All Liberals Are the Same

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Health Care

Peter Singer is an Australian philosopher with a lot of provocative ideas. I don’t always agree with his ideas, although I don’t always disagree, either. He’s the sort of fellow who generates a perspective that’s interesting to think about, but I think sometimes he likes to say outrageous things just to stir the pot. He is alleged to have postulated that maybe it’s OK to euthanize handicapped infants, for example. I don’t know if that’s exactly what he said, and at the moment I’m not interested enough to check it out. However, one may be grateful he’s an academic and not actually in charge of anything.

Anyway, Singer wrote an op ed for the New York Times titled “Why We Must Ration Health Care.” The op ed is a philosophical exercise, not a policy proposal — Singer’s no economist or policy wonk — and he’s basically saying, here’s another way to think about this. His essential point is that people ought to own up to the reality that health care is a commodity with limits and is rationed. He makes the observation that U.S. health care is rationed now, by ability to pay.

Dr. Art Kellermann, associate dean for public policy at Emory School of Medicine in Atlanta, recently wrote of a woman who came into his emergency room in critical condition because a blood vessel had burst in her brain. She was uninsured and had chosen to buy food for her children instead of spending money on her blood-pressure medicine. In the emergency room, she received excellent high-tech medical care, but by the time she got there, it was too late to save her. …

…When the media feature someone like Bruce Hardy or Jack Rosser, we readily relate to individuals who are harmed by a government agency’s decision to limit the cost of health care. But we tend not to hear about — and thus don’t identify with — the particular individuals who die in emergency rooms because they have no health insurance.

This is an excellent observation. I have quibbles about some of Singer’s reasoning, and how he presents his ideas, but still, it’s thought-provoking. However, my first reaction to his headline was “Why Pete Singer Should Shut Up,” because I knew this would enflame the passions of the Right and throw them into a cage-rattling, feces-throwing fit. We don’t need any more of that now. And sure enough, a number of rightie bloggers are having hysterical fits about the headline, although so far none I have seen seem to have actually read Singer’s op ed.

For example, A.J. Strata writes, “Americans Have Succeeded Without Rationing Health Care.” Singer gave one example after another of the way Americans do ration health care, and in fact, ration it even more than the awful European countries with “government run” health care.

Far more Americans reported forgoing health care because of cost. More than half (54 percent) reported not filling a prescription, not visiting a doctor when sick or not getting recommended care. In comparison, in the United Kingdom the figure was 13 percent, and in the Netherlands, only 7 percent.

I take it A.J. didn’t get that far into the article, as he makes no attempt to address Singer’s point.

My favorite example of teh stupid, however, is American Power, which turned Singer’s headline into “Obama Will Ration Health Care,” because, you know, all liberals think alike. So whatever some Australian philosopher says must be what Barack Obama intends to do. Brilliant.

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15 Comments

15 Comments

  1. SteveG  •  Jul 16, 2009 @8:47 am

    Peter Singer is fun because he is a fully committed utilitarian. When you teach ethics in the classroom and a student tries to raise a limiting case counter-example to the principle of utility (an act is morally right just in case it maximizes pleasure and minimizes pain) by saying something like, “Wouldn’t they have to say then that, I don’t know, having sex with farm animals is morally good if if causes the animals no discomfort?”, you can pull out some Singer where he argues exactly that, and argues it smartly. We come to the table largely sympathetic with Singer’s approach but there are always cases where you see people quickly switch into Kantian “always/never” mode.

    A colleague of mine asked me a while back if there was a single living philosopher who had made any difference in contemporary discourse and Singer’s work on the treatment of animals was all I could come up with.

  2. Pat Pattillo  •  Jul 16, 2009 @11:49 am

    Ahhh, the old Soylent Green approach to healthcare where rationing it is tantamount to rationing life. I’ve always believed that population would reach levels for which the planet would not sustain life but any humanitarian utilitarian would deal with the problem at its inception which is not even birth but procreation. Dare I utter the word “China”?

    Nor would everyone willingly enlist in the plan to save the planet from ourselves. So would there be totalitarian survivalists vs. blissfully ignorant freedom advocates?

    The master plan deals with animal populations much more cruelly so why should we think we are so special except possibly in the innate intelligence required to deal with the problem more humanely.

    If a child quota would send many reaching for their guns then imagine what rationing life might cause…maybe hell on earth?

    Some utilitarian. Committed? Should be committed maybe.

  3. moonbat  •  Jul 16, 2009 @12:02 pm

    I read about Singer ages ago in a New Yorker article, and until I came across SteveG’s comment, I’ve been lacking for a way to describe/understand his viewpoint (thanks, SteveG).

    I’m of the opposite view with your post – I’m glad Singer found expression in the NYT opinion page. He’s much too strange for wingnuts to grasp, but frankly I am very tired of having to dial back the discussion for the sake of wingnuts’ sensibilities (such as they are). Wasn’t there some famous general whose motto was “Attack! Attack! Attack!”? And let the reactionaries react.

  4. dyedinthewoolliberal  •  Jul 16, 2009 @12:31 pm

    This is fascinating. I like the idea of making Medicare for ALL responsible for ALL treatment of basic health care needs, with out deductibles or co-pays. It seems that QOLYs could used to assist in defining these basic needs, that and common sense. It truly gets complicated and stretches our trust level in the people given the task of making these decisions. One thing should be perfectly clear, there is no place for a person with a financial interest in making the decision for me who isn’t making the same decision for himself. So, an insurance claims agent deciding whether to allow my treatment should not get a ‘bonus’ for denial of claims. Can we at least agree on that?

  5. maha  •  Jul 16, 2009 @12:49 pm

    It’s really the headline that’s the problem. I think if the headline had been “Health Care IS Being Rationed Already,” I wouldn’t have had a problem with it, and it would have been closer to what Singer actually wrote. Righties, who are famous for not reading, don’t get past the headline, of course.

  6. joanr16  •  Jul 16, 2009 @12:59 pm

    As I understand the usual practice, the NY Times wrote the headline for Mr. Singer’s piece. Not surprising that it’s way off the mark, considering the vast amount of human discourse the Times no longer understands.

    I’d never heard of Mr. Singer before; it sounds to me like he’s more of a semi-professional provocateur than a philosopher. But then, all I know about Australian philosophers comes from Monty Python’s “Woolamaloo University” sketch. G’day, Bruce.

  7. maha  •  Jul 16, 2009 @1:01 pm

    dyedinthewoolliberal — We could consider a policy in which the government plan pays for things that are essential for life and health, and people can buy supplemental insurance to pay for “extras.” The problem is, one person’s “extra” is someone else’s “necessity.”

    There are also “extras” that many people can say with absolute certainty they will never need, and which are purely elective, like infertility treatments. I’m not sure one could make a profitable business out of selling infertility insurance. On the other hand, maybe some companies would be willing to sell low-interest loans pay for IVF.

  8. maha  •  Jul 16, 2009 @1:01 pm

    Pat P — don’t be too hard on Singer until you know more about him.

  9. felicity  •  Jul 16, 2009 @3:13 pm

    If England is any example of a kind of ‘rationing”, the first two years that National Health was in place, the Brits were running to the doctor for everything from a broken fingernail to an uneven tan. As soon as the ‘newness’ wore off, however, they quit and the system eventually settled into a degree of efficiency. Kind of a self-rationing.

    I found this statistic a while back so I’ll throw it in here: Every year 30,000 medicare patients die from OVER treatment while ‘only’ 20,000 die from lack of access to health care. This ugly crap and much more is the compelling Republican argument that we have the best health care system in the world so don’t change it???

  10. Bonnie  •  Jul 16, 2009 @5:36 pm

    I have said this before; but, it is still true about America’s health care system. Right now, America’s health care is rationed. If you have a little bit of money, you get a little bit of health care. If you have a medium amount of money, you get a medium amount of health care. If you have a lot of money, you get a lot of health care. That is rationing. I injured my knee on the same day Michael Jordan (playing for the Washington Wizards then) injured his. Jordan had x-rays, MRIs, surgery, rehabilitation, and was back on the basketball court while I was still trying to get approval for an MRI. I mentioned to one of my doctors that I wasn’t being treated as well as Michael Jordan for the same injury. His reply was, “Of course not, Jordan’s worth 32 million dollars.” It took me 2 years to get my knee surgery. In the meantime, I walked on my bad knee, possibly making it worse, and endured an excruciatingly amount of pain.

    In eary 2008, I read about a little boy who died because of an infected tooth. He was somewhere around the ages of 12-14. His single mother could not afford to take him to a dentist. Health care is more than just going to an internist or surgeon. Yet, if we could get a commonsense version of a health care plan for all Americans, we can begin working on the other too expensive needs for good health. It doesn’t matter how healthy the rest of your body is if you have a mouthful of infections.

  11. aimai  •  Jul 17, 2009 @10:41 am

    I think the very word “rationing” is so culturally and politically loaded that its important for everyone–not just philosophy professors–to push back against the right wing misuse of the term. The weirdest thing of all in our so called health care debate is how utterly dishonest the entire thing is from first to last. Of Course health care is rationed by ability to pay. And of course people get the short end of the stick when they can’t pay premiums or for medical treatment without premiums. But the right and its shills have insisted semantically that “rationing” only happens when the government does it, not when the market does it. We have a tall hill to climb to even begin to take back the discussion from this viewpoint because it has been incohate and unchallenged for so long. Just as the discussion slips rapidly from health care to health insurance if you don’t police the boundaries of the discussion.

    aimai

  12. s  •  Jul 17, 2009 @11:33 am

    I like the idea of our reps and the people who work for them having the health plan that they plan for “we the people”. I think they will think the plan over more carefully and really try to have something that will work for them and everyone else.

  13. JackieBinaz  •  Jul 17, 2009 @11:56 am

    The right would go into a cage-rattling, feces-throwing fit? Isn’t that their default position?

  14. Francis D  •  Jul 17, 2009 @1:05 pm

    I knew this would enflame the passions of the Right and throw them into a cage-rattling, feces-throwing fit.

    There’s already a “y” in the day. You mean it would throw them into another fit?

    In comparison, in the United Kingdom the figure was 13 percent

    For the record, as one of those 13% the reason may be that idiot GP has told me that something was viral and then prescribed me antibiotics [/rant]. Money isn’t normally the issue.

    And it’s impossible to run a non-rationed system without a perpetual motion machine…

  15. SteveG  •  Jul 17, 2009 @10:55 pm

    “I’d never heard of Mr. Singer before; it sounds to me like he’s more of a semi-professional provocateur than a philosopher.”

    joanr16, Singer’s at Princeton. He’s among the biggest names in contemporary ethics. His book Animal Liberation is the bible of the animal rights movement and played an important role in the history of the environmental ethics movement.



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