O lucky man!

It’s official.

I’m a wreck.

Doctor told me so yesterday. I went in for a check up. And to have my blood pressure looked at. And my bad back. And my ulcer. And my cold.

Came out with a prescription for a third medication, appointments for an X-ray and blood work, a consult with a GI who will probably order some tests, and a referral for physical therapy.

About the cold, I’m just going to have to suff.

Needless to say, I left there feeling mighty sorry for myself.

It wasn’t until I was on my way home that I started thinking about what I hadn’t had to think about while I was promising the doctor I would do all the things he wanted me to do, including coming back in two weeks for a follow-up.

That I can do all these things.

I will have the prescription filled, get the X-ray, have blood drawn, see the GI, undergo whatever tests he orders, and sign-up for PT because I can.

Our insurance will cover it all.

Just about all of it.  We have co-pays, but they’re not too big.  And all of it is pre-approved by the insurance company.

Not only that, but because of where we live, I was able to get appointments right away---I could have had the X-ray done across the hall, right then and there, no waiting, but I didn’t have time, so I’m going back Thursday morning, when I will also have the blood work and see the GI.

I’m a lucky guy.

But what if I wasn’t?

What if we didn’t have as good insurance or any insurance?

What if I wasn’t lucky?  What would I do if I had to pay for all this out of my own pocket?

What do people with bad backs, high blood pressure, ulcers, and colds, just to name a few minor examples of the thousand natural shocks that flesh is heir to and that can wreck you and your life, and who don’t have insurance do?

They suff.

They don’t go to the doctor, if they can help it.  They live with the backaches and the headaches and the heartburn.  They pop aspirin and chew Rolaids all day.  They try to ignore it and hope it goes away or at least doesn’t get any worse.  They keep going as best they can until they can’t go on anymore, until their back seizes and lays them out on the floor or they learn the ulcer isn’t an ulcer it’s you know what or their heart bursts or a blood vessel pops and they drop dead from a heart attack or a stroke.

And then at their wake some Republican friend looks down into their coffin and says, “Your own fault, pal.”

“You should have planned better. You should have made smarter decisions.  You should have managed your money more wisely.  You should have taken better care of yourself, and don’t give me any crap about genetics.  You should have lived your life the way I lived mine. You should have arranged things so that you were as lucky as I’ve been.”

Well, no they don’t.

At least not that very last bit.

You’d never hear one say, “I’ve been lucky.”

They haven’t been lucky.

They’ve been deserving.

They’ve deserved everything they have because they’ve earned it.

They earned having the parents they had. They earned being born in the richest, freest country in the world.  They earned having no genetic predispositions to high blood pressure, arthritis, depression, schizophrenia, cancer.  They earned not being hit by a bus when they were in grade school.  They earned having a roommate in college who was able to explain general relativity or Hamlet to them the night before that midterm.  They earned not having the plus sign turn blue. They earned that the company they went to work for didn’t go belly up when the market crashed or let them go in the round of mass layoffs that followed.  They earned having children who didn’t get deathly sick or have disabilities or develop emotional problems or drug habits that required them to take their focus off their jobs, take time off work, and cause their bosses to say, “We feel your pain, but we can’t afford to carry you anymore if you’re not here to pull your weight.  Here’s your hat, don’t let the door hit you on the way out. Make sure you give your cell phone to security.  And, no, we don’t have any idea what you’re going to do about insurance now and we don’t care and we don’t have to care and anyway you should have planned better. You should have saved more. You should have worked harder.  You should have been luck…You should have deserved not to have what’s happened to you happen to you.”

They deserve it. They earned it.  You?  You didn’t.  If you had, you’d have it. QED. And what you didn’t earn and don’t deserve, you don’t get.  Simple as that.  You suff.

I don’t understand this.  How can anyone think like this?  When someone’s in trouble, you help them.  You don’t ask them if they deserve to be helped.

“I’d like to give you a lift, pal.  But let me ask you.  Before you set out on this trip, did you have the oil checked?  Did you top off the fluids?  And how come you’re driving a beater like that anyway?”

“Hold on!  I’ll get a ladder!  But before I do, I got to know.  How’d the fire start?  Were you smoking in bed? Did you leave something on the stove?  Did you let the kids play with matches? How many smoke alarms do you have? Where do you keep the fire extinguishers?”

But this is the essence of Paul Ryan’s budget, the Republican budget, Mitt Romney’s “marvelous” budget, isn’t it?  It’s the guiding ethos of Romney’s campaign.  If you don’t have it it’s because you didn’t earn it, so you don’t deserve it.  And if you don’t deserve it, you don’t get it.

You suff.

So you’d better start doing more to deserve it.

It’s government based on the ant’s reply to the grasshopper, with the sneering assumption that they’re all ants and everybody else is a grasshopper.

It’s the model for a society based on the idea that if your car breaks down, you start walking, no matter if you’re old and sick and can’t walk or if you have a baby in the car you can’t leave alone, because you should have had AAA.

A society in which you should have your own private fire department, just in case.

It’s a plan for a country where there’s no such thing as lucky.  Just deserving and undeserving.  And if you’re one of the undeserving?

You suff.

Comments

[S McCoy]

Lance - I know lots and lots of fiscal conservatives, and none of them feel the way you continually describe them. FYI, it really is possible to genuinely care for less-fortunate people and still think there's a better way to help them than voting for ineffective and corrupt federal programs. The vast majority of Republicans and Democrats want the same basic things for America, but have different ideas on how to get there. We'll never be able to have a legitimate debate on whose ideas are better as long as we keep starting the conversation by saying those we disagree with are morally inferior.

[AnDa]

Lance,

What you touched on I hear alot. Maybe S. McCoy's circle is small because I do know that is how a lot of conservatives feel toward those who suffer.

[Lance Mannion]

S McCoy, I've asked you this before. Do you not believe that Paul Ryan believes what he says he believes? Or Eric Cantor? Or Ron Paul? Or Rand Paul? Or Virginia Foxx? Just to name a few. And they weren't appointed to the offices they hold. They were elected. Millions of people voted for them. Do you think all those people didn't know who or what they were voting for?

[Stewart Dean]

Written tongue firmly in cheek to a libertarian:
Just as there are moral hazards, there are also moral incentives and they work like this:
= If you give the rich more, they will work harder, invest more (and produce more jobs)
= If you give the poor less, they will work harder (to be able to survive, and as a happy result, they will be more productive)

This happy epiphany was sparked by something from EJ Dionne

"Forgive me for noting that conservatives seem to believe that the rich will work harder if we give them more, and the poor will work harder if we give them less."

[J. Dvorak]

Lance, I meant to comment earlier but you'll understand that I was here in Wisconsin having my heart rent in twain by a voting public that persists in shooting itself in the foot at every opportunity.

I think this was a good piece and pretty accurately describes the "I'm All Right Jack" feelings of most of the people who describe themselves as conservatives in this country.

[S McCoy]

Lance - I'm not sure what Paul Ryan has SAID that upsets you so. His budget is a political document with no chance of being enacted. I'm sure you don't agree with his suppositions about how to promote economic growth, or his belief that the best way to help the less fortunate is to create opportunities with a thriving economy. But I've sure never heard him say that poor folks should just suffer. At least he has the courage to admit we're all being lied to about the sustainability of Medicare and Social Security. You might not like that truth, but at least he's willing to talk about it, in spite of the certainty that you and your friends will call him a granny killer.

[Libby]

Well said as always my friend.

[Jody Schaeffer]

"Blitzer asked what Paul would prefer to having government deal with the sick man.

“What he should do is whatever he wants to do, and assume responsibility for himself,” Paul said. ”My advice to him would have a major medical policy, but not before —"

“But he doesn't have that,” Blitzer said. “He doesn't have it and he's — and he needs — he needs intensive care for six months. Who pays?”

“That's what freedom is all about: taking your own risks.,” Paul said, repeating the standard libertarian view as some in the audience cheered.

“But congressman, are you saying that society should just let him die,” Blitzer asked.

“Yeah,” came the shout from the audience. That affirmative was repeated at least three times."

Shorter McCoy: They said it but they don't mean it because I don't want them to mean it.

[Tarheel]

S.McCoy, you say that Republicans and Democrats want the same things but just have different approaches to getting there, with Republicans preferring to forego "corrupt federal programs" in favor of, I'm assuming "free-market solutions." So my question to you is where on earth are these workable in the real world ideas from Republicans? Social Security would be fixed for eternity if we lifted the income cap on FICA withholding, or if we increased FICA tax for everyone by a very small percentage (like Reagan and Greenspan did in the 80s). Republicans say NO to both of these options in favor of "privatization" or slashing benefits, effectively undermining the program rather than making it whole. That's not hoping for the same outcome, that's hoping for a dismantling of Social Security as it currently exists.

Same song, different verse with respect to health care. Republicans did NOTHING to address increasing numbers of uninsured and escalating health care costs over the past few decades, even going so far as to make it illegal for Medicare administrators to negotiate more favorable prices for prescription drugs with drug companies. Empirically, if you look at the actual data, Medicare, the VA, and other federally-run health care programs provide better care (as measured both in outcomes and in patient satisfaction) at lower cost than the absolute mess of private health care insurance options. What is corrupt about a program that patients like better, that results in better outcomes, and comes at a lower cost? What is the Republican plan to contain rising medical costs and to get our population adequate health care? If conservatives do not feel that the government has any responsibility to provide for the general welfare of the population in this way, let them say so. But, again, that is not both parties wanting the same outcomes and just finding different, equally effective ways to get there. That is one party trying to come up with real-world solutions, and one party saying I got mine, screw you.

[Jay B.]

"But I've sure never heard him say that poor folks should just suffer."

It's the obvious -- and I mean simple, obvious reality -- conclusion of his preferred policies. He claims to admire and believe in a philosophy literally based on the premise that society has too many parasites.

"At least he has the courage to admit we're all being lied to about the sustainability of Medicare and Social Security."

No, he's lying about Social Security. Plain lying. Medicare is something different. And his plan to dismantle it by giving out wholly insufficient vouchers in its stead is going to literally drive the elderly to abject poverty. It would help in your pleas for understanding to actually be factual. Otherwise you risk looking exactly like the stereotype I have of uninformed conservatives.

"You might not like that truth, but at least he's willing to talk about it, in spite of the certainty that you and your friends will call him a granny killer."

It's not a truth by any stretch. Address his proposed solution. What is the end result of that? What is he risking? You yourself say that his scheme will never be enacted. What is he brave about? The moral choice to let people have awful health care?

You have done what millions of other conservatives have done. You conflate Medicare with Social Security. You think Ryan is a honest man, but do not believe that his budget is anything but a conversation starter and he's not serious about his belief system. And, despite the endless proof that government-run health care is cheaper, per capita, and at least as effective as market-based health care, you refuse to see it as an option. Your way has led to economic malaise and a massive transfer of wealth, but you still cling to the idea that conservatives are compassionate, they just believe in the way things are going. It's massive dissonance.

[S McCoy]

Tarheel, your proclamations are simply not true. Republicans have proposed many innovative solutions to the healthcare problem - de-linking insurance from employment, health savings accounts, allowing policies to be sold across state lines - just to name a few. You can argue that these are bad ideas - fine. But they're still ideas. The ONLY solution the left can come up with is for the federal government to take over the entire industry and manage it with the same efficiency and service as the IRS.

Same for Social Security. You may hate the idea of privatization, and maybe you're right. But at least it's a suggestion worth debating. Would it be so terrible if people were allowed to voluntarily manage and invest their own retirement account (which is what SS was originally sold as)? No, the Dems just want to have the top 10% of taxpayers foot the whole shortfall (pretending that wouldn't create a drag on the entire economy) and have the whole system turned into a free pension regardless of what anyone paid into it. And no, that doesn't mean I hate old people. Of course we should have a safety net for those who are dealt a bad hand in life, but that shouldn't be the default solution for the entire population.

I'm not a die-hard Republican that just wants to spew the party line. I dislike corporate welfare and bad religion as much as Lance does. I've just felt compelled to point out that there can be a much more stimulating and productive conversation if we drop the name calling and stop making dramatic accusations about what motivates those we disagree with.

[bcamarda]

Recognizing that anecdotes aren't data, my intuition and personal experience tell me that there are a relatively few intellectual conservatives -- folks like, say, Ross Douthat -- who honestly believe that an important reason to pursue free market policies in America is that they are the best way to help the poor.

But I see a huge number of people in America who call themselves conservatives and really don't much care whether their policies work for the poor -- and I include the tens of millions of invisible working poor who'll never do anything but struggle no matter how hard and honorably they toil. I would go further and say I've met quite a few conservatives who, if convinced that free market policies hurt the poor, would consider that a feature, not a bug. ("Less poor people around here!")

Now, how might we tell whether my instincts are right or wrong? One way would be to ask conservatives: at minimum, if your policies immediately remove support from people who have no current alternative, how do those policies actually work when implemented? Do you have alternatives? If you do, are they credible, or just fig leaves to cover a fundamental disinterest in solving the problem?

Take, for instance, health care. Would the HSAs conservatives like so much actually be a credible alternative for poor people? What would be the impact on the working poor of the nationwide availability of super-high-deductible, lowest-common-denominator state insurance policies that turn out not to cover much when needed? When you ask people to shop around for high stakes financial services such as healthcare, how do they typically perform? What has been the result of shifting pension responsibilities away from employers and onto the individual through 401Ks and so forth? How well has this worked in practice?

If you really believe in such solutions, don't you have some moral obligation to assess what impact they really have on people? I don't see a whole lot of that kind of objective, concerned assessment happening on the right, do you? When evidence arises that, say, charter schools don't work any better than public schools, do you see conservatives revisiting their theories? (If not, one can't help but be suspicious about motivation.)

Do you see Rush Limbaugh (or his 20,000,000 listeners) earnestly seeking the best way to ensure that all women have access to the contraception they need to control their own lives? Do you see the Koch Brothers concerned with ensuring that waitresses and warehouse workers get a decent retirement? Such questions pretty much answer themselves, don't they?

Show me something other than nearly unrelenting contempt leavened by occasional lip service. I'd sure like to see it.

[MikeG]

The ONLY solution the left can come up with is for the federal government to take over the entire industry and manage it with the same efficiency and service as the IRS.

S McCoy, this is your example of "drop the name calling and stop making dramatic accusations"?

[S McCoy]

Bcamarda - I can't answer for all conservatives, but can only tell you that I genuinely believe the best way to help the less fortunate people in our country is to do all we can to create a vibrant economy and promote a culture where we care about one another. It sounds great to provide free health care and free college and free retirement, but then those radical right wingers come along and point out we have to pay for it all somehow. Since the original post was more-or-less about healthcare, let me point out that the US has the most advanced and marvelous medical care in world. It was built by doctors and scientists and pharmaceutical companies that were motivated by the opportunity to make a profit. What we must do is find a way to pay for it and make sure all Americans have access to it. I disagree with the notion that federalizing the industry will do either of those things. Ask the people in England or Canada (or Cuba! or Russia) how they like the waiting times and other ways the bureaucrats ration treatment. History has proven over and over that centralizing control over the economy stifles innovation and breeds corruption. And then there's the small matter of freedom. As the government gets involved in ever more area of our lives, it's the nature of those in charge to tell us how to live. Heck, we can't even decide what size toilet we want installed in our bathrooms or what size soda to buy at McDonalds. Don't you see what these folks are capable of? Bigger government is not the answer.

And again, I'm not saying this as a selfish, thoughtless ignoramus that you suppose all conservatives to be. I hold seriously the charge to care for the least of my brethren. But I'm telling you, I could do a lot better job of caring for them if the do-gooders in charge would quit creating perverse mis-incentives and destroying opportunity for all of us.

[Tarheel]

bcmarda, thanks for answering some of the questions/problems S McCoy had with my post. I guess what I was really trying to say was that what few proposals the Republicans have made regarding healthcare and SS have mostly negative real-world consequences for the poor (e.g. the "race to the bottom" effect of allowing insurance to be sold across state lines with no standard minimum coverage required). And you still haven't answered the question of if federal programs are so horrible, why do we get such positive results with Medicare, etc. compared to private insurance? Why was it that before Social Security literally half of all elderly people died in poverty?

As far as other countries' experiences of healthcare. The overwhelming majority of citizens in England, Canada, Sweden, etc., like their health care system and would not choose to exchange it for what we have. And as far as waiting times go, have you ever tried to make a new patient appointment with an OB/GYN. Average waiting time, 3-4 months here in the good old USA. Have you needed to see an Orthopedist for non-emergency surgery? Same months-long waiting period that you decry in other countries.

You seem confused about what we are hoping for - not a system where there is no profit, or even significant profit for doctors, pharmaceutical companies, hospitals, etc., but one where billions of dollars of economic activity is not leached from our pockets by middle men insurers who provide no added benefit at all in either improved health outcomes, increased patient satisfaction, or increased medical innovation. What you seem to be arguing for is the freedom to be fleeced by corporations rather than the freedom to live a healthier more productive life not having to worry about going bankrupt because you had a medical problem. Honestly, I would rather have the government be in control of "rationing" my care than corporations, which is how it stands now, because I at least have a voice in my government through voting or running for office; I have NO input into corporate decisions.

[Jay B.]

"It sounds great to provide free health care and free college and free retirement, but then those radical right wingers come along and point out we have to pay for it all somehow."

Once again, you parachute in and pretend that you are being serious. The right has lied to you for decades now about "paying for things" and you still choose to believe it. At what point do you begin to acknowledge objective reality?

The only things they start being "serious" about when it comes to cost are things that actually help people. Reagan, in case you don't know, don't remember or are simply being obtuse, was the one who sent the budget out of whack. GW and Reagan and the Republicans who follow them, simply don't care about "paying for things" when they are in charge. GW enacted a shameful tax cut for the most wealthy among us -- what has that done? Has it helped anyone but the wealthiest among us? Did the budget deficit explode or, again, are you simply being obtuse? These are objective facts, your preferred policies have been enacted and millions of people have suffered because of them.

You pretend or really believe, in spite of actual evidence, that it's "compassionate" to do things like shunt the poor into a woefully underfunded health care voucher system. You even pretend this is an idea that should be debated -- well, make the case then. "The left", since you obviously embrace a double standard when it comes to generalizations, doesn't simply have one idea about health care, in fact, "the left" passed a goddamn health care plan that doesn't, remotely, resemble single payer. Again, you are proving the thesis that conservatives simply don't understand or accept demonstrable reality.

Canadians and the British like, overwhelmingly, their health care systems. And if you somehow don't think Americans are burdened by a corporate bureaucracy when it comes to health care you again live a complete lie. The sole difference between the American and Canadian system is that we are expected to pay on top of what our meager insurance covers and the money spent is simply for profit. Health care is a necessity. OF COURSE capitalists will force "consumers" to pay a premium for it.

Here's part of a study about NHS in England: "An independent survey conducted in 2004 found that users of the NHS often expressed very high levels satisfaction about their personal experience of the medical services they received. Of hospital inpatients, 92% said they were satisfied with their treatment; 87% of GP users were satisfied with their GP; 87% of hospital outpatients were satisfied with the service they received; and 70% of Accident and Emergency department users reported being satisfied."

So again, you are either oblivious to what people who use that system actually believe or, like my stereotypical conservative, you are lying. If you want to debate, use facts. Try it. Support your thesis that the free market provides decent, affordable health care for most people. Everyone else actually uses the system and bases their opinion on demostrable facts.

[Subnumine]

Thank you for this. I am sorry you are troubled with a troll who believes that the United States has had no prosperity and no innovation since 1933; but he does prove your point by arguing that it would not be "terrible if people were allowed to voluntarily manage and invest their own retirement accounts."

Well, yes, it would be. There are two alternatives: (1) this "management or investment" comes with a guarantee that the investor will not lose everything, in a world that has such crashes in it as 2008. But I doubt S. McCoy would propose this; it's as economically distorting as the gambling of a king's mistress, who knows her losses will be paid by the treasury (or a speculative shareholder, whose bankruptcies will be paid for by the banks unwise enough to loan his bubbles money).

(2) People will starve if they are undeserving enough to believe the financial press and invest in Krueger & Toll or Enron. That is precisely the attitude you, Lance, draw so vividly; crocodile tears make it soggier, not sweeter.

[S McCoy]

For whatever it's worth to those of you I've "troubled" so much, I happen to think the Republican Party is full of awful ideas and dirty politicians. I just also happen to believe the Democratic Party is full of even worse ideas and even dirtier politicians. My initial post was simply to remind Lance that there really are people of good will who think there are better ways to achieve the same essential goals he desires. For my trouble I've been called an obtuse, oblivious, un-serious, uninformed, lying troll. It's true that I philosophically believe that the government that governs best governs least....ie, the best way to protect our economy, our freedom, and our collective well being is to limit the power of those in charge to the bare minimum. Jay B says I should support my thesis with facts (even though his facts are really just opinions too), but remember that my opening thesis was that it's possible to care deeply about other people and still not vote for Mr. Obama. The fact is that I do, and I won't. I'd love to buy you all a beer sometime and try to convince you I'm not a troll.

[S McCoy]

Oh and by the way, you should each put $10 in Lance's tip jar as a penalty for taking yourselves so seriously. Cheers!

[Lance Mannion]

Subnumine,

Thanks for the comment and welcome to the blog! Did you come over here from digby's place? You bring up an important point about "investements." It's terrifying to think where we'd be if Bush had succeeded in privatizing Social Security and those "investments" had taken the hit everybody's 401k's did. And this gets at the heart of Republicans like Paul Ryan's and Mitt Romney's heartlesness. To them the Market is magic. It never causes any damage. The Invisible Hand makes sure that it all works out for the best for everyone in the end. And, S McCoy, before you object, go back to what Mitt said about the $2 billion MF Global "lost". As they see it, capitalism as practiced by Wall Street is the one human activity in all history that has always resulted in the general good. Consequently, no one involved in it needs to actually act for the public's good. We can all be as selfish and greedy as we want because no matter what it all turns out for the best. This is a great defense against attacks of conscience.

But, I want to make this very clear, I don't consider S McCoy a troll and I don't feel troubled by him/her. S is a faithful and attentive reader who just refuses to believe that the people running the Republican Party, which includes the base, are as heartless and ruthless on behalf of the corporate rich as they proudly announce themselves to be. I sort of understand, having grown up in New York State in a time when we were well represented by many truly compassionate conservatives. My grandmother was one. They were generally known as liberal Republicans but they were in principle what S thinks of as fiscal and small government conservatives. An important difference is that they believed there were some things govt could do and had to do and that from time to time those things had to be paid for with taxes. I have trouble myself believing that these Republicans don't exist anymore. For one thing, they do. Here in New York we still have them in our state legislature. My town board is run by them. But, nationally, for all intents and purposes, they don't matter.

My only real complaint about S is that he/she doesn't seem to read any of my posts that aren't about politics. But I have the same complaint about a lot of my liberal readers.

[subnumine]

I did come here from Digby; I am not from New York, but I remember Jacob Javits. He, like Clifford Case, was a genuine conservative - by which I mean that he conserved something; I am glad to hear such politicians still run some local Republican parties. Nationally, they do exist as independents and as Democrats, since the Republicans have no place for them; the GOP prefers machines, like Nassau County's.

The difficulty with the national Republicans is not only that they are not compassionate; it is that they are not conservative. Hayek wrote, three-quarters of a century ago, about the prevalence of aspiring monopoly (and oligopoly) in the American economy; the difference since has been that they no longer aspire, and that they oligopolize the global economy. As Hayek said then, they have not achieved their position by competitive efficiency, but by collusion - and by the steady favor of policy. The Republicans propose to continue these policies, as they have since 1924; as Gandhi said about Western Civilization, a free market economy would be a good idea.

Those who quote Mr. Jefferson as though he meant to praise a government that did not govern at all know nothing about his Presidency; but then hardly any of them know any economics. "Private GOOOOD, Gummint BAHHHHD" belongs in Animal Farm, not the public councils of a democracy.