Surgery Center of Oklahoma Blog

November 22, 2011

Morton’s Fork, Subsidiarity, Health Care and Op Ed Shills

Filed under: Uncategorized — surgerycenterok @ 3:01 pm

Check out this article.  After you read it, imagine that you are in a room with the author, Mr. Zelman.  Deep down you know his advocacy for making people buy health insurance (more on what this really means later) against their will is wrong.  How would you counter the points he makes, points he considers rhetorical?  I’ll deal with the article point by point because the points he makes are important, he just happens to be wrong (thought I’d go ahead and give you the punchline, trusting that you’ll stay with me on this one). This op-ed piece from the LA Times is written in the style that so many statists use, that seems water-tight, or impenetrable.  This is achieved by leaving out certain details, the inclusion of which reveal the holes in their argument.  This is also achieved by asking what are meant to be rhetorical questions, usually weighted with subtly biased terms.  Finally, conclusions drawn from faulty logic, a technique that has become unconscious in folks like Mr. Zelman, is rather commonplace and begs the reader, I think, to challenge the premise, not the conclusions that come later.  Ok.  Let’s take him on.

At the beginning he says, “Would conservatives (he is obviously not one of these) rather have government impose a financial requirement on people who choose not to buy healthcare, or have those who behave responsibly bear the financial burden of a few?”  This is the crux of the entire article and employs what is called a choice characterized as a “Morton’s Fork.” He might as well have said, “would you prefer to be robbed by a government thug or be mugged by the hospital administrator when you pay your bill?”  The obvious answer to me is “neither.”  The way this sentence is crafted, however, leaves little comfortable room for dissent, and makes more difficult the idea that another possibility exists.

Later in the article he says that if you are responsible, you are going to buy insurance anyway, so the effect on you is basically “zero.”  Wow.  He has left something out, hasn’t he,  and his ommission is deliberate as he is no fool.   Remember that this guy is the chairman of a large public health department in LA and their county health plan.  Here is his ommission:  the definition of health insurance once this wonderful mandate becomes effective, changes in to what the federal government says it is.  The type of insurance you will be required to buy to “qualify” as a  legitimate purchaser of health insurance and therefore not subject to the penalties applied to non-purchasers, will be different than what you now have.  You must purchase those policy provisions that Uncle Sam says you must purchase with deductible and co-pay restrictions as the feds see fit.  You won’t, for instance, be able to maintain a high deductible plan and mostly pay as you go, reserving your insurance for catastrophic issues.  You will be forced to purchase mental health coverage and obstetrical coverage and other politically correct and protected services, that you might neither want or need.  This is a huge problem for the author at this point in the article and throws the rest of his reasoning out as duplicitous, in my opinion.  He might as well have said, if you are responsible you are going to buy food anyway so the effect on you of a statute requiring you to buy food would be “zero.”  See the error in this logic?  Substituting anything other than “health insurance” into the variable box exposes what Mr. Zelman believes the role of government should be:  a nanny state.  He never once contemplates whether it is the proper role of government to compel the purchase of something.  He does not have the same concept of property rights as most readers of this blog, I would think.

He next lists all those who are “winners” in the scheme to require the purchase of health insurance, including those who can’t afford it and will be added to expanded Medicaid roles.  Where does he think this money will come from?  Does this new revenue not also come from the hapless taxpayer or cost-shifting victim he addresses in his first questions at the beginning of the article?  He is really falling apart now.

Now he comes to his conclusion, his punchline.  ”In fact, the only individuals who may actually be forced to do something they would not do voluntarily are those who can afford insurance but choose not to buy it.” He almost redeems himself here.  But keep in mind his conclusion is based on the faulty premise that property rights are violable.  He has long since moved to the place where morally and ethically he has no trouble denying you your wages to support someone else on Medicaid and denying you the right to prioritize your family budget which might include not buying health insurance this year or that.  He is also not addressing (ever) the false high cost of the care, the burden of which he maintains is passed on to us as taxpayers or health bill payors at the hospital or clinic.  He is pretty good, but has gotten a little cocky and sloppy with his statism at this point in the article.

Now, armed with a stuffed animal and a paper sword, he goes in for the kill:  first he blurs the distinction between charity and theft, the difference between charitable care and care funded by taxpayer robbery….then…..

“In considering the individual mandate, conservatives need to address three questions. First, why is it so troubling that the government is requiring responsible individuals to purchase what they would purchase anyway? Second, is it fair or appropriate to make the responsible pay more in order to protect the rights of the irresponsible? Third, what should be done when the principle of limited government clashes with that of individual responsibility?”

“Or, put another way, is the principle of limited government so compelling that it should cause us to penalize the responsible and reward the irresponsible?”

Seems like there’s no escape from his rhetorical corner,  right?  Wrong.  Why is it so concerning that government is making me buy something that I would buy anyway?  First they are going to make you and I buy something that we would not buy anyway:  their brand of “health insurance.”  Second:  leave me alone you goon.  If I’m going to buy it anyway, why do you need to make me buy it?  Second:  is it fair to make you and I pay more for those who can’t pay?  The answer is “no.”  What ever happened to the whole idea of mutually beneficial exchange?  Why does another man’s disease have to represent a pre-existing liability on my balance sheet or yours?  Why does one man’s motorcycle wreck mean my family can’t go on vacation this year?  If I want to help the unfortunate that is another matter entirely.  If the hospital administrator wants to blister me for a portion of someone else’s bill through “cost shifting” that is not OK and is easily solved with a little thing known as price transparency and market competition.  I just won’t go to those places that cost-shift…how about that?  Third, and finally,   the simple answer to this goon is:  ”Health care is not a right!”  This is the premise upon which his entire article rests and which must be challenged.  As a follower of this blog you know that you have no right to anything, the exercise of which, results in the violation of another’s rights.  A right to health care by one, for instance, violates the property rights of another.

Finally, another assumption made in this piece that while hard to see is just barely under the surface:  health care is a national problem.  Mr. Zelman, and those like him, are not idiots and the concept of the doctrine of subsidiarity is not unknown to them.  Simply put, the government that governs the best, governs closest to home.  Why are the various health care challenges in Lousiana the problem of folks in Montana?  Why not let each state/city deal with these issues without the federal goon squad’s involvement.  Lord knows that the politicians in D.C. don’t have the guts to deal with entitlement programs like Medicare and Medicaid that are bankrupting us.  I would imagine that health care issues and needs in Montana are quite different from those in Louisiana, requiring different solutions, anyway.  The state of Lousiana has a Charity hospital system, the funding for which is partially derived from a tax paid by tourists visiting and staying in New Orleans hotels.  If you don’t like that, don’t go there.  Maybe Montana would put a 1% tax on saddle sales…something like that.  There is no end to the possible ways to deal with issues like this in various places and at different times.  Mr. Zelman, like most radical socialists, seems to have figured it out for all of us no matter where we live.

Sparring with socialist folks like this can get tiring, as their ability to polish and spin can make the flaws in their arguments hard to see.  This, unfortunately, is the kind of trash that policy makers and legislators are exposed to every day and pseudo-intellectuals like Mr. Zelman shoulder much of the blame for the mess we are in.  I believe that his agenda is clear and however clever he may think his little op-ed piece is, it is more of the same banal, statist balderdash….in my opinion.

G. Keith Smith, M.D.

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