Tuesday, June 26, 2007


It is Sweet to do Nothing

I have an ongoing discussion (argument, debate, word fight) about universal health care, or UHC. I favor it. My conservative friends H, M, and R oppose. H and M tend to advance arguments or anecdotes to show that UHC either doesn’t work or works very poorly in countries that have it. R argues that health care is not one of the services government should provide. He agrees that government should provide military protection, postal service, and sound money. Health care, along with free food, free housing, and free clothing, is a service that government should not provide.

I presented the argument that countries with UHC (e.g., Britain, France, Germany, and Canada) spend less per person on medical services and have better outcomes in terms of longevity than the United States. R does not dispute my claim that we spend more on health care than these other countries. He argues instead that the longevity in various countries is not related to the existence or absence of UHC. Longevity in the United States is lowered because of the high incidence of murder and other crime here. Costa Rica, which does not have UHC, experiences longevity in the same range as Britain because the Costa Rican people have a naturally healthy life style.

I could not argue with nor disprove R’s statistics. After stating that I believe that government on some level (federal, state, or local) should provide basic health care for all I presented the emergency room argument. Emergency rooms are overburdened and some have closed because of the large number of uninsured patients who get all their medical needs provided at hospital emergency rooms. R stated that it is not true that emergency rooms have been closed because of overuse by the uninsured. I stated that many have indeed been closed here in Los Angeles.

Rather than concede that he had been mistaken, R’s response was that the situation in Los Angeles and Tucson was the result of large numbers of illegal immigrants who use the emergency rooms. San Francisco and other cities farther from the Mexican border do not have the problem and do not have hospitals that have had to close their emergency rooms.

R is arguing that none of my reasons have any validity. UHC is not a solution for emergency room overloads; the solution is, by implication, to get rid of the illegal immigrants. In R’s world, UHC is unnecessary. There is nothing wrong with our medical care system that can’t be fixed by getting rid of frivolous malpractice lawsuits. There is nothing else that needs to be done. Dolce far niente, as the Italians say.

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Dear Al,

I too support UHC, but I will not go into all that here. Instead, what struck me was the counterargument about longevity that was based upon the US murder rate. While this may be a good counter to stats about longevity and UHC, it certainly isn't a very appealing one.

I would argue that one measuring stick about the health of a society should be its rate of incarceration and capital punishment. Why does what is arguably the most technologically advanced and affluent nation ever to exist maintain the highest number of incarcerated people (both flatly and per capita I believe) of any nation? Why do our laws not more closely coincide with our behaviors? There is a disconnect somewhere when so many people feel so marginalized that they'd prefer to break the law and risk punishment than to follow the law.

A conservative position would be that if people are willing to risk the stick, then we need to make the stick bigger. Yet many nations that have lower incarceration and crime rates than does the US also have what conservatives would consider to be lighter sticks.

My conclusion would be that ultimately what we're doing is instead of addressing why people resort to drug addiction, to violence, and to theft and seeking to treat the causes, we're simply maintaining conditions conducive to crime but locking up and paying for the criminals after the fact. I think the sensible approach would be to try to address policy that lends itself to contributing to crime rather than to address the effects side (corrections) with so many resources.
Dear Michael,

I agree that we lock up too many people and we impose unduly long sentences for relatively minor offenses. Conservatives who believe in making the "stick" bigger dominate the discussion and the thinking about sentencing.

For many minor offenses we should impose probation rather than a long prison sentence. It's a cheaper way to keep track of the convict and I believe it's more likely to lead to rehabilitation. Too many convicts come out of prison after serving their sentences with no marketable skill and revert to committing more crimes.

By the way, do you have a blog? If you do, why don't you write a convincing article in favor of probation rather than prison time for minor crimes. Or, perhaps you have already done so.
Dear Al,

Nope. I don't have a blog. The closest I come to it I guess is occasionally creating my own diary entries in Michigan Liberal (which is where I found you).

Mostly what I do is write on several different broadly public forums and a few personal blogs of others. So far I've been content with just joining the fray but I may take your suggestion sometime and start my own blog and/or write a substantial piece on corrections. :)
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