A weakness of mine is reading the "Letters to the Editor" section
in our local newspaper, Foster's Daily Democrat.
(I assume, by the
way, that a large slice of traffic to their website,
from people looking for
Aussie beer company. I wonder
how much the newspaper guys could make by selling the
domain name to the beer guys? Hmm…)
Anyway: a few days back, I was struck by the following
(reproduced in its entirety):
Health care: who should
To the editor:
Think about this. Who do you
want making decisions about your health care? A CEO of an insurance
company who makes $800,000 a year and who, if you receive less in health
care, makes more money? Or a government bureaucrat who makes
$90,000 a year and who, if you receive more or less in health care,
makes the same money.
Think about it.
You get to decide:
insurance companies make your health-care decisions or your government
— which, by the way, you vote for and put in office.
Ms. Trumble demands (twice!) that we "think about" this. So I did.
The first thing I thought was how utterly pathetic "you" are, as
the consumer of health care in Ms. Trumble's vision. You are,
in essence, a supplicant. Your only "choice" is in the (theoretical)
selection of the detached, disinterested,
individual who will thereafter literally make any life-or-death
choices concerning you, you poor bastard.
The proper (and, I'd like to think, normal)
response to this dilemma is, at least, a mild outrage.
You (almost certainly,
if you're reading this) don't need
to beg for other of your life's necessities. Critical decisions on
obtaining your food,
investments, and housing are generally not made for
you by either insurance
companies or government bureaucrats. You make them.
How did you get stuck in such a dangerously different
position for your health care?
And how the hell do you get unstuck?
But Ms. Trumble doesn't want us to think such troubling thoughts;
as far as she's concerned, the notion that you should want
to become less dependent on others for your health
care decisions is off her mental
table. Just shut up and make the choice: insurance
company exec or government bureaucrat? C'mon, what's your
answer? She's waiting!
Let's take Ms. Trumble's choice seriously. She seems to think
it's a no-brainer: obviously the government bureaucrat
will be "on your side" and, ironically, she attempts to trot
out an economic argument that demonstrates that.
We could quibble, by the way, with Ms. Trumble's theoretical
implication that the $800K
insurance company guy and the $90K bureaucrat guy would be involved
in the same level of decision-making in regard to "your" health care.
That seems ludicrous on its face, but she no doubt posed the issue
that way to pump up the Demagogic Quotient (DQ) of her letter to the
minimum standard guidelines;
that's really the least of
the problems with Ms. Trumble's thought experiment.
Because it's rare that any "decisions" involving
your own personal health care would be
made by either the bureaucrat or the CEO. In either
case, you'll be "covered" by your "health plan" for
any particular service, or you won't be. In the vast majority
of cases, things are on routine autopilot, clearly delineated in the fine
print of whatever policies or regulations apply.
[Of course, there are relatively rare
exceptions at the margins, typically for exceptional and
experimental treatments. Rarely, "arbitrary" decisions
are made—everyone's probably seen anecdotes—but
I've seen no evidence that government-bureaucrat decisions
tend to cut more humanely than private ones. I would bet they
probably don't, independent of the salary of the decision-maker.]
So Ms. Trumble's argument on "decisions" is not
about fictional people making arbitrary health-care
decisions about individuals;
about whether broad-scale power on health-care industry
coverage and pricing
should rest with government or the private sphere.
Put that way, I think the call really is a no-brainer.
While our current health-care "system" is far from a free-marketer's
dream, it still retains some flimsy connections to economic reality
in terms of profit, prices, incentives, and costs. Ms. Trumble—despite
relying on an economic-sounding incentive argument—is really
advocating moving to a socialist model, where incentives and
planning are moved under the coercive power of the state.
To quote one of my favorite political philosophers: "That
trick never works." Or as one wag put it: socialized medicine
combines the efficiency of the Post Office with the flexibility of the
IRS and the warmth of the DMV. Good luck with that.
Now, lest you dismiss Ms. Trumble as just another random New Hampshire
I was going to simply quote the body of the letter, omitting the name,
the Google for "Mayme Trumble"
reveals she is
actively and deeply involved in
Democratic Party politics. She is,
local Democratic chair in the town of Madbury (NH),
and a member of the
Strafford County (NH) Democratic Executive Committee.
In short, it's likely Ms. Trumble's letter is representative of
the quality of "thinking" that's driving the Democrat end of the health
care debate. God help us. Are there any grownups over there at all?