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Sunday, November 01, 2009

Warfare vs. Health Care: What Do Americans Value?

Warfare vs. Health Care: What Do Americans Value?
Image © Austin Cline
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Actions speak louder than words, which means you can tell a lot more about what a person truly values by looking at what they do rather than merely at what they say. We can, though, also learn a lot by looking at a person's contradictions. No one is perfectly consistent, and while some inconsistencies may be due to outright hypocrisy, far more are likely due to blindness — probably a self-defense mechanism to prevent us from truly seeing how our real values may be pulling us in a direction different from what our professed values are.

I think we're seeing this in the contradictions between how people treat America's foreign wars versus how they treat domestic health care. The justifications being offered by conservatives and "moderates" for continuing wars in the Middle East are ignored when it comes to questions about providing domestic health care. So what are the real values which lie behind it all?

Economics of Health Care

The most important and obvious contradiction would have to be attitudes on borrowing and spending. Anyone who treated the critics of health care reform as credible would get the impression that America's economy couldn't possibly handle any extra strain, no matter what sorts of gains might be achieved in systemic efficiency or workers' health and security. Regardless of how moral or reasonable health care reform might be, we can't do it if we can't afford it.

America certainly can't pay for better health care if that might require borrowing more money from China, mortgaging our children's future to foreign bankers and foreign governments. If we did that, we might start to lose control over our own future! Granted, many of our children might not have a future if they don't get adequate health care today, but that's far preferable than falling deeper into debt to the Chinese...

Economics of Warfare

When it comes to putting children's parents into harm's way in foreign wars, though, none of those principles apply. I'm not sure if a single conservative who has objected to health care reform on the basis of economic costs or debt has raised any similar objections to paying for wars in Iraq or Afghanistan. This is especially significant because of the relative costs involved — America's wars in the Middle East don't just cost far more than even pessimistic estimates of health care reform, but they are likely to cost far more than health care reform is feared to cost over the long term.

What this tells us about these conservatives' real values is that they can't just be mere economics. There must be something about making war against foreigners which overrides the extreme costs but which isn't present when it comes to the lower costs of addressing the health needs of Americans. It's difficult, though, for defenders to point to any immediate or direct benefits from waging wars in the Middle East, whereas the direct and immediate benefits of providing basic health care services to Americans are obvious.

Economics of Security

Even if we assume for the sake of argument that wars in the Middle East enhance American security, this only means that reduces the likelihood of Americans dying due to a preventable terrorist attack. Providing more health care to Americans, though, would do the same thing: reduce Americans' likelihood of dying due to preventable illness or injury. So if the goal really is to save American lives, then health care is clearly a legitimate method.

It is reliably estimated that nearly 45,000 Americans die every year because of problems with health insurance coverage. Even if that's high, though, we could safely assume that many thousands, and probably tens of thousands, of Americans could be saved or at least helped to live a bit longer with proper medical care — that's far more every year than have been killed in terrorist attacks against America.

America launched two wars in the Middle East in the wake of a single terrorist attack that killed far fewer Americans than likely die in a couple of months due to inadequate health care, and we haven't even touched on the improvements to basic quality of life as well as overall feelings of personal and familial security that could be achieved through guaranteed health care.

So it's implausible that a willingness to spend more money and go further into debt to pay for foreign wars than would be necessary to pay for domestic health care is largely dependent upon concerns with American security or safety. Those are at best rationalizations, and they aren't even very good rationalizations considering how quickly and easily it is to reveal the lies upon which they are founded.

Economics of Class Warfare

The people who are sagely advising that America can't afford to provide basic health care to most Americans, and especially to the poorest Americans, all have the best possible health care and health insurance available — and often, it's health care provided by public funds. The people who are advising that America must keep borrowing and spending to continue waging wars in the Middle East do not themselves have to worry about ever going abroad to be put in harm's way, nor are they likely to have children and other close relatives who are asked to risk their lives in this way.

I don't think that it's a coincidence that these two groups are almost identical. People who enjoy the best health care available and who don't have to risk their lives in foreign wars have declared it a "luxury" for others to enjoy even basic health care. It's not a "necessity" that large numbers of Americans be protected from preventable deaths due to illness or injury, but it is a necessity that an uncertain but certainly smaller number of Americans be protected from unknown, dubious threats. Both positions weight the cost and suffering towards the poorest Americans while the richest Americans can sit back, enjoy what they have, and be entertained by the others' war exploits.

At least the Roman coliseum was open to everyone, and even the emperors recognized the value of ensuring everyone had bread.

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  1. To tweak a line from Shakespeare: Our humanity is displayed more in the breach than in the observance.


  2. nicely and concisely stated, AC!

  3. I don't disagree on any particular point. Though, there seems to be an unstated assumption that the elite class deliberately oppresses the less privileged.

    Like you said at the top of the post, there's a degree of blindness involved. Elites keep their kids out of harms way because that's what parents do. They're not thinking, "I have to go find poor kids to die in my kid's place." They're simply trying to look after their own interests without much thought to the consequences elsewhere.

    One of the hallmarks of a declining civilization is a disconnect between the best interests of the most powerful and the best interests of the society at large. This disconnect ultimately leads to impoverishment, militarism and the fracturing of the society. One could argue that precisely that is happening in the US today.

    The key to saving ourselves is for the balance of the population to find a way to realign the interests of the most wealthy and most powerful with the rest of America.

    How we do that, I don't know.

  4. I usually argue that the first problem America has are the results of the Philadelphia Convention of 1787, but I could add that the problem you're identifying here with military spending over healthcare spending has to do with another problem: America as the Sparta of the world.

    America prides itself in being the foremost military power in the world, and it has become so through enormous military spending. Some have argued that because the military offers relief for impoverished areas, it is the de facto welfare state for America, both for impoverished individuals who sign up, and for communities that have military industries (and usually little else).

    With so much of the American social network tied up in the military, there are some consequences to this: first, if your going to have a massive military complex, it'll need to be used on occasion. Arguably this is why the Middle East couldn't be invaded fast enough. Unlike wars throughout history however, chances are the spoils wont cover the massive debt incurred.

    The second consequence to the Spartan assumption is that the nation supporting this complex will need to suffer privations for the war effort, and healthcare is just such a luxury. How concerned is the government about those at home compared to those on the front line?

    Unfortunately there is a much uglier reality to this: the rich and powerful are quite prepared to play along with this and declare wars on anyone, particularly if there are natural resources to win (or at least have access to). In this regard, this is a hideous manipulation of the public for quasi-imperialistic ends, and possesses little of the altruism of modern-day sensibility.

    I think America needs to be weaned off the military complex before it can fix things 'at home.' This however, is a very tall order.

  5. We cannot keep cutting taxes and waging wars. We cannot keep cutting taxes and expect to pay for major government programs such as health care reform, an idea that is desperately needed and is long overdue. While making the "upper crust" pay by not giving them the same tax breaks as those enjoyed by the middle class is a good start, but sooner or later we will all have to pay, one way or another, so let's top this silly Republican idea of tax cutting and start making Americans pay for the government they want.

  6. Isn't it odd that while the US has lower life expectancy that most developed countries, it has one of the best cancer survival rates anywhere?

    "Survival was significantly higher in the United States for all solid tumors, except testicular, stomach, and soft-tissue cancer, the authors report. The greatest differences were seen in the major cancer sites: colon and rectum (56.2% in Europe vs 65.5% in the United States), breast (79.0% vs 90.1%), and prostate cancer (77.5% vs 99.3%), and this "probably represents differences in the timeliness of diagnosis," they comment. That in turn stems from the more intensive screening for cancer carried out in the United States, where a reported 70% of women aged 50 to 70 years have undergone a mammogram in the past 2 years, one-third of people have had sigmoidoscopy or colonoscopy in the past 5 years, and more than 80% of men aged 65 years or more have had a prostate-specific antigen (PSA) test. In fact, it is this PSA testing that probably accounts for the very high survival from prostate cancer seen in the United States, the authors comment."

  7. Aaron,

    With the American rich coughing up for their own healthcare, would you expect anything less than top shelf results?

    The more salient question is, would YOU, as a middle class person (I assume) fall within those same statistics? What if the lower life expectancy reflects a greater cross-section of the public, and the cancer survival rate only reflects the percentage successes of reported cancers? If you can't afford healthcare, you might not even get diagnosed with cancer, let alone treated for it.

  8. Joe Visionary,

    I work at a health insurance company, and I have no medical insurance, by choice. I have had 3 uninsured medical emergencies (broken leg, strep throat, and gash to the scalp requiring dermabond), and all three times I paid with cash. Each time the hospital gave me a BIG discount for paying cash up front. In two of those instances, the cash discount undercut what my copay would have been if I was insured. And yes, I am middle class.

    Insurance is not the only, nor is it even the most cost effective means to pay for medical care. That includes both private and public insurance.

    You mention rich Americans. Why does America have so many more rich people than Europe (as a percentage), I wonder?

    As far as detection of cancer, the studies show that Europeans are more likely to get late diagnosis than Americans. The USA has better and earlier screening and detection, partly because it has a higher ratio of medical resources (equipment, facilities, and personnel) per capita than Europe.

    I agree that the American healthcare system needs reform. But not European-style, because that is more like the opposite of reform.

    The solution is less red tape, not more of it. The current regulations only enrich insurance companies and encourage their greed. I should know!

    For example, why is the AARP in favor of the healthcare bill? The AARP sells supplementary insurance to seniors, did you know that? The AARP supports the bill because it would INCREASE their revenue. That is a classic example of legislation exacerbating, not solving, the problem.

  9. Austin, you kind of dance around this without saying it, so I'll say it for you: The "conservative" positions on war and health care are completely consistent when you understand that underlying them both are the economic interests of the corporate oligarchy that owns all three branches of the United States government.


We'll try dumping haloscan and see how it works.