Your Mom Did; She Had It Coming

If our current health care system is unsustainable, then reform is a necessity. The question should be not whether we should reform health care but how best to do it. Given that other countries do a better job at less than half the cost, there really isn't any sound reason to oppose reform – just lack of awareness among the general public - and politics, ideology and spite from reform opponents. Objecting to a specific plan is certainly fine if there are good reasons for doing so. Some reformers want single payer (which would save money), or oppose insurance mandates without a public option and other measures to prevent additional burdens on the poor and middle class. The Republican leadership promised a plan months ago, and then they've never delivered it. This is hardly shocking, and the media's failure to press the GOP on this isn't, either. Blue Dog Max Baucus' bill apparently has a few decent provisions, but is mostly a big giveaway to insurance companies. The deficit arguments also make little sense. Good reform will save money in the first year, and even more in the long run. Few members of Congress wailing about the deficit this time are supporting cost-cutting measures in the proposed legislation, and most never opposed other expenditures such as Pentagon waste, the wars in Afghanistan and Iraq, or Bush's 1.8 trillion tax cuts (that went primarily to the richest Americans). Most of the honest critics of reform are on the left. The conservative position has been satirized in several ways, but it really boils down to: "Pray that you don't get sick. If you can't afford care (or have it denied), then you deserve to die."

Your Mom Probably Did

This exchange has been making the rounds, for good reason:

Senator Kyl: I don't need maternity care and so requiring that to be in my insurance policy is something that I don't need and will make the insurance more expensive.

Senator Stabenow: ...I think your mom probably did.

The lack of basic empathy, and the refusal to acknowledge how insurance companies screw customers over, are amazing. Kyl is a characteristic conservative lawmaker in both aspects.

Igor Volsky explains Kyl's (failed) amendment at ThinkProgress (head over for the links):

Kyl’s amendment would prohibit the government from defining which benefits should be included in a standard benefit package and would permit health insurance companies to design policies that exclude higher-cost beneficiaries. Currently, “it is difficult and costly for women to find health insurance that covers maternity care” in the individual health insurance market. According to a survey conducted by the National Women’s Law Center, the vast majority of individual market health insurance policies “do not cover maternity care at all. A limited number of insurers sell separate maternity coverage for an additional fee known as a ‘rider,’ but this supplemental coverage is often expensive and limited in scope.”

A well defined minimum benefits package would compel health insurers to provide basic services to all Americans. The Kyl amendment, which ultimately failed, would have allowed the industry to continue profiting from discriminatory practices. As former health insurance executive Wendell Potter explained in an interview with ThinkProgress, insurers would like to move us all into “these limited benefit plans that are very skimpy and don’t cover you, don’t cover what you need. That way, when you do get sick, they’re not on the hook to pay you anything. They would love to have you enrolled in these.”

My favorite comments come from the Obsidian Wings thread:

John Kyl's mother didn't need maternity care, either.
He sprang fully formed from Ayn Rand's forehead.
- John Thullen

If you customize your insurance coverage perfectly, it is indistinguishable from paying for everything yourself (except for paying the insurance company its rake off).
- Free Lunch

As Maha comments:

Once again, do Republicans not get risk pooling? If the only people who add maternity benefits to their insurance are young couples planning families, their insurance is going to go through the roof. It’s only by spreading the cost out across a big pool that it can possibly be affordable.

Kyl's position reminds me of former GOP Congressman Tom Davis telling a caller good luck," Tom Coburn's squirming, contradictory bullshit, Eric Cantor's lame lies and incoherence, Olympia Snowe's lack of independence, and Michael Steele inept, incoherent lying. (Ask a bullshitter a few sharp questions, and their position crumbles.)
Oh, and then there's key Democratic Blue Dog Kent Conrad, who doesn't know what the hell he's talking about.

It's not a coincidence that the folks opposing health care reform, and deriding systems that are effective in other countries, can't keep their stories straight when they know the facts at all. The obliviousness is galling, but the callousness is disgusting. Still, all that pales compared to the next, putrescent example...

She Had It Coming

Tintin at Sadly, No understates the case with the title "Another Portrait Of An Asshole As A Young Man." Here's the full item that drew that:

When Artists Starve [Stephen Spruiell]

A few points regarding this story:

• The median starting salary for Miami University (Ohio) graduates is $47,100.

• A healthy 22-year-old female in Oxford, Ohio can purchase serviceable health insurance ($30 co-pay for office visits) for $55 a month, according to ehealthinsurance.com.

This young woman's death is indeed tragic, but it is not an indictment of the U.S. health-care system, cheap left-wing moralizing to the contrary notwithstanding. Many capable young people forgo stable careers in order to try their hands at starving-artistry. The rest of us are under no obligation to subsidize that choice.

Honestly, this may be the most appalling "opinion" on health care I've yet heard. I think it's even worse than views of the crazy doctors the Wall Street Journal editorial page keeps on dredging up - including the one who thought he was being awfully clever for asking folks 'why people should not be left to die in the street (other than that they have a right to health care).' Spruiell's just as smug, but even nastier, because we're not dealing with hypothetical people, but a real young woman who just died, probably needlessly.

Spruiell, who used to work for current anti health care reform group FreedomWorks, apparently couldn't be bothered to read the story he linked:

Friends say the Miami University graduate who died this week after reportedly suffering from swine flu delayed getting medical treatment because she did not have health insurance.

News of Kimberly Young’s death Wednesday, Sept. 23, came as a shock to those who knew the vibrant 22-year-old who was working at least two jobs in Oxford after graduating with a double major in December 2008.

Young became ill about two weeks ago, but didn’t seek care initially because she didn’t have health insurance and was worried about the cost, according to Brent Mowery, her friend and former roommate...

Young, who studied French, Spanish and earned two degrees at Miami — international studies and fine arts photography, was an active member of the Students for Peace and Justice and the Association of Latin American Students.

The Wayne, Ohio, native was still in Oxford after graduating in 2008 because she wasn’t able to find the right job. Hey said this past summer, Young was debating pursuing a graduate degree or working for a nonprofit organization.

“She had an incredible commitment to social justice,” Hey said. “She was a person with a huge heart and a very free spirit as well. She really cared about people here and around the world.”

Read the rest; it sounds like quite a loss. Memorandum has some other blog reactions, some thoughtful, some repulsive. Perhaps if Young had been a conservative activist, right-wingers would have reacted differently – but they'd probably invent some reason she was an exception in that case. I know the same conservatives who attacked Graeme Frost don't get this, but the reason liberals people with souls are focusing on this story is because it is tragic, and Kimberly Young's fate was probably preventable. Compassion and empathy are not foreign concepts or viewed as evil by those who aren't authoritarian conservatives. Why the hell would anyone want a fellow citizen, let alone a vibrant, young college graduate, to die unnecessarily?

Young's case is hardly unique – a recent study estimates that 45,000 Americans die every year due to lack of insurance. That's not counting the many Americans who are under-insured but think they're covered, and will be denied necessary care when they need it. One has to be pretty cloistered not to know any stories like this.

Tintin summarizes Spruiell's attitude as "People who don’t have jobs deserve to die," but Kimberly Young in fact held two jobs. It'd be more accurate to describe Spruiell's attitude as "People who don't have jobs and pursuits I approve of deserve to die." I'd shorten it to simply, "She had it coming."

Spruiell's argument on the merits fails pathetically. Tintin examines the truth behind his health insurance claims. Unsurprisingly, that $55 plan offers crappy coverage – and even that assumes the insurance company would cover every applicant, which is obviously false. Especially in today's economy, there are plenty of graduate students, let alone college students, who can't find a job at all. (Unemployment among those 16 to 24 is at a historic 52.2%.) More power to those who can find one with a starting salary of $47,100 or better (note that's a median, not an average), or another gig that offers good health care. (Hey, not everyone can land a gig at a wingnut welfare, loss-leader outlet like National Review.) Since Young eventually went to the hospital, the public picked up the tab for her care anyway, and preventative and early care are both cheaper and more effective. Kimberly Young clearly was quite active and studious, and had diverse interests, one of which was art. Contrary to Spruiell's sneering, art is valuable, artists are valuable, and they deserve health care along with every other American. Even Scrooge (who cited the poor houses) wasn't as smug nor as callous.

Now, even if Spruiell wasn't a self-righteous asshole and full of shit, how many people buy his conclusions? "This young woman’s death is indeed tragic, but it is not an indictment of the U.S. health-care system." "The rest of us are under no obligation to subsidize that choice." Really? We already did "subsidize" it with her hospital care. More to the point, would anything indict the health care system in Spruiell's eyes? Young's death wasn't some rare occurrence. Health care horror stories aren't hard to find in America. If some 45,000 people die every year due to lack of insurance, one in six Americans aren't insured, we spend over twice as much as other industrialized countries for worse care, and reform would be an enormous economic boon and make people happier to boot – what's the argument against reform? Why couldn't Kimberly Young and many more like her live instead of die?

Spruiell is a hack whose argument falls apart with only cursory scrutiny. The same goes for Kyl, Steele and the rest. But honestly, Spruiell's little turd of a post is one of the most loathsome things I can remember reading. Yes, his case fails on the merits, but the key factor is simply that he is a raging asshole. He's probably aware of this, and proud of it – spite is the driving force behind movement conservatism. As Tintin describes it, this is the "I Got Mine, Fuck You" attitude. In Spruiell's circle at National Review, being an asshole, especially toward the poor, the struggling, the liberal, the artistic, isn't just acceptable – it's encouraged. (Revisit Dinesh D'Souza in Johann Hari's classic piece on the National Review cruise.) Spruiell's paid to be an asshole. He's not even an effective liar or dissembler. There is absolutely nothing useful he can contribute to any discussion, on health care, or probably any other subject. Wonks take care of skepticism and criticism just fine without bad faith hacks muddying the waters. It also takes no independent thought or insight to be an asshole like Spruiell, although the far right and glibertarian crowd really do have the conceit that they're bold thinkers, most of all when they're expressing juvenile entitlement and ire.

Obviously, pointing out Spruiell's colossal wankerdom in profane terms won't fly on TV. But it would be a grave mistake to treat him and his ilk as honest, rational or decent. They're not interested in solving problems. In some cases – such as Spruiell's – they won't even admit there's a problem. While public grace has its uses, it's folly to believe these people can be worked with at all. They simply don't give a damn whether anyone (other than their own crowd) lives or dies. The most effective debates or political tactics will expose this and make these scumbags state their actual positions. Some, like Spruiell, are arrogant enough to do so proudly. He'd make a splendid PR man for the Republican party on health care.

I've said it before, but I take no pleasure in the mean, greedy and pathetic state of movement conservatism in America. It really hurts the country, and we'd better off with two parties working to solve problems and offering honest and thoughtful solutions. Kyl is smoother than Spruiell, but his position is pretty callous, too. There are few national conservatives who are honest and aren't obstructionists. And they have no viable solutions to offer. Perhaps if Spruiell and his crowd faced the same fate as those they dismiss and deride, they might change their minds. That's about the only thing that ever does change the mind of a devoted hack or authoritarian conservative – and sometimes, even that won't do the trick.

Oh, and on the artistic front – while it's appropriate to tell Spruiell to Go Cheney Himself (and the Sadly, No thread has plenty of other creative suggestions) - the Bard said it more artfully in King Lear, 2.2:

KENT
Fellow, I know thee.

OSWALD
What dost thou know me for?

KENT
A knave; a rascal; an eater of broken meats; a
base, proud, shallow, beggarly, three-suited,
hundred-pound, filthy, worsted-stocking knave; a
lily-livered, action-taking knave, a whoreson,
glass-gazing, super-serviceable finical rogue;
one-trunk-inheriting slave; one that wouldst be a
bawd, in way of good service, and art nothing but
the composition of a knave, beggar, coward, pander,
and the son and heir of a mongrel bitch: one whom I
will beat into clamorous whining, if thou deniest
the least syllable of thy addition.