As the Senate moves to debate the Senate health care bill, we're seeing another stream of opinion pieces that fall into the broad category of "Oh my God! Who would have thought that a government run health care plan would make coverage decisions based on political considerations?"
Most of them seem to come from feminists who blithely assume away concerns about the personhood of the fetus, and the staunch political opposition to subsidized abortion from those who lean towards the "person" side. This allows them to spend 1,000 words or so having a completely irrelevant discussion of the disparate effects of the Stupak amendment on poor women, arguing that women's reproductive health care is too real health care, and similarly unrelated side points.
Memo to authors: you could prove beyond a shadow of a doubt that women's health care is important, that this has a hugely disparate impact on women, that it will result in more women carrying unplanned pregnancies to term, etc . . . and that still wouldn't make a majority of the country want to pay for other peoples' abortions out of their tax dollars.
Moreover, there is near-perfect overlap between the group of people who most fervently desires a national health care system, and the group of people who are "strong" supporters of abortion rights (don't want them to be illegal at any time for any reason). This group thus has zero bargaining power, because at the end of the day, they are not going to walk away from this bill. The pro-lifers can and will.
(And no, you cannot get around this by arguing that the Catholic Church/evangelical liberals should care as much about the people who die from lack of health care as the fetuses killed by abortions. Last time I looked, there were over 1 million abortions a year in the United States. The most methodologically shoddy, activist-induced statistics on the number who die from lack of health insurance is 44,000, and the real number is much lower. The abortion statistics, on the other hand, are carefully collected numbers from a pro-choice group. Even if you only value a fetus as 1/20th of a person, the fetuses win.)
Moreover, abortion rights aren't really a good reason to walk away from this bill. The women who genuinely can't afford $500 bucks for an abortion are the women closest to the poverty line. Those women will be covered by Medicare, and they won't get abortion coverage anyway in most states. The women who will be buying insurance on the exchanges presumably mostly do not have health insurance now, and thus are losing nothing if their new insurance doesn't cover abortions.
The Joint Committee on Taxation does estimate that approximately 3 million people will exit employer-based health insurance for the exchanges, but almost certainly the majority of them will be people who are unlikely to be in need of abortion services, which are overwhelmingly consumed by a minority of women in a pretty narrow age band. Right now only 13% of abortions are currently paid for by private insurance.
If insurers do take abortion services out of their coverage, then according to the model used by the CBO and the JCT, that will reduce the price of insurance, and that money will flow back into paychecks.
Obviously, I am not saying that feminists shouldn't worry whether women will be denied access to abortion if this passes. But the number of people who are going to lose access that they currently have, and therefore be forced to carry a pregnancy to term, is not likely to be all that large. We're mostly talking about a modest number of women who will have to hand over several hundred dollars that they would really rather spend elsewhere. The very small number of women who currently have access to abortion services, and will lose them, and cannot get together a few hundred dollars for an abortion in time--those women can easily be taken care of if everyone who is outraged by this makes a small donation to Planned Parenthood.
So I don't get the outsized reaction to all this--I mean, outside the professional interest groups, who of course are contractually obligated to get outraged about everything. Fears that women will lose their current access to abortion often seem to be muddled together with frustration at not being able to expand access to abortion. But anyone who was not seriously entangled in an opaque ideological cocoon could see that using government funds to help expand access to abortion was never. going. to. happen. More people are against it than for it, and they're in a stronger bargaining position.
I wouldn't mind the complaining so much except for one thing; it's actually absorbing the energy, and media attention, that should be used to debate a real setback for women's reproductive health: the current Senate bill apparently does not include routine gynecological care in its basic package of required services.
Regular pap smears are the reason that cervical cancer is no longer a leading killer of women, and the exams can also help detect other problems that menace women's health and fertility. Most of the women who leave their employer plans for the exchanges won't be getting abortions--but most of them should be getting annual exams. Why not focus the movement's energy on something with a prayer of actually changing these bills for the better?
Copyright © 2010 by The Atlantic Monthly Group. All rights reserved.
Excellent post, Megan.
What we learn from all the arguments on abortion funding is: once the state controls the funding for a specific service - in this case healthcare services - you better hope and pray that your needs/wants/desires for said service are that of the majority.
Megan good article. Another important one which you missed is contraceptives. Does the current version of the bill provide women access and coverage to contraceptives? Would that include ones considered abotifacient like plan B?
Megan wrote: "The women who genuinely can't afford $500 bucks for an abortion are the women closest to the poverty line. Those women will be covered by Medicare, and they won't get abortion coverage anyway in most states."
You mean Medicaid, not Medicare. A sloppy mistake for one writing about health care reform. Not too many in the over-65 crowd needing any abortion coverage.
I was going to point out this typo, too, in part for sake of clarity for readers, but mostly because I think that I'm really awesome because I know the difference between Medicaid and Medicare.
Of course Megan knows the difference, too, and this was just a typo and there's no reason to be snarky and dissing it as a "sloppy mistake." What is it about anonymous blogging and commentating that brings out the obnoxious arrogance in so many of us (including myself at times)?
I'm not being arrogant. A typo is typing "Medicase" instead of "Medicare". Conflating Medicare and Medicaid is altogether different and a very frequent mistake made by both journalists and policymakers who should well know better. There is no shortage of misinformation in the health care reform debate. I think the distinction is critical, especially when you consider the proposals for opt-out or opt-in on the public option. When you examine the differences between a state-administered healthcare program and a federally administered healthcare program, they are stark.
The programs should be remained to correct the problem ASAP.
I vote for PoorPeopleCare™ and OldPeopleCare™ or PPC and OPC for short. Obama's new program will have to fall under LPC - LazyPeopleCare
Oh please. To quote the old but reliable flame warriors:
Nitpick compensates for his limited fighting ability by pouncing on points that are only marginally relevant to the discussion. For example, if his opponent in a sports forum conflict casually mentioned the Cubs’ 4-2 victory in the 1908 World Series, Nitpick would quickly counterattack with something like, “4-2 !? Any moron knows the Cubs won the Series 4-1!
My personal rule-of-thumb: A mistake made once is innocent, provided the context makes it clear what was intended. A mistake made two or more times, icnonsistently, suggests poor writing and/or proofreading skills. A mistake made two or more times, consistently, suggests a person might not have a good grasp of the topic under discussion.
I thought JWAL was only a little bit snarky, in a way that might help people remember the difference.
I think the mistake that Ms. McArdle made is a variation on the brain glitch that produces Freudian slips.
A typo, as JWAL says, is when you type "Madicaid" instead of Medicaid.
McArdle's error reveals a carelessness born of an utter inability to empathize or care about people for whom $500 is a Big F***ing Deal.
men pay for most abortions, either the presumed father(s) or male friends.
this is of course never mentioned by pro-choice folks, but actually bothering to ask girls who get abortions where the money came from reveals this again and again.
It's not a Big F***ing Deal for me or for anyone who works for a living either. And not our problem. Pregnancy is not a disease and abortion is not a cure.
Medicare and Medicaid are both welfare programs. One is purely federal funded and the other state and federally funded but both are run under federal mandates. While any state could in theory opt out of medicare, they wage earners in that state would still have to pay the federal payroll tax portion allocated for medicaid. For the tax payer, between the two there isn't that much of a difference. Please keep the snark to a minimum.
I was told that abortion was a sacrosanct discussion between a woman and her doctor and that government should never be involved in decisions about our bodies and our health. That was always the appeal to me, as a libertarian, of the pro-choise position.
When you throw that argument under the bus to get free health care through government intervention, you lose me. It's not like I was ever going to be happy about abortions but I could see a principled argument that the State should stay out of it.
It's beginning to look like Leftism really doesn't rest on any principles after all, just whatever might fool the rubes into embracing the State. Go figure.
If you're not happy about abortion, then I'm not sure what the principled libertarian argument was that the state should stay out of it. Most abortion opponents think (or should think) that abortion involves more than the mother and her body, but the baby as well, which is also a human being (and person). And of course, a libertarian should think that the state should intervene in the affairs of its citizens, in cases where some of its citizens are are contemplating taking the life of an innocent human being (person).
When I say I could "see" that argument, I guess it was a more polite way to say I didn't spit-take when I heard it. I could believe that someone could end their analysis at that point--that it's none of the State's business.
I'm not so sure I agree that your position--as elucidated--is a particularly libertarian one. But it is mine as well. I'm not such a great libertarian but I pray every day to get better!
But a libertarian does not necessarily think that all people must consider a fetus a person. One could presumably be Christian, libertarian, and dislike abortions, yet still respect that other people do not think that a fetus is a person. Of course, one can think that abortion should not be restricted yet still support the outlaw of using public funds for abortion. There is no inconsistency there.
If the abortion restriction is being added by a liberal Congress with a liberal President, what sorts of other ideological provisions do liberals think will added once Congress and the Presidency revert to conservatives? No coverage of birth control? No coverage for treatment of STDs, since only immoral people get those?
Stupak is actually the slippery slope that the anti-reform people and the GOP were warning us about all summer. It defines a specific medical procedure as out-of-bounds. And if you do that to one procedure, you can do it to any procedure. What Stupak does is establish an avenue for government to actively deny people certain types of medical care. Maybe no one will stand up for abortion, but what about other elective surgeries?
As for the liberal/conservative question, every Republican in the House except one voted for the amendment (the other voted present). Perhaps it was strategic, but it makes me take GOP arguments about "threats to freedom" with a big grain of salt.
What if a racist libertarian didn't consider blacks to be persons? Would you respect that choice?
Hagios, I would not grant the same respect to the opinion of someone who did not consider those of a different race to be human. But that is a different question. Whether a person is a human an easy question to answer because of DNA.
It is not clear that a fetus is a person. And if a fetus is a person, it is not clear when a fetus becomes a person. Furthermore, it is even less clear as to when a fetus should be entitled to rights and as to when the fetus's rights should outweigh those of the mother.
TomB:
I'm not trying to disagree or say a fetus is more of a person than someone of a different race, but your DNA analogy is awful. The difference in DNA between some primates and humans is infinitesimal, and humans actually share a lot of DNA with many species of insects, mammals, etc. On the other hand, my friend's fetus shares more of the same DNA with her than does her Asian neighbor.
Your second paragraph is much more on target, and is one of the main faults I have as a conservative with the legislation.
Sorry, make that your second paragraph of your previous post (12:55 PM)
Since I apparently have nothing better to do, let me clarify.
What I mean is that we are the same genus and species. We can reproduce with each other. We can't, despite my earnest attempts, reproduce with other primates. So even if the DNA differences between us and animals are infinitesimal as a percentage, they are sufficiently significant to differentiate us as a species. We are all human, and arguments to the contrary must be based on some appeal to a superficial factor. At least superficial now that we are civilized.
With the personhood of a fetus, there is more room for argument.
It seems clear enough to me that if what we care about is protecting the rights of persons, then some clarity and objectivity about who is and is not a person is pretty critical. That's why the idea that we should leave it up to individual judgment about who is--and who is not--a person, seems utterly incoherent to me.
And having a category of thought and law of "human-but-not-person" gives me the willies. Of course, it's less concerning if you cannot imagine society around you deciding YOU now belong in that category.
TomB:
I wasn't trying to get nitpicky for the sake of being nitpicky, so I apologize if it seemed that way. My general point was, in fact, that because we are a civilized society, we shouldn't use something superficial, because that has tended to get us in trouble in the past (religion, race, gender, sexuality, etc.). I was trying to convey that (poorly) by pointing out that the science is much more complicated than that, as well as endlessly changing.
In fact, in my experience as a current medical school student science does not answer this question at all, nor should it. Currently, there is no objective viewpoint that says "This is a human, this you can discard." In the end, it comes down to personal morality, ethics, religion, or whatever you want to call it. In that case, it comes down to whoever has the most votes to legislate what they think is right. This is a perfect example of my problem with government health care: what will or won't be morally acceptable to pay for/cover next?
I'm one of those who think health insurance should really be insurance against major events, not prepaid health care plans for predictable expenses. So I would argue against including annual exams (of any kind) or contraceptives. That's exactly the kind of thing people should include in a normal budget and not expect to get "for free."
I'm female and very much in favor of regular exams and contraceptive use. I even think first trimester abortions should be legal, although I arrive at that conclusion reluctantly. But I don't think that anybody else is obliged to buy that stuff for me, any more than they pay for my eyeglasses.
Preventative care does decrease the need for/cost of major events. More pap smears = fewer radiation treatments. That's why insurance companies (often) give you preventative care for free.
Indeed. The libertarian/conservative approach to health care reform usually involves implementing more of a pay-as-you-go system that doesn't cover routine exams, preventative care, etc. The more people are accountable for those costs and the more transparent the costs are, the more they'll shop around, and greater competition will result in lower prices, increased availability, etc.
But, as you note, that may not be in the interests of your insurer, even if they're only ostensibly covering major expenses. They may wish to cover preventative care as a way of heading off those more expensive claims further down the road (this is especially true if we end up moving toward an individual insurance market where you're less likely to switch plans when you take a new job). Likewise, it may be in their interests to limit you to services performed by specific providers with which they've negotiated low rates. And, of course, if your perception of the situation is that this keeps your costs lower, you'll see it as being in your interests to go along. And that kinda puts us right back where we started.
Agreed, I think that the reaction to the proposed amendment clearly highlights the difference between those who can legitimately be called “pro-choice” (at least on abortion” and those who are actually just pro-abortion. There is nothing “pro-choice” about using the power of the State to force someone else to pay for an abortion whether it is through confiscating their money directly through taxes or by mandating that a third party (e.g. insurance provider, hospital, doctor) provide or pay for it. The people who want Medicaid to pay for elective abortions or for tax dollars to subsidize policies that cover abortions or for the “exchanges” to mandate that private insurance policies cover abortions aren’t “pro-choice,” they’re pro-abortion.
Precisely.
For years, the Left, with both the conscious and unconscious assistance of the 'old media' have played a massive Orwellian word game with public affairs, since they onntrolled the media and the academy, they got to define the terms of the debate. This was nearly unchallenged until the last fifteen-twenty years, and the challenge only became daunting in the last ten.
Most 'pro-choice' activists are actually pro-abortion. There's a strong overlap between them and the 'zero-growth' activists who obsess about overpopulation, and indeed one of the roots of the pro-abortion movement are in population control. Margaret Sanger was not the staunch advocate for poor and weak women that the feminist movement wants to paint her as, for example.
We see the same phenomenon in many areas, for that matter. There's an ongoing attempt to replace the phrase 'illegal alien' with 'undocumented American', for example, or to define all opposition to Obama as 'racism'.
When you're following politics, watch the choice of words a speaker or group uses. In a large percentage of the cases, their choice of of words will tell you a great deal about who they are and what they really believe in.
The larger issue is how Obama's health care plan will kill mostly women.
See this NY Times article on how the death panelists are recommending not allowing women under 21 to get a pap smear any longer.
They're already trying to cut out mammograms and now pap smears. You girls are going to be the primary targets for cost-cutting. You have a lot of extra costs involved in your reproductive organs that the cost-cutters are going to focus on.
Forget about abortion ... you should be more worried about forced hysterectomies and mandatory tubal ligation. Good luck with your cervical cancer under Obama ladies.
http://www.nytimes.com/2009/11/20/health/20pap.html?_r=1
Well, yes, that's because it's becoming increasingly obvious that you don't need to treat adolescents with pap smear abnormalities, so why look for them?
Some things are just not amenable to practice by armchair know-it-alls like yourself, and medicine just happens to be one of those things.
Some things are just not amenable to practice by armchair know-it-alls
I hope you don't mind me pilfering this sentence and re-using it frequently.
So Obama is out to kill blacks and women now? Leaving only white men? Who typically vote Republican?
Obama is really Dick Cheney in disguise?
As usual Mover appears incapable of reading what he links to.
"The advice, from the American College of Obstetricians and Gynecologists, is meant to decrease unnecessary testing and potentially harmful treatment, particularly in teenagers and young women. The group’s previous guidelines had recommended yearly testing for young women, starting within three years of their first sexual intercourse, but no later than age 21."
Obama and health care reform had absolutely nothing to do with the recommendation.
They'll, of course, be implementing the recommendations of the death panels.
And probably saving lives by doing so, by reducing rates of premature labor due to cervical damage from unecessary surgical procedures.
Yes, yes ... all in the interests of saving lives ... so many pap smears ending in the accidental deaths of the patient.
Oh, and no flu shots for you if you're over 65. There's simply not enough to go around.
Another death panel is born:
http://www.lvrj.com/news/elderly-question-flu-shot-controls-78063362.html
DBN,
"Dr. Iglesia said the argument for changing Pap screening was more compelling than that for cutting back on mammography — which the obstetricians’ group has staunchly opposed — because there is more potential for harm from the overuse of Pap tests. The reason is that young women are especially prone to develop abnormalities in the cervix that appear to be precancerous, but that will go away if left alone. But when Pap tests find the growths, doctors often remove them, with procedures that can injure the cervix and lead to problems later when a woman becomes pregnant, including premature birth and an increased risk of needing a Caesarean."
So ... we should stop pap smears because:
1) If you give a women a pap smear the doctors might find something.
2) If the doctors find something, they might try to do something
3) If they try to do something, side effects occur from treatment.
So, stop pap smear testing? That's their solution to the side effects of treatment. With no discussion what the mathematical odds say will happen to incidences of cervical cancer? Stop testing because we might find something and somebody might get hurt. That's their big theory?
Hey, it's your cervix. I could really care less, since I don't have one and I can give myself a prostate exam. But if you can't see the logical fallacy that's being foisted upon you by unelected "experts" set on denying you the health care your insurance contract demands then I hope you do get cancer.
I would certainly not recommend eliminating Pap smears in general. They're one of the best examples of effective screening we have.
However, it's becoming obvious that using them on adolescents is inappropriate. Pap smears are most appropriate on women in their 20's and 30's; in adolescents, the precancerous lesions are much less common, and much more likely to regress on their own. And because of the natural history of cervical cancer, lesions that begin in teens can still be caught safely in the 20's if they fail to regress.
The downside of screening teens is that you catch a lot more nothings, and the not-nothings could have been caught just as safely later.
Colonoscopies are good for detecting neoplastic precursors in 50 year olds, but that doesn't mean the average 15 year old should get one. Screening has to be adapted to the demographics of the population and natural history of the disease, or it does more harm than good.
I found a troll!
But otherwise,
Great post, Megan! It's nice to have a sober cost/benefit look at this to compare with the more emotional arguments.
I never thought the plans in the public exchange were going to cover abortion. Americans simply don't want their tax dollars to subsidize abortions.
Americans don't want Obamacare at all, it's popularity is in free fall, yet the Dems are pressing forward. This goes to the heart of several things that motivate them, they've wanted this for decades and the leaders of the Party are mostly from safe, super-liberal districts. Nationalized health care has been a fixation of the Dems for fifty years, and abortion has been the symbollic heart of their cultural activists for thirty-five years. Right now they control both Houses of Congress and the White House, so there's a sense of 'now or never' at work.
Rest assured, right now they still plan to cover abortion with this, they're just planning to take the Stupak provisions out in some later stage. They may end up not achieving it, but that's the plan.
"Regular pap smears are the reason that cervical cancer is no longer a leading killer of women, and the exams can also help detect other problems that menace women's health and fertility."
If they are regular and routine, they really shouldn't be covered by insurance anyway.
I know that is kinda beside the main point of the article, but it just goes to demonstrate the extent to which "insurance" has become a code word for "socialism" in the socialized medicine debate. These sort of casual comments indicate the extent to which we already accept this truth.
One also notes that assumption that women just wake up one day and find themselves pregnant.
The knowledge that they will be shelling out their own money may ensure the best of all possible scenarios all around, for at least some of them: they don't get pregnant.
The outrage is easy to understand- those outraged had thought Obamacare was a way to get rid of the Hyde Amendment once and for all time. They found out they were wrong.
You nailed it right. The outraged were trying to be too clever by half.
Megan, your analysis is excellent. I also have been astounded by the overreaction by some to the Stupek Admendment. Per the Hyde Amendment, government provided health services already don't cover abortion services, except for very narrowly defined situations. Stupek doesn't seem to really veer very far from Hyde, so I don't get the wailing and knashing of teeth by the feminist/pro-choice crowd.
I'm pro-choice and don't think it's any of my business to tell someone whether or not they should carry a pregnancy to term. However, I do not want my tax dollars used to pay for abortions and am fully in support to the Stupek Amendment.
The wailing and gnashing of teeth is because, as others have noted, the Democrats' activist core really saw this (and still do!) see this as a road to full public subsidy of abortions. For them, that's a large part of the entire point.
These people have always seen Roe as a beginning, a first step, toward a much more elaborate vision, and they've been frustrated for decades by public and religious resistance to it.
Why should health "insurance" pay for contraceptives at all? I mean, my car insurance does not pay for oil changes, car washes and fancy spinners for the wheels. I get why preventative visits (including those of a gynecological nature) are covered - it is sort of like the safe-driver discount or the discount for taking a defensive driving course, but contraceptives are part of a lifestyle choice (one I wholly endorse, but that's my choice). Why should this be covered by insurance? It is not an "unforeseen event", it is simply the cost of living your life the way you choose to live it - and why should the other folks in your insurance pool pay for it? And isn't it sexist that most insurance presently covers female, but not male, contraceptives? Of course, like any other medication, one should be able to use HSA account money to pay for all kinds of contraceptives.
I also think there is a practical argument to this - I truly believe that if Americans were purchasing their pharmaceutical products themselves, for cash, that we'd see some real movement on pricing. The PharaCos would be getting cash on the counter, instead of dicking around with insurance companies, and we'd see some real pressure on pricing, instead of just demagoguery and empty promises.
If only people took a totally rational approach to having sex. They would carefully plan each time they had sex and with whom, taking precautions each time and never using any substances that would cloud their thinking .
In the real world, half of all pregnancies are unplanned.Pregnancies happen even among teenagers who take abstinence pledges. Hey, I know more than one case in which it happened to single people who were studying to enter the ministry! And there are quite a few women who are pro-life-until they have an unplanned pregnancy .
http://mypage.direct.ca/w/writer/anti-tales.html
If only people took a totally rational approach to having sex. They would carefully plan each time they had sex and with whom, taking precautions each time and never using any substances that would cloud their thinking .
Well some of us do.
And we get pissed off at paying for other peoples drunken sex romps.
If only there were a vaccination
against pregnancy, and other STDs.
If only people took a totally rational approach to having sex. They would carefully plan each time they had sex and with whom, taking precautions each time and never using any substances that would cloud their thinking.
If that argument is good enough to justify gun control, then it ought to be good enough to justify sex control.
those tales are all third hand and have no first-person sourcing. so they kinda are 'tales' rather than 'verifiable'.
And there are a lot of woman who are pro-'choice' until they get pregnant. Either way, it's not my obligation to pay for someone else's pregnancy. When you have sex, you have to consider the possibility of pregnancy.
Abortion is only one of several sizzling hot political issues masquerading as health-care in this bill.
A few others to consider:
1) illegal migration
2) re-distributive tax increases
3) government rationing of public services
Spot on.
I still remember Obama's infamous speech before Congress (really an address to the public) after the Town Meetings of August, in which he tried to rally support. Up until that point, supporrters had been throwing around the figure of, IIRC, 47 million uninsured.
That number only made sense if you count illegals as 'uninsured', and were planning to cover them. But in that speech Obama wanted to put out the word that they would not be covered (in fact, the Dems do intend to cover them, but they know they have to lie about it), so the 47 million figure magically fell to 30 million at that point.
People joked at the time about how the plan was so impressive that it covered 17 million people without even having been passed yet.
Regarding government rationing, it's instructive to look at past writings by Rahm Emanuel's brother, who was right in the middle of the planning stages of Obamacare. His comments about the balance of remaining lifespan and 'utility' to the community are chilling.
Yes, I agree that Ezekiel Emanuel's sentiments on "the balance or remaining lifestyle and utility to the community" are unsettling (particular in the context of a gov't mandate), but there is some truth to what he's saying. I think we tend to get delusional when we ignore that death is a reality and one that is a perfectly normal biological function. At what point does life support go too far? When keeping someone alive consumes so many resources that we can't educate our youth effectively or it discourages investment (over-taxation on both labor and capital) in the US, an inconvenient truth arises: such a balance between lifespan and communal utility exists.
It's tough, but it's the truth. Call me a Nazi/Fascist or whatever you like, but we can't go on forever putting off grandma's death as she increasingly struggles to enjoy and watch her favorite tv show as her condition worsens. Life is finite and we need to learn to except that. Not all of us are Bill Gates or Walt Disney. We can't afford to fight death forever nor can society.
Gov't rationing? Meh, don't we already ration healthcare based on our wage and who employs us?
That is not rationing.
Everyone should pay for their own health care. If they can't, then they need to accept that life is finite and we all die.
If everyone adopted your attitude, there wouldn't be this manufactured "crisis" of lack of coverage.
I applaud your maturity.
2nd attempt, to correct the codes.
Great, so you're against universal coverage, right?Everyone should pay for their own health care. If they can't, then they need to accept that life is finite and we all die.
If everyone adopted your attitude, there wouldn't be this manufactured "crisis" of lack of coverage.
I applaud your maturity.
It doesn't really matter whether I'm for universal coverage or not. I was just pointing out that one of the largest contributors to our healthcare problem is the intensive care to keep someone alive shortly before they die. Obviously it's difficult to predict when someone will die, but we should be more respectful to the realities of death. I'm talking about the cases here when a patients family member keep making decisions to prolong their family member's life when their odds aren't looking too good. I know the whole "odds not looking too good" phrase is scary, but most IC doctors can tell you a patients odds with straight face.
I do think this crisis isn't manufactured because manufacturing is something we do directly and willingly. I think the crisis is an externality of the way the existing market is structured. It's not greedy insurance agents, it's not big pharma, and it's not greedy doctors, it's the way we consume healthcare that gives all participants in the market, the producers (healthcare and pharma), the intermediaries (insurance, financiers, billers, gov't), and ultimately the consumer, the incentives to use and distribute the healthcare resources inefficiently.
I conclude that there is a lack of coverage. My gf is a college student and her parents were recently laid off. As a result she has no health insurance. Sure, she can get insurance through school, but it delivers very little value to her because it doesn't cover what she needs. I don't get why our taxes can go to fund an elderly individual with a .00n probability of surviving more than a month after a $nn,000+ procedure that requires a week of IC care costing $n,000 a day and not some young girl who costs less to treat and is likely more useful to society in the long run. I'm not saying slaughter the seniors, but be realistic. It's pathetic that we ration our healthcare that affords grandma to watch oprah and die an extra month instead of affording a working family or student basic healthcare without bankrupting them.
The issue may not be so much as a lack of coverage but rather too much coverage for some. 55% of the healthcare is payed for by the gov't. We already ration our healthcare resources based on how much we can afford. The bigger problem isn't figuring out how to ration or developing some sophisticated insurance scheme to pay for it, but rather how to bring prices in line with their true value. Our market is distorted. We give specialists the incentive to prescribe procedures like crazy. Consumers don't know the true costs of those procedures let alone what they, their insurance, and gov't transfers can actually provide. We disguise value. Paying for anything with insurance is the most expensive way to pay for anything.
More $$$ for abortion = less money for blowing $hit/people up. Sanctity of life, etc. etc.
Your concern for the sanctity of $hit is duly noted.
I am pro-life but if a woman chooses to have an abortion she will do so.What I object to is paying for it. I would like to see more education on preventing unwanted pregnancies (including abstinence) & adoption instead of abortion in schools & in news media outlets.
Where did you come up with that ratio for the value of a fetus compared to a human - 1/20th??? That is a very arbitrary number you came up with in order to say, "The fetuses win!!!", whatever that means. I think a more apt ratio for valuation would be either the number of cells that make up said organism (fetus, newly born, or adult), or their mass. In this way we can value fetuses, especially fetuses in the first few weeks of pregnancy, as being thousands or millions of times less valuable than a single person, and so - the people win!!! Yay!!! More people die from lack of healthcare than fetuses from abortion every year (according to my own highly arbitrary metric.) Can we have universal health care now?
Megan didn't come up with the 1/20th number arbitrarily. That is simply what the math says.
44,000 unecessary deaths due to lack of insurance, divided by 1 million aborted fetuses, equals slightly less than 1/20.
That whooshing sound was Megan's logic blowing past you.
Pay for your own health care. What a concept!
I'm not completely clear on why pro-lifers preferences about what they want their tax dollars to pay for are so sacrosanct. Pacifists have to pay for wars, vegans have to subsidize school lunches that include meat and milk, I have to pay for agricultural subsidies. Why are their tax dollars so special?
You're free to petition the government to pass a law that eliminates the federal funding of bombs... Don't get upset because someone else is able to pass legislation.
National defense is a constitutional requirement. If pacifists (the ultimate freeloaders) are that vexed about war spending they can always amend the constitution. As for agricultural subsidies, you have a point. It should not be a tax payer subsidy.
Because they have the voting power to make their wishes count, and the center of political gravity is moving their way, for Darwinian and cyclical reasons.
About national defense...what Cubanbob said. About ag subsidies--I agree.
About school lunches that include non-vegan things: well, if you are saying that Vegans are, or should be, as offended by paying for someone else to eat meat, as pro-lifers are about the killing of an unborn child, then I would say your moral compass is off. And so is any Vegan who actually thinks these are in the same moral neighborhood.
Despite all the silly rhetoric one hears to the contrary, law does ultimately involve collective moral judgments.
I'm against agricultural subsidies too, but I'm pretty clear on why I have to pay for it. Farmers vote for congressmen, agribusiness donates to congressmen, congressmen pass the laws.
Because they have a pretty clear majority of the voters...
Because they have the representation in Congress to enforce their demands. Duh.
Congress effectively voted for the war in Iraq (by abdicating the decision to the executive branch and then voting to continue the funding every time it came up).
Same with the rest - the school lunch program has enough defenders in Congress to make it happen. Subsidized abortions don't.
I think I want to introduce a Stonetools Amendment opting out of paying for trillion dollar unnecessary wars. Those who want to financially support such wars should be free to do so. Its the conservative, libertarian way.
Why you would assuem a libertarian would be automatically against such an idea is beyond me.
But a counter point is that we have essentially all agreed, since the inception of the US, is that defense is a public good. I'm pretty sure the same thing cannot be said for abortion services. If abortion is under the umbrella of health care, which is a semi-public good...well, that's what we're debating now isn't it.
In the end, I would applaud any measure to make war more difficult to wage. Having Congress actually vote on whether to wage it instead of abrogating their Constitutional responsibility would be a good start.
And if you can get the votes, there may well be fewer wars. Certainly fewer ones that we can win. Good luck with that.
The most methodologically shoddy, activist-induced statistics on the number who die from lack of health insurance is 44,000, and the real number is much lower
Shorter Megan: this study disagrees with my ideologically arrived at conclusion , so it must be wrong. I myself say so.
This study - http://pnhp.org/excessdeaths/health-insurance-and-mortality-in-US-adults.pdf - was published in the America Journal of Public Health, a peer reviewed journal, and was touted by Harvard. I guess peer review and you know, actual scientific research doesn't mean much around these parts.
No need to pile on about the Medicare/Medicaid glitch. I guess to libertarians it's all that evil gumint health care.
I think Megan and Ezra are right and that reform backers want health care reform more than expanded abortion rights. Count on the Stupak language surviving, then. This means more unwanted children born to poor women and more deaths and injuries from do-it-yourself abortions.
Conservatives, who love unborn children up to the moment of their birth, can be relied on to oppose any funding to help poor young mothers and abused children. Sad and hypocritical , but there it is.
If I don't advocate the extermination of the homeless, am I hypocrite for not wanting to spend money to house them?
Actually yes you are . Next question.
If you pose a dumbly unrealistic hypothetical, expect a similar answer.
If you are in favor of a course of action that leads to the bringing of unwanted children into the world, it seems that the least you can do is to cowboy up and be willing to pay for their upkeep. If we could impose a special tax on abortion opponents to pay for the pre and post natal care of unwanted children, most opposition to abortion rights would disappear overnight.
If we could impose a special tax on abortion opponents to pay for the pre and post natal care of unwanted children, most opposition to abortion rights would disappear overnight.
If we could impose a special tax on abortion defenders to pay for the loss of expected utility of the fetus, support for abortion would disappear overnight
This is a fun game!
If we could impose a special tax on social liberals equal to the cost of a father's contribution to raising children, then support for single motherhood would disappear overnight.
If the point you are making is that progressives have a worldview which properly internalizes the cost of their actions rather than shifts it to others, then you are playing a losing hand.
You have a lot of attitude for someone who just got owned.
So presuming that you are not posting from a hut in Africa, are you in favor of Africans dying of starvation and disease because you have not reduced your lifestyle below the point where you have internet service, and sent the money to Africa? Or is this logic ridiculous?
Stonetools, passing peer review does not make a study impervious to attacks on its methodology or conclusion. You can find a study that says just about anything.
Hagios, I believe the expected value of a fetus is likely negative. I am estimating here, but most people have to reach the age of 22 before they start earning more than they spend. And then they have a long way to go to earn back all of the money it cost to raise them.
Also, Yancey Ward and Jay are winrars.
Um, I'm pretty sure that most abortion opponents are also AGAINST the course of action that leads to the bringing of unwanted children into the world, today. Though your idea that I should be taxed because YOU screwed around is certainly novel.
Hagios, I believe the expected value of a fetus is likely negative. I am estimating here, but most people have to reach the age of 22 before they start earning more than they spend. And then they have a long way to go to earn back all of the money it cost to raise them.
And?
You admit that they will earn back all of it, so that makes it positive.
"it seems" isn't really an argument.
Anyway, you've come up with a great argument for the welfare state. I'm against killing people, so it seems I must be responsible for feeding and clothing them all. Tax me 100%, its only fair!
Conservatives, who love unborn children up to the moment of their birth, can be relied on to oppose any funding to help poor young mothers and abused children. Sad and hypocritical , but there it is.
You do realize that rates of child poverty and broader indexes such as the Kids Count index of Child Well-Being all worsened from the early 1970's until the mid-1990's, and then improved above the previous baselines, even after adjusting for the state of the economy? If we go by "have beliefs grounded in empirical evidence about what actually benefits children" then conservatives are the ones who care about children, not progressives.
Well from the mid 1970s to 1992, we had mostly Republican presidents. Then things began to improve under a Democrat. Thanks for that stat. I do not think it proves what you think it proves .
I don't think anyone in this whole wide world thinks that Republican administrations care much about poor children. I mean, really, come on, that's not even plausible.
I think he's pointing to welfare reform...
Maybe you could run through the dominant parties in the Senate and House during that same time period. I don't think it says quite what you think it says, especially considering which branch of government passes the budget.
I see that everyone replying is all gung ho about pursuing a policy that will bring unwanted children into the world but also insist that there is no obligation to financially help these children and their mothers. Yep, that's conservative "logic" for you. You WILL have these children and you WILL raise them also, with no help from me!
Of course, these self righteous Scrooges fail to understand that they will pay for those children when they show up the schools and unfortunately all too often in jails, group homes , emergency rooms and in social program rolls.
You pays now or you pays later, but you pays.
no, one can financially help those children and their mothers through private means, rather than governmental coercion.
i don't have to be bullied to help out single mothers, and falsely framing the issue as 'if you don't support government checks for single mothers, you totally don't want to financially support them!' is quite dishonest.
conservatives actually tend to privately support single mothers. conservatives in fact tend to provide private support, which is why they don't like government-funded coercive social welfare schemes.
It isn't poor women who are having the huge majority of abortions. The large majority of abortions, based on the figures of the Alan Guttmacher Institute, are sought out women in the 20s and 30s, with incomes well above poverty level. A significant percentage of that majority are 'repeat' 2nd or 3rd instances.
(Since those numbers first came out, the AGI has been trying to massage their figures to make it look more like the propaganda is accurate, playing games with definitions of phrases like 'economically disadvantaged'. You have to go digging to find the figures in a straight form.)
The poor scared teenager or poor single woman denied an abortion is the favorite propaganda image of the pro-abrotion movement, but it's mostly a myth.
it's actually absorbing the energy, and media attention, that should be used to debate a real setback for women's reproductive health: the current Senate bill apparently does not include routine gynecological care in its basic package of required services.
That is as it should be. That's insurance 101: Insurance is the transfer of risk from an individual or business unable to bear the risk to the capital markets, which can. Routine gynecological care is not a risk. It is a certainty.
Routine care is not, in any measure, an insurable risk. You are confusing insurance with entitlements.
If people would remember the difference between insurance and entitlement, this bill would be much less problematic.
Here's something I honestly don't get: how is the proposed "taxpayers paying for abortion" thing any better or worse than what already exists?
I mean, we're already fudging things a little here to claim that taxpayers are going to be directly paying for abortions, no? As I understand it, the core of the current legislation proposes an exchange that people can choose to pay into. That plan is sure to be subsidized by the government in some way, and there are various proposals for how to mix in abortion coverage that involve options in the exchange with various levels of abortion coverage + extra premiums, etc.
The objection is that somehow, some way, any government subsidy that touches any part of this system is thus involved in "paying for abortions" even if the money isn't directly connected.
The question is: how is this different than nearly all private insurance now? Currently, whether we actually have abortion coverage in our plans or not (and few of us have any choice in insurers: our employers do) we pay into a large pool of insurance that generally will also cover abortions on other plans. It's all the same pool of money.
Even the RNC, which claims to have fixed its "we cover abortion" problem is still doing the same thing: they are paying into an insurance pool that covers abortions (even if their employees do not receive that particular sort of coverage).
And the entire thing is HUGELY subsidized by the current tax exemptions (unless you really think that not taxing one part of the economy while taxing the rest isn't a subsidy).
how is this different than nearly all private insurance now?
Choice.
and few of us have any choice in insurers: our employers do. A ridiculous myth. You are under zero obligation to take your employers' plan. You can purchase coverage as an individual for your family, and you can do it right now. And if you want to purchase a plan that doesn't cover abortions (few, actually, do), you are perfectly free to do so.
You lose your employer's subsidy (maybe), but that's not at all the same as not having a choice.
Women would remain free to purchase abortion coverage from plans that are not federally subsidized. How is that different from losing your employer's subsidy if you choose to buy your own insurance rather than taking yor workplace coverage?
And given the fact that abortion is vastly cheaper than childbirth I suspect most insurers will market some sort of supplemental "Women's care" policy on the side precisely for this purpose.
Women would remain free to purchase abortion coverage from plans that are not federally subsidized.
This is one of the biggest lies of all Obama's lies. Obama lied that if you like your current plan, you can keep it. The problem is this: there won't be any plans that are not federally subsidized. They will disappear from the market. Healthy individuals will flee them for the subsidized plans. Adverse selection will cause them to collapse, and destroy the private health insurance industry.
To Obama and his clowns, this is a feature, not a bug. (Remember, Obama happens to be a proponent of a single-payor system. He WANTS to get rid of private plans. "Everybody in, nobody out."
In other words, choice be damned.
And given the fact that abortion is vastly cheaper than childbirth I suspect most insurers will market some sort of supplemental "Women's care" policy on the side precisely for this purpose.
They are free to do so now.
But insurers don't want to abort fetuses. They want to profitably ensure customers' children for 18 years and collect premiums on family plans.
If pro-abortion people were proposing sterilization for those not wanting children, I would vote for that & recommend it. After you have one child given up for adoption, get yourself "fixed".If you want children later in life , adopt one of those unwanted human babies. To ask us "pro-life" to kill or pay to kill a human baby because you don`t want it , well you ask too much.I would also be willing to support surgery removing embryos & placing them into women who are willing to carry them to term.
Uh huh.
Also, we should ensure that any man who decides not to take care of a child and ends up paying child support instead should get a vasectomy.
Ditto for guys who start pregnancies that end in abortion.
Cause we wouldn't want things to be unfair, would we?
Or perhaps we do.
I assume they would end up under the same rules - 1 adoption and sterile. Child support is fine, as it is paying for his child. And as long as women get to choose to abort, that can't be counted against the man. Now, deadbeat parents (moms and dads) would be subject to sterilization.
Yes, deadbeat moms & dads should be sterilized.
Yes, any man that doesn`t support & take care of his child should be sterilized.
Megan mentions the 44,000 lives "saved" per year as way too high, but does not provide a better figure. Can anyone here point to anything that's widely regarded as the most accurate guesstimate of the number of Americans who die each year because lack of insurance kept them from getting care? Perhaps more importantly, does anyone know how many extra years/months/days these folks would have gotten, on average, had they had insurance? Does all this money buy an extra good decade for the folks who would have died or an extra three months? These would seem to be pretty important figures in calculating the benefits of the bill -- don't we care about giving people extra years of life rather than signing them up for policies? -- but you never hear them.
So I don't get the outsized reaction to all this--I mean, outside the professional interest groups, who of course are contractually obligated to get outraged about everything.
I think a lot of it comes from the way Obama tried to sell it as all things to all people. That only works until some people find out it isn't quite what they thought.
I'm mostly pro-choice myself, but America splits about 50/50 on this and the 50% that are pro-life are horrified at the idea of their taxes paying for what they consider murder.
Yeah, um, obviously you aren't poor then. Way to empathize there, McArdle. Gee, it's just $500! Gee, it's just about 1/5 of my entire monthly income--what's the problem?
Gee, donate to Planned Parenthood, and everything will be taken care of--unless you're one of the many poor women who don't have a Planned Parenthood or anything like it within 500 miles. Ah heck, there's not that many of them, and they're poor anyway, and they're disproportionately women of color, so the heck with it! Screw them!
Gee, what's all the outsize reaction about?
The very poor's situation won't change - they'll be on the same federal plan as always.
The women with employer provided coverage won't change (see promises of Obama, Barack)
The women who make too much money to qualify for federal programs but not too much to qualify for a subsidy but don't receive employer provided insurance (any clue as to the size of this small group?) MAY lose this coverage.
So we're talking about a change in status for a narrow income band of women, a fraction of which don't receive employer provided coverage, and who currently have individual insurance which covers them. And they aren't prevented from buying said coverage as a side policy with the extra income they will be saving through the subsidy.
shorter: calm down unless you can prove the minority of a minority of a minority of people is large enough to walk away from this altogether.
"Well, there's your problem. Someone had set this thing on 'evil'."
planned parenthoods that specifically focus on abortion provision are disproportionately dumped in black urban neighborhoods. poor women of color, if anything, have disproportionately high access to abortion compared to poor white women (who are likely to be the rural dwellers who live 500 miles from planned parenthood).
so this is a stinky red herring.
I'm familiar with the access problems outside of cities, but this is a completely separate issue that will not be appreciably affected either way.
As for the rest--what can one say? People who substitute impugning their interlocutor's motives for actual argument are usually people who know they can't make a logical case for their side.
Girls keep your panties on , boys keep your pants zipped unless or until you are mature enough to accept responsibility for what can happen when you have sex. Don`t tell me you can`t control your urges, you are potty trained, right? Well there you go ,you controlled the urge to go potty in your pants. You can control the urge to have sex too.:) It`s called growing up.
And from that comparison, we can infer your affliction is called "not having a clue".
Really folks, we've tried screaming at teenagers not to have sex for a while now. He still have the highest rate of teenage pregnancy in the developed world. Lecturing teenagers on controlling urges is not the answer. Well, I believe it's a small part of the answer, but it's remarkably ineffective in isolation.
And the "Fooling around, are we? Now I'll make you raise a child, you irresponsible nitwit" attitude is hardly a good solution to the problem.
Nice try, Sam, but that argument holds no water.
If you discount the inner-city culture, which is on an entirely different planet than the rest of the country, those teenage pregnancy numbers are lower than most parts of the world. And nice strawman about screaming - I don't see this word in iamone3's post at all. How about communicating effectively? How about schools not actively promoting values that are contrary to parents' wishes? How about the entertainment industry at least trying to help as opposed to hinder?
Isn't it funny how up until the 60's, teenagers in this country were able to keep zipped up just fine, so the idea that this is "clueless" shows your cluelessness.
Thank you 1 Callahan, I couldn`t have said it better.Keep it zipped works ,LOL.
That's trivially true. If you remove a segment of our country's population with high teenage pregnancies while not doing the same for other countries, our numbers will get better.
The thing is, most other developed countries have a higher percentage of the population on urban areas than ours. Shouldn't that make their teenage pregnancy stats worse than ours?
I'm all for communicating effectively. How's that working out so far? If you think we're not communicating effectively right now, how would we go about doing it? Just saying (or screaming) "We're not communicating effectively. Let's do it!" doesn't solve anything - and that was kind of my point. The same goes for complaining about Hollywood.
Suppose I accept your explanation that the 60's are to blame for the current state of affairs (I don't). There was a "60's" in every other developed country on the planet. So how come ours is the one with the highest rates of teenage pregnancy?
See, even if we accept your statements at face value, they don't account for much. Furthermore, putting our teenagers in a time machine set to 1953 is not an option.
That's why "screaming" is not a strawman. That's exactly the attitude in yours and iamone3's posts so far - making general assertions that, even if true, don't shed any light on the teenage pregnancy phenomenon.
I'll repeat that educating our teenagers to make them aware of the consequences of their behavior is part of the solution. But I also believe that today's teenagers are more, not less, aware of the consequences of sex than teenagers in the 50's. The problem is, that doesn't seem to have that much of an impact in the pregnancy statistics.
The primary problem isn't the teenagers. The problem is mostly men and women in their 20s, 30s, and 40s.
Because then all those Lib women wouldn't get to take full advantage of their chance to participate in the murder of an unborn child.