Time to Start a Health Insurance Boycott?

I have been observing with rising amusement the currently raging battle over health insurance.  The tastiest morsel of the last several weeks has been Mark Weiss’s article on the Huffington Post.  Californians, who have been complaining a lot lately about wanting stuff without having to pay for it, are now upset because “health insurance costs too much”.  What’s the result?  We’re now going to have a government inquest into why Anthem raised its rates in California, and new regulations to prevent insurance companies from charging what they need to to protect their shareholders.

What I find absolutely baffling about the whole situation is this: if these people hate Anthem so much, why don’t they just boycott it?  What happened to the do-it-yourself, grass-roots American spirit?

By all arguments, the health insurance industry should be ripe for a boycott: everyone says that they provide no essential services, but just act as a middleman vacuum cleaner for consumer dollars.  If that’s so, why buy insurance?  Californians and their doctors could act together to boycott the insurance companies.  Just stop paying health insurance bills, and hand the money to the doctor.  It will be objected that some people cannot pay their exceedingly high health care costs.  But allegedly, this is what is already happening; allegedly, insurance companies dump someone whenever they become unprofitable.  If this is true, the cases of people suddenly becoming unable to pay their health costs without insurance support should few and far between.

The boycott needn’t be perfect, although one could imagine plenty of organizers arising to solve the logistical problems that would arise if a boycott ever took off.  The only really essential element is that people stop sending checks to the health insurance companies.  Sure, most healthcare is provided through employers, but it hardly seems conceivable that employers would object to people declining to receive benefits.  Sure, out-of-pocket costs would increase for a few months, but how many months would it take to cripple the insurance companies.  (I pass over the immense economic boon that decreased benefits costs would bring to the state.  Firms would actually start hiring again!)

As if the tide of hatred rising against the insurance companies does not already render them vulnerable to a boycott, there is also the government breathing down their collective neck, with the threat of healthcare reform.  My guess is that if the beginnings of a boycott appeared, it would suddenly become impossible for a health insurance company to get a loan… AIG all over again.

Indeed, here is the only substantive objection to a health insurance boycott.  We know what the government does when insurance companies go under…

Scott Brown vs. Martha Coakley

The citizens of Massachusetts face a very difficult decision on this coming Tuesday.  How are they to come to a reasoned conclusion?

It may seem odd, but the first thought that came to us when considering which candidate to endorse was this: what are their characters?  Is one candidate clearly corrupt, while another is clearly the moral superior?  Does Scott Brown, for instance, have a record of drowning kittens, or does Martha Coakley regularly light her yard on fire just to add some CO2 to the air?  (No such allegations have been raised.)

In the consideration of character, it is often a negative consideration that we must make.  Praiseworthy actions rarely come to light, whereas smears or attacks are gleefully highlighted by the opposition.  Following this, the first point that came to our consideration of character was this comment by Scott Brown.  After supporting the uncouth Sarah Palin, Mr. Brown casually suggests that Barack Obama was born out of wedlock.  Like our considerations of kitten killing or predilections for pyrotechnics, Mr. Brown’s allegation is completely unfounded, and what’s worse, has little bearing on any real qualification that Obama might have had for the office of President (the comment having been made before the 2008 election).  From this comment, out of his own mouth, Scott Brown shows that he will be a partisan of standard Republican attack techniques, showing little regard for truth or fact, and raising “questions” that are designed to puzzle the simple-minded into doubt.  In short, Scott Brown shows every sign that he plans to manipulate the people rather than speak the truth to them.

By comparison, what can we say of Martha Coakley?  After some searching, and the sampling of many laughably inept Republican attack ads (for example), the best I could come up with was Dorothy Rabinowitz’s unbelievably partisan piece on the Wall Street Journal on Coakley’s role in the Amirault affair.  Herein, Coakley used her formidable powers as a prosecutor, and then attorney general of Massachusetts, to pursue (on scant and dubious evidence) drastic penalties against a family accused of sexual offenses against minors.  The consensus, according to Rabinowitz, is that Coakley’s case was weak, and that she needlessly defamed and ruined the lives of the Amirault family.

This in and of itself does little to settle the question of Coakley’s character.  The question becomes this: why did she defend the case against the Amiraults so viciously?  Was it all a mistake or misunderstanding?  Was her reason corrupt, or was it noble?  A case could be made that prosecutors should always pursue their cases to the very ends of the Earth, on however slim evidence, because often criminals can be very slippery, and can manipulate the truth to their own ends, and appear for all the world like the most innocent of men.  Recall the villains that Eliot Spitzer pursued when his was a noble name; who would deny that he should have used all the powers at his disposal to pursue the Wall Street fat cats?  Even now, who thinks he should have acted with more restraint?

Unfortunately, it seems unlikely that Coakley’s motivations were so principled; as M. Leblanc suggests, it is more likely that Coakley was acting to further her own political interests and ambitions, by trying to appear tough on crime.  Especially against sex offenders, as the Amiraults were suggested to be, the consensus everywhere is to penalize them in the severest ways, because such action is unlikely to encounter much public disapprobation.  In short, Coakley probably kept Gerald Amirault in prison not out of a personal conviction that he was guilty, or even out of a principled belief that, regardless of her own convictions, the harmony of the entire justice system required that her capacity as district attorney pursue the maximum possible penalty against him… not for these things did she pursue his incarceration, but for her own personal political ambition.

Such a thing is a great moral tragedy, although arguably one that any candidate for political office might be guilty of.  Also arguably, we do not think it is a much greater crime than Scott Brown’s apparent willingness to use disingenuousness and manipulation to achieve his own ends.  It seems our decision will not be made on character; who knows that this would have been a sufficient basis anyway?

Indeed, even arriving at a basis for decision in this election is difficult; we have every reason to believe that Coakley, as a Massachusetts liberal, and Brown, as a member of a minority opposition party clinging to the filibuster, will both vote along party lines more often than not.  Are we not then justified in ignoring their personal positions on issues, and in considering only their parties?  What’s more, the composition of the Senate will change dramatically in just a few months, when the 2010 elections happen; between now and then, it is hard to imagine but that the healthcare reform currently before Congress will be by far the issue of greatest import.  Considering then, that the Senate currently has 59 Democratic-aligned senators and 40 Republican-aligned, and that 60 votes are necessary to break a filibuster and pass legislation, it seems that our decision to vote for Coakley vs. Brown is a referendum on healthcare reform.

What, then, of healthcare?  In previous posts (in several different places) on the healthcare debate, I have argued, in broad summary, that spending on healthcare is not bad for the economy, that it represents the purchase of a good that, in general, people want, that increased government spending on healthcare would have a healthy and multiplicative effect on the economy, and finally, that despite all this, the current system has seriously skewed incentives due to the government-imposed insurance model.  I at no time reached a conclusion on whether the healthcare reform that we now face is a good thing or not.  Let me do so here.

The healthcare reform that we face is essentially socialism.  This is not out-and-out a bad thing, but it’s important to recognize it for what it is.  Whether or not the bill before us will immediately create a socialized system, or whether it will merely attempt to create the conditions for such a system in years to come is not relevant.  What is relevant is whether we want a socialized system.  All other developed countries in the world have systems that are socialized, or moving toward socialization, and even not “developed” countries with powerful economies, like China, have socialized healthcare.  Only the United States does not.

Let’s be clear on the facts: these other developed countries are doing fine.  While partisans will batter us with statistics from either side, there seems to be little citizen testimony from any developed country that the state of health in other countries is substantially different from that in the United States today.  The only thing that is different is that they do not have to pay for their healthcare (except in their taxes, and in such a way that income is redistributed from the rich to the poor).  The only advantage that the United States has over these other countries is our markedly better pharmaceutical development industry, but I think that the intellectual property issues surrounding pharmaceutical development are separate enough from the mundane questions of who will fix broken bones or diagnose your kid’s strep throat that we can leave pharma for another time.

With this in mind, shouldn’t we get socialized healthcare too?  I think that the answer is a resounding “no”.  Our country was founded as an experiment in the affirmative freedom of the individual citizen, an experiment in minimalist government.  We are a bold experiment, and a novel one.  We are the eternal opposition party of history; we are the opposite of China.  They desire harmony; we desire dynamism.  While other societies were created to endow all of their citizens with a collective good, we exist to provide a haven for those who wish to pursue their own individual goods.  We see the inalienable rights to life, liberty, and the pursuit of happiness as precluding other rights, such as the “rights” to jobs or healthcare, which rights would necessarily be provided to some citizens at the cost of the liberty or happiness of others.

If every other civilized country will have universal healthcare, and yet right now – as I said before – their healthcare and ours are on roughly the same footing, I say let us continue to experiment.  The situation is not yet so dire that consensus has been reached, that socialism has been proven to be the answer.  There is still room to doubt, so doubt we must.  If everyone else chooses socialism, let us choose anything else.

Such a position would seem to lead us to recommend Scott Brown for United States senator from Massachusetts.  Can it be that the heroic pursuit of truth leads us to select  this manipulating, two-faced, Sarah Palin-supporting rascal to be elected to the Senate of our land?  Citizens of Massachusetts, you truly face a difficult decision.

On Bernie Sanders and Tom Coburn

In the Senate today, Bernie Sanders and Tom Coburn got into an altercation over an attempt by Mr. Sanders to insert a single-payer amendment into the healthcare bill.  Mr. Coburn asked that the 767-page amendment, which would have been the ultimate Christmas present for Democrats, and anathema to Republicans, be read aloud on the Senate floor.  According to one reporter, the exercise would have taken eight hours.  This possibility prompted Mr. Sanders to withdraw the amendment, though not without some sharp words for his colleague.

This is part of a larger trend: a major, if subtle, Republican tactic to drum up popular opposition to healthcare reform has been to cite, as frequently and as loudly as possible, the huge numbers of pages of legislation that healthcare reform would consume.  In response, Democratic talking heads have used the Republican complaints about length as an example of the absurd, trite, and insubstantial nature of the Republican opposition to healthcare reform.

So the question: can the length of a bill be sufficient reason for opposing it?  I would like to submit that the answer is yes.  Arcane and lengthy legislation removes power from citizens in a variety of ways.

First, a 767-page amendment is difficult to read.  When Congress publishes thousands of pages of legislation a year, how is the average voting citizen supposed to keep up?  I am all for civic participation, and I would accept the proposition that the average American does not care enough about or invest enough time in the government, but it is simply not reasonable to expect working Americans to come to a considered conclusion about several pages of legalese for each day of the year.  In this way, by making legislation lengthy, it is almost guaranteed that only a tiny minority of the voting public will ever have any direct knowledge of what it contains.  Very few people will be able to perform primary evaluation of the legislation.  Very few people will actually know what it contains.

This forced ignorance of the American public has several pernicious consequences.  First, it is in part responsible for our current culture of partisanship.  When a voter cannot read the legislation, he turns to the news media to inform him.  Thus, by means of several mostly redundant thirty-second soundbites a day, he acquires in his mind a caricature of the legislation.  This image is further distorted by the almost inevitable intentional or unintentional bias of most popular media outlets, ranging from Fox News (intentional) to the New York Times (apparently unintentional).  In the end, the voter is reduced to chanting a slogan – “Healthcare is a right!” or “Universal healthcare is socialism!” – while having a thousand micro-debates on parts of the bill that never make it to the President’s desk, such as the “kill Granny” provision.

The same hapless ignorance that distorts the creation of legislation is also a danger to citizens once the legislation has been passed.  Consider the tax code: a frequent complaint against it is that its complexity enables rich citizens, who can hire lawyers, to make careers out of sifting through the tax code, understanding its complexities and loopholes, and in this way performing legal pirouettes so as to pay less taxes than even the poorest among us.  Meanwhile, the rest of us can never be quite sure that we’re not committing tax fraud – sure, I filed my 1040, but did I spend the extra twenty minutes tracking down Schedule 4149 to make sure that I’m eligible to file just a 1040?

This state of ignorance can be induced by any complex piece of legislation.  For example, suppose that healthcare reform passes: how will you determine what you must do to be in compliance with the law?  Will you read the entire piece of legislation?  Unlikely.  Have you read the entire tax code?  No… if you’re responsible, you’ve probably paid someone else to do your taxes, someone who has the time and resources to understand the tax code, or if you can’t afford this, you’ve done them yourself and hoped for the best.  In just the same way, if healthcare reform passes, the very same insurance companies that are taking your money now to offer you “protection” will switch their packs of lawyers from finding ways of denying you coverage to finding short, snippy tidbits of information they can give you about the new legislation (that come with no guarantees, of course).

In short, complex legislation, regardless of its intended effect, transfers power.  It transfers power from the citizens, who are the ultimate source of the law, to bureaucracies, both governmental and corporate, who have the time and resources to understand complex legislation.  Common citizens, ignorant of the law, are at a disadvantage against these organizations.

This is not an argument against big government.  One can imagine a tax law as simple as a flat tax that would produce the same level of income as the current gargantuan tax code.  One can imagine a brief charter for a governmental healthcare corporation.  This is simply an argument that, no matter one’s political beliefs, in a democratic society, all expression of the law must be comprehensible, so that it is subject to the evaluation of the citizens, because the citizens themselves are ultimately responsible for the justice of their society.

I do not say that complex legislation cannot work under any conditions; a society like China’s is well-suited for complex legislation.  The servile populace, under the iron fist of a sprawling governmental bureaucracy, has no hand in the justice of its own society.  The government, subsuming all power itself, also subsumes all responsibility.  The common Chinese citizen cannot be expected to understand the way his government works; he can only hope that it will be just to him, and reward or punish him according to his deserts.  He gives up his freedom of action and his political voice, and in return, he is freed from the responsibility of helping to provide his society with justice.

How nice it would be if in our country we didn’t have to worry our pretty little heads with understanding laws before they’re passed.  Help make this a reality!