Reading the National Review‘s Kevin Williamson discuss healthcare is like reading a koan designed to make you understand the essence of modern-day conservatism by demonstrating the weakness of rational thought.
The topic is a bill under discussion in Texas that would require insurance companies to cover the cost of hearing aids for children who are born with impaired hearing.
Williamson sets up the debate his way:
The case for the bill is exactly what you would expect, presented in exactly the way you would expect…For newborn children who can benefit from hearing aids, sooner is better: The sooner the hearing aids are in use, the better the child’s chances of normal language development.
The case against the bill is exactly what you would expect, presented in exactly the way you would expect: Business groups oppose the mandate, as they oppose all additional mandates, arguing that such mandates increase the cost of health insurance for all Texans and for employers who provide insurance.
This is seemingly a straightforward debate about values. Should children get hearing aids as soon as possible so that they have a good chance of normal language development, or should they be denied this health care so that Texans as a whole can enjoy slightly lower costs?
But Williamson is too clever to debate on those terms. For him, it’s wrong to mandate that insurance plans cover anything, but it’s also wrong to deny children the opportunity to hear and develop normally. So the solution is to have the State of Texas man-up and offer to provide these hearing aids directly to the kids who need them. The state can budget for this (it would be expensive but not that expensive) and they can stop pretending that a mandate to an insurance company is anything other than a disguised social-welfare program.
What motivates Williamson to take this stance?
If you want to provide the benefit, then, for Pete’s sake, write the damned check. The alternative is not — no matter what our Democratic friends insist — getting insurance companies to pay for children’s hearing aids out of their profits and the bonuses of their fat-cat executives.
What offends him isn’t the cost, since he’s happy to have Texas pay it. He’s not really concerned about the premiums people will have to pay, since that’s just a laundered way of paying the taxes that Texas would need in his preferred scenario.
No, what bothers him is that when the state mandates something be covered in an insurance plan, it comes out of the “profits and the bonuses of their fat-cat executives.”
Insurers might simply try to pass those costs along to subscribers in the form of higher premiums, but, contrary to the economic model that exists in the head of Bernie Sanders, companies do not have the power to unilaterally set prices. Companies in very competitive and price-sensitive businesses (think McDonald’s or Walmart) cannot simply raise consumer prices.
And here I thought the problem with Obamacare was that there wasn’t enough competition to keep premiums low.
In any case, I’d actually be fine with Texas paying for kids’ hearing aids instead of having it all washed through a for-profit insurance industry. It’s just that it’s kind of crazy to me that the motivation for doing that wouldn’t be to reduce cost by cutting out the middle man and instead would be to avoid cutting into the profits and bonuses of insurance executives.
But it gets even more confusing, because Williamson certainly doesn’t want Texas to pay directly for kidney dialysis or chemotherapy or separating conjoined twins. That would destroy the health insurance industry and take socialism to level not seen outside the Veterans Administration.
So, why hearing aids but not birth control pills or hysterectomies?
There’s nothing really coherent here in terms of policy or principle. The only consistency is that Williamson thinks that health insurance executives shouldn’t suffer from anything that will interfere with their compensation, and that means that they should be able to sell crap insurance of any kind that they want with no regulation.
If some benefit must absolutely be provided because the people in need are so sympathetic, then let the state do socialism in just those cases but no others.
Doesn’t this make you want to donate to the National Review?
Well since Texas has one of the highest rates of uninsured I guess more children would get hearing aids that way
Untended consequences
Sounds like the beginning of single payer to me.
People who have health emergencies can’t wait for us to have a theoretical debate about some better idea that will never, ever come to pass.
(Apologies to AkamaiGuy, but what is my party’s current healthcare objective?)
Why apologies to me? I’d love to know what the party’s stance will be on this and a bunch of issues. My only request was that people on this forum avoid rehashing the 2016 Democratic primary in the 2017 DNC chair election. Nothing good has come from the arguments about those topics on the Pond.
I hope, and think, that we should all be able to have a productive discussion what policies the party should pursue and how best to do the messaging for those policies.
The first sentence is a quote that rehashes the primary.
Ok then let me amend my request:
Can we please not rehash the PROCESS arguments/flame wars (e.g., “thumbs on the scale” by DNC old timers) during the 2016 Dem Primary and 2017 DNC Chair election (e.g., “interference by Obama”)?
NOTHING good has come from those pursuits.
Definitely let’s talk about what the current and future leaders of the Party are putting forward as far as policies and public arguments/messaging for those policies!
Williamson goes socialist! GOVERNMENT TAKEOVER!! Those baby hearing aids are a slippery slope, Kev.
“Companies in very competitive and price-sensitive businesses (think McDonald’s or Walmart) cannot simply raise consumer prices.”
What’s that got to do with health insurance companies? They pretty much do whatever they want.
These guys, always claiming a market approach is the most ideal and robust solution to literally everything, yet ready to fall to pieces at any moment.
Nigel Tufnel: Don’t touch it!
Marty DiBergi: We’ll I wasn’t going to touch it, I was just pointing at it.
Nigel Tufnel: Well… don’t point! It can’t be played.
Marty DiBergi: Don’t point, okay. Can I look at it?
Nigel Tufnel: No. no. That’s it, you’ve seen enough of that one.
I truly believe that low income Trump supporters, even when they are dying in the gutter from the predation of Ryancare, will manage to smirk in their final spasms of agony, triumphant in their spite that Obamacare was undone.
No — like most Americans, they are whiny and scream bloody hell if they personally get poked.
For profit health insurance would work great if insurers didn’t have to pay for, you know, medical care.
While it’s correct that the state must step in when the private sector can’t/won’t do what’s needed; regulations/mandates are often the least cost/most efficient (for society and the economy as a whole) means to get it done. And that’s the correct medicine in this issue.
While fraud and corruption is endemic in the US health care “system,” is there any evidence that it exists in the child hearing aid sector?
“The problem is that politicians would rather not have the paper trail. If the state of Texas were to package the hearing-aid benefit as what it is — a straightforward social-welfare program — then that would mean accounting for expenditures on the state’s budget, and levying taxes to pay for them. Because politicians are cowardly creatures, they would rather have the insurance companies tax you on their behalf rather than do the thing themselves.”
The honest statement. In fact, Matt Stoller believes it was this very fact that made the financial market a conscious choice of state actors (beginning back before Reagan) to obscure their fingerprints to an angry voter base:
“A simple way to state Krippner’s thesis is follows. In the 1970s, politicians got tired of fighting over who would get what, and just turned those decisions over to the depoliticized market. This is known as `financialization’. Then political leaders didn’t have to say “no” anymore to any constituency group, they could just say “blame the market”. It’s very much akin to the rationalization for inequality one hears from elites these days, that it’s globalization and technology, as if those are just natural trends with no human agency or decision-making involved.”
Marie, I think you will enjoy this history, “Capitalizing on Crisis”, by Greta Krippner.
http://mattstoller.tumblr.com/post/76864855963/review-of-capitalizing-on-crisis-by-greta
Interesting. Didn’t like treating inflation as some natural phenomenon; it can be but is usually man-made and someone is making an extra buck off it. Some mistakes by Stoller (or Knipper) in his discussion of her work, but not necessary to delve into them because Stoller redeemed himself near the end:
Mostly there were interests and individuals (Chicago Boys) that pushed legislators/regulators to make the changes they wanted — selling the snake oil as solutions to problems/issues that were manageable by other means. The smart people were locked out of the discussions during each of the critical points in time. (and by “smart” I don’t mean those like “The Best and Brightest.”)
Funny that Texas can just write a check — without having to raise taxes to cover the additional cost or cutting spending somewhere else to cover the additional cost.
Conservatives have very strange rules of accounting and of what they consider socialist.
Government paid private prisons somehow aren’t socialist institutions nor are government private military contractors because “that’s the only stuff that should be socialized”.
We prospered when we had a mixed economy and people understood what makes infrastructure common property. Then one party became ideologized as ant-communist, anti-socialist, anti-government, and now anti-public. What was understandable became the grounds of conflict and then opportunistic and corrupt electioneering.
I think we’ve reached the extreme point of this if the National Review is entertaining second thoughts.
There is only one mandate; pay your fair share of taxes.
I’m glad they brought up McDonalds, because that’s one of my favorite examples of bullshit conservative economics.
McDonalds is a company that makes billions by selling sub-par food (food its executives and shareholders, I’m sure, wouldn’t take one bite of) through predatory price-fixing, agricultural strong-arm market control tactics, and brutal exploitation of a disadvantaged non-union workforce of teens, the elderly, and immigrant labor. And they contribute to our national obesity and health crises (you could probably save billions in health care just by eliminating fast food).
Over the past few years there have been strikes, publicity drives, and all kinds of efforts to raise the pitifully-low wages for McDonalds’ employees.
And what happens? Wall Street types shriek in outrage: “You can’t raise wages! That would mean raising prices!” (And, therefore, defeating the purpose of bad food aimed at low-income customers.)
Of course, it never even occurs to them that raising wages without raising prices could be easily accomplished just by cutting into the obscene profit margins and the executives’ compensation. You could probably raise the hourly wage of every single McDonalds employee for a year, just by cutting five or ten million off of the bonuses the top executives get (with their private planes and multiple homes and dozens of cars and etc.) But that’s just beyond the pale — it’s crazy talk. Don’t you believe in capitalism? In rewarding “job creators”? Those precious executives might go elsewhere (and receive enormous “golden parachute” exit packages) if their precious hundreds of millions in compensation were threatened.
So that’s out of the question. It can only mean raising prices. That’s the only option. (Or, keep the wages low.) There aren’t any other factors in the equation except the holy, sacrosanct commandment of executive and shareholder compensation.
I think I know what it’s about, and why it’s so twisted. Their favorite thing to have their shorts in a twist about in the ACA is the requirement that insurers cover childbirth, which is like total government discrimination against dudes! And women past menopause (they carefully add). “Why should I pay for that?” To which the answer, of course, is why should women pay for prostate surgery, but let that pass.
Like Ryan, he doesn’t really understand what insurance is, other than a kind of club for the well-off, with members’ privileges, and he doesn’t think people should have it if they haven’t got the money to pay the full premium. He doesn’t want the lower orders to be “entitled”–let them have charity. And he doesn’t think government should interfere in this private gentlemen’s arrangement by issuing rules on what should and shouldn’t be covered at all (having never experienced or imagined the fear that he’s not covered for something he’s got.
So the Texas lege has given him an analogy here, to demonstrate how his views are not in any way targeting women, or the poor, but based on pure reason–and nonpartisan! Why, he’ll even argue against good-hearted Texas Republicans and nice little deaf babies!
And he never notices what a senseless analogy it is.
Doesn’t this make you want to donate to the National Review?
No, it makes we want to grab my baseball bat and knock some sense into him…
Congrats Booman: the NR noticed.
And you annoyed a one of their more dimwitted writers in the process.
http://www.nationalreview.com/corner/445763/martin-longman-dumb-plank
As so often, this whole discussion is based upon a category error.
Here is an experiment that will prove it.
Go listen to a short piece of instrumental music of your choice. Ideally, unless you really grudge the time, listen to it several times.
Now assess it from the standpoint of the “weakness of rational thought”. Is there anything “really coherent” in it? Does it display “consistency”? Do the major and minor premises of each syllogism support the conclusion?
Williamson is not doing rational discourse. He is doing performance art. His audience reads him the way they listen to music — as a succession of atomic gestures, each of which resonates subconsciously to a greater or lesser degree. What they are getting from it is an affect — in most cases, probably, nothing more. If they actually scan the words, what is being exchanged is a succession of verbal talismans, not any kind of “logical” “argument”.
So it is a category error to assess this kind of writing as if it were rational discourse, whereas in fact it is postmodern poetry.
You have also just written a very good description of Scalia’s legal writing.
How many ways can Republicans rationalize selfishness, all the while claiming not to be selfish? Sure, Texas, go ahead and legislate hearing aids for children. Just don’t pay for prenatal care or anything else.
The logical extension of Williamson’s article is single payer. He doesn’t see it only because he doesn’t want to.
Clearly, Williamson also doesn’t understand how insurance works, something he has in common with Paul Ryan. The costs of these hearing aids are not going to come directly out of the CEO’s compensation or even the profits of the insurance company. Unless, there are hundreds of thousands of deaf babies being born in Texas every year (and I doubt whether the number is even a couple hundred), this mandate will have a negligible impact on insurance rates and profitability. National review is a rag written by RW nutjobs for RW nutjobs.