crisis. What do we do about it? That’s at the crux of the philosophical debate that’s been waging some a long time now.

Similarly, you ask, “Family structure as judged by whom?” As judged by long-term international Darwinism. And “How is cultural confidence a compass for morality?” Without cultural confidence, the culture is overrun by another culture. One of the main purposes of morality is to promote the overall well being of all the individuals who are part of a society. If large segments of that society are guided by a moral compass, which tells them that their society is no better than any other society, would that moral compass help to promote the overall well being of the individuals in that society? I say no.

I have other concerns about the effects of “progressive” ideology on morality/morale, but to do them justice, I might need to write a full post on the subject at some point. After all, it is a rather ambitious project to “lay out” a detailed, comprehensive argument that attempts to show how/why U.S. and Western European society have been in moral decline for x-number of decades. I’m not even sure that is the case. My original points were that “some people [not necessarily I] would say that morality in western Europe (and the United States) has continued to deteriorate under social democracy” and that social welfare policies and nanny statism in general CONTRIBUTE – on balance – to an erosion of morality (or morale). Fortunately, the Left has not had a complete free hand to push the U.S. and Western Europe even further toward social democracy and/or socialism. If enough positive forces are offetting the negative effects of the social welfare policies that were implemented, then it is possible that morality improved overall in these societies in spite of the social democratic influences.

I’ve clarified above that it is too strong to say that progressivism has no moral compass.

Thanks for that.

That is partially an emotional reaction to hearing about possibilities like the government making life & death health care decisions for families, a precedent which I would consider to be immoral (not just amoral) on any level

Some one in some bureaucracy will be making decisions on what coverages are allowed and what coverages are disallowed for all but the very wealthy regardless of what system we choose. How is a government bureaucrat making health care decisions for individuals morally inferior to a HMO bureaucrat making health care decisions for individuals?

The post-WWII U.S. political-economy has leaned more toward liberal capitalism than has most Western European versions, and the U.S. has had by far the most successful, dynamic economy in the world.

The US industrial base was built up by WWII and most of Western Europe was decimated by WWII. This fact cannot be separated from our tremendous post WWII success. If we had all started from a level playing field of industrial, natural, and human resources can any of us say with confidence where we would all be now?

I say that the elements of liberal capitalism that they did preserve were very beneficial, while the social welfare policies have tended to be net negatives.

I would say that both are potential net positives and that the real argument to be had is how much of each is ideal for any given society.

It is true that economic prosperity can be correlated with declines bith rates in the U.S. and Western Europe in the 19th and 20th centuries, but we’d need to isolate the variable to really evaluate it.

Difficult to do, but I think far less difficult to do than to relate it to the morality of the society.

As judged by long-term international Darwinism.

1) How does one make that calculation?
2) How does that leave it as a marker for societal morality?

Without cultural confidence, the culture is overrun by another culture.

1) But the hallmark of American culture has been absorbing other cultures and blending them into our own (quilt, melting pot, choose your own analogy) rather than holding fast to a preset culture. In this arena the youth and nature of American culture make it more resilient to immigration than Western European cultures (willow and oak or again choose your own analogy).
2) It is also possible to have too great a confidence in ones own culture.

“some people [not necessarily I] would say that morality in western Europe (and the United States) has continued to deteriorate under social democracy”

My point is that some always have and likely always will complain about the moral decay of society because the ethics of any living society will change over time. In order for this argument to carry any weight there needs to be a rubric and designing that rubric might be even more challenging than evaluating it.

After all, it is a rather ambitious project to “lay out” a detailed, comprehensive argument that attempts to show how/why U.S. and Western European society have been in moral decline for x-number of decades.

There we are in complete agreement.

Jeb wrote, “Some one in some bureaucracy will be making decisions on what coverages are allowed and what coverages are disallowed for all but the very wealthy regardless of what system we choose. How is a government bureaucrat making health care decisions for individuals morally inferior to a HMO bureaucrat making health care decisions for individuals?” It seems like you and I have much different perceptions of how these decisions are made now, as well as how they would be made in the future under a nationalized health care system that includes Obama’s “independent group” giving guidance on policies and government bureaucrats/computers implementing those guidelines.

Today, we often have to wrangle with health insurance companies to get them to cover what we think they’re supposed to cover, etc., which requires us, or more often the provider, to interact with insurance “bureaucrats” who are trying to keep costs down for their companies, sometimes using questionable tactics. Also, insurance companies have been known to kick people out of their plans, or to not offer coverage to people with pre-existing conditions.

What we don’t have is insurance “bureaucrats” making decisions based on your estimated remaining life expectancy – whether you are worth the expense and risk, etc. Right now, if you’re a 45 year old with a bad heart, the insurance company would much prefer not to have you covered by one of their plans. Under ObamaCare, the government would prefer that you die as soon as possible.

Medicare is not set up for cost containment – either via market forces or by rationing – which is one the reasons that it is distorting the market. If you attempt to greatly expand the public component and still keep costs in line, however, the rationing would also have to apply to patients now or soon to be covered by Medicare. Presumably, that’s part of why Obama was taking about end of life care and suggesting that his grandmother would have been a bad investment.

I also made the point that having the government make life & death health care decisions for families would be a morally corrupting enterprise. If this process corrupts insurance “bureaucrats,” that’s bad; but it’s much worse when it has a corrupting influence on elected officials and civil servants.

“The US industrial base was built up by WWII and most of Western Europe was decimated by WWII. This fact cannot be separated from our tremendous post WWII success. If we had all started from a level playing field of industrial, natural, and human resources can any of us say with confidence where we would all be now?” That is a good point, Jeb. But, even if we grade on a curve, I think you’ll find that the U.S. economy has had the best post-WWII performance. Besides, European collectivism played a big role in fomenting WWII. The self-destructive aspects of collectivism cannot be decoupled from its other aspects. Indeed, collectivism has a history of unleveling playing fields – for the worse. And, yes, I understand there was a big difference between pre-war Western European collectivism (socialism/facsism) and the post-war mixed economies under social democracy. That’s partly why the E.U. nations have tended to perform as well as they have economically. But my original concern was about what happens to a nation’s moral fabric (or morale) when the see-saw tilts back toward collectivism.

International Darwinism: you asked, “1) How does one make that calculation?; 2) How does that leave it as a marker for societal morality?” You’re right, Jeb, for the most part, it’s pretty difficult to evaluate the relationship between dominant moral philosophies within a society and indicators like birth rates and family structure, using social scientific calculations. Of course, history will do the “calculations” for us. I’m not saying a society that flurishes is necessarily moral, but my contention would be that nations that have dominant moral cultures (and hence public policy regimes) that undervalue the importance of family creation and the traditional nuclear family structure, and which teach people their society is no better than any other, will decline over time. Yes, it’d be very difficult to prove that scientifically, but some very important matters require us to venture beyond what can be explained and/or calculated by science.

Jeb wrote, “But the hallmark of American culture has been absorbing other cultures and blending them into our own (quilt, melting pot, choose your own analogy) rather than holding fast to a preset culture. In this arena the youth and nature of American culture make it more resilient to immigration than Western European cultures (willow and oak or again choose your own analogy).” I agree, but I feel that the aspect of American culture you describe is undermined by multi-culturalism, anti-Americanism, identity politics. I believe that American exceptionalism has been fueled in part by immigrants coming from all over the world to participate in the American experiment, bringing their talents, labors, cultural experiences, different ways of doing things, etc. But for much of American history, the emphasis was on assimilation. Immigrants came to America to pursue opportunities, but also because they believed in the American dream. These new Americans helped to shape the dominant culture(s) and subcultures, point it in new directions, but in turn it shaped them, too. The end result was a distinctly “American” culture that was always evolving but not splintered into different identities. Americans were very confident about what it meant to be part of the American experiment.

I also agree with you that “It is also possible to have too great a confidence in ones own culture,” especially if it means that people within that culture tend not to be self-reflective, self-critical. I don’t think that the so-called western world tends to have that problem these days, do you?

Finally, I agree to with your point that, “some always have and likely always will complain about the moral decay of society because the ethics of any living society will change over time. In order for this argument to carry any weight there needs to be a rubric and designing that rubric might be even more challenging than evaluating it.” But, again, by the time that someone were able to design a rubric that could evaluate the moral health (or morale) of a society, it might be too late.

Some one in some bureaucracy will be making decisions on what coverages are allowed and what coverages are disallowed for all but the very wealthy regardless of what system we choose. How is a government bureaucrat making health care decisions for individuals morally inferior to a HMO bureaucrat making health care decisions for individuals?

If I can take a stab at this one…

I mostly agree with Patrick’s response of how a govt bureaucracy would be worse (generally speaking, that’s because govt by it’s very nature has more power than a privately operating company’s bureaucrats.)

But I would say it’s only a matter of degree of difference, and that neither situation is ideal. However, when you look at why the status quo is not ideal, it’s because there’s little to no market pressure bearing on the health insurance providers. Since that’s obviously a problem, and it’s become much more of a problem in recent years, shouldn’t we look at what factors have so weakened the market forces and determine if any policies might reverse that trend?

My layperson’s analysis of that question leads me to several observations: first, the degree of nonresponsiveness to consumers has risen proportionally with the increase in size of insurance companies via mergers and acquisitions. Second, our current system which ties insurance heavily to employment has created far more problems than it solves (in fact the main problem it was meant to solve is no longer an issue, as the policy came into play during the time of govt mandated wage caps, so employers sought to offer increased benefits and the govt decided to encourage this with the pretax option for provision of health insurance.) But clearly, people are much less likely to shop for a private health care plan if one is available through their employer, and the employer is not in a position to shop for the best plan for each of his/her employees (nor is it even logical that all in that group would be best served by the same plan.) This alone removes a tremendous amount of market induced responsibility from the insurance companies.

The employment based system also, of course, leads to problems with portability of insurance when jobs are lost or left.

A third factor is the current state based insurance system which doesn’t allow for shopping (and competition) across state lines.

Fix these three points- stop allowing megamergers which create a near monopoly in some areas, decouple insurance from employment by levelling the tax playing field (and allowing people to enter pools that are based on other associations besides work, in order to get competitive rates on individual policies), and federalize the oversight of health insurance to allow for interstate competition- and you’ve already enabled far more cost containment than the current proposal will by restoring some competition.

Health care will never be a perfect model of free market capitalism, by any means. For one thing, demand is quite inelastic while supply remains quite finite. But much of the cost escalation has come from current policies which remove the insurers even more from consumer choice than they need be- which allows them to make decisions which are often not in the consumer’s best interest. If people had more direct purchasing power, it would be a step in the right direction.

In addition to all of this, of course, other conservative suggestions through the years bear consideration- tort reform, health savings accounts, etc. And finally, one thing that hardly ever gets mentioned at all- address the supply side issues by increasing the number of physicians, increasing the duties which can be performed by PAs, and stop the cartel policies that require CONs for the construction of new hospitals and medtech facilities, which virtually guarantee that these providers operate without competition.

I dunno, maybe it’s me, but I can’t fathom why all of that doesn’t make more sense than replacing one set of bureaucrats with another group which will have even more power over both the providers and the consumers of healthcare.

Regardless of the costs involved, what of the Civil liberties involved? If we reduced end of life care for the sake of a buck, how is that upholding the right to life, if an individual would prefer to choose to try a procedure that may extend their life? Again, regardless of cost, as citizens of the United States, we have the right to life that protects an individual from the government of the nation in which they reside. In this case, *the Government* would be deciding who lives or dies, even if it is against that individuals will. Civil liberties are in place to set limits for government so that it cannot abuse its power and interfere unduly with the lives of its citizens. I am not saying I have the answer, or that what we have now is perfect but as I see it, most Americans have the best possible shot at attempting to extend their lives if they so choose under the current system. A single payer Governement run system will only allow politics and special interest into this mix, whichto me, seems like a recipe for worse care.

‘However, when you look at why the status quo is not ideal, it’s because there’s little to no market pressure bearing on the health insurance providers. Since that’s obviously a problem, and it’s become much more of a problem in recent years, shouldn’t we look at what factors have so weakened the market forces and determine if any policies might reverse that trend?”

Right, I do think that different insurance companies should be able to compete in the free market more than they are now. Right now, as far as I know, you cannot go outside your state. Like anything else, in the free market, if some private company can provide a better quality product, at a better price, so be it. However, if this were allowed, just to think ahead… If the government just so happens to “give money” or “bailout” a ceratain private insurance company down the road, we should be careful of that private company morphing into a trojan horse if it were taken over by the government.

Hasnt anyone by now figured out that the US Government is just a bloated, oversized, highly inefficient CORPORATION that has no soul and takes what it wants and gives you a shoddy product?

The only difference is they dont have to make a profit and if they cant pay their bills then they just borrow more money to keep paying their bills.

Hasnt anyone figured out that if any company, any small business, large business or Corporation ran its bidness like the US government they would not only be bankrupt but every person who ever held a job in that company would most likely be in JAIL.

Thats what you want running our health care now.

Like they havent screwed up ENOUGH already?………sheesshhhhh!!!

Shooting off the hip like a well known president stated is alot better than not replacing the hip and just give her pain killers as recently mentioned aimed toward some ideas or intentions of this new legislation.