The Bible Answer Man is in the middle of an extended, two day interview of Jay Richards, about Jay’s new book, Money, Greed and God: Why Capitalism is the Solution and Not the Problem. It’s the most in-depth discussion of the book I’ve encountered on the internet, and Hank Hanegraaff’s introduction alone makes it worth a listen. Yesterday’s interview is here. Today’s interview will stream here.
History shows us that civil rights can exist as nothing more than legal fiction. Take, for example, the right to vote. Although suffrage was extended to African-Americans under the Constitution in 1870, that right was little more than a nice idea until the Voting Rights Act of 1965. With many activists and politicians calling for America to recognize the “right” to health care, it is well worth looking at what this means. Making promises that cannot be met is a betrayal of the public trust, and the integrity of the government depends on its ability to hold to its word. In many other economically-developed countries, the “right” to health care coverage exists, and nearly everyone is enrolled in some sort of insurance or public plan. Unfortunately, coverage is not the same as health care procedures. Many governments insure nearly everyone, but cannot deliver the health care that those insured people need. These governments leave a broken promise in the place of the right that exists in their laws.
Take serious diseases, for example. Although Great Britain professes to treat health care as a right, there is no right to an oncologist. In fact, John Goodman of the Cato Institute reports that only 40% of British cancer patients even see an oncologist. This has had devastating results on their health: 70% more cancer patients in Great Britain die than in the United States. In addition, wait times for free health care in that country are so extreme that 20% of colon cancer cases diagnosed as curable are incurable by the time treatment is available. Great Britain is not the only country that falls short when it comes to treating major health problems. The Heritage Foundation recently created a laundry list of places where Americans, despite lacking the “right” to treatment, still have better health outcomes than other countries with universal health care: “Breast cancer mortality is 52 percent higher in Germany than in the United States, and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the U.K. and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher. Breast cancer mortality is 9 percent higher, prostate cancer is 184 percent higher and colon cancer mortality among men is about 10 percent higher (in Canada) than in the United States.” Whether it is cancer, pneumonia, heart disease, or AIDS, Americans have better chances at surviving than Europeans and Canadians. If enshrining a right to health care in the law only eases consciences and not human suffering, then it is a lie on the part of government.
One of the major reasons for America’s advantage in treating major diseases is that our patients have far more access to modern medical technology and diagnostic procedures than other countries. The Heritage report shows that Americans are more likely to get mammograms, pap smears, colonoscopies, and PSA tests than Canadians. Americans have better access to drugs than Europeans: “44 percent of Americans who could benefit from statins, lipid-lowering medication that reduces cholesterol and protects against heart disease, take the drug. That number seems low until compared with the 26 percent of Germans, 23 percent of Britons, and 17 percent of Italians who could both benefit from the drug and receive it. Similarly, 60 percent of Americans taking anti-psychotic medication for the treatment of schizophrenia or other mental illnesses are taking the most recent generation of drugs, which have fewer side effects. But just 20 percent of Spanish patients and 10 percent of Germans receive the most recent drugs.” We also have far more CT scanners, dialysis machines, and MRI machines than Europeans and Canadians, despite the fact that the first two pieces of technology were developed in Great Britain. Here again, the abstract right to health care does not translate into meeting the needs of the sick. It is far more honest and humane to establish a system that delivers health care than to write laws that promise it.
Waiting for necessary procedures also has a lethal toll on the populations of Europe and Canada. Greenwood writes that, “During one 12-month period in Ontario, Canada, 71 patients died waiting for coronary bypass surgery while 121 patients were removed from the list because they had become too sick to undergo surgery with a reasonable chance of survival.” The Canadian Supreme Court recognized this problem. Overturning Quebec’s ban on private health insurance, Chief Justice Beverly McLachlin stated: “The evidence shows that, in the case of certain surgical procedures, the delays that are the necessary result of waiting lists increase the patient’s risk of mortality or the risk that his or her injuries will become irreparable. The evidence also shows that many patients on non-urgent waiting lists are in pain and cannot fully enjoy any real quality of life.” Any time that a “right” to health care means artificially lowering or eliminating its costs, there will be too much demand for too few services. There is nothing moral about a system that trades in real efficiency and comfort for imagined equality.
Even where America does recognize the right of the poor and the elderly to health care, it tends to restrict rather than liberate the sick, as Sue Blevins documented in 2003: “Before Medicare was passed, seniors were promised that the program would not interfere with their choice of insurance. However, existing rules force most seniors to rely on Medicare Part A to pay their hospital bills — even if they can afford to pay for private insurance. Additionally, today’s seniors and doctors must abide by more than 100,000 pages of Medicare rules and regulations dictating what types of services are covered or not under the program.” Even the privacy and family rights of patients in the “care” of the government are violated in the name of the right to health care: “Under Medicare rules established in 1999, patients receiving home health care are required to divulge personal medical, sexual, and emotional information. Government contractors — mainly home health nurses — are directed to record such things as whether a senior has expressed ‘depressed feelings’ or has used ‘excessive profanity.’ If seniors refuse to share medical and lifestyle information, their health care workers are required to act as proxies. This means total strangers will be permitted to speak for seniors.” Rights cannot contradict each other. The “right” to health care means a loss of the rights to privacy, family, and consumer choice. This is no right at all.
Health care is not a right. Since we have such a murky understanding of what rights are in today’s world, many governments still pretend that it is, only to see increased regulation and bureaucracy stifle the delivery of good care. Outdated technology, rationing of time and services, and intrusive government follow the “right” to health care. Declaring health care to be a right puts it under the government’s supervision. Unfortunately, health care itself can never be a right. Coverage might be, as evidenced by how many countries have insurance rates near 100%, but there are still limited health care resources out there. The best that we can do is to let them be distributed in the most efficient way possible, which remains the free market. Trying to follow in the steps of Europe and Canada by making health care a civil right is a nice intention, but it will never amount to anything more than another broken promise by the government.
[UPDATED BELOW] The DNC has released a political commercial and an email warning Americans about dangerous mobs gathering to do dangerous things (protest socialist health care reform). Meanwhile, the White House has issued a call for loyal citizens to report fishy behavior to a special White House website. Well, I want to do my part to inform on my fellow Americans. The three images below show just how deep the problem runs. It’s fishy mobs all the way down. [UPDATE: ANOTHER OLD FISHY MOB HERE]
In the current issue of The City, a journal published by Houston Baptist University and just arrived in my mailbox, I review a book on the oft-maligned relationship between journalism and religion. In Blind Spot: When Journalists Don’t Get Religion, the case is compellingly made for a deeper and more authentic integration of religion into every aspect of the news media.
The City, and this issue in particular, comes highly recommended from the likes of Russell Moore of The Southern Baptist Theological Seminary, James Grant at Between Two Worlds, and the enigmatic and insightful millinerd. This issue has been promised to appear online, but in the meantime be sure to sign up for a complimentary hardcopy subscription.
In my review I speculate that within the context of challenges brought about by new media, “perhaps a newfound emphasis on responsible religion reporting is a recipe for the revival, maybe even the redemption, of professional journalism.” I briefly mention the efforts of some religious groups to take steps in this direction, including the World Journalism Institute, which offers short-term sessions, what director Bob Case has called a kind of “boot camp for aspiring journalists of faith.”
I neglected to mention, however, the work of the Washington Journalism Center, an initiative of the Council for Christian Colleges & Universities. Where the World Journalism Institute focuses on short-term training seminars, the Washington Journalism Center offers the “Best Semester” program, a full semester of education for full-time students to “receive academic credit for the program from their home institutions.”
Blind Spot contributor Terry Mattingly is the founder and director of the center, which he says has been around “in one form or another for 15 years.” Mattingly also founded the essential religion and journalism blog, GetReligion, and points us to the student blog of the Washington Journalism Center, Ink Tank. Other blogs of note include The Revealer and When Religion Meets New Media.
The question of journalism in the age of new media was the focus of a past series of PowerBlog Ramblings. But one concrete place to look to see how things play out might just be the city of San Diego, which is home to “a Web venture that gives writers a cut of the ad money created by their own stories; another whose nonprofit founders raise cash from readers to buy laptops for their reporters; and a third, which, in spite of the $10 million it nets each year, faces a very uncertain future.”
One other issue that I don’t think gets enough attention is the question of archival integrity as digital media becomes more ubiquitous. The question, “Do any newspapers have explicit archiving strategies for Web content?” is a hugely important one.
If newspapers do not have such a strategy, then on whom does the responsibility for long-term archiving and accessibility fall? Libraries? Researchers? Non-profits? Archive.org?
I just read today that the cars traded in for the Cash for Clunkers program are rendered unusable by running liquid glass through the engines.
Has anyone considered the impact of this on the poor? What has happened is that a huge number of low cost cars are being removed from the market. These are cars low income earners would ordinarily drive or teenagers would buy them who need to get to school or work.
What happens when we radically reduce the supply of a particular good? If there are no good substitutes, then the price goes up. In effect, this is a tax on the lower end of the market.
“Progressive” policy isn’t always good for the poor. Acton has been making that point for years. Hopefully, it is becoming more obvious.
Now that the saga of Dr. Henry Louis Gates Jr. and Officer James Crowley has moved to the back-burner, let’s look at three less obvious lessons from Skip and Jimmy’s not-so-excellent adventure.
Understand that government is the use of legitimate force. Not necessarily “legitimate” in terms of morals and ethics, but legitimate in terms of what is legal. Police officers have moral and legal authority to use force in order “to serve and to protect”. At times, they may exceed or fail to exercise their authority. But the nature of their job implies a readiness to apply force.
It follows that one should be on their best behavior around the police. It doesn’t take a Ph.D. to know that yelling at police officers will increase the probability that one will be arrested. In this case, even if Professor Gates was treated improperly, he clearly had it within his power to avoid being arrested.
At its root, government policy is about the use of force—whether to regulate behavior, to redistribute income, or to restrict mutually beneficial trade. We can miss this point by focusing on a democratic process where we seem to exercise tremendous choice over those who govern us. Or we can underestimate this point by assuming that government is typically benign.
President Obama’s word choice tells us something about his worldview. His now-famous decision to speak to the specifics of the Gates case was an over-reach of startling proportions.
It was surprising in that Obama “spoke stupidly” when he is usually so careful—often painfully so—with his words. (As a corollary, perhaps it should worry us that he values “diplomacy” so much, but is willing to speak out-of-pocket on awkward and sensitive issues.)
It was odd in that he is the Commander in Chief and chooses the Attorney General to be the chief law enforcement officer in the United States. A president’s default position should be to support the police.
It was sad in that our “post-racial” President botched a key moment for race relations. Instead of sticking to eloquent but general remarks about the underlying issues, Obama extended his comments to inappropriate specifics that created a firestorm and deepened unfortunate stereotypes.
Finally, it seems revealing in terms of what he thinks about his powers of intellect and assessment. This connects to the current debate on health care. In both cases, the President believes that a federal solution is the best way to handle problems. Instead of deferring to the locals who knew far more about the Gates situation, Obama presumed to be able to speak with expertise. In health care, he imagines that a single, grand, federal experiment in a remarkably complex and important arena is preferable to 50 state-wide experiments.
Labor economists distinguish between “personal discrimination” and “statistical discrimination”. Interestingly, both stem from a form of ignorance. The former is a subjective preference rooted in a socially unacceptable form of ignorance. A person doesn’t like a group of people out of bigotry.
The latter is more interesting because it is based in the reality that all of us make important decisions with imperfect and costly-to-obtain information. Out of varying degrees of ignorance, we make choices with the best information available to us at reasonable cost. Often, our best information about individuals involves their affiliation with groups. So, we stereotype from what we know about a group to members of that group. By definition, all of us discriminate in this manner.
Consider a pool of job applicants. The firm has relatively little information about candidates. So, they generalize from what they do know: where the applicants went to school, their GPA and field of study, the quality of reference letters, job experience, and so on. None of those are definitive; they are only somewhat predictive. For example, will someone with a 3.8 GPA be a more productive worker than someone with a 2.8 GPA? Usually, but not always.
Think about the term “prejudice”. Taken literally, it means to “pre-judge”, implying that someone is making a decision with too little information. At times, such decisions are necessary—and hopefully, people do the best they can with the info they have. At other times, it implies an unnecessary rush to judgment.
In this particular moment of crisis, both parties—Gates dealing with the police and the police dealing with him—were making important decisions with (very) limited information. By definition, Gates and the police were engaged in stereotyping. Of course, it is ironic that Gates did this while self-righteously accusing the police of doing the same. And it is absolutely fascinating that, by their training, both Professor Gates and Officer Crowley are “experts” on racial profiling.
Sadly, in judging the events from the outside, many people have been unnecessarily quick in a rush to prejudicial judgments in favor of Professor Gates or the police. The irony here is greatest among those, including President Obama, who have pre-judged by accusing Officer Crowley of discrimination.
One of my colleagues reduced the Gates situation to the following: Would a 58-year old man, with the same attire, etc.—but white—have been treated the same way? The question is only somewhat helpful. Interestingly, it sets up potential accusations of age-ism, sexism, and “clothes-ism” (or class-ism). Should it have mattered to Officer Crowley if Gates was 18, 38, or 88 years old? Would a similar woman have been arrested in this case? What if Gates had been dressed in a ripped t-shirt or a tuxedo?
At the end of the day, the police and our President must make vital decisions with information that is far less than ideal. Hopefully, they do the best they can with what they have—in humility and patience—drawing the best, reasonable inferences from a competent worldview, formidable character, and the best available data.
One of the main arguments for nationalized health care is a moral argument: Health care is a right and a moral and just society should ensure that its people are taken care of–and the state has the responsibility to do this. Bracketing for the time being whether health care is actually a right or not–it is clearly a good, but all goods are not necessarily rights–whether the state should be the provider of it is another question.
But there is another question as well: It is often assumed that those arguing for national health care and socialized medicine have the moral high ground and those of us who oppose it are always arguing on economic terms. I would argue that this is a ground too easily given and not deserved. While the economics are pretty clear (see Hunter Baker’s post), the moral arguments against nationalized health care are sometimes overlooked. Here are a couple of reasons why nationalized health care is in fact not a morally pure as proponents would like us to believe.
1. Handing something off to the state so citizens don’t have to take responsibility for themselves and others doesn’t doesn’t really contribute to the moral fabric of a society.
We love to talk about solidarity and the common good but too often solidarity gets turned into “let the state take care of it.” A broader and I would argue morally rich concept of the solidarity and the common good would look to human flourishing and a rich civil society and turn to the state only as the last resort.
It hurts the common good to have the state take over responsibilities that we should bear ourselves or for our fellow citizens. A large nanny state contributes to the “individualism” that Tocqueville warned about: a turning into self that isolates us from everyone but our nearest circle. If the state does everything for us then we don’t need to care about our brothers and sisters and fellow citizens. This means the breakdown of guess what–solidarity. Solidarity is the driving principle behind subsidiarity, voluntary organizations, and charity. Love of neighbor should prompt us to help each other not pass it it off to the state.
From a moral point of view, having the state take over health care breaks down solidarity and harms the common good.
2. At least equally important–how moral is a health care system based on utilitarian cost benefit calculus and consequentialism? Not very, but that’s how nationalized healthcare operates.
Think about what this means for a minute. Health care decisions are made based on cost benefit and utility which itself puts us on dangerous moral ground. This danger becomes clear when when we realize the consequences. A utilitarian, data driven or what ever you want to call it system ends up by putting pressure on the weak and especially targets the disabled and the elderly. Why? Because if decisions are make based on utility then why would we want to spend health dollars on the disabled and the elderly when their “usefulness” is minimal. Keeping the elderly and the disabled alive costs money. For Christians or other who accept the inherent dignity of life the value of this is obvious, but for secular utilitarians and a utilitarian health care system this is a waste of money–which means that after a time within a national health care system, pressure will mount to euthanize the elderly and infirm. If this sound ridiculous and conspiratorial to you I suggest that you look at Europe and what is beginning to happen there. After years of population decline Europe is a demographic disaster and guess what? Euthanasia has been legalized in three countries (Holland, Belgium, and Luxembourg), is widely practiced in a fourth (Switzerland) and many pro-euthanasia advocates are starting to introduce cost-effectiveness arguments into their position.
The facts are that a state run health system, while sounding very moral, actually undermines the common good and ends up putting pressure on the unborn, the elderly, and the disabled.
Proponents of nationalized health care attempt to make emotional arguments because economic and medical data supporting their position doesn’t exist. Let us not grant them the moral high ground on this debate. Nationalized health care is scientifically, spiritually, and morally bankrupt—oh yes as Europe is demonstrating, financially bankrupt as well.
The Radio Free Acton crew is back in the studio! On today’s broadcast, Dr. Donald P. Condit and Dr. Kevin Schmiesing join our host Marc VanderMaas for a discussion of the ins and outs of the US health care system. Dr. Condit gives us some background on how the current system came into being, the problems associated with it, and the pitfalls of the current healthcare reform proposals in Washington.
Next week RFA will be back for part 2, bringing us alternate ideas for reforming the system in ways that will both increase the availability of care for all who need it and make economic sense.
[update below] British physician Theodore Dalrymple weighs in on government healthcare and “the right to health care” in a new Wall Street Journal piece. A few choice passages:
Where does the right to health care come from? Did it exist in, say, 250 B.C., or in A.D. 1750? If it did, how was it that our ancestors, who were no less intelligent than we, failed completely to notice it?
When the supposed right to health care is widely recognized, as in the United Kingdom, it tends to reduce moral imagination. Whenever I deny the existence of a right to health care to a Briton who asserts it, he replies, “So you think it is all right for people to be left to die in the street?”
When I then ask my interlocutor whether he can think of any reason why people should not be left to die in the street, other than that they have a right to health care, he is generally reduced to silence. He cannot think of one.
Not coincidentally, the U.K. is by far the most unpleasant country in which to be ill in the Western world. Even Greeks living in Britain return home for medical treatment if they are physically able to do so.
The government-run health-care system—which in the U.K. is believed to be the necessary institutional corollary to an inalienable right to health care—has pauperized the entire population. This is not to say that in every last case the treatment is bad: A pauper may be well or badly treated, according to the inclination, temperament and abilities of those providing the treatment. But a pauper must accept what he is given.
After 60 years of universal health care, free at the point of usage and funded by taxation, inequalities between the richest and poorest sections of the population have not been reduced. But Britain does have the dirtiest, most broken-down hospitals in Europe.
[update] Also, later today we’ll be posting the first part of a conversation our multimedia manager, Marc Vander Maas, had with Kevin Schmiesing and physician Donald Condit on healthcare reform. Schmiesing is an Acton research fellow and has posted regularly on health care topics here on the PowerBlog. Condit is the author of Acton’s new monograph, A Prescription for Health Care Reform.
The Public Discourse recently published my article, Rethinking Economics in the Post-Crisis World. Text follows:
In the wake of the financial crisis, we need an economics with greater humility about its predictive power and an increased understanding of the complicated human beings who, when the discipline is rightly understood, lie at its center.
Apart from bankers and politicians, few groups have received as much blame for the 2008 financial crisis as economists. “Economists are the forgotten guilty men” was how Anatole Kaletsky, former economics editor and current editor-at-large for the London Times, put it earlier this year when explaining why “a bank with just $1 billion of capital [would] borrow an extra $99 billion and then buy $100 billion of speculative investments.”
Greed and sheer imprudence played a role, but so too, Kaletsky argued, did those (unnamed) economists who posited that their models proved that events such as the collapse of Lehmann Brothers in 2008 or Long Term Capital Management in 1998 were mathematically likely to happen once every billion years.
Kaletsky’s broader point was that contemporary mainstream economics had been sufficiently discredited by the financial crisis that the entire discipline required what he called an “intellectual revolution,” or it risked being dismissed as a rather suspect sub-branch of statistical analysis and mathematical modeling.
Kaletsky is hardly alone in arguing that economists need to rethink key aspects of their discipline. Though unwilling to call for a total paradigm shift, the Economist recently opined that the financial crisis has raised profound questions of coherence about two areas of economics: macro-economics and financial economics. “Few financial economists,” the Economist observed, “thought much about illiquidity or counterparty risk, for instance, because their standard models ignore it.” Likewise, the Economist commented, “Macroeconomists also had a blindspot: their standard models assumed that capital markets work perfectly.”
All this is certainly true. But the key expression to note here is “their standard models.” (more…)