Friday, February 26, 2010

Condescender in Chief

From the NYT's

"The president made it clear to Republicans that he would not scrap the health care bill, as the GOP leadership has been asking, and start fresh. At the same time, he also pleaded with them to find common ground.

"I'd like the Republicans to do a little soul-searching and find out are there some things that you'd be willing to embrace that get to this core problem of 30 million people without health insurance and dealing seriously with the pre-existing condition issue," Obama said."

I find this striking. The NYTs reports that the President is trying to find common ground and as support quotes him as saying they should examine their consciences and think about the victims of their intransigence. The assumption in Obama's comment is that the Republican's plans do not address the problems of the 30 million, that the only reason that they oppose the President's plans are their lack of concern for the 30 million, that they have put some base interest before the faint voice of their un-searched souls leaving them unwilling to embrace the problem of the 30 million and do something serious about the 30 million without health insurance. This is hardly fair. The Republican plans do do something about them. Indeed, they have already solved a third of the problem: Republican insistence that any benefits be limited to legal residents has already cut the number of "Americans" without health insurance from 45 million to 30 million.

Finding common ground would be mentioning things that they both agree on. His quote is implying that he cares about the people without health insurance and they don't. His plea is not lets work together but for them to recognize the moral superiority of his side. It is condescension, not compromise.

Of course, to the ears of someone in the intelligentsia fishbowl what Obama is saying sounds like a simple statement of the obvious. That is the problem with the ideological homogeneity of our elites, they can conceive of no principled objection to their plans, no other reasonable means to their ends. If one cares about the people without health insurance then one must be for government provision and price controls on insurance companies. That is something too obvious to be seen as requiring explanation, too settle to invite debate, too self-evident to be seen as a question at all, let alone one worth debating.

How do the Republican plans deal with the problems of those with pre-existing conditions and who are without health insurance? First, they lower the cost and then make health insurance portable by introducing real competition. The main Republican proposal costs nothing: make insurance purchasable across state lines--like practically every other thing you buy. Then, allow people to buy term health insurance the way they buy life insurance. You don't lose you life insurance when you change jobs, why should you lose your health insurance?

Isn't it odd the way we approach this question? Our health insurance and health care system in general is way out of wack with rampant inflation. Everything else that our economy produces gets steadily cheaper or at least doesn't go up with the exception of a few commodities that are under the political control of others (mainly oil). If health care behaves differently, wouldn't the natural place to start looking for solutions is in looking at how the laws governing health care differ from the laws governing other products?

From that starting point the first thing that is striking about health care is that you don't purchase it yourself, you don't get to take it with you, and you can't buy it from anyone outside your state. Can you think of any other product like that? No, just like you can't think of any other product which has anything like health care's problems of rampant inflation. Before we hand over 17% of our economy to the government, why don't we at least try what works in the computer market, the car market, the everything else 80% of our economy market, even the part of the medicine that is now part of the free market (lasic eye surgery, etc.), the market? Letting people spend their own money to make their own choices and, if they don't have enough money to do that, subsidizing the people, not the product (as we do in higher education)?

Look into your soul and give choice a chance.