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December 17, 2009

We are all cost vs. benefit utilitarians now!

Filed under: health care,Politics — David Hume @ 11:27 pm

Many liberals now want to kill the healthcare bill. At Talking Points Memo here is a dissent from an individual who is obviously going to get screwed if the bill is not passed:

If I feel abandoned, it’s not by Obama and the Democratic party, it’s by those on the left advocating to kill the bill.

I am unemployed and have a pre-existing condition that requires daily medicines, quarterly doctors visits and an annual test. I am on COBRA, which runs out mid-2010, when I will have to find new health insurance. I will need to purchase some kind of health insurance, assuming I can find provider who will insure me

I don’t pretend to understand all the intricacies of the health care reform bill, but I do read a lot. From what I can glean, if the bill passed, I would be able to find health insurance because I could not to be turned down due to my pre-exisiting condition. And based on my income at the moment, my premuims would be subsidized.
Am I disappointed in the reform effort? Yes. I believe in single payer. I was terribly disappointed the Medicare buy-in for 55 and older was dropped, not because I give a rat’s ass about Lieberman or the political wrangling involved, but because I am two years shy of 55 and I would have loved to be able to tough it out on the private market for a little while longer knowing Medicare coverage was just around the corner. Believe me, it’s scary being 52 and unemployed with a medical condition. Any form of security is vital.

My case is not unique or unusual. In fact, it is common. I am one of thousands if not millions with the same issues that this bill would affect. And when I read or hear people from the left arguing against the bill that would likely provide me and people like me with some modicum of security because the bill doesn’t accomplish everything they had hoped it would or it doesn’t help every last person or the insurance industry will benefit, I do feel abandoned.

Do liberals want these people to suffer? No. But, their working supposition now is that passing the bill and ameliorating the distress in this individual’s life (and many like them) will have negative long term consequences. So in a cost vs. benefit they now believe that this short-term injustice is something that must be accepted for the greater good; i.e., The Perfect Bill. So now liberals are in a position where they believe that they must accept that people will die because of lack of healthcare because the compromises necessitated will cause even more misery down the road. I find this all interesting because this is the exact same general framework that many moderate libertarians, such as Megan McArdle, are operating under. Megan et al. do not think that the current regime is optimal, but, they believe that just doing something, anything, is not necessarily superior to the status quo. Liberals may not accept the same ends as libertarian critics of the status quo, but the same cost vs. benefit analysis is compelling to them as well. They only make recourse to moralistic language bereft of a broader utilitarian context as a tactical measure. They too believe that sometimes you need to break a few eggs to make an omelette. Though this is always clear when those without political careers in the future openly admit the need for technoratic rationing. Some must die so that others may live. Thus it has always been.


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