Health Care Bill Passes

The bad news is the health care bill passed. I had thought that a bill couldn't be passed without 60 senators to make it filibuster proof. Little did I know there was some fancy 'budget reconciliation' process that only required a simple majority to pass any bill that had already been passed before in some earlier version. So now that the House has passed the Senate's version of the bill with some new changes, the Senate can go back and affirm those changes with 8 senate votes to spare. This means the House vote was the only vote where something could go wrong, and nothing went wrong.

At least my initial prediction of the health care bill passing was correct. It would be strange for democrats to control Congress and the Presidency but not be able to pass any legislation. If government is that powerless we may as well disband it.

I would have preferred a citizen's dividend combined with a universal misfortune insurance plan that would be a cheaper and simpler way to take care of all U.S. citizens. These sorts of bills that run for thousands of pages and pick winners and losers do little to help Americans and a lot to enrich paper-pushers and special interests. However, there's no reason to believe the current health care system is more fair than the new bill. The government already pays most of the bills for health care, and uninsured patients still receive free care from hospitals via the emergency room. Getting everyone on insurance rolls will relieve the costs placed on hospitals and push them onto taxpayers and insurance companies. Since I have no special love for insurance companies, or the rich who will be paying these taxes, especially compared to doctors, I think this is a good change.

Some other good changes from the current system: Currently sick children can be denied care. If health care doesn't treat sick children, but does treat terminally ill 100 year olds, there's something morbidly wrong with the system. Now children can't be denied health insurance even if they have pre-existing conditions. They will receive the care they need at a price their parents can afford. The same is true of young adults, who will now be covered by their parent's health insurance plans longer, until age 26. In reality, the age of adult independence has been pushed back by the need for longer and longer educations before securing a reasonably paying job. This change was a much needed acceptance of this new reality. There's no way college going kids, steeped in debt, could afford health care if something unfortunate were to happen to them. And yet these are the most valuable people America has. Again, why are we denying them care while treating terminally ill 100 year olds for free?

Unemployed people can easily get sick due to a weakened immune system from the depression of being unemployed. Or people can get sick and lose their job because of it. These people used to be unable to ever get health insurance again, because health insurance was tied to employment, and health insurers didn't have to accept people with pre-existing conditions. Since unemployment should not merit the death penalty, it is unfair to suddenly withdraw the safety net of health insurance from these vulnerable groups. The new bill solves all of this by subsidizing health insurers who take on people with pre-existing conditions.

The detestable health insurance mandates system, which was meant to steal from the healthy, young, and poor and give to the unhealthy, old, and rich, has been restructured. Now the poorest Americans are not required to buy health insurance, and will be provided medicaid instead. The next poorest group will have to buy health care, but at a subsidized rate. Therefore the mandate has lost most of its bite -- it is more of a requirement to buckle your seat belt than an expropriation.

Taxes that used to be directed at poor people like a tax on soda (I guess everyone should have to drink tea like the yuppie class) is gone, with a much more reasonable tax aimed at rich people who earn over $200,000 a year. There is also a tax on people with huge health care benefits, which is really just a tax dodge where people are 'paid' in benefits that don't count as income for purposes of the income tax. I'd like to tax benefits at the same level as income and thus get rid of this noxious tax haven, so this is a step in the right direction.

The original bill was meant to take money from young, poor, healthy people and give it to old, rich, unhealthy people. The final form of the bill is going to take money from old, rich, unhealthy people (with large cuts in medicare and raises in taxes) and give it to young, poor, unhealthy people. This is a vastly improved version of the bill. Young unhealthy people can be cured more or less permanently of whatever afflicts them, whereas old unhealthy people just go from one illness to another until they die. Treating old people has very little return in terms of quality or quantity of life preserved. Treating young people can genuinely save their life and return it to normalcy. Furthermore, young unhealthy people are usually the victims of fortune -- genes they never chose to have, or accidents, or just a rare bug deciding to victimize them. These are the people we should shower compassion on most. They did nothing to deserve their poor health and haven't saved up nearly enough money to pay for it (who except a dot-com billionaire could at such an age?). What is the use of a nation, or a society, if it doesn't help each other out when misfortune strikes? We have FEMA to help out victims of natural disasters, but no health care to help out victims of medical disasters. Since the victims are even less to blame in the latter case than the former (No one intentionally gets sick, but plenty of people build houses on fault lines, flood plains and hurricane prone beaches), there's an obvious cognitive dissonance about what our moral principles are as a society.

There are certain things people should enjoy as a moral right, so long as there is surplus money available to pay for it. The poorer a nation becomes, the less it can provide its people, with the excuse of necessity tying its hands. But the richer a nation becomes, the less excuse it has to ignore the plight of the suffering for the sake of the super-rich. There shouldn't be a single yacht in existence until all Americans have enough food, shelter, electricity, water, sewage, etc to furnish a decent standard of living. Only a sociopath could even enjoy sailing around in a yacht with the knowledge that elsewhere people were dying of cold or starvation for lack of his help. If we have enough money to supply fripperies to the rich, we have enough money to supply necessities to the poor. America is the richest nation on Earth, but was too stingy to give free health care to its own children. That imbalance is just too vast. If America were to get richer, the claims the poor would have upon it would grow. If it grew poorer, it would be justifiable to reduce said claims in order to help the economy back on its feet. The best way to represent these claims is a citizen's dividend, directly tied to the well-being of the country. For instance, every year we could have a 25% flat tax on GDP which would then be redistributed between all citizens equally. Some would come up ahead after the taxation and redistribution, some would come up behind, but everyone would get to share in the wealth, promise, and productivity of the nation. Anti-business activity like protectionism or ludditeism that would depress GDP all Americans would be averse to, for the simple reason that it would directly impact the size of their citizen's dividend that year. Pro-business legislation that improves GDP would likewise be favored by all Americans, because everyone would benefit from some portion of a business's gains. (Note how this flat tax would replace all current taxes and would come under the cost of socialist redistribution we already pay.)

If the citizen's dividend is unacceptable, you will instead see these sorts of halfway measures that grant various directed benefits instead of free-floating funds gradually being passed in Congress from here until eternity. America knows it can afford a trillion dollar health care bill that taxes the rich and gives to the poor, because it just saw a trillion dollar military bill passed this year, and a trillion dollar bailout to rich bankers besides. The populace has every right to wonder why they can't be given some portion of this pie in the form of basic necessities instead. After people provide themselves with free education and free health care and free food (via food stamps) and free shelter (via HUD housing) they will move on to free internet (the new FCC plan to broaden high-speed coverage to everyone in America) and college education (New, more easily paid student loan programs and more pell grants.) We, like the rest of the world, are a socialist people who prefer socialist benefits to just 'going it alone.' Eventually, the money will be redistributed anyway, only in a more chaotic and inefficient manner that helps lawyers, middle-men, and special interests/corrupt politicians more than it does the people who voted for these measures. You can't stop socialism, because no matter what argument you make, you will never convince more than 1% of the public that children should be left to starve in the streets so that rich people can buy extra yachts to put in their garages. The only argument people will ever listen to is that more socialist good can be accomplished from a relatively light system of taxation and regulation than a relatively heavy one, because freedom produces more wealth than slavery. That is the only argument in the republican's quiver, but it forms no argument whatsoever for libertarians. After all, what does it matter how much wealth the rich have, if they aren't going to redistribute any of it? Anything multiplied by 0 is still 0.

Now, someone might ask, "Why restrict this socialist redistribution to our own nation? There are plenty of starving poor all over the world who could also use our help."

But there are a few objections that distinguish international socialism from national socialism.

First, poor people outside of our country can't vote. They can't riot. They can't do crime. They can't start a civil war. They can't go on strike. They can't hurt the other members of a nation. Ignoring their plight will have no blow-back on America at large. Since we must live among our own poor, improving their life conditions is the only way to improve our own neighborhoods and living spaces. The issue is forced whether we want to help or not.

Second, there is a more direct linkage between a country's policies and its poverty. There is good reason to believe that any poor person in a country is poor due to the laws of said country. This is so true that genetically identical North and South Koreans have dramatically different per capita GDP's. The same is true of West and East Berlin in the 1980's, China and Taiwan, etc. It is hard to tell what a person's potential is when he is always stuck in an environment not of his choosing. Since other Americans are responsible for an American's environment, the fact that he's doing poorly could well be our fault. On the other hand, other Americans are not shaping the environments of people outside our borders (aside from Bush's ridiculous wars of aggression), and therefore we can't possibly be to blame for their life conditions. Rather, they should seek redress from their own immediate fellow-citizens and governments who have a much clearer hand in the matter.

Third, it is only natural to treasure people who are closer to us, genetically and culturally, than total aliens. People like us can be equally well envisioned as people who are a % us, and it is only natural to prefer your own well-being to another's. If a program helps millions of people who are .1% 'you,' you are helping yourself by paying taxes ten times over the cost it hurts 'you'. But if you are helping people who aren't remotely like you, even if it is trillions of people, there's no similar sense of satisfaction. Also, it is more likely that fellow nationals would love, care for, and protect us than complete outsiders, the same as any family vs. non-family sorting. Therefore loving, caring for, and protecting them is just reciprocating their favors, real or at least imagined, to us, instead of a wholesale giveaway like charity spent on outsiders.

Fourth, there are limits to the possible. We cannot care for all of the world's poor. But we can care for our own poor. There's plenty of money for that objective. And until our own poor are taken care of, obviously we can't spare any to help others. No one is to blame for not rendering services beyond their means.

Fifth, it is possible to link national socialism to laws regarding conduct and behavior. We can, for instance, require people stop smoking, or that women on welfare can't have children, in order to reduce the burden socialism imposes on fellow nationals. We have no authority to change the conduct of outsiders, who only answer to other governments. It is only fair that he who pays the piper calls the tune. The IMF vaguely answers to this logic, where we don't extend loans to poor countries until they agree to adopt our policies. So if we won't even give loans to people who don't do as we say, why should we give charity?

Wonder of wonders, all countries on Earth have seen this logic as well and continue to spend more socialist goodies on their own citizens than aliens abroad.

Libertarians need to realize that they lost the argument over socialism a century ago, when the progressives banned child labor and limited the hours of the work-week. Imperialism lost its argument in 1945. Communism lost its argument in 1990. National socialism proper, the one that grants its citizens unemployment benefits, a minimum wage, food stamps, public health care, old age insurance, etc, has conquered the world and isn't going anywhere. Republicans will not succeed as the party of 'no.' Either offer new, better alternatives to achieving socialist goals like Charles Murray has, or discard yourselves into the ashcan of history. Let this health care bill be a lesson to you. You had eight years to pass a republican version of health care reform, but chose to do nothing as the ranks of uninsured swelled and the cost of health insurance rose well above the rate of inflation. Now the democrats were duly elected for the sake of 'change,' they passed the democratic version of health care reform, and republicans were driven so far out of power they weren't even able to gain a compromise. Live and learn. Adapt or die.