A Republican’s confession of support for Obamacare
Arthur Greene never really gives away who he is, except to tell us that he is some type of consultant to Republican politicians, has worked as a senior-level staffer for one of the ‘big name’ GOP politicians, is friendly with folks who held big jobs in the Bush White House … and is a supporter of Obamacare.
That’s right. An affirmed and avowed Republican who is ideologically opposed to the government subsidies to the middle class and increased regulations on private business that he acknowledges are to be included in the reform bill, but supports it just the same.
Why?
Because for Mr. Greene, it has become personal.
Greene writes about the reasons for his support on today’s Frum Forum, the on-line site for GOP strategist and former Bush speech writer, David Frum.
I highly recommend you read the piece.
I’m not singling out Mr. Greene’s story as a way of holding him up as an example of a bright, influential Republican who has made the ‘right’ choice. Rather, I’m singling him out to make a far more important point – when it comes to health care, ideology has a way of becoming irrelevant. When you, or someone you care about, is sick, your party affiliation means nothing. All that matters to you is seeing to it that the person in question is able to access affordable, quality health care and that the same should be possible without it dragging your family down into financial ruin.
In Mr. Greene’s situation, that person is his wife, a woman who has had a hard time with her health – chronic severe life-long asthma, a heart condition, and, as Mr. Greene describes it in his piece, ‘ a lifetime of terrible medical luck’. Making this worse, he is about to face a very serious financial problem as he and his wife are completely ‘uninsurable’ due to Mrs. Greene’s pre-existing conditions and Mr. Greene is self-employed.
Here’s the Greene family’s problem, in his own words:
Even with a pretty good income of my own and the resources of our families we’d have enormous difficulty paying anything close to the medical bills my wife has run up without very comprehensive insurance. One stay she had at a major hospital cost over $130,000 and afterwards my then-employer’s HR director all but accused her of raising health insurance premiums for everyone in the office. (She was right.) A recent visit to the emergency room that included an MRI cost over $10,000. And I haven’t even seen the tab for her most recent 3-day hospital stay.
For now, largely thanks to President Obama’s policies, none of this is a major problem even though my co-pays and deductibles can exceed $500 a month (and our health insurance is, by all accounts, a very solid PPO plan). The federal government picks up about half of the health premium from the job my wife held before she got too sick to work — I made too much to qualify for the full 65 percent subsidy now available — but even this won’t last forever. We have about 7 months left on the subsidy and another few after COBRA runs out altogether.
Via Frumforum.com
Why does Mr. Greene see Obamacare as an answer to his problems?
We’d be better off (and I think society would too) under something like Obamacare. In a “public option” or community-rated individual market plan offered through an exchange I’d have no problem paying a premium and the costs of any subsidy we paid would be distributed across the entire exchange rather than focused narrowly. This seems a lot fairer than putting us on a heavily subsidized community-rated national health care plan largely intended for the elderly or, worse yet, forcing every employee of a small business to pick up a portion of our health care costs.
And I can’t see any other way to get through. No developed country, not even ours, requires the very sick to pay their own hospital bills in full. Through group plans, community rating, and public coverage, someone else will always pay a portion of the bills for the truly sick. After all, my wife exercises when she’s healthy enough to, keeps her weight within recommended guidelines, gets all preventative care doctors say she should, takes her medications, eats right, has never smoked, and drinks only once in a while. Her conditions result entirely from genetics and bad luck. It is one thing to say she should be responsible (she is) and another to say that my family deserves enormous financial hardship because of things entirely beyond our control.
In fact, the total level of subsidy would probably go down under Obamacare. Right now, we get a COBRA subsidy I don’t deserve. Without some serious reform, it’s likely that my wife will ultimately end up on Medicare with taxpayers picking up a large portion of her bills in any case. What makes sense is a policy that would give us sturdy health insurance covering all of her preexisting conditions with predictable, if high, premiums and enough benefits that we won’t owe thousands of dollars out-of-pocket after a single hospital stay. It seems pretty simple but, absent sweeping health care reform, no such option exists or will exist.
Mr. Greene openly acknowledges that his point of view is a selfish one. He doesn’t wish to see his family’s financial life left in ruins because Mrs. Greene had the misfortune of coming from a bad gene pool.
Can anyone really blame him?
It turns out, at least one person can.
Check out this comment to Mr. Greene’s piece from one Alex Knepper-
So what you’re saying, then, is that you want to use the force of the law to make other people pay for it instead so that you can live somewhat more comfortably? — As much as I sympathize with your trials — and they really are, unfortunately, the result of chance, not of your own making — I’m not comfortable with using the law this way.
No, Mr. Knepper. Mr. Greene is not worrying about living ‘somewhat more comfortably.’ Mr. Greene is worrying about complete financial destruction as a result of health issues that are completely beyond his or his wife’s control.
What’s more, Mr. Knepper, if a decent society cannot come together to aid our neighbors who face these difficult situations, can we really call ourselves a decent society at all?
Health care is not about who gets to have a nicer home, a larger television screen or a fancier car. One can only hope that Mr. Greene’s courageous article will help some to see that this is the case and that while ideological purity is all well and good – it won’t count for a thing when you or someone you care about becomes a victim of that ideology when a health disaster strikes.
When it comes to the basics like hunger and health, a decent society should not leave a good earner like Mr. Greene to face health and financial destruction any more than it should allow the same to happen to the average American earning under $50,000 a year or someone in abject poverty. And while politicians may find it easy to use health care reform as a tool to curry public favor (comfortable in the knowledge that their own families are not at risk), it takes a cold heart to expose the rest of America to the problems the Greene family is now forced to experience.
This is the week when it counts. Make sure you let your Congressional representative know what you think the United States should really be all about.
Post Your Comment
You must be logged in to post a comment
T/S Members
Log in with your True/Slant account.
Very nice piece. Heartfelt. Thank you.
There are many conservative arguments for healthcare reform, but this is perhaps the most poignant in that no individual or family can realistically anticipate and attempt to protect themselves against medical catastrophe. Mr. Knepper is exactly right that it is matter of chance, not the Greene’s own doing, and therein make the argument for us.
In cases like this, it makes sense to spread that risk across society so that if anyone of us taken down this road, it wont be to the detriment of their entire family, in the form of financial ruin, and society’s detriment in say the loss of Mr. Greene’s contribution while he faces financial ruin.
Mr. Knepper might argue that it is unacceptable to use the force of law to make us pay for insurance premiums to help mitigate this risk, but it’s terribly short sighted not to see that he pays either way when hospitals absorb these cost and pass them on to insurance companies who pass them right back to him. Does Mr. Knepper also argue that it is unacceptable to use the force of law to pay taxes to make sure society maintains the fire and polices departments just because his house hasn’t been burnt down or robbed? – Surely, he sees the benefit in maintaining these services, so what is so different here?
I have a feeling that Mr. Knepper might have a problem with using the force of law to insure that taxes are paid. That said, you make your point very nicely.
In response to another comment. See in context »“What’s more, Mr. Knepper, if a decent society cannot come together to aid our neighbors who face these difficult situations, can we really call ourselves a decent society at all?”
This is a question for the culture, not for the law. “Enforced fraternity” is a contradiction in terms. If you want to assist other people with their health care, please feel free to do so. I’d be interested in seeing your charitable contributions. Until then, I’m forced to conclude that you’re just another guy who wants to be generous with other people’s money.
In response to another comment. See in context »First, welcome Mr. Knepper. I’m pleased you found us.
Now, I would point out that cultural dictates are enforced by law. We have codes of ethics, of behavior, etc. all of which is enforced by the rule of law – or they would, in fact, not be enforceable at all. So, I have to disagree with this point.
While you will forgive me if I don’t reveal my charitable contributions, suffice it to say the are, I believe rather substantial. However, since I’m not prepared to disclose the details to you, feel free to assume that I am just another guy who wants to be generous with the societies money, despite the fact that, given that I am taxed at the highest possible rates – and have been for a great many years – a fair amount of that generosity would be paid for by me.
I wonder if I am being generous with other peoples’ money when I pay for the highways you drive on, the subsidies that keep the prices of the food you eat at a more reasonable level, the Medicare that cares for your parents and grandparents and the armed services that protect you?
Personally, I don’t see that as generosity. I see that as an obligation to a better society. You, on the other hand, appear to believe that you are in this for yourself and bear no responsibilities for anyone else.
And until I see any evidence to the contrary, I am left to assume that you are in this for yourself and don’t have much concern or care for much of anyone else.
In response to another comment. See in context »The code of ethics that should be enshrined is one of voluntary cooperation, rather than a massive scramble to see who can get the most out of other people’s paychecks. A truly fraternal, communitarian society would be one in which no “cooperation” occurs at gunpoint. We are men, not robotic automatons, and should be treated as such.
Taxes are not charity. Please do not insult me with such language. But it’s a perfect insight into the left-wing psyche: they think that they’ve done their job, that they’re being good community members — so long as they do what the government tells them to do. Back in the days of real communities, people were actively engaged in each others’ affairs — by choice. We helped our neighbors because we wanted to — not because we knew that if we didn’t, Uncle Sam would jail us. The welfare state destroyed that truly communitarian ethos.
On a related note, it is utterly appalling that we have actually reached a point in our culture where we suggest that a person who wants to choose how to spend his own life, money, labor, and values is clearly “in it for himself” in a craven sense.
So let me state that yes, I am absolutely “in it for myself” — insofar as I proudly care more about my own life, the lives of my friends, and the lives of my family members than about random strangers. I would certainly hope (for your family’s sake) that you do, too.
And yes, I absolutely oppose Medicare — which is going to bankrupt us in the coming decades if nothing is done to reform it) — as well anti-trade, anti-property corporate welfare (“food subsidies”), and, indeed — government-sponsored roads, although I won’t raise much of a fuss about the last point. It’s a fairly benign use of government, given that roads are basically an inexhaustible resource, unlike, say, health care. On that note, I’d be interested in your reply to the second paragraph of my initial comment on FrumForum — you know, the one that expounds upon my thoughts that you omitted.
Finally, the military is an example of what a government is properly instituted for: self-defense and protection against aggression.
In response to another comment. See in context »Apparently in Alex Knepper’s Libertopia, roads don’t need to ever be widened or repaired, and traffic doesn’t exist either, since roads are inexhaustible resources.
Also, the ‘welfare state’ didn’t destroy shit. The ‘communitarian ethos’ whose death you decry never existed. The only thing the ‘welfare state’ destroyed or damaged were the net worth of the ultrawealthy to help hundreds of thousands of people move out of poverty into the middle class. That you still buy arguments proven bunk at the turn of the Twentieth Century really makes you look like a carictature.
In response to another comment. See in context »It’s an absurd comparison. The difference between health care and a police force is profound. One does not go into the police for check-ups, routine care, and preventive services.
What’s terribly short-sighted is that you can’t understand that health care is a finite resource, and that some people are ultimately going to have to go without. I would rather have free people in a free market with their private property making those decisions. The second paragraph of my comment, which Mr. Ungar omitted, was this:
“Another problem: health care is a finite resource. It is an unfortunate fact of life that, at some level, someone, somewhere is going to have to go without. We need to let go of this delusion that there’s somehow enough available care and enough trained professionals to create a worldly utopia where no one ever has to go without. “Rationing” in this sense is inevitable. The question we should be asking ourselves isn’t: “Should anyone have to go without?” — That question’s been asked and answered by reality. — The real question at hand is: “Who should be making the decisions?” — Free individuals, mutually consenting? — Or government, telling people what they can and cannot do with their own private property and their own years of medical training?”
In response to another comment. See in context »And a police force is not a finite resource? Try explaining that to the cities who are struggling to pay for them.
The health system is filled with people and technology that provides the benefits of health care. How would you describe the police force?
I wonder how you make this ‘finite resource’ argument in the face of the many industrialized nations in the world that do succeed in bringing health care to their total population?
Are there problems in those systems? Yes. We all know the drill…waiting periods, etc. But great effort is made to get health care to all who need it.
Health care is not a finite resource. You’re simply worried that if others gain access to it, it just might impact in some negative way on how you personally might wish to receive it and too bad for everyone else.
Unless I’m missing something, you sure do seem to have an incredibly selfish take on life.
In response to another comment. See in context »And in reality, the whole wait periods thing is a right-wing trope that’s really got no grounding in reality. I lived in Canada for a couple years when I was younger and I keep in touch with friends of mine up there.
The Canadian system allocates their ‘finite’ resources using a triage model, meaning that if you have a brain hemorrhage and need your head CTed, you get it CTed within five minutes. If you are getting a boil lanced, well, you can wait a little while as someone whose life is at stake is treated.
All my friends can get doctor’s appointments within a day or so of calling to schedule. I can’t even do that here. Every one of my friends up there that needs to take medicine never has to worry about being able to afford them.
The real issue with healthcare affordability is that the drug companies get away with what’s tantamount to extortion. You fix that and medical costs with plummet.
In response to another comment. See in context »My point is that (1) Violent crime is rare, compared to illness requiring the attention of a doctor, and (2) People only use the police when they really need to. My further reasoning behind this has already been explained.
“Bringing health care to all of their citizens”? Get real. Everyone had health insurance in the Soviet Union. Having something in claim is not having something in fact. It’s not just about “waiting periods.” It’s that, sure, but there’s more — it’s the fact that we remove the profit motive and thus remove the impetus to new breakthroughs. It’s the fact that it distorts market equilibrium and more is attempted to be consumed than is actually available. It’s the fact that it’s evil for the government to tell free men who they can and cannot treat, how and how they cannot treat them, and how much they are allowed to charge for their own services.
My take is “selfish” insofar as I am proudly in love with my own life, my own family, and my own friends. Yes, I put them first, and I’d crawl naked over broken glass to save some of them. That’s what real community is — not this gunpoint-enforced “fraternity” of robots you advocate.
HL Mencken put it well: Most people don’t want to be free. They want to be safe.
In response to another comment. See in context »Dude, the Soviet Union is almost twenty years dead. You hold it up as the sole example of universal health coverage to scaremonger about totalitarianism when Canada, the UK, France, Germany, Austraila, Japan, Spain, Taiwan, Austria, Switzerland, Finland, Sweden, and Norway all have some form of it and all are democratic societies.
You’ve also apparently never heard of market failure, either.
In response to another comment. See in context »And by the way, Mr. Keppler- do you take any medicines? Have you ever had to take medicines for a life threatening illness? Got any parents or kids who have had to do so?
In response to another comment. See in context »Do you understand that these medicines that save lives may well not have been created without the subsidy of the federal government through the NIH program? No appreciation for that?
Mr. Keppler? Now, Mr. Ungar, my name is plainly posted…
Anyway — my grandmother gets her medicines mostly through the assistance government programs. In this current era — which is one of massive, arbitrary inflation and cost-increasing subsidies — this is, unfortunately, what many people are reduced to. The massive inflation required because of policies you support is an incredible back-door tax on our sick and our elderly. In a free market, we’d put hundreds of billions of dollars back in the hands of our citizens, allowing for new charities, new innovations, and new efficiencies in our market — but right now, we settle for less out of economic ignorance.
Either way: People are not monsters. Before the age of Medicare, doctors and pharmacies routinely cut costs — voluntarily — for the poorer among us out of the spirit of community — to say nothing of charities and neighbors that would pitch in. Today, it’s simply assumed that government will pick up the tab, so communities have dropped the ball.
In response to another comment. See in context »And there was no poverty in the Gilded Age. Tell us another one.
Great God, man. You really think it’s people that control access to medicine nowadays and not for-profit corporations? You can reason with people, you can get them to see your side of things and empathize for you, whereas the first empathetic corporation you run across will be the first. That’s the colossal hole in your logic and why your free market utopia will never work.
In response to another comment. See in context »Apologize for the name mispelling – not intentional. I was running to catch a flight where I am now sitting delayed for three hours (any chance your utopian vision would banish cancelled flights?)
If you feel as strongly as you seem, why do you not take your grandmother off the government programs and buy her the medicines yourself? I also can’t help but notice you didn’t answer my question about how you get your health care. It’s a pretty important question and a simple one to answer. Why not answer?
You have your facts wrong on what happened before Medicare. You can easily find the numbers for how many of our seniors were without medical care or, if they accessed it, ran out of their retirement money and compare that to the data today. You’ll find the numbers in many places on my site. Again, you have a vision of what was that is not realistic at all. Why do you think our seniors were clamoring for a Medicare program if it all was going so well for them?
In response to another comment. See in context »Nobody else seems to think people are monsters but you. But people are people. And people did not do all these wonderful things for the poor and disadvantaged that you seem to believe they did. It would be great if they did and it would be great if they still would. But you’re simply living in a dream world which conveniently ignores the serious problems people face. Mr. Greene is not a poor man. He is not a lazy man. He works for a living and does reasonably well. But to provide his wife with the health care she requires cost more money than he could possibly pull together. Too bad for Mr. Greene, eh? I have a feeling you don’t yet have children. I wonder if you’d feel the same way if you did and, God forbid, one of them faced a serous illness.
I had the bad fortune to experience cancer. I’m lucky. I have good medical insurance. And yet, even with this insurance, I had to pay $50k out of pocket. Again, I’m a fortunate person and I could afford this. The overwhelming number of Americans would have gone broke if they had to come up with $50k. According to your argument, that’s okay because that’s how life goes — until it happens to you or someone you love. That is precisely the point Mr. Greene was making, and something you clearly just can’t get your arms around.
Alex-
Because you write so well, it occurred to me that you might, indeed, be a blogger. I googled, found this to be the case, and read some of your posts.
I note that you are an undergrad – obviously a very bright one. I, in no way, intend to suggest that just because you are young your opinion is, in any way, less valid (I know I didn’t appreciate that when I was younger.) But I have noticed that younger members of society, whom I often call the immortal youth, who do not sense the difficulties of health care in their life quite yet, sometimes are unable to grasp some realities of the problem.
I suspect that while you may or may not be in a committed relationship, you likely do not have children yet. As a result, you may not yet be able the grasp the horror of having a child with a life threatening illness when you don’t have the ability to cover the costs of caring or curing that child. This is not hypothetical – it happens every day.
It simply is not good enough to say, ‘well that’s bad luck, but what are you going to do?” I promise you without a question that should you find yourself a parent down the road, this will not be an option you are prepared to accept. And all the community good will in the world is unlikely to deliver the incredibly expensive medicines that may be required for such an illness.
It’s fine to have to well through through ideological beliefs. It’s certainly fine to believe in the free market to the extent that you do. But you must realize that some things simply don’t function as well in the free market as others. To every rule there is an exception.
I am keenly aware of the problems in socialized medical systems around the world. But I am equally keenly aware of their benefits. There is no such thing as perfection. The American system has some decided benefits – it just is not available to as many people as it should be. And while you can theorize any way you wish as to why it must be this way, I guarantee you that when it is someone you love that is on the line, none of this will mean a thing a to you. You would sign up with the devil to save that person.
You’re obviously a smart man – but is it possible that you are so absorbed with theory that you have yet to discover that no system yet devised is perfect and that human beings do have a moral obligation to do the best they can to help others? I know that you see this as a matter of people being obligated to help themselves and their families. But you don’t know how you’re life is gong to turn out. While I suspect you will be very successful, should things not go quite as planned, and you or someone you care about needs an expensive regimen on chemotherapy – something that no doctor can afford to give you at no charge or even a greatly reduced charge, do you honestly believe you are prepared to give your life – or, even worse, the life of someone you love- in defense of your theoretical and ideological beliefs and do so with the knowledge that the medicine exists to help or cure you if only there was someone, or something, that could help you gain access?
One final comment – when you explain away another’s position as a ‘glimpse into the left wing psyche’, you assume much and turn to a very easy way out to try and make your point. I think many readers – including some of the writers here at True/Slant whom I know you read and with whom you often agree, would tell you that my psyche is decidedly not your typical ‘left-wing’ variety. When you assume so much as an easy way to explain away disagreement, you suggest that only your opinion can be the right one. And if you actually believe that, you have a long way to go.
In response to another comment. See in context »alexknepper-
A great libertarian speech! And completely illustrative of the problem. I can’t help but note that you did not answer the questions I asked – electing instead to give us a speech.
1. When you find that society where “the code of ethics that should be enshrined is one of voluntary cooperation”, let me know so I can move there with you. Sadly, there has not been such a place since the dawn of time so you’ll forgive me if I hold onto a bit of cynicism regarding the potential. This is precisely why we have the rule of law. In the meantime, I hope you won’t mind if I concern myself with the society my family does live in here in the real world.
2. I might have had a brain hemorage, but I can’t seem to recall where I said anything about ‘cooperation at the point of a gun’. If you are intent on stating your point of view over what America has become to you, we aren’t going to get very far on the specific issue I thought we were discussing.
3.I don’t believe I suggested that taxes were charity, so if you are insulted, it is entirely the result of your own lack of understanding.
4.”Back in the days of real communities, people were actively engaged in each others’ affairs — by choice. We helped our neighbors because we wanted to — not because we knew that if we didn’t, Uncle Sam would jail us. The welfare state destroyed that truly communitarian ethos.”
Again great drama. But I’m afraid nobody is getting jailed in the conversation I thought we were having.
5. Will you parents, grandparents or you pass up their medicare? Simple question. I hope you’ll answer.
6.Do you have health insurance for your family? Another simple question that I hope you’ll answer. And if you do, do you receive it at work or do you have an individual policy?
I believe I did respond to your paragraph on healthcare being a finite resource just as I believe a police force is a finite resource.
Where your argument breaks down is that I strongly suspect that you aren’t willing to accept that it would be virtually impossible for you to bring all the care you would want for your family without the assistance of the money provided by the public. While it is true that, as you state, communities of long ago did more to help one another, a very good thing, you fail to note that people lived a much shorter period of time in those days. While this might be okay with you, you’ll forgive the rest of us if we want a better and longer quality of health for our own families and appreciate how that becomes possible when the public pools together to make it happen.
And by the way, while the government may be hampering a physician’s ability to earn as much as you think a doctor should (something I would agree with by the way), it is not true that government tells doctors what to do – that privilege is reserved to the private insurance companies.
It’s clear that you wish you lived in another time. And I’m sorry that is not the case. But for the rest of us who have a concern for how families live in ‘real time’, your points just fall flat – existing in a 35,000 mile about the ground world when mortals have to live right here at sea level.
I would simply say that if you want free markets I’m all for it, but before we get lost in all the Ann Rand stuff we need to understand that the McCarren-Ferguson Act of 1945 is one of the culprits here. The free market, as it exists today, is defined oligopolies in each state in the union. As a result, due to the inelasticity of demand the free people in each of these free markets are getting jacked by the (often sole) provider in the market.
The result is this: http://blogs.ngm.com/blog_central/2009/12/the-cost-of-care.html. Highest cost in the world for the outcomes that are – meh. Compared to other countries, ours is not working properly in this area. So this is really about fixing a broken market – and the exchanges envisioned by the reform are a positive step, along with bringing in more people into the market to spread risk and costs across the largest spectrum of consumers.
Were we to get medieval on the problem, we might be tempted to create some full-on socialist solution the likes of which you (Keppler) seem to think are imminent, but what I see is pretty reasonable.
Moreover, when it comes to mitigating risk, and this was actually the point of my comparison with the police and fire services you enjoy, the conservative argument for healthcare reform stands because it has value for individuals and society as a whole by ensuring that no one gets sucked under when disaster strikes and keeps them free to be productive. And let’s face it, losing your wife is still going to be a disaster, but at least a Mr. Greene will be able to keep going and not wind up ruined (and presumably on welfare). So it’s not about utopia at all, it’s about realistically dealing with risk and costs, and that it happens to be compassionate and decent is really just icing on the cake. For a society as rich and robust as this one is, it seems unlikely that we can’t figure this out.
It takes a true heart to recognize a neighbors challenge. It takes a medical bill to recognize your own.
nice!
In response to another comment. See in context »