Is healthcare a right or a privilege?

Healthcare is probably the single biggest issue in our country right now, as republicans try to dismantle our current system and progressives push for single payer healthcare. Indeed, more Americans than ever are interested in single payer healthcare: 33% say we should adopt such an approach to healthcare (up 14% from 2014), and 60% say that the federal government has a responsibility to ensure its citizens have healthcare coverage (whether that be public or private).

This stands in stark contrast to the current republican government’s approach to healthcare, which, judging by the legislation they’ve written, is that you should only get healthcare if you can pay for it. Naturally, republican politicians have taken to all forms of media to speak out against single payer healthcare.

But really, there isn’t much of a data-driven argument against single payer healthcare. We know that it’s significantly cheaper. We know that the health outcomes for people tend to be the same, if not better. No, people in Canada and Sweden aren’t dying in the streets because of “rationed care.”

The main objection to single payer healthcare, as far as I can tell, is completely philosophical and boils down to one simple question:

Is healthcare a right or a privilege? 

Ask most conservatives and they’ll probably tell you it’s a privilege, not a right. I’ve had numerous conversations about that with people lately, and I’d like to closely examine this argument.

There’s an underlying assumption in this conservative argument that healthcare is a privilege, namely that there is some finite amount of rights in existence, and everything else is just a privilege. The conservative argument that healthcare is a privilege seems predicted on treating rights as if they’re matter or energy–they can be neither created nor destroyed.

To that end, many conservatives use the constitution as the end-all-be-all of rights. If it isn’t in the constitution, it isn’t a right and therefore must be a privilege. This meme perfectly illustrates this line of thinking:

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This is a particularly bizarre argument given that the founding fathers purposely created a constitution that can be changed, amended. And indeed it has been, 27 times. 100 years ago this meme could have said, “Trying to find in the constitution where it says women have the right to vote.” Or you could have run this meme in 1859 to say, “Trying to find in the constitution where it says black people aren’t personal property.” It’s just a foolish argument.

But the point is that rights aren’t some static, finite thing. You’re given new ones all the time. The 26th amendment gave 18 year olds the right to vote. The 17th amendment gave you the right to vote for your own state senators. Prior to those amendments being written, those rights did not exist.

Similarly, rights can be taken away. The 18th amendment took away your right to manufacture or sell alcohol. That one was repealed, thankfully.

The ultimate point here is that rights aren’t written in stone. We give ourselves new rights all the time, as the previous examples showed. So why couldn’t healthcare become a new right?

It almost was. FDR was on the verge of introducing a second bill of rights in the 40’s, shortly before the end of WWII.

Unfortunately, FDR didn’t live long enough to see this enacted, and it became a mere footnote in American history. I’m sure though, that many conservatives would argue that FDR was some kind of communist for this proposal. Ironic, given that in this short speech he seems intent on protecting free markets.

So then, what would be the argument that healthcare is indeed a right? Well, if you’re having a conversation with someone who wants to use to constitution as an argument that it’s a privilege, try giving them this line:

“We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.”

It’s right there in the preamble. “Promote the general welfare.” What’s the argument that single payer doesn’t fulfill this part of the constitution? Or, conversely, how does a “you can have it only if you can pay for it” model promote the general welfare?

But, one might argue, even if healthcare were a right, that doesn’t mean that government run healthcare is. Perhaps it’s simply a matter of the government ensuring that you have access to affordable care. On the surface, this seems like a valid argument.

Well, this is where I would point out that single payer healthcare is vastly cheaper than the alternative. But even ignoring that point we could still make an argument for it. If we were to argue that “promote the general welfare” means that the government is obligated to look after the health of its citizens, that doesn’t necessarily follow that you need to use it. If you want to buy your own private insurance, you should be free to do so. And indeed, in many countries with single payer healthcare, citizens have every right to buy their own supplemental or private coverage. Just because the government offers a single payer option to its citizens doesn’t mean your right to choice vanishes. Indeed, perhaps a little competition between the government and private industry would be a good thing.

If nothing else, we could look at this issue through an ethical lens. If your neighbor was dying and could be saved, but he doesn’t have the means to save himself and you do, are you ethically or morally obligated to help him? What would you want if you were the dying neighbor?

Ultimately, I think I can walk away from this post to leave you with a couple of ideas. First, in reality, there is very little difference between a right and privilege. Indeed, I might argue that a right is simply a legally protected privilege. Which means, as we’ve seen throughout history, we are capable of being granted new rights if we demand them, if there’s a referendum on them. Second, if a government has an obligation to look after the welfare of its citizens, there is no reason why this should stop at healthcare. We’ll subsidize your education, your protection, your infrastructure–the line drawn at healthcare seems completely arbitrary.

 

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Stop it, liberals

I’m really disappointed with liberals this week. Actually, I’ve been disappointed with liberals for awhile, but everything came to a head for me this week. In case you missed it, Bill Maher said “nigger” on his show and the internet exploded.

Here’s what he said:

Ben Sasse: “You’re welcome. We’d love to have you work in the fields with us.”

Bill Maher: “Work in the fields? Senator, I’m a house nigger.”

Cue the demands that HBO fire him.

DeRay McKesson, BLM activist, tweeted: “But really, @BillMaher has got to go. There are no explanations that make this acceptable.”

Chance the Rapper tweeted: “Please HBO Do Not Air Another Episode Of Real Time With Bill Maher.”

This is exactly what’s wrong with liberalism at this moment in history. This is exactly why the other side doesn’t take us seriously, and why we lose independent voters. The left has abandoned issues of substance for identity politics. Ironically, this is a point Maher has made over and over again on his show.

The republican party is taking away your healthcare, fucking up the climate, destroying our education system, and Trump is under investigation. Meanwhile, liberals are trying to get one of their own fired for making a tasteless joke.

The joke itself is stupid. But it doesn’t make Maher himself a racist. Maher uses his show to give a platform to movements like BLM. Maher himself would be the first one to support legislation that helps minorities. Maher is outspoken in his support for the many things that the very people calling for his firing also support.

The right doesn’t let identity politics stop their agenda. The President of the United States admitted to sexually assaulting women. He blatantly made fun of a handicapped journalist. Of course what he said was wrong, but now he’s president and he gets to set the agenda for this country because conservative voters don’t give a shit about that stuff.

Meanwhile, in liberal land, things like single-payer healthcare, protecting the environment, voting rights–all of that is drowned out by incensed Twitter activists who steer the conversation away from issues toward microaggressions and trigger warnings.

Stop it.

If we had to fire every media personality who’s ever said or done something stupid, we’d have to fire pretty much everyone on TV and radio. It’s mind-boggling to me that liberals can let a joke take priority over every other issue on the docket.

“But the joke was racist!”

Fine, yes. But Maher arguably isn’t. Maher supports people like Killer Mike and Cornell West and Nina Turner and has had them on his show many times. He supports every piece of legislation that would help black people, like decriminalizing marijuana use (which disproportionately affects black men) and ending private prisons. This is the same guy who donated a million dollars to Obama’s re-election. You know, because he’s such a huge racist.

Because while liberals argue about whether the jokes that comedians tell are appropriate and which talking head should be fired, there are things detrimental to minorities happening right now: Gerrymandering. Voter ID laws. Rolling back the Voting Rights Act.

This is reaching such absurd levels that I’m hesitant to even all myself a liberal anymore, because liberalism has changed. It seems like the core principles of liberalism have been replaced by PC warriors patrolling every joke and phrase that politicians and pundits use.

Stop talking about racist jokes and start talking about racist legislation. Stop focusing on shit pundits say and start focusing on shit politicians say.

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America’s problem with welfare

Well, folks, welfare is front and center in our national political discourse once again, and the image of the “welfare queen” is still burned into the collective retinas of a generation. The Trump administration’s latest budget is proof that the idea that welfare recipients are lazy scammers is thriving in conservative politics. They’ve proposed cuts to social programs like SNAP (Supplemental Nutrition Assistance Program), TANF (Temporary Assistance for Needy Families), housing, etc.

This article and this article, from real RealClear Politics and Breitbart, both expound upon the virtues of slashing assistance programs and forcing able-bodied moochers to get back to work. That’s the rationale behind the administration’s proposals to cut $190 billion from SNAP alone over the next ten years. Mind you, this is the administration that wants to eliminate Meals on Wheels because there’s no financial return on investment.

But does this narrative that conservatives spin really ring true? As always, there are data we can look at.

According the US census for 2012, 21.3% of Americans received some form of government assistance that year. Those under the age of 18 were more likely than anyone to receive means-tested benefits than all other age groups. In an average month, 39.2 percent of children received some kind of benefit. The greedy little bastards.

Furthermore, 12.6 percent of people older 64 years or older received a benefit of some kind. Come on, granny–get a job, you lazy old bat!

Meanwhile, only 33.5% of unemployed people received some kind of benefit. Of people who aren’t considered part of the labor force (like retired folks, folks with disabilities, etc), only 25% received a benefit.

17.6% of part-time workers received benefits, and 6.7% of full time workers did as well. In other words, many of the people who receive assistance are already working. Or they can’t work, because they’re too old, too young, or disabled.

And for a lot of people and families who received a benefit, it really was temporary. Almost 2/3 (62.9%) of people participating in TANF did so for less than 12 months. And food stamps? Again, almost 2/3 (63.4%) of people used the program for less than 3 years. The majority of the people on these programs really do only use them temporarily, to get back on their feet. Most of the people who are “permanently” on welfare are the folks who really should be–the elderly and the disabled.

In fact, a recent study out of UC Berkeley highlights the fact that many people who receive government assistance do work, finding that over half (56%) of combined state and federal public assistance spending goes to working families.

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So what’s really going on here? As the study from Berkeley points out, the real problem with welfare in America isn’t laziness–it’s a lack of high paying jobs. Turns out that people who make a decent living don’t need government assistance, a fact that’s been lost on many big employers who let the taxpayers subsidize the low wages they pay their workers.

The real hourly wage of the median American worker has only increased 5% since 1979. And for the bottom 10% of workers, their real hourly wages have actually fallen 5% in the same time interval. There are entire industries in our economy where the pay is so low, close to half of the people working in them still need public assistance:

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We spend literally billions of dollars every year on public assistance so that places like Burger King and Walmart don’t have to pay their employees a living wage.

But there is a group in America that receives billions of dollars in welfare every year who absolutely do not need it. Corporate America.

Corporations that turn hundreds of millions of dollars in profit every year receive subsidies to the tune of billions of dollars.

Nike has taken a little over $2 billion in government subsidies. Intel has taken $3.8 billion. Alcoa has taken $5.6 billion. And Boeing is the biggest welfare queen of them all, having taken over $13 billion in government subsidies. You can see the whole list here. The point is, we’ve given away hundreds of billions of dollars to companies turning immense profits. And for what? Apple, which is on the list, has taken almost $500 million in free government money and they have $230 BILLION stashed overseas.

If that doesn’t outrage you, but a single mom trying to feed her kids does, then there really is something profoundly wrong with America.

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Why the GOP can walk all over its voters–and get away with it

The GOP finally got their bill to repeal and replace the ACA out the house. It’ll now go to the senate, where it’s pretty much doomed. If it doesn’t collapse altogether, it’ll be sent back as a much different bill. Regardless, pundits and experts are predicting that the AHCA has shown the republican hand, namely that they care more about tax cuts for the rich and not at all about your health.

That’s certainly true.

The bill sees hundreds of millions of dollars cut from medicaid and a corresponding tax break for the wealthy. It also allows insurers to drop you if you become ill or have a pre-existing condition. It’ll raise premiums for the elderly. It’s just an awful, awful bill. Which is why pundits are predicting a major backlash against the party come 2018.

I don’t think we’re going to see that.

Ultimately, a few red districts in blue states may flip, but it won’t be enough to shift the balance of power. Because I don’t think that this will perturb republican voters. History has shown, time after time, that they’ll vote against their own self-interest and I don’t think that this moment in history is an exception. Many of the deep red states have had republican governors, legislatures, and courts for 30+ years. And yet things keep getting worse for those states. If republican voters were ever going to finally wake up to the fact that they’re voting against their own interests, it would have happened by now. In fact, it’s probably never going to happen.

Here, take a look at this:

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Every single one of those states is solid red, and every single one voted for Trump. And every single one of those voters with a pre-existing condition will see their insurance either disappear or skyrocket in price. But I’m willing to wager that come 2018 they’ll still vote for the very same congressman who voted to strip them of healthcare. Why? Because many republicans are single issue voters. And what is that issue, you ask?

Abortion.

As long the GOP continues to be the party that opposes abortion and wants to overturn Row v. Wade they can pretty much do whatever they want to voters and still get re-elected.

59% of republican voters think abortion should always be illegal. Even among moderate or ‘liberal’ republicans, 41% think it should always be illegal. And that number has shifted up from where it stood in 1995; 20 years go, republicans were split almost evenly, 49%/48%. In the last two decades, republican voters have only become more conservative on this issue. In 2015, 21 percent of Americans said they would only vote for a candidate who shared their abortion views, up from 13 percent in 2008.

Particularly ironic, given that the AHCA isn’t friendly to pregnant women or babies and children. But I digress.

Economically, many conservatives align with progressive values. 52% of republicans with family incomes <$30,000 say the government has a responsibility to provide healthcare coverage for everyone, up from 31% just last year. And in a recent Gallup poll, 45% of republicans said they think the wealthy don’t pay their fair share in taxes. They hate those free trade deals that sent their jobs overseas–something Bernie Sanders talked about extensively during the election.  In other words, conservative voters know that they’re getting screwed over economically. As time goes on, they seem to be getting more progressive economically.

And yet…when it’s time to step into that voting booth, they always pull the red lever. And what does it get them? Healthcare? Gone. Overtime pay? Gone.  Clean water and air? Gone, too. Taxes? More income redistributed from the middle and lower classes to the donor class.

But hey, abortion, right?

The new GOP “healthcare” plan

In case you missed it, republicans are back with a re-vamped version of their failed ACA repeal. The new American Healthcare Act (AHCA) is somehow even worse than before after a new amendment was added by Representative Tom MacArthur (R-NJ). The problem with the last bill was that it apparently didn’t screw enough people over, so the “freedom caucus” (hint: the freedom they want is the freedom for you to die destitute) lifted their noses in disgust and said no. The new amendment by MacArthur aims to bring those ultra-conservative members of the freedom caucus over to their side. How does this amendment do this, you ask?

I am so glad you asked. Here’s a copy of the actual amendment to the bill. The proposed changes are many, but I’d like to focus on one specific part which I think illustrates why this bill isn’t really a healthcare bill at all. One of the main focuses of this amendment is eliminating the mandate that insurance plans offer certain “essential health benefits” as outlined by the ACA. Here’s the actual text of the amendment:

(B) In the case of plan years beginning 2 on or after January 1, 2020, for health insurance coverage offered in the individual or small  group market in such State, to apply, subject to paragraph (5), instead of the essential health benefits specified under subsection (b) of section 1302 of the Patient Protection and Affordable Care Act, essential health benefits as specified by the State.

“Essential health benefits” are things that, by law, insurance is currently REQUIRED to cover. So, what kind of things did the ACA define as “essential” to your heathcare plan?

  1. Ambulatory services
  2. Emergency services
  3. Hospitalization
  4. Maternity and newborn care
  5. Mental health and substance use disorder services
  6. Prescription drugs
  7. Rehabilitative services
  8. Laboratory services
  9. Preventive services and chronic disease management
  10. Pediatric care, including oral and vision screening

Right off the bat, we can see some major hypocrisy here. I find it truly insulting that the party that claims to be about “family values” and touts how “pro-life” it is says you don’t need newborn care, maternity care, and screw your children’s pediatric care. They don’t give a fuck if your child’s teeth rot out or he can’t get glasses.

Second, whenever the issue of gun control comes up, republicans are the first people to shout, “It’s not a gun problem, it’s a mental health problem!” So naturally their healthcare plan would allow insurance companies to drop mental health coverage.

Third, and also just as disgusting: Trump campaigned on the opiate epidemic. Remember that? He talked about how it’s a tragedy and he feels their pain. So of course now they can just take the whole substance abuse treatment part out of your plan.

So how does this save you money? Well, let’s say your insurance company says, “Sure, we can provide all ten of those benefits for $500/month. But what if we lobbied the state, and now your plan looks like this…”

  1. Ambulatory services
  2. Emergency services
  3. Hospitalization
  4. Maternity and newborn care
  5. Mental health and substance use disorder services
  6. Prescription drugs
  7. Rehabilitative services
  8. Laboratory services
  9. Preventive services and chronic disease management
  10. Pediatric care, including oral and vision screening

“There. We’ll just provide you with those 4 benefits. You won’t need to visit the hospital, right? And you didn’t want drug coverage, did you? And forget preventive care–you don’t need to waste your money on avoiding illness. If we take all of those things out, we can give you a plan for $50/month.”

The problem with this amendment is that it allows states and insurance companies to decide what’s essential, and let’s them pare down the plans they offer to the point that you aren’t even really receiving healthcare anymore. Of course healthcare will be cheaper if nobody is actually offering you healthcare.

It saves you money in the same way that selling a car without windows, doors,  mirrors, seat belts, airbags, a back seat, and brakes would save you money on a vehicle.

Of course none of this is an issue if you’re rich. If you’re wealthy, you can afford everything that’s essential. But if you’re poor? Screw you, you have to pick and choose from bare-minimum plans that don’t cover everything necessary to keep you healthy.

If you’re middle or lower class, here’s your GOP healthcare plan:

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What happened to those bootstraps?

Does anyone else find it supremely ironic that republican and conservative voters elected Donald Trump on the promise that his government would bring jobs back? Because I certainly find this sentiment to be the epitome of hypocrisy.

For decades now, all we’ve heard from the GOP and other conservatives is that the government is horrible and meddlesome, and everything would be better if there was less government interference and everyone took more personal responsibility for their lives.

Conservatives 2008/2012: “The government just makes things worse. Get rid of the government and everything will be fine–it’s not the function of government to create jobs, you libtards.”

Conservatives 2016: “PLEASE BRING BACK MY JOB, GOVERNMENT!”

It’s galling to me that the party of moxie and rugged individualism is now the party that applauds a government that directly gets involved in business and trade negotiations–the very things conservatives were crying the government should stay out of for the past 30 years.

How many times have we seen conservative politicians and voters say the following about welfare or the minimum wage: “We don’t believe in handouts. If you want to make more money, improve your situation, work harder, etc. Pull yourself up by your bootstraps like a real American.”

Well apparently conservatives in 2016 have thrown out their old bootstraps.

This article on CNN interviews people in a Kentucky town, “the poorest city in America,” that overwhelmingly voted for Donald Trump. Here are some snippets:

Beattyville residents want jobs, especially ones that pay more than the minimum wage of $7.25 an hour. They think if anyone can bring jobs back, it’s Trump.

Yeah, of course. The guy whose Trump brand suits and ties are made in Chinese factories is going to bring your job back. The same guy who immediately nominated the CEO of a fast food company who hates the minimum wage, Andy Puzder, as labor secretary.

Here’s what one of the men Kentucky elected to the senate, Mitch McConnell, had to say about the minimum wage: He cited a Congressional Budget Office study that he claimed said raising the minimum wage to $10.10 an hour would “destroy half a million to 1 million jobs. […] That’s not the way to grow our economy,” he added.

And here’s what Kentucky’s other senator, Rand Paul, had to say about raising the minimum wage: ‘The minimum wage is a temporary’ thing, Paul said. ‘It’s a chance to get started. I see my son come home with his tips. And he’s got cash in his hand and he’s proud of himself. I don’t want him to stop there. But he’s working and he’s understanding the value of work. We shouldn’t disparage that.’”

Good luck getting jobs that pay beyond the minimum wage, Beattyville. You elected people who propose the very opposite of that, who think, in Paul’s case, that trying to raise a family on a minimum wage job is great because it’ll build your character and teach you the value of hard work!

“If you got a job here in Beattyville, you’re lucky,” says Amber Hayes, a bubbly 25-year-old mom of two, who also voted for Trump. She works at the county courthouse, but is paid by the Kentucky Transitional Assistance Program (K-TAP), a form of welfare.
The vast majority of Beattyville residents get some form of government aid — 57% of households receive food stamps and 58% get disability payments from Social Security.

But I thought that welfare was just for the takers? Isn’t that what all the conservative politicians campaign on? Haven’t we all heard some iteration of that from conservative friends and relatives? Isn’t that what Mitt Romney said just 4 years ago, that 47% of the country votes to just get free stuff?

Here’s what Kentucky’s own Mitch McConnell said about food stamps as recently as last September: Asked about the improving economy, McConnell scoffed: Business leaders tell him they have “a hard time finding people to do the work because they’re doing too good with food stamps, Social Security and all the rest.”

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Residents of Beatyville would apparently beg to differ with Mr. McConnell.

From the outside, it’s easy to wonder why people in Beattyville don’t just move somewhere else. But out of all the people CNNMoney met in Beattyville, only one wanted to leave. The rest are drawn to the beauty of the place and the friendly community. “I’m country to the core,” laughs Puckett. He husband of 39 years nods beside her. Judge executive Mays puts it this way: “We’re perceived as a hillbilly, backwoods, all this and that. But we’re a good people.”

Again, whatever happened to those bootstraps, hmm? That’s what Paul Ryan or Rand Paul would tell you to do–work to improve your own situation and don’t depend on the government to save you. If you lose your job, find another, even if it means moving. Retrain yourself. Oh, you can’t pay for that? Well, you just need more gumption and definitely less of that darned government in your life, always making things worse.

Look, I have lots of sympathy for the people of Beatyville. They’re certainly in a bad place. Yet at the same time, they and the rest of their state have repeatedly voted for people who have told them that the government will make their life worse. That getting rid of food stamps will create an incentive for people to get a real job. That social security and medicaid should be cut or outright privatized. That the problem with America in general is too much reliance on the government.

In the end, Beatyville and other red cities in red states that are suffering are the victims of their own voting. It’s particularly tragic that they now expect the same government that believes that the government shouldn’t be engaged in safety net programs or other forms of public assistance to save them. If the democrats were smart, they’d get out grassroots campaigns to go to towns like Beatyville and help explain this to residents.

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I guess we’ll see what happens in 2018.

The protest condundrum

Well, over a million people marched in protest of President Donald Trump yesterday. And while I definitely agree with the protesters and their messages, I couldn’t help but think of one thing as I watched the coverage on the news:

Where the hell was all of this during the election?

If all of those protesters had poured as much energy and organization into the election, I would bet that we wouldn’t be talking about president Donald Trump right now. So while I think the protests were totally awesome on one level, on another level it seems like it’s too late. Trump has already been sworn in and he’s sitting in the oval office right now.

Trump, Pence, and the republicans in congress probably don’t give a rat’s ass about the protests because they already won and protests aren’t going to change that.

But that kind of activity probably could have changed the outcome of the election. Of that I have very little doubt. This past election suffered from pretty low voter turnout. People just weren’t excited about Donald and Hillary, so they stayed home.

voter-turnout-graph

But imagine if all of these people who protested had mobilized in a similar way before the election. Imagine if they worked that hard to drum up more excitement for voting. The outcome probably would have been different. Imagine if they’d all worked that hard to ensure that he didn’t get elected in the first place. These protests should have started the moment Trump won his party’s nomination, not after he took office.

There’s always 2020.