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6/28/12
The Freeloader Argument
Hurray for the Supreme Court's decision to uphold the Affordable Care Act, but now there will be increased zeal to strike down Obama himself and elect Romney, who wants to repeal it. President Obama really needs to get out there and sell Obamacare, and especially the individual mandate, in a way that speaks to conservatives, not just liberals. It's all wrong to think the individual mandate is a nanny-state provision that forces rugged individualists to take care of themselves. Quite the opposite--it reins in freeloaders who are poised to take advantage of emergency rooms, but don't want to pay for the safety net until they actually land in it. This is like refusing to pay for the fire department until you have a fire, or refusing to pay for the safety net at the circus, until you actually fall off the high wire. It's also like not having your kids vaccinated, because all the other kids at school are vaccinated. As it stands, people without insurance are ripping off the rest of us, and they shouldn't be allowed to continue. See? It's an argument that appeals to a sense of fairness, not to the compassion that the anti-Obama conservatives are so evidently missing. It could easily be done--Republicans against the ACA could be cast as letting freeloaders get away with continuing to rip us all off. Compassion is part of the argument for other provisions in the ACA, but Obama needs to make the freeloader argument to get conservatives to shut-up about the individual mandate, and its alleged assault on our freedoms. We shouldn't have the freedom to be freeloaders. That's what Obama needs to say ... over, and over, and over again.
I agree. It's also important to stress that this way of introducing better health care -- pragmatic, careful, step-by-step rather than root-and-branch reform -- is quite conservative, in a Burkean sort of way.
ReplyDeleteThere is a severe difficulty with your rhetorical strategy. Specifically the fact that the ACA involves large ammounts of subsidization to those who could not otherwize pay. There is no way (for the conservative observer) to view this as anything other than "freeloading" by those who can't otherwise afford to pay, so I'm skeptical that such emphasis on freeloading would have the impact on the conservative mind that you suggest it would.
ReplyDeleteI was kind of hoping conservative would be able to make the distinction between these two groups--
ReplyDelete(1) people who can afford to pay for the medical safety net, but aren't right now doing so (they're freeloaders), and will have to under the ACA
(2) people who can't afford to pay for the medical safety net, and will get subsidized under the ACA (that won't make them freeloaders, because the help they get will be need-based)
I noticed that in Obama's speech yesterday, he talked about people in group 1 as having to "take responsibility". So he came close to saying that right now they're being irresponsible, which is close to saying they're freeloaders. Sounds to me like his PR team has settled on the language of responsibility, which is maybe for the best (it's less accusatory and punitive).
"(that won't make them freeloaders, because the help they get will be need-based"
ReplyDeleteBut isn't the crucial difference between the "liberal" and the "conservative" how people's "needs" should be adjudicated with regard to their "just deserts"? I think there are a lot of conservatives who simply disagree that the fact that someone "needs" medical care entitles them to it, even if they couldn't pay and have never been in a position to pay. It's "their fault" that they didn't "work hard enough" or "get the right kind of job" or didn't "manage their money properly" or what have you.
They are thoroughly un-Rawlsian with regard to their thoughts on who "deserves" what. I go round and round on this with my libertarian friends and whether or not one agrees with Alistair McIntyre that the Nozick/Rawls choice is "criterionless" it certainly runs very very deep.
I do think a generic "responsibility" message isn't bad as it cuts both ways: those who can pay should, and we ought to feel responsible for providing all members of our commons society health care. Where conservatives disagree with liberals is about the reach of "common society"
Sadly, I think you may be right about all of that. Maybe "responsibility" talk really is the best way to go.
ReplyDeleteMust be brief...real life beckons AGAIN!
You are talking as Kantians would talk to each other, about "deserts" as various shades of Kantians understand deserts. But in the real world, non-academic voters think about consequences and circumstances.
ReplyDeleteHere's a real-world commentator: http://andrewsullivan.thedailybeast.com/2012/07/the-first-elite-conservative-to-say-enough.html
"As it stands, people without insurance are ripping off the rest of us, and they shouldn't be allowed to continue."
ReplyDeleteThis isn't true - it's only people who can afford healthcare insurance and don't purchase it and then use emergency healthcare that are ripping people off!
What about those who can afford to pay for their healthcare and don't want to fund insurance companies?
What about those who won't get sick (or die in such a way as to not use healthcare)?
What about the legitimate fears that because now "we all have to pay for healthcare" people taking voluntary health risks (smokers, obese people, drinkers etc.) should be taxed or outlawed. cf. People's justification of NYC's stupid drink size limit.
I happen to be a fan of universal healthcare (in one form or another) but it is completely the wrong approach to try and convince conservatives by ignoring their fears and simply attempting to appeal to one of their less pleasant instincts.
"(2) people who can't afford to pay for the medical safety net, and will get subsidized under the ACA (that won't make them freeloaders, because the help they get will be need-based)"
ReplyDeleteWell, that's going to be a lot of people. I think a lot of people who get full coverage through their jobs aren't very conscious of costs, but have you *seen* the cost of medical insurance these days? $300/month is typical, unless you go with an incredibly high deductible that effectively only covers the most serious emergencies.
Unless there's a real plan in place to make insurance an order of magnitude less expensive, the individual mandate is absolutely sticking it to the poor, much the way a flat tax would.
I was having this argument recently with a friend, and I feel obligated to address it here:
ReplyDeleteThe discouragement an individual mandate offers from not buying health insurance is not the same as encouragement to buy health insurance—only lower prices could accomplish that. So long as the penalty tax for abstaining from coverage is less than the price of insurance, it only makes sense for people to pay the penalty; for most, the cost-benefit analysis remains the same. The provision of the bill forbidding insurers from rejecting clients based on previous illnesses encourages the irresponsibility you mention above outright (and makes for better application of the analogies you use): it empowers people to wait for the winter to put away the fiddle, which in turn drives up prices, leading to more people refusing healthcare on an economic basis. And even if those people are lucky enough to fall within the expanded purview of Medicaid, that completely defeats the above stated purpose of promoting personal responsibility and decreasing the burden on the middle class.
The whole problem with the bill is that it was born out of two separate and conflicting impulses to compassion and justice, and as such is bound to fail.
Consider this:
ReplyDelete10 years from now. Homeless guy, doesn't ask for hand outs and lives by scavaging. He is healthy except for being a little off in the head if minding ones own business is off. One day he has an epiphony, goes to a shelter, cleans up and finds a job. At the end of the year he files his taxes with gross earnings of $15K and pays no income tax. Nine months later the IRS knocks on his door and tells him he owes $5500 for not having health insurance for the last eight years. Low income is not an excuse as the AHA tax on freeloaders is a tax without regard to income.
Camber, If your point is that Homeless Guy didn't use any health services, THAT doesn't get him off the hook, surely. If he never called the fire department, should we forgive the taxes that support the fire department? We pay taxes to have certain services available, and not just for using them. How we deal with low income (the guy's homeless) is another question, of course.
ReplyDelete