Recommended by Ricochet Members Created with Sketch. Getting Through to the Left: A Story of Success

 

I have a friend, a dear and kind man. He’s not an intellectual, neither atheist nor agnostic; in fact, I’m sure he does not even know what an agnostic is. (I’m not sure I do either, except that I think I’m one.) He’s Christian and accomplished, but not highly educated. He’s hardcore blue collar, the son of a farmer. Yet despite all this, he’s of the Left. It seems incongruous, but that’s what he is. He doesn’t hate conservatives, he just believes that the Left shows a more empathetic way; a kinder way. In his world, life is hard, and harder for some than for others. Government, to him, seems the best and most efficient way to soften life’s edges and help those who have it tough. To him, that is progress. Republicans impede that progression in his view: they oppose funding; they oppose welfare programs; they oppose everything. In his mind, it’s always about money for the Right. Dirty pieces of paper with pictures of dead men on them.

So, this morning, I was relaying the fact that I had promised a second essay for Ricochet on health care reform. I explained how I struggled to put my thoughts together, having earlier tweaked my back. Vicodin was clouding my mind, but I got it done. He asked about the details and I gave him my “unleashing the uncanny ability of American consumers to find a bargain” speech. He was following the logic when he stopped me, and asked “Why don’t we just nationalize health care? They do it in Canada, and in Britain. People say it’s great.”

I answered thus:

There is not enough money for some things. Education is one of those things. Health care is another. If health care is nationalized, the government will be placed in charge of our health! We will rely on the government to use its authority to force unpopular compromises to keep costs down. Many people will be affected by these decisions and actions, heavy-handed as they must be, and will take exception, calling for more money to be spent on health care. Thus, we will make the serious and intimate discussion of our health a national, politicized conversation about money and priorities. It will be an unending, unstoppable shout fest that will drown out all other conversation and no one will ever be satisfied. Is that what you want?

I could see his mind churning away as he took this all in. My revelation had slammed against preset dogma, collided with his settled questions, and upset the organization of his liberal mind.

I left him in this muddled state.

This is how conversions begin.

There are 46 comments.

  1. Profile Photo Member

    Or not. Don’t be too surprised if the next time health care comes up in your discussion he doesn’t say:

    Doug Kimball: “Why don’t we just nationalize health care? They do it in Canada, and in Britain. People say it’s great.”

    • #1
    • January 30, 2017, at 10:16 AM PST
    • Like
  2. DocJay Inactive

    It’s a hard conversation and one that our nation is likely unwilling to accept even starting.

    Great article about having a talk with a reasonable person Doug. Are Americans reasonable enough to discuss this looming fiasco?

    • #2
    • January 30, 2017, at 10:18 AM PST
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  3. HalapenyoHarry Inactive

    Thanks for the insights into liberal thinking. It always helps.

    • #3
    • January 30, 2017, at 10:19 AM PST
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  4. Chuck Enfield Coolidge

    Isaac Smith (View Comment):
    Or not. Don’t be too surprised if the next time health care comes up in your discussion he doesn’t say:

    Doug Kimball: “Why don’t we just nationalize health care? They do it in Canada, and in Britain. People say it’s great.”

    Don’t be surprised if I do too, but I doubt you’ll catch me calling it great. I read your two previous posts and I think you’re going in the right direction, but part 3 is where the real problem lies. I’m looking forward to reading your suggestions, but I haven’t ruled out basic healthcare as an entitlement. While it runs counter to my principles, I think it may be the most efficacious solution for the current political and economic environment.

    • #4
    • January 30, 2017, at 10:26 AM PST
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  5. MarciN Member

    It is discouraging.

    Perhaps the Democrats will pause in their inexorable march toward the government’s supplying all their healthcare: They hate Donald Trump with a fury and passion that outdoes their anti-GW energy. Perhaps we should take advantage of this moment and say, “Would you want Donald Trump in charge of your healthcare?” The liberals I know would not hesitate to say, “No!”

    They trust Obama. That’s why they were ready to cede their personal control over their own life to him. They do not trust Trump.

    • #5
    • January 30, 2017, at 10:29 AM PST
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  6. Profile Photo Member

    Why don’t we pass a constitutional amendment empowering states to set up state level ‘national’ insurance plans, and thereby motivate more people to pay attention to state government, and increase bargaining power of insurers? How can small-pool, private, state-by-state, highly-regulated insurers be expected to negotiate well against international, high-dollar drug companies and multi-state hospital chains?

    • #6
    • January 30, 2017, at 10:32 AM PST
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  7. Mr Nick Member

    Doug Kimball:“Why don’t we just nationalize health care? They do it in Canada, and in Britain. People say it’s great.”

    Not those who have to use it…

    • #7
    • January 30, 2017, at 10:36 AM PST
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  8. The Reticulator Member

    Doug Kimball: [quoting someone] People say it’s great.

    Also, people say it’s awful. So now what?

    • #8
    • January 30, 2017, at 10:36 AM PST
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  9. Nanda "Chaps" Panjan… Inactive

    Indeed so, DK…Working on a post now; will bookmark and be back…

    • #9
    • January 30, 2017, at 10:43 AM PST
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  10. MarciN Member

    This post has made me think of a great idea for a book on healthcare reform. It would consist of conversations with ordinary people outside of the insurance and healthcare fields.

    I can see a conversation that asks, “Do you want the Republicans sitting across the desk from you deciding what hospital and doctor you can see when your child needs medical care?”

    • #10
    • January 30, 2017, at 11:08 AM PST
    • 1 like
  11. PHCheese Member

    Mr Nick (View Comment):

    Doug Kimball:“Why don’t we just nationalize health care? They do it in Canada, and in Britain. People say it’s great.”

    Not those who have to use it…

    Or or do you mean those who have lived through using it.

    • #11
    • January 30, 2017, at 11:10 AM PST
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  12. Richard Finlay Member

    Chuck Enfield (View Comment):
    I haven’t ruled out basic healthcare as an entitlement.

    The problem will be what ‘basic’ means. How do you keep it from becoming all-encompassing (compassion, fairness, etc) so the only control is rationing from on high… as is done in UK, Canada, etc.

    • #12
    • January 30, 2017, at 11:25 AM PST
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  13. Terry Mott Member

    Richard Finlay (View Comment):

    Chuck Enfield (View Comment):
    I haven’t ruled out basic healthcare as an entitlement.

    The problem will be what ‘basic’ means. How do you keep it from becoming all-encompassing (compassion, fairness, etc) so the only control is rationing from on high… as is done in UK, Canada, etc.

    Exactly!

    • #13
    • January 30, 2017, at 11:31 AM PST
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  14. Joe P Member

    Isaac Smith (View Comment):
    Or not. Don’t be too surprised if the next time health care comes up in your discussion he doesn’t say:

    Doug Kimball: “Why don’t we just nationalize health care? They do it in Canada, and in Britain. People say it’s great.”

    When people come back with that, it helps to point out:

    1. Most of the people who are surveyed don’t have choices, so they don’t understand what they’re missing.

    2. These other countries view their healthcare systems with national pride, meaning they will overlook flaws in their system in order to brag how nice their country is to its people.

    3. Every one of these systems that doesn’t use the free market will find some other horrific way to manage scarcity. In the UK, you may have to wait 2 years to get an operation that you’d otherwise be able to get in a few weeks. In Japan, the doctor will only see you for five minutes, because price controls do not make it economical for him to do more than that. Etc.

    4. Nationalizing health care might actually be better than Obamacare, if we actually could do it the way those other countries did it. Our government doesn’t typically work as well as theirs, so why assume that whatever they’re doing would work as well for us?

    • #14
    • January 30, 2017, at 11:47 AM PST
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  15. Chuck Enfield Coolidge

    Richard Finlay (View Comment):

    Chuck Enfield (View Comment):
    I haven’t ruled out basic healthcare as an entitlement.

    The problem will be what ‘basic’ means. How do you keep it from becoming all-encompassing (compassion, fairness, etc) so the only control is rationing from on high… as is done in UK, Canada, etc.

    That’s the biggest challenge, but I see challenges everywhere I look when it comes to the politics of healthcare.

    • #15
    • January 30, 2017, at 11:52 AM PST
    • 1 like
  16. The Reticulator Member

    Chuck Enfield (View Comment):

    Richard Finlay (View Comment):

    Chuck Enfield (View Comment):
    I haven’t ruled out basic healthcare as an entitlement.

    The problem will be what ‘basic’ means. How do you keep it from becoming all-encompassing (compassion, fairness, etc) so the only control is rationing from on high… as is done in UK, Canada, etc.

    That’s the biggest challenge, but I see challenges everywhere I look when it comes to the politics of healthcare.

    Might be good to pick some word other than “basic.” I haven’t given it a lot of thought yet, but one idea that comes to mind is the “government” level of health care.

    • #16
    • January 30, 2017, at 12:10 PM PST
    • Like
  17. Chuck Enfield Coolidge

    The Reticulator (View Comment):

    Chuck Enfield (View Comment):

    Richard Finlay (View Comment):

    Chuck Enfield (View Comment):
    I haven’t ruled out basic healthcare as an entitlement.

    The problem will be what ‘basic’ means. How do you keep it from becoming all-encompassing (compassion, fairness, etc) so the only control is rationing from on high… as is done in UK, Canada, etc.

    That’s the biggest challenge, but I see challenges everywhere I look when it comes to the politics of healthcare.

    Might be good to pick some word other than “basic.” I haven’t given it a lot of thought yet, but one idea that comes to mind is the “government” level of health care.

    I’m on board, but any legislation would have to make the limits clear. The good news is that @dougkimball is going to propose an alternative that’s superior in every way. At least I hope so. I dread the prospect of supporting a new entitlement.

    • #17
    • January 30, 2017, at 12:19 PM PST
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  18. Terry Mott Member

    Any legislative limits would just be moved or completely thrown out a few years down the road. Too many votes out there for the buying for them not to be.

    • #18
    • January 30, 2017, at 12:24 PM PST
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  19. Chuck Enfield Coolidge

    Terry Mott (View Comment):
    Any legislative limits would just be moved or completely thrown out a few years down the road. Too many votes out there for the buying for them not to be.

    Anything done legislatively can be undone the same way. In this case, you might say undone can be redone. Even the constitution doesn’t mean what it plainly says. If the people want to vote themselves nice stuff at other people’s expense, there’s little that can be done to stop them. The only remedy is to convince them that it won’t work.

    • #19
    • January 30, 2017, at 1:12 PM PST
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  20. Terry Mott Member

    Chuck Enfield (View Comment):

    Terry Mott (View Comment):
    Any legislative limits would just be moved or completely thrown out a few years down the road. Too many votes out there for the buying for them not to be.

    Anything done legislatively can be undone the same way. In this case, you might say undone can be redone. Even the constitution doesn’t mean what it plainly says. If the people want to vote themselves nice stuff at other people’s expense, there’s little that can be done to stop them. The only remedy is to convince them that it won’t work.

    The anti-poverty programs of the ’60s lead inevitably to the metastasized welfare state we have now, where any expectation that people provide for themselves to the best of their ability is denounced as racism, sexism, homophobia, etc., while the majority of the people vote themselves nice stuff at other people’s expense. Socialized medicine would inevitably lead to a similar result, piled on top of what we have now. No limits are possible, and any language to that effect would be meaningless.

    Hence, I’ll never be on board.

    • #20
    • January 30, 2017, at 1:36 PM PST
    • 1 like
  21. Doug Kimball Member
    Doug Kimball Post author

    Chuck Enfield (View Comment):

    The Reticulator (View Comment):

    Chuck Enfield (View Comment):

    Richard Finlay (View Comment):

    Chuck Enfield (View Comment):
    I haven’t ruled out basic healthcare as an entitlement.

    The problem will be what ‘basic’ means. How do you keep it from becoming all-encompassing (compassion, fairness, etc) so the only control is rationing from on high… as is done in UK, Canada, etc.

    That’s the biggest challenge, but I see challenges everywhere I look when it comes to the politics of healthcare.

    Might be good to pick some word other than “basic.” I haven’t given it a lot of thought yet, but one idea that comes to mind is the “government” level of health care.

    I’m on board, but any legislation would have to make the limits clear. The good news is that @dougkimball is going to propose an alternative that’s superior in every way. At least I hope so. I dread the prospect of supporting a new entitlement.

    The essential principles and concepts that should comprise a market based health care payment/financing program for the majority of Americans are detailed here. I will deal with the poor, elderly, uninsured and chronic cases in a final essay that I promise I will post before the end of this week. I will also address other issues, like tort reform and federalism (states rights to control their own health care requirements) in essay 3.

    • #21
    • January 30, 2017, at 1:46 PM PST
    • Like
  22. iWe Reagan
    iWe

    I always use comparisons to things people know the government is awful at:

    • You don’t buy cars from government-owned car companies. Why do you think they will be better at health?
    • Can you imagine hospitals working just as well as the DMV?
    • When you ship something, do you prefer the customer service at Post Office or UPS/FedEx?
    • #22
    • January 30, 2017, at 3:56 PM PST
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  23. EJHill Podcaster

    Every Canadian I’ve ever encountered who told me how great their health system was had one thing in common: they were all healthy. The only time they encountered their provincial providers it was for strictly routine stuff like physicals for work or an occasional bout with the flu.

    I usually ask if they’ve ever had a suspected cancer diagnosis or chronic problem. And then we talk about the hotel near the Cleveland Clinic that takes in nothing but Canadians fleeing backlogged hospitals in Ontario. And why, I ask, did Danny Williams, the premier of Newfoundland (’03-10) go to Miami when he need heart surgery? Or why did MP Belinda Stronach (’04-08) have her breast cancer done in San Francisco? If they tell me the best doctors and the latest technology is in the States I ask them why do they think that’s the case?

    • #23
    • January 31, 2017, at 6:53 AM PST
    • 1 like
  24. Ralphie Member

    iWe (View Comment):
    I always use comparisons to things people know the government is awful at:

    Education. We spend more and more and get less and less.

    Kermit Gosnell and his legal abortion clinic.

    I tell my friends that government is basically force. It cannot care. The most dedicated social worker follows rules that they must obey that run contrary to their beliefs about what is best to do. If you disobey a rule, and the outcome is poor, you could be ruined. If you obey the rule and the outcome is poor, it is just how life goes. There is only one set of rules in a government monopoly. And rules generally are conservative and work to encompass the least competent worker. Good medicine requires rule breaking.

    • #24
    • January 31, 2017, at 6:56 AM PST
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  25. Johnny Dubya Inactive

    We already have an example of government healthcare in this country: VA hospitals.

    People say they’re grrreat!

    As with any services or products we consume, from healthcare providers we expect quality, innovation, and efficiency. Since when have any of those qualities been demonstrated by government?

    • #25
    • January 31, 2017, at 7:28 AM PST
    • Like
  26. Ontheleftcoast Inactive

    DocJay (View Comment):
    Are Americans reasonable enough to discuss this looming fiasco?

    As opposed to other looming fiascos?

    • #26
    • January 31, 2017, at 7:52 AM PST
    • Like
  27. EJHill Podcaster

    OntheleftcoastAs opposed to other looming fiascos?

    Just the other day I was making cloth and ran out of freshly picked cotton. Says I to no one in particular, “What a looming fiasco this is!”

    • #27
    • January 31, 2017, at 8:12 AM PST
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  28. Ontheleftcoast Inactive

    This looms pretty good:

    Two national actuarial associations established a joint task force to study the thorny discount rate issue, but a dispute erupted over publishing the research project’s conclusions that public pension earnings assumptions are too high and should be sharply reduced. Were its recommendations to be followed, the nation’s unfunded pension liability would quadruple from $1.5 trillion to $6 trillion.

    In other words, there is a $6 trillion liability but shifty reporting practices and earnings assumptions not based on reality have made it look smaller, and a lot of people want to try to keep sweeping the problem under the rug.

    California has about 12% of the U.S. population and its true unfunded liability accounts for about one sixth of the total:

    Even at [the bogus estimate of] $450 billion, California’s unmet pension liabilities are immense, with only about two-thirds of pension promises now covered by assets.

    If pension debt is $1 trillion or more, as the new actuarial study suggests, it threatens to overwhelm state and local governments, crowding out vital public services.

    • #28
    • January 31, 2017, at 8:33 AM PST
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  29. Doug Kimball Member
    Doug Kimball Post author

    Republican to Liberal mansplaining the unfunded pension liability issue: “You see, you must consider the ages of those in the program. There are those who are already retired and those still in the workforce. Taking into consideration compensation history, current actuarial tables (predicted age at death) and date of retirement (after 20 years of employment) you can reasonably predict the benefits expected to be paid out to retirees. You can then discount (using the expected asset appreciation rate) those annuities and calculate the present value of that liability. If you compare that figure to the current assets in the plan , voila, if the liability is the higher figure, you have an unfunded liability.”

    Liberal response: You are a rich jerk and hate brown people.

    • #29
    • January 31, 2017, at 8:56 AM PST
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  30. Terry Mott Member

    Doug Kimball (View Comment):
    Liberal response: You are a rich jerk and hate brown people.

    And women, gays, Muslims, the transgendered, the gender-non-specific, children, kittens and puppies.

    Hater.

    • #30
    • January 31, 2017, at 9:01 AM PST
    • Like