Sympathizing: Must Loving Fishtown Equal Hating Belmont?

 

We have plenty of folks on Ricochet who inhabit Belmont, more or less, but identify with Fishtown. It seems the easiest way to signal this sympathy is to be a self-hating Belmontonian. But what if you don’t hate everything about Belmont? Is it possible to sympathize with Fishtown even then? I would say yes. Though I would not, at this point, expect to be believed.

I recently reviewed Dreamland, a reporter’s magnum opus on the opiate addiction epidemic. My interest in its devastation isn’t academic. After all, I, too, have known chronic pain, death-wish despair, and repeated exposure to opioids through injury and surgery. Nor am I the only one in my family to have had these problems. Yet we’ve been spared from narcotics addiction, and the buffer of Belmont customs is at least partly to thank for this. Growing up, I hadn’t thought of myself as “Belmont.” My parents’ one sacrifice to dwarf all others was buying us a precarious perch in a Belmont neighborhood so we could attend its famed Belmont schools. It meant money was always tight. We dressed in the kind of secondhand clothes that made other kids point and laugh. In Belmont, we were at the bottom of the food chain, and that, plus my family’s right-leaning distaste for Belmont smugness, left us thinking of ourselves as outsiders, crypto-Fishtowners. It took leaving Belmont to find out how Belmont we’d become.

Being Belmont isn’t such a bad thing. There’s much more to Belmont than smugly looking down on the rubes. We rely on Belmont to support much of the finest flower of Western civilization – the arts, the sciences. As Charles Murray noted, Belmont neglects to preach the morals it still practices, while Fishtown struggles to practice what it preaches. But practice is not nothing, especially for youngsters who get to grow up surrounded by the practice. In my teens, I began attending about the Belmontiest church you could imagine – folks way richer than us, socialites on the “in” when I was “out,” with everybody reluctant to preach what they practiced. But among the things they practiced was traditional worship music (it’s why I went) and, as Lutherans like to say, music is its own sermon. You can get a pretty good Christian formation in one of those churches by ignoring what’s spoken and taking to heart what’s sung. And oh, the music!

Whenever I’m around other classical-music lovers, I can pretty much guarantee that I’ll be in the political minority. Loving classical music seems very Belmont, and my family never did adopt Belmont’s progressive politics. It can grate to hear other musicians and music-lovers toss off progressive opinions like they’re sure everyone agrees. It can grate that the arts aren’t “owned” by the faction whose stated political project, after all, is preserving the best of Western tradition from whatever threatens it. It can grate, but what does not grate is listening to and making music – participating in the perpetuation of that tradition – with these progressives. We decry progressive attacks on aesthetics when Belmontonians support modern works that don’t deserve to be included among works of historic greatness – but that only happens because works of historic greatness are still being performed, largely thanks to Belmont’s support. Music, at least, is something traditional conservatives do with Belmont. Not without it.

From music, and the tacit-but-powerful pressure to stay on the straight and narrow, to all the other social resources and little customs which can fortify a family in the face of pain and despair, my family owes Belmont too much gratitude to really hate it. If proof of loving Fishtown is denouncing Belmont, I’m in trouble. Should it be?

According to some, perhaps:

If the poor have vicious habits, whose fault is it — theirs or the people who made fortunes encouraging and refining these habits with the help of international consulting firms?

Supposing the indictment against international consulting firms were true, not every Belmontonian makes money with the direct help of such a firm. But just being part of the Belmont class – or even getting along ok with the Belmont class – might seem like tacit approval of those who do. As @jon just observed,

Elitism is Belmont hating Fishtown. Populism is Fishtown hating Belmont. Either is just Americans wanting to hurt their fellow Americans, which is where our politics has been for at least a decade.

Is it still possible to be neither an elitist nor a populist? To have sympathy for those who are hurting without hating the better-off?

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  1. Judithann Campbell Member
    Judithann Campbell
    @

    Could Be Anyone (View Comment):
    According to Gallup only 19% of Americans want abortion totally illegal. Are you trying to tell me that is a significant majority of people?

    I never said that a significant majority of people want abortion outlawed; I said a significant percentage. I don’t know how many times I need to correct you on this, but at this point, I think you are willfully misrepresenting what I am saying. Goodbye.

    • #181
  2. Umbra Fractus Inactive
    Umbra Fractus
    @UmbraFractus

    Could Be Anyone (View Comment):
    I don’t believe me not capitalizing trump is against the rules of the CoC.

    No, but much like Max’s refusal to admit that the man has done a single thing wrong since taking office, such blatant displays of bias harm your credibility.

    • #182
  3. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    Damocles (View Comment):

    Midget Faded Rattlesnake (View Comment):

    Alarming? Because I see the alarm overblown, I perceive the alarm as less. Perhaps it’s just my contrarian nature?

    Perhaps it is your contrarian nature.

    Myself, I’m surrounded by the best and the brightest. People who are the leaders of the current generation, and the upcoming leaders of the next.

    And most of them firmly believe that according to the constitution, “hate speech is not protected speech,” and that people who speak out in favor of the President in Berkeley get what they deserve when people beat them up.

    I fear that by the time you are alarmed it may be too late to protect these brave souls.

    You can fear that, but what would it matter to my behavior?

    Is it realistic to expect that my increasing my level of alarm earlier could somehow intervene in time to protect California’s Trump supporters from the calamity you dread on their behalf?

    • #183
  4. Could Be Anyone Inactive
    Could Be Anyone
    @CouldBeAnyone

    Judithann Campbell (View Comment):
    I never said that a significant majority of people want abortion outlawed; I said a significant percentage. I don’t know how many times I need to correct you on this, but at this point, I think you are willfully misrepresenting what I am saying. Goodbye.

    That was a mistype. I meant to type percentage. Its been corrected.

    Umbra Fractus (View Comment):

    Could Be Anyone (View Comment):
    I don’t believe me not capitalizing trump is against the rules of the CoC.

    No, but much like Max’s refusal to admit that the man has done a single thing wrong since taking office, such blatant displays of bias harm your credibility.

    And yet mine is an aesthetic insult to the man, not a proclamation that I can only find fault in him. Its not attacking his followers (unless they identify closely with him which would be weird). As to showing bias I have defended trump on various occasions. Most of them are not on Ricochet because he has plenty of supporters (but I have had times where I have).

    Could Be Anyone (View Comment):

    Paul Dougherty:0b283a5a331d8fec94b3ffdd94e658ba

    For what it may be worth, this was in my Facebook feed about thirty minutes ago. (facts- unchecked for lack of interest)

    Let me be the first to defend tRump. Snopes.com looked into this and its false. No such interview occurred between tRump and People Magazine in 1998. The closest date an interview occurred with him involving politics was in 1999 and he made no such statement.

    Typical left-wing pravda trying to attack Republicans and Fox News.

    I find it surprising though that my simple decapitalization is eliciting more reaction than never trump or other slanders used against trump critics on this site.

    Is my decapitalization just that powerful? I doubt it, I am but one person and I usually don’t get responses to my posts or arguments. Regardless of my capitalizing or decapitalizing trump. Besides if it truly mattered why are there no complaints about the derogatory terms used for the clintons or obama? Why should it matter for trump but not them if we truly are dedicated to not showing bias. As to our biases we all know each others biases by now on this website (its been hashed out a thousand times by now) as it relates to trump. To pretend otherwise would be blinding to say the least.

    • #184
  5. Could Be Anyone Inactive
    Could Be Anyone
    @CouldBeAnyone

    Lois Lane (View Comment):
    Economists have studied the issue closely, and Medicare has had an impact on quality and quantity of life. Medicaid, on the other hand, has had much less impact. I don’t have charts handy, but I remember this from graduate school.

    According to information from the late 1990s on the Social Security website life expectancy had already risen substantially from 1900 to 1960. In fact since 1965 life expectancy had only risen by 5 years roughly in 1996. In the same time period from 1900 to 1930 it had risen by 13 years (and from 1900 to 1965 it rose by 23 years; compare roughly the same period of time from 1965 to now and life expectancy has rise by only 8 years). Medicare is not beating the private market in allowing people to live longer.

    The same pattern follows in death from age related illness. Death from age related illness was 1,860,000 a year in 1935. By 1955 it was 1,314,000. That was roughly half a million fewer deaths a year. Today its roughly 800,000. Another reduction of 500,000. The big difference is that the 500,000 fewer deaths occurred in 20 years time before Medicare or Medicaid came into existence. It took 50 years to accomplish the same results with Medicare, Medicaid and the like.

    Given those facts it strikes me as unlikely that Medicare had anything to do with it. Life expectancy was already rising and mortality from age related illness falling significantly (and at faster rates than after Medicare was instituted). I would need to see a study that accounted for the countless variables related to age related illness and life expectancy in order to believe state intervention was truly the cause (the but for).

    Midget Faded Rattlesnake (View Comment):
    @judithanncampbell seems to be suggesting that some Americans worry the price of reducing the welfare state is killing more people, either through abortion or denying the elderly care.

    Now, it’s true that permitting the elderly to die is different from abortion. One is something done, the other is something left undone. Americans do expect medicine to save lives, though, rather than just ameliorate quality of life. I’d rather give up sooner when the end is coming anyhow, but a lot of Americans see the struggle to remain undead as noble and worth rooting for.

    I doubt you are arguing that the elderly cannot die unless they don’t receive medical care. We all will die. The flesh will go back to dust. As to reducing the welfare state and killing people I did not institute the policy. I am not responsible for making people dependent on the state. The guilt is to be borne by those who instituted it. As to Judith making the argument of relation to abortion and welfare.

    Judithann Campbell (View Comment):
    What I did say is that lots of people who would otherwise object to welfare and single motherhood generally, don’t, or if they do, their objections are rather muted, because they don’t want to do anything that might pressure women into abortion. It is very possible to believe that both welfare and abortion are wrong, but that one is far worse than the other. And lots of people who believe that abortion is far worse than welfare are willing to tolerate welfare because they suspect that it may reduce the number of abortions.

    That is an argument that welfare reduces the number of abortions. Judith is arguing that an increase in welfare correlates with a decrease in abortion. I responded to that by asking how welfare prevents abortions. Judith did not give an explanation. I will wait for one. I would be more than happy to read a study if she wishes to present one.

    Damocles (View Comment):
    It’s just that it makes you sound somewhat bitter,

    I would ask you to see your doctor if you voice sounds bitter when reading my words (after all my words do not communicate my voice and they are just words).

    • #185
  6. Damocles Inactive
    Damocles
    @Damocles

    Judithann Campbell (View Comment):

    Could Be Anyone (View Comment):
    According to Gallup only 19% of Americans want abortion totally illegal. Are you trying to tell me that is a significant majority of people?

    I never said that a significant majority of people want abortion outlawed; I said a significant percentage. I don’t know how many times I need to correct you on this, but at this point, I think you are willfully misrepresenting what I am saying. Goodbye.

    Everything you need to know about your interaction is detailed here:

    http://blog.dilbert.com/post/160696999931/how-to-know-you-won-a-political-debate-on-the

    tl;dr: you’ve won, since you’ve pushed him into the Absurd Absolute cognitive dissonance tell when he asked you if “19% is a significant majority?”.  His brain rendered “significant percentage” as “significant majority.”

    • #186
  7. Damocles Inactive
    Damocles
    @Damocles

    Midget Faded Rattlesnake (View Comment):

    Is it realistic to expect that my increasing my level of alarm earlier could somehow intervene in time to protect California’s Trump supporters from the calamity you dread on their behalf?

    Yes. You might be motivated to do something to help.

    • #187
  8. Judithann Campbell Member
    Judithann Campbell
    @

    Could Be Anyone (View Comment):
    Judith is arguing that an increase in welfare correlates with a decrease in abortion

    I argued no such thing. I explained that some people fear that eliminating welfare might result in an increase in abortions. I was explaining a concern, not making a claim. No one knows  for certain what the effect on abortion would be if we ended welfare; for as long as we have had abortion, we have had welfare. In order to find out if one correlates with the other, we would have to end one or the other. For pro-lifers, ending welfare while continuing abortion presents an incredible risk, one that many are understandably not eager to make. But I want to repeat: I am describing a concern, not making a claim.

     

    • #188
  9. Judithann Campbell Member
    Judithann Campbell
    @

    Midget Faded Rattlesnake (View Comment):
    Is it realistic to expect that my increasing my level of alarm earlier could somehow intervene in time to protect California’s Trump supporters from the calamity you dread on their behalf?

    If I thought that the only people in danger would be a few Trump supporters in California, I would still be alarmed, but not as alarmed. But once powerful people decide that violence against political opponents is acceptable, everybody is fair game. These “anti-fascists” will use violence against anyone they disagree with anytime they think it will work. They are a threat to everyone; they are far, far, far more of a threat to a free society than anybody in Fishtown is.

    • #189
  10. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    Could Be Anyone (View Comment):

    Midget Faded Rattlesnake (View Comment):
    @judithanncampbell seems to be suggesting that some Americans worry the price of reducing the welfare state is killing more people, either through abortion or denying the elderly care.

    Now, it’s true that permitting the elderly to die is different from abortion. One is something done, the other is something left undone. Americans do expect medicine to save lives, though, rather than just ameliorate quality of life. I’d rather give up sooner when the end is coming anyhow, but a lot of Americans see the struggle to remain undead as noble and worth rooting for.

    I doubt you are arguing that the elderly cannot die unless they don’t receive medical care. We all will die. The flesh will go back to dust. As to reducing the welfare state and killing people I did not institute the policy. I am not responsible for making people dependent on the state. The guilt is to be borne by those who instituted it.

    The ones who suffer – or who fear they will suffer – from cuts aren’t the ones who instituted it, either. Understanding their trepidation, and accepting they will have trepidation, does not require you to consider yourself responsible for others’ dependence. It’s just understanding, accepting that humans are human.

    • #190
  11. Could Be Anyone Inactive
    Could Be Anyone
    @CouldBeAnyone

    Damocles (View Comment):

    Judithann Campbell (View Comment):

    Could Be Anyone (View Comment):
    According to Gallup only 19% of Americans want abortion totally illegal. Are you trying to tell me that is a significant majority of people?

    I never said that a significant majority of people want abortion outlawed; I said a significant percentage. I don’t know how many times I need to correct you on this, but at this point, I think you are willfully misrepresenting what I am saying. Goodbye.

    Everything you need to know about your interaction is detailed here:

    http://blog.dilbert.com/post/160696999931/how-to-know-you-won-a-political-debate-on-the

    tl;dr: you’ve won, since you’ve pushed him into the Absurd Absolute cognitive dissonance tell when he asked you if “19% is a significant majority?”. His brain rendered “significant percentage” as “significant majority.”

    Glad to see Damocles still subscribes to peddlers of pseudo science. Logic can be hard for some.

    Judithann Campbell (View Comment):
    I argued no such thing. I explained that some people fear that eliminating welfare might result in an increase in abortions. I was explaining a concern, not making a claim. No one knows for certain what the effect on abortion would be if we ended welfare; for as long as we have had abortion, we have had welfare. In order to find out if one correlates with the other, we would have to end one or the other. For pro-lifers, ending welfare while continuing abortion presents an incredible risk, one that many are understandably not eager to make. But I want to repeat: I am describing a concern, not making a claim.

    What if someone (or several pro lifers) feared that eliminating the minimum wage would relate to more abortions? Is there any evidence to suggest such? Is the fears of these “individuals” you speak of founded in anything? How big is this group of people fearing the loss of welfare (because you, nor I, speak for all those who proclaim to be pro life)? Do they have any evidence to support their fears? How did they come to the conclusion to that it is an incredible risk? One would have to have evidence, have found a correlation between the two, in order to conclude such.

    If not I don’t see why anyone should take them seriously and as to your claim that welfare and abortion coexisted again this is false. Medicare, Medicaid, and Social Security all pre existed the Decision of Roe v Wade by a decade or more. So arguing that somehow the welfare state is linked to the abortion is false.

    • #191
  12. Could Be Anyone Inactive
    Could Be Anyone
    @CouldBeAnyone

    Midget Faded Rattlesnake (View Comment):
    The ones who suffer – or who fear they will suffer – from cuts aren’t the ones who instituted it, either. Understanding their trepidation, and accepting they will have trepidation, does not require you to consider yourself responsible for others’ dependence. It’s just understanding, accepting that humans are human.

    Some of them perhaps are (there are those who were old enough to have voted when Medicaid and Medicare were enacted under Johnson) and others voted to support Obamacare. They voted in the representatives and senators which passed such legislation and policy. Your definition of “understanding” is awfully close to sympathy.

    But why should I have sympathy for those would seek profit on the loss of others. Why should I? They sought the ruin of others for their own gain. Now that they are old and frail am I to take pity on them? Not likely, in fact I doubt they will suffer because they will most likely not see the welfare state end in their life times. They will get to benefit off the work of others who pay for their medicare and Social Security.

    Understanding does not require acceptance. I don’t have to affirm why they did what they did. I simply need to know why they did it and how they did it.

     

    • #192
  13. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    Damocles (View Comment):

    Midget Faded Rattlesnake (View Comment):

    Is it realistic to expect that my increasing my level of alarm earlier could somehow intervene in time to protect California’s Trump supporters from the calamity you dread on their behalf?

    Yes. You might be motivated to do something to help.

    Why is alarm necessary to help others, and what are the odds that you and I would agree on what’s helpful here?

    I see myself as already doing helpful things. If you disagree I already do helpful things, your telling me alarm would motivate me to “do something to help” won’t persuade me, since our disagreement is likely about what constitutes help.

    • #193
  14. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    Could Be Anyone (View Comment):

    Midget Faded Rattlesnake (View Comment):
    The ones who suffer – or who fear they will suffer – from cuts aren’t the ones who instituted it, either. Understanding their trepidation, and accepting they will have trepidation, does not require you to consider yourself responsible for others’ dependence. It’s just understanding, accepting that humans are human.

    Some of them perhaps are (there are those who were old enough to have voted when Medicaid and Medicare were enacted under Johnson) and others voted to support Obamacare. They voted in the representatives and senators which passed such legislation and policy. Your definition of “understanding” is awfully close to sympathy.

    Yes. Because when it comes to understanding most ordinary people, sympathy is part of that understanding.

    But why should I have sympathy for those would seek profit on the loss of others. Why should I? They sought the ruin of others for their own gain.

    Why? “For all have sinned and fall short of the glory of God” comes to mind. Sinners are called to beg Christ for mercy, and Christ is merciful. Christians are called to imitate Christ – the God who sympathized with human nature so much He became human.

    And that’s supposing these voters consciously sought the ruin of others, rather than what may have also happened: they were voters seduced into believing that this time, somehow, politicians had found a unicorn, a unicorn that could fart rainbows. Add in the fact that voters have to vote for whole politicians, not policy-by-policy, and maybe it’s reasonable to judge these voters less harshly. I’m sure gullibility is some kind of sin, especially gullibility abetted by wishful thinking, but sins come in different sizes.

    Now that they are old and frail am I to take pity on them? Not likely, in fact I doubt they will suffer because they will most likely not see the welfare state end in their life times. They will get to benefit off the work of others who pay for their medicare and Social Security.

    That they’ll get their benefits and won’t need pity for that is one thing. That it might be humane to pity someone who were suffering, even if that someone once, perhaps long ago, invited the suffering onto himself, is another.

    Understanding does not require acceptance.

    But what does refusal to accept that humans act human get you?

    I don’t have to affirm why they did what they did.

    To accept humans act human is not to affirm what they do wrong while acting human.

    I simply need to know why they did it and how they did it.

    If you wanted to get them on board with your plans for reform, you’d need to know more than that.

    • #194
  15. Could Be Anyone Inactive
    Could Be Anyone
    @CouldBeAnyone

    Midget Faded Rattlesnake (View Comment):
    Yes. Because when it comes to understanding most ordinary people, sympathy is part of that understanding.

    I would contest such a notion. As Aristotle said one does not have to agree with a notion to entertain it. I do not have to sympathize with something to understand it.

    Midget Faded Rattlesnake (View Comment):
    Why? “For all have sinned and fall short of the glory of God” comes to mind. Sinners are called to beg Christ for mercy, and Christ is merciful. Christians are called to imitate Christ – the God who sympathized with human nature so much He became human.

    And that’s supposing these voters consciously sought the ruin of others, rather than what may have also happened: they were voters seduced into believing that this time, somehow, politicians had found a unicorn, a unicorn that could fart rainbows. Add in the fact that voters have to vote for whole politicians, not policy-by-policy, and maybe it’s reasonable to judge these voters less harshly. I’m sure gullibility is some kind of sin, especially gullibility abetted by wishful thinking, but sins come in different sizes.

    Does God’s desire to imitate his example preclude stating those who did wrong? I don’t think so. In fact if one is truly trying to imitate God’s example they won’t sin to begin with. Obviously all humans (not God and human) fail, some more than others but that is no excuse to not mark out what is wrong.

    Unicorn or not it is a fact that said policies were passed with super majorities in both houses of congress and this reflects that a super majority of Americans wanted them and no such will currently exists to eliminate them. This despite constant warnings about insolvency and budget crises for at least 2 decades. And to even believe such programs were unicorns is a bit of an exaggeration. Unicorns work for everyone. These policies worked for only certain people, the poor or elderly, at the expense of other people. Americans in 1935 or 1965 were not so stupid as to not see it for what it was.

    It wasn’t their gullibility but their greed. There is a reason why men like FDR were able to ride on a wave to power by using class warfare rhetoric. A vast majority of Americans thought they were entitled. Greed is a considerable sin and one which is hard for many to let go of.

    Midget Faded Rattlesnake (View Comment):
    But what does refusal to accept that humans act human get you?

    No, I refuse their actions because they are the wrong actions. Humans can do good or wrong. When they do wrong I criticize them for it.

    Midget Faded Rattlesnake (View Comment):
    If you wanted to get them on board with your plans for reform, you’d need to know more than that.

    No I would have all I need to know. I know why they did what they did and how they did it. If I know why then I know whether or not they are receptive to my reforms or not. Those that are not receptive need not be talked to, its a waste of time otherwise. Besides who says that the elderly must be in a coalition to reform. The youth might be getting more politically active globally and in any growing nation there are more youth than elderly. That’s where the votes are.

    • #195
  16. Lois Lane Coolidge
    Lois Lane
    @LoisLane

    Damocles (View Comment):

    Lois Lane (View Comment):

    Maybe I’m just not aware but it seems to me that groups like Antifa have been universally condemned in Belmont.

    Hmm, at least here in San Francisco, the condemnation is reserved mainly for those who speak out hatefully. Antifa is considered déclassé, but they’re giving people what they deserve.

    If you’re stupid enough to speak out in favor of the president, or against sex change operations for children in Berkeley, you deserve any beating you get.

    I am definitely talking about conservatives in Belmont.  I, for example, live in Belmont and in a very progressive city, but I condemn abridged free speech and violence all of the time, even when this is uncomfortable.

    However, I also know plenty of Democrats who aren’t at all cool with the suppression of speech in colleges… including people at Berkeley.

     

    • #196
  17. Lois Lane Coolidge
    Lois Lane
    @LoisLane

    Could Be Anyone (View Comment):
    Medicare is not beating the private market in allowing people to live longer.

    Let me first say that I agree with a lot of your points on entitlements.  The thing I disliked during 2016 and continue to dislike about President Trump is that he could be LBJ on these issues, and that leaves me with no party.

    I also agree that Medicare/Medicaid drive up the costs for medical care, but nothing is ever simple.  For example, expanding the healthcare market and building more hospitals to accommodate elderly patients can also have a positive impact for others seeking medical care.

    In The Quarterly Journal of Economics (2007 – Oxford UP), Amy Finklestein  demonstrates that between 1965 and 1970, there was a 37% increase in real hospital expenditures for all ages per the introduction of new hospitals and expansion of the old hospitals to accommodate new patients.  (Health insurance in general played a role here, too, but she sees Medicare as a major driver.)

    She speculates that some of the new spending was on new technology, which drives up general medical costs as well but can have many positive outcomes, i.e. in the field of cardiac surgery.  (Medicare’s generous reimbursements encouraged innovation in this field.)

    In truth, there have been lots of aggregate effects  on medical spending, and discerning the “good” versus the “bad” is difficult.

    The first 10 years of the program did not increase elderly lifespans at all, but many elderly in New England already had health insurance, so Medicare’s impact varies according to region as it greatly expanded access in places like the South.

    There are other studies that show a correlation between Medicare spending and increased life span though that increase may be relatively low per the cost.

    However, I’d also argue you can’t look at the program’s impact on just quantity of years lived but quality of life, and that is harder to measure.

    A 1987 study in the Journal of Health and Human Resources asked the question in its title: “Do the Elderly Overuse Medicare?”  The conclusion was that this is also a hard question to answer in general, but need appears to be the biggest driver of utilization as elderly diabetics with Medicare do not get more treatment than young diabetics.  Rather, they get the medicines/treatment required to treat diabetes, and I don’t think I need to give you a study to show you that diabetes needs to be treated.  (Yes, diet and exercise are important factors in some types of diabetes but we are getting back to complicated measurements… lots of moving parts.)

    In an article in Tax Policy and the Economy (University of Chicago), Medicare is demonstrated to be a massive redistribution program to the poor elderly.   However, in the 1990s there was no increase in mortality rates for the biggest benefactors.

    Lower income people in general die quicker than upper income people.

    (cont..)

    • #197
  18. Lois Lane Coolidge
    Lois Lane
    @LoisLane

    So I’m not arguing anything by offering a very, very, very small sample of some studies that are easily accessed in peer reviewed journals.

    I’m simply giving some real data that think shows Medicare is a mixed bag, ie. it seems to me that there have been good and bad outcomes associated with Medicare, and nothing about it is simple.

    I can only spend so much time on Ricochet, but I also know the positives associated with Medicare are higher than those associated with Medicaid.

    This is in part related to the fact that not just the poorest elderly benefit from the first.  The reasoning behind that–if I remember correctly–is essentially this:

    Unfortunately, the poorest amongst us often make poor choices, whether given access to healthcare or not.  For example, they might not change diet after being told they have diabetes.  However, the lower middle class elderly who can now access a diet plan along with medical care are better able to see positive outcomes because they’ll make lifestyle changes on an individual level.

    I don’t know how that plays into Fishtown v. Belmont, but there are many, many, many studies on this if you have access to something like JSTOR.

     

    • #198
  19. Lois Lane Coolidge
    Lois Lane
    @LoisLane

    Could Be Anyone (View Comment):
    It wasn’t their gullibility but their greed. There is a reason why men like FDR were able to ride on a wave to power by using class warfare rhetoric.

    Here, you are throwing more stones than you should.

    FDR was certainly making populist appeals, but Social Security was a much harder sell than you make it sound.  Though Townsend Clubs–basis for SS–were infinitely popular amongst the old, many people were still concerned about hurting future generations, did not want hand outs, and insisted this program should be “earned” by citizens through small contributions that would act as a safety net later on.

    The desire to help widows and orphans as well came out of the Great Depression in a way that I think is hard to understand today.

    I agree entirely that health insurance became a “thing” because of FDR’s wage controls during WWII, but the consequences of this policy were not easily foreseeable.

    I could care less if you capitalize a name or not.  Truth be told, I didn’t even notice the lower case letter until it was made into a “thing.”

    However, I do think you can be too hard on people in general… even though I understand and sympathize with some of your ideology.  ;)

    • #199
  20. Judithann Campbell Member
    Judithann Campbell
    @

    Could Be Anyone (View Comment):
    If not I don’t see why anyone should take them seriously and as to your claim that welfare and abortion coexisted again this is false. Medicare, Medicaid, and Social Security all pre existed the Decision of Roe v Wade by a decade or more. So arguing that somehow the welfare state is linked to the abortion is false.

    There you go again, putting words in my mouth. I never argued that the welfare state is linked to abortion; I don’t know how many times I have to say this: I never argued or claimed anything. This is getting tiresome :)

    • #200
  21. Judithann Campbell Member
    Judithann Campbell
    @

    Could Be Anyone (View Comment):
    It wasn’t their gullibility but their greed. There is a reason why men like FDR were able to ride on a wave to power by using class warfare rhetoric. A vast majority of Americans thought they were entitled. Greed is a considerable sin and one which is hard for many to let go of.

    People are complicated, and all of us are a mix of good and bad. A big problem-maybe the biggest problem with modern liberalism is their inability to absorb that fact. How could so many of the Founding Fathers have been slaveholders? How could such good people do such a bad thing? Well, because they were people.

    The generation that you condemn for supporting FDR also defeated Hitler, at great personal cost to themselves. We owe them our eternal gratitude. This doesn’t mean that we should agree with them about everything, or ignore the mistakes they made, but if you look at the WWII generation and all you see is greed and sin, then there is a great deal that you aren’t seeing. We should acknowledge both the good and the bad; we must absolutely try to correct the mistakes our ancestors made, but to unilaterally condemn them as immoral is to miss most of the picture.

    • #201
  22. Could Be Anyone Inactive
    Could Be Anyone
    @CouldBeAnyone

    Lois Lane (View Comment):
    also agree that Medicare/Medicaid drive up the costs for medical care, but nothing is ever simple. For example, expanding the healthcare market and building more hospitals to accommodate elderly patients can also have a positive impact for others seeking medical care.

    In The Quarterly Journal of Economics (2007 – Oxford UP), Amy Finklestein demonstrates that between 1965 and 1970, there was a 37% increase in real hospital expenditures for all ages per the introduction of new hospitals and expansion of the old hospitals to accommodate new patients. (Health insurance in general played a role here, too, but she sees Medicare as a major driver.)

    She speculates that some of the new spending was on new technology, which drives up general medical costs as well but can have many positive outcomes, i.e. in the field of cardiac surgery. (Medicare’s generous reimbursements encouraged innovation in this field.)

    If we decided to create a tax credit for farmers to produce more wheat we would also get more wheat produced as a nation. You get more of what you subsidize. But how do you, or those that advocated for Medicare, know that it was the most efficient allocation of those dollars (you have not one but two outside parties in the matter, the government and health insurance providers so its not the most efficient use). Sure you might have helped some elderly people on the margins (those with heart problems) by making it easier for them to buy medical care but what moral imperative do I have, or anyone for that matter, to pay for care of the elderly? What makes them a collective of people worthy and not others? And how is the state using its force to compel such ends moral?

    In truth, there have been lots of aggregate effects on medical spending, and discerning the “good” versus the “bad” is difficult.

    Not really. Unless you subscribe to a utilitarian calculus I don’t see how the good can outweigh the bad. It not only is unsustainable in a stagnating country, but inflates costs, and favors one collective against others. It is not general welfare, but specific.

    The first 10 years of the program did not increase elderly lifespans at all, but many elderly in New England already had health insurance, so Medicare’s impact varies according to region as it greatly expanded access in places like the South.

    There are other studies that show a correlation between Medicare spending and increased life span though that increase may be relatively low per the cost.

    On the margins it might help people, but as I already stated from the trends its hard to artificially make a naturally improving situation better.

    However, I’d also argue you can’t look at the program’s impact on just quantity of years lived but quality of life, and that is harder to measure.

    A 1987 study in the Journal of Health and Human Resources asked the question in its title: “Do the Elderly Overuse Medicare?” The conclusion was that this is also a hard question to answer in general, but need appears to be the biggest driver of utilization as elderly diabetics with Medicare do not get more treatment than young diabetics. Rather, they get the medicines/treatment required to treat diabetes, and I don’t think I need to give you a study to show you that diabetes needs to be treated. (Yes, diet and exercise are important factors in some types of diabetes but we are getting back to complicated measurements… lots of moving parts.)

    Insulin treatment for Diabetes was invented in 1921. That was the biggest game changer for the elderly with Diabetes. I doubt Medicare changed that. State intervention didn’t resolve the issue of that deadly disease. A man with a batchelor’s degree in Canada did.

    In an article in Tax Policy and the Economy (University of Chicago), Medicare is demonstrated to be a massive redistribution program to the poor elderly. However, in the 1990s there was no increase in mortality rates for the biggest benefactors.

    Who are the biggest benefactors? I thought the elderly were the only benefactors (and I bet by biggest it means those with the worst health conditions)

    Lower income people in general die quicker than upper income people.

    Income has been found to have a correlation with living longer. I would bet that the underlying variable related to living longer though has more to do with a high IQ score.

    • #202
  23. Could Be Anyone Inactive
    Could Be Anyone
    @CouldBeAnyone

    Lois Lane (View Comment):
    So I’m not arguing anything by offering a very, very, very small sample of some studies that are easily accessed in peer reviewed journals.

    I’m simply giving some real data that I think shows Medicare is a mixed bag, ie. it seems to me that there have been good and bad outcomes associated with Medicare, and nothing about it is simple.

    I never argued that Medicare did not benefit some. The issue is that it is immoral and benefits a few from the cost of the many. It is not general welfare as outlined in the constitution and the benefits it does give are to the elderly on the margins. Its unjust and inefficient.

    To put it another way how do you know that the dollars spent on Medicare were spent the best? What if you had subsidized cancer research? That would benefit people of all ages at least (from little children to the most elderly). What if Medicare had not existed to begin with and the tax dollars spent towards it were kept by tax payers and they spent said wealth as they saw fit to their own benefit? Just because you are benefiting some materially at the cost of others does not make it a worthwhile pursuit.

    I can only spend so much time on Ricochet, but I also know the positives associated with Medicare are higher than those associated with Medicaid.

    This is in part related to the fact that not just the poorest elderly benefit from the first. The reasoning behind that–if I remember correctly–is essentially this:

    Unfortunately, the poorest amongst us often make poor choices, whether given access to healthcare or not. For example, they might not change diet after being told they have diabetes. However, the lower middle class elderly who can now access a diet plan along with medical care are better able to see positive outcomes because they’ll make lifestyle changes on an individual level.

    I don’t know how that plays into Fishtown v. Belmont, but there are many, many, many studies on this if you have access to something like JSTOR.

    I know what JSTOR is and have used it before, but it is not my burden to show that Medicare, or Medicaid, ought to exist. That burden exists for those who wish to defend it.

    • #203
  24. Damocles Inactive
    Damocles
    @Damocles

    Lois Lane (View Comment):

    However, I also know plenty of Democrats who aren’t at all cool with the suppression of speech in colleges… including people at Berkeley.

    I wish they were more vocal.

    As far as I can tell, “hate speech is not protected speech” has become a pretty common belief on the left. And “marriage is a union between one man and one woman” is hate speech.

    For me, this is one of the key battleground areas in the legal, cultural, and political arenas.

    • #204
  25. Could Be Anyone Inactive
    Could Be Anyone
    @CouldBeAnyone

    Lois Lane (View Comment):

    Here, you are throwing more stones than you should.

    This is an excerpt from FDR’s acceptance speech at the Democratic National Convention in 1936. I am not throwing stones.

    For out of this modern civilization economic royalists carved new dynasties. New kingdoms were built upon concentration of control over material things. Through new uses of corporations, banks and securities, new machinery of industry and agriculture, of labor and capital – all undreamed of by the Fathers – the whole structure of modern life was impressed into this royal service.

    There was no place among this royalty for our many thousands of small-businessmen and merchants who sought to make a worthy use of the American system of initiative and profit. They were no more free than the worker or the farmer. Even honest and progressive-minded men of wealth, aware of their obligation to their generation, could never know just where they fitted into this dynastic scheme of things.

    It was natural and perhaps human that the privileged princes of these new economic dynasties, thirsting for power, reached out for control over government itself. They created a new despotism and wrapped it in the robes of legal sanction. In its service new mercenaries sought to regiment the people, their labor, and their property. And as a result the average man once more confronts the problem that faced the Minute Man.

    The hours men and women worked, the wages they received, the conditions of their labor – these had passed beyond the control of the people, and were imposed by this new industrial dictatorship. The savings of the average family, the capital of the small-businessmen, the investments set aside for old age – other people’s money – these were tools which the new economic royalty used to dig itself in.

     

    FDR was certainly making populist appeals,but Social Security was a much harder sell than you make it sound. Though Townsend Clubs–basis for SS–were infinitely popular amongst the old, many people were still concerned about hurting future generations, did not want hand outs, and insisted this program should be “earned” by citizens through small contributions that would act as a safety net later on.

    Social Security was proposed in the House by House Resolution in April of 1935 and then passed through the House by a vote of 372 to 33 in May of the same year. That is not a hard sell. Its conference committee report was accepted by the Senate by a vote of 70 to 30 in July 1935. Again a super majority. Not a hard sell and then it was signed into law by August. And even if I were to take what you typed at its face value it is contradicted by what Social Security is. Peope who were 64 and working could have been receiving benefits within a year. That is not gaining cash you put into it but gaining cash from younger workers. It is also is not the most efficient means because bureaucrats are getting paid to oversee such.

    The desire to help widows and orphans as well came out of the Great Depression in a way that I think is hard to understand today.

    Helping widows and orphans does not relate to Social Security unless you are worried about the 65 and older demographic widows (which would have been incredibly small I would bet at the time). I can’t think of orphans that would benefit from the program. As to desiring and actually helping orphans and widows that was happening long before Social Security came into the picture. There are charities and churches which helped said people. If the desire existed long before the Great Depression.

    I agree entirely that health insurance became a “thing” because of FDR’s wage controls during WWII, but the consequences of this policy were not easily foreseeable.

    How were they not? If you introduce a third party into a two party exchange you by definition incur additional costs and if you subsidize something you get more of it. Combine those two simple facts and then apply it to Medicare and employer mandated health insurance coverage and you have a sure fire formula for inflating health care costs (and that isn’t considering the myriad of other variables).

    • #205
  26. Lois Lane Coolidge
    Lois Lane
    @LoisLane

    Could Be Anyone (View Comment):
    But how do you, or those that advocated for Medicare, know that it was the most efficient allocation of those dollars (you have not one but two outside parties in the matter, the government and health insurance providers so its not the most efficient use).

    I don’t, and I’m not advocating for Medicare.  I’ve said it was a mixed bag.

    Could Be Anyone (View Comment):
    Sure you might have helped some elderly people on the margins (those with heart problems) by making it easier for them to buy medical care but what moral imperative do I have, or anyone for that matter, to pay for care of the elderly?

    The thing that the writer I cited found was that the increase in funding for medical care created new innovations that helped the broader society, not just “some elderly person on the margins (those with heart problems).”

    Amazingly enough, men and women under 65 often have heart attacks.

    I never said you had a moral imperative to help the elderly.  I offered a study in a magazine about economics that showed Medicare may have spurred spending on hospitals and technology that helped everyone.

    Could Be Anyone (View Comment):
    What if Medicare had not existed to begin with and the tax dollars spent towards it were kept by tax payers and they spent said wealth as they saw fit to their own benefit? Just because you are benefiting some materially at the cost of others does not make it a worthwhile pursuit.

    I have no way of knowing what the outcome there would be, nor am I arguing that Medicare was a) bad or b) good.  I can say that according to at least one economist to whose work I referred, you had a measurable increase in the medical field that came directly out of Medicare.

    Could Be Anyone (View Comment):
    I know what JSTOR is and have used it before, but it is not my burden to show that Medicare, or Medicaid, ought to exist.

    It’s not my burden either, but you wanted some studies to further the conversation, so I was happy to help.

    Damocles (View Comment):
    Damocles

    Lois Lane (View Comment):

    However, I also know plenty of Democrats who aren’t at all cool with the suppression of speech in colleges… including people at Berkeley.

    I wish they were more vocal.

    Me, too, but they aren’t as quiet as you think they are either.  There are movements like https://heterodoxacademy.org/ that I find interesting.

    Could Be Anyone (View Comment):
    This is an excerpt from FDR’s acceptance speech at the Democratic National Convention in 1936. I am not throwing stones.

    I agreed that FDR was a populist.  He was pulled Left by other populists as well.  However, if I put up a speech by Obama talking about Obamacare, does that reflect your views?  Social Security could not be passed as a hand out.
     

    • #206
  27. Lois Lane Coolidge
    Lois Lane
    @LoisLane

    Could Be Anyone (View Comment):
    Social Security was proposed in the House by House Resolution in April of 1935 and then passed through the House by a vote of 372 to 33 in May of the same year. That is not a hard sell. Its conference committee report was accepted by the Senate by a vote of 70 to 30 in July 1935. Again a super majority. Not a hard sell and then it was signed into law by August. And even if I were to take what you typed at its face value it is contradicted by what Social Security is. Peope who were 64 and working could have been receiving benefits within a year. That is not gaining cash you put into it but gaining cash from younger workers. It is also is not the most efficient means because bureaucrats are getting paid to oversee such.

    I will have to look back at the discussions that took place, but having a super majority does not mean that the program did not meet cultural resistance in the wider public.

    I agree that Social Security is essentially a pyramid scheme, but it was set up with the idea that the Great Depression would not last forever, and you had to contribute to get benefits in the long run, even if a small number of people got a good “deal” by getting money back–based on money put in–per quick “retirement.”

    One of the arguments that I hear about SS is that it discriminated against minorities because it did not give them $.  However, the agricultural sector was exempt–a sector which included plenty of poor white people–because it was very hard to deduct wages from some farm work without set hours, and the administrative state would have been difficult.  Domestic workers simply did not have enough disposable income to have some $ deducted per their “contribution” so they weren’t able to get anything back either.

     

    Could Be Anyone (View Comment):
    Helping widows and orphans does not relate to Social Security unless you are worried about the 65 and older demographic widows (which would have been incredibly small I would bet at the time).

    If the number of widows over 65 is small, the number of men over 65 was also small.  Either way, those old people gaming the system were not a huge group.

    was, however, thinking about our small number of widows…. While you might not be able to help the ones that were already living on the edge in 1935, men who were working then were thinking about their wives in the future.  They did not want them to be on street corners later.

    You’re right about the orphans.  They were added later to SS.

    (continued)

     

    • #207
  28. Lois Lane Coolidge
    Lois Lane
    @LoisLane

    Could Be Anyone (View Comment):
    As to desiring and actually helping orphans and widows that was happening long before Social Security came into the picture. There are charities and churches which helped said people. If the desire existed long before the Great Depression.

     

    My answer to this comment:

    Sure.  I’m a Catholic.  I believe quite a bit in this, and I am with you on the idea that it is much more Christlike to give as an individual than to have the government compel one to give at what is essentially the point of a gun.

    However, I’m going to return to another idea I put up earlier.  It is very difficult for me to understand the economic crisis of the 1930s as I sit on my very comfortable couch with salmon in my refrigerator.

    I recently re-watched the movie Cinderella Man.  Did you ever see it?  There were many men who worked very hard while being crushed by a system way beyond their control.  They did not want handouts.  They wanted jobs.

    Many of these social programs were not born from greed but desperation.

     

    • #208
  29. Could Be Anyone Inactive
    Could Be Anyone
    @CouldBeAnyone

    Judithann Campbell (View Comment):

    There you go again, putting words in my mouth. I never argued that the welfare state is linked to abortion; I don’t know how many times I have to say this: I never argued or claimed anything. This is getting tiresome ?

    Really?

    Judithann Campbell (View Comment):
    I argued no such thing. I explained that some people fear that eliminating welfare might result in an increase in abortions. I was explaining a concern, not making a claim. No one knows for certain what the effect on abortion would be if we ended welfare; for as long as we have had abortion, we have had welfare. In order to find out if one correlates with the other, we would have to end one or the other. For pro-lifers, ending welfare while continuing abortion presents an incredible risk, one that many are understandably not eager to make. But I want to repeat: I am describing a concern, not making a claim.

    Stating that some people fear eliminating welfare will increase abortions is a claim. I asked what evidence they have to fear such? If they have no evidence I don’t know why I, or you for that matter, should care. You also made the absolute claim that abortion and welfare have existed for the same time. I pointed out that such was false. Welfare predates legalized abortion. Lastly you claimed absolutely that for pro-lifers ending welfare while continuing abortion is an incredible risk. For it to be a risk you would need evidence that there is in fact a link between the two, hence eliminating one increases the other (a risk).

    You have not brought any evidence to support these claims you have made. Its okay if you don’t want to, I never said you have to. But if you are unwilling to then don’t expect said claims to be taken seriously.

    Judithann Campbell (View Comment):
    People are complicated, and all of us are a mix of good and bad. A big problem-maybe the biggest problem with modern liberalism is their inability to absorb that fact. How could so many of the Founding Fathers have been slaveholders? How could such good people do such a bad thing? Well, because they were people.

    Being human is not an excuse to do bad things. If it was then why did God even bother with trying to reconcile men to him. He didn’t say “well you guys keep on making mistakes and its okay because you are humans”. He reconciled man because he loved him and wanted to excel in his purpose, which is to love God and thus not sin. Understanding the complications of human existence is not an excuse for wrong actions. Praise the good and criticize the wrong.

    The generation that you condemn for supporting FDR also defeated Hitler, at great personal cost to themselves. We owe them our eternal gratitude. This doesn’t mean that we should agree with them about everything, or ignore the mistakes they made, but if you look at the WWII generation and all you see is greed and sin, then there is a great deal that you aren’t seeing. We should acknowledge both the good and the bad; we must absolutely try to correct the mistakes our ancestors made, but to unilaterally condemn them as immoral is to miss most of the picture.

    Did I type that every American had voted in those politicians that passed those bills? I don’t think that I did so I am not condemning them. You are again reading a little too far into what I am typing. There is a reason why I am mentioning the voting margins by which the bills passed and why I have said super majority several times over. Because I am being accurate.

    As to WWII that war came to us. Did Americans do the right in fighting the Axis powers. Undoubtedly yes. But Americans also tolerated other wrongs to boot. Jim Crow and the camps for the Japanese. There are other sins, and good deeds, that could be mentioned, but they are not related to the discussion of Fishtown hurting itself repeatedly. And as I stated before a super majority of Americans currently, as they have for roughly 100 years, have not shown the courage to correct those mistakes.

    Those that believe Belmont is the source of Fishtown’s worries are ignoring that Fishtown is failing because its inhabitants choose to, both by their own decisions and by the politicians they elect into office.

    • #209
  30. Lois Lane Coolidge
    Lois Lane
    @LoisLane

    Could Be Anyone (View Comment):
     

    I agree entirely that health insurance became a “thing” because of FDR’s wage controls during WWII, but the consequences of this policy were not easily foreseeable.

    How were they not? If you introduce a third party into a two party exchange you by definition incur additional costs and if you subsidize something you get more of it. Combine those two simple facts and then apply it to Medicare and employer mandated health insurance coverage and you have a sure fire formula for inflating health care costs (and that isn’t considering the myriad of other variables).

    I think politicians and people think in political terms whilst economics think in the terms you’ve laid out here.

    Employees who got benefits instead of wage hikes were told they were helping to control inflation.  They weren’t being “greedy.”

    I think it was horrible that companies got a tax break on health insurance and individuals did not.  (You can thank labor unions for this.)  This created a system that truly did disconnect individuals from the cost of medical while also tying them to employers in a way that I think is very, very unjust.

    However, as much as I dislike this, I don’t think people envisioned the outcome we’ve gotten.

     

    • #210
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