Categories
Health care Libertarianism Political Philosophy The Opinionsphere

There Is Such A Thing As A Right to Health Care

[digg-reddit-me]F. Paul Wilson had a post that was reddit-famous last week (in the Libertarian subreddit) in which he declared “There ain’t no such thing as a right to health care.” He proposed “the alone-on-a-desert-island rule [as] a convenient way to differentiate genuine human rights from the poseurs.” The genuine human rights are inherent, according to Wilson – and he says – on this desert island alone – one has the right to life, liberty, the pursuit of happiness, the right to free speech, free sexual expression, freedom of religion, and freedom to smoke or inject anything you want. What you don’t have – according to Wilson – are the right to a house (because there is no one to build it), the right to three solid meals a day (because there are no farmers), or the right to health care (because there are no doctors.)

But by Wilson’s “alone-on-a-desert-island rule” Iran would be considered quite free. Fine – they don’t have freedom of assembly – but you can’t have that on a desert island. They don’t have free speech in public – but they would in the privacy of their own homes (in their own, walled-in desert island), especially if no one was listening. The Iranian authorities actually  allow their people a broad range of rights as long as they keep their activities private.

The problem is – as social animals, humans cannot fully express their freedom of sexuality, the freedom of religion, the freedom of speech, or many of their other freedoms except in the presence of others. Many of the rights we take for granted are social rights – relying on others to a society to make these rights possible.

Perhaps the distinction Wilson is trying to make is between negative rights – rights which constrain the government – and positive rights – rights which impose responsibilities on the government.

The right to health care is one of the latter – but that does not make it any less a right. While the right to health care is not absolute – as if one is alone on a desert island, one has no such right, just as one has no right to assemble, or vote – few today would deny that each individual has a right to some level of care if they are sick and injured. While Wilson is concerned about imposing a burden on doctors, they have already sworn an oath to provide such care if it is needed, a responsibility they take upon themselves with their profession.

This right to health may not be inherent – but that does not make it less substantive. All humans live in some sort of society – as it is our nature. One of the most basic purposes of a society is to take care of the sick and hurt. As a citizen in such a society, I have a right to health care – even as it imposes a burden on others, just as I have a right to vote, even though others must then count my vote, and as I have the right to an attorney if accused of a crime, even though this imposes another burden. It is a right inherent in my citizenship, in my status as a member of a society.

[Image by Matthew Winterburn licensed under Creative Commons.]

Categories
The Web and Technology

Brief Thoughts for the Week of 2009-07-10

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Categories
Barack Obama Criticism Foreign Policy History Iran Law National Security Politics The Bush Legacy The Opinionsphere The War on Terrorism

McNamara, Cuomo, Bearing Witness, Iran’s Bomb, Sri Lanken Victories, and Historical Dignity

It’s that glorious time of the week – Friday. So, here’s my recommendations of some interesting reads for this weekend that came up this past week…

  1. There were a number of excellent obituaries of Robert McNamara published upon his death. But what I would recommend would be reading this speech given in 1966 at the height of his power.
  2. Another speech worth reading is Mario Cuomo’s “Our Lady of the Law” speech from November 2007 which was published for the first time on this blog earlier in the week.
  3. Roger Cohen in the New York Times tries to express the insufficiency of online reporting aggregating news and media – as Andrew Sullivan and Nico Pitney did so usefully did during the Iranian protests. As these two journalists amassed tweets, photos, videos, news stories and every other bit of information about what was going on in Iran, Roger Cohen himself was in Tehran having evaded the Iranian censors. He went to the protests, interviewed the protesters, ran from basij with them. What I could see then was that while what Sullivan and Pitney were doing was new and unique – and extremely useful for understanding what was happening, it was missing a certain urgency that Cohen was able to provide with his bylines from Tehran. So he writes here about the “actual responsibility” of the journalist – to “bear witness:

    “Not everyone realizes,” Weber told students, “that to write a really good piece of journalism is at least as demanding intellectually as the achievement of any scholar. This is particularly true when we recollect that it has to be written on the spot, to order, and that it must create an immediate effect, even though it is produced under completely different conditions from that of scholarly research. It is generally overlooked that a journalist’s actual responsibility is far greater than the scholar’s.”

    Yes, journalism is a matter of gravity. It’s more fashionable to denigrate than praise the media these days. In the 24/7 howl of partisan pontification, and the scarcely less-constant death knell din surrounding the press, a basic truth gets lost: that to be a journalist is to bear witness.

    The rest is no more than ornamentation.

    To bear witness means being there — and that’s not free. No search engine gives you the smell of a crime, the tremor in the air, the eyes that smolder, or the cadence of a scream.
    No news aggregator tells of the ravaged city exhaling in the dusk, nor summons the defiant cries that rise into the night. No miracle of technology renders the lip-drying taste of fear. No algorithm captures the hush of dignity, nor evokes the adrenalin rush of courage coalescing, nor traces the fresh raw line of a welt.

  4. Robert Patterson in Foreign Policy brings some measured historical analysis to what would happen if Iran got the bomb.
  5. Robert Kaplan in The Atlantic explains how the Sri Lankan government was able to achieve a monumental victory over a terrorist group – and also why America should not imitate its methods in any way. He concludes bleakly:

    So is there any lesson here? Only a chilling one. The ruthlessness and brutality to which the Sri Lankan government was reduced in order to defeat the Tigers points up just how nasty and intractable the problem of insurgency is. The Sri Lankan government made no progress against the insurgents for nearly a quarter century, until they turned to extreme and unsavory methods.

  6. David Brooks wrote about dignity:

    In so doing, [George Washington] turned himself into a new kind of hero. He wasn’t primarily a military hero or a political hero. As the historian Gordon Wood has written, “Washington became a great man and was acclaimed as a classical hero because of the way he conducted himself during times of temptation. It was his moral character that set him off from other men.”

Categories
Barack Obama Criticism Domestic issues Health care The Web and Technology

An idea for a new health care public service announcement

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Categories
Domestic issues Economics Health care Political Philosophy

How the Problem of Health Care Undermines the Legitimacy of the Market-State

[digg-reddit-me]Philip Bobbitt and other use the term “market-state” to describe the next (and to some extent current) role of the state – in contrast to its previous historical roles. While throughout most of the 20th century, the state’s role was to provide basic services and goods to its people, by the turn of the century – starting in the late 1970s and early 1980s, the state’s role had evolved to providing opportunities to its citizens. The United States has been on the leading edge of this evolution – from Jimmy Carter’s first steps towards deregulation to the Ronald Reagan’s riding of this zeitgeist to power – as he ushered in an era of increasing deregulation and privatisation, and a reduction of all government interventions in the economy. In proposing that “Government is not the solution to our problem – government is the problem!” Reagan placed the Republican Party at the head of this evolution in the government’s role – making Democrats who opposed this seem out-of-touch.

But if a market-state’s success is judged by the extent to which it maximizes opportunities for its citizens – the problems of global warming and health care now threaten to undermine the legitimacy of America’s market-state. The problem in each case began long before the transition to the market-state – but in both, this transition escalated the scale of the problem and made it harder to manage. However, for this post, I’m only focusing on health care.

Coinciding with the deregulation of various industries and other market-state reforms that began in the early 1980s, health care costs began to grow substantially faster than other products and services in America (though without providing better results.) This growth in the costs of health care has created three problems that undermine America’s market-state:

  1. Given the government and state insurance plans for the poor and elderly, this growth undermined the fiscal solvency of the government overall.
  2. The rapid rise in costs has undermined the faith of many citizens in the market.
  3. The business model private health insurance companies have adopted creates extreme insecurity for citizens – thus dampening economic growth and the entrepreneurial spirit needed for a market-state to thrive. Paul Waldman describes the perversity of this model in The American Prospect:
  4. [T]he central pathology of our deeply pathological health-care system is that most of us have no choice but to get health coverage from an entity whose sole reason for being is to take our money and then try to avoid paying for our care when we get sick.

With prices increasing so rapidly and with people feeling less secure in their coverage and the government deficit exploding in the next fifty years, the sense of an impending crisis is palpable. The crisis in health care thus undermines the entire market-state model.

To date, most Repbulicans and right-wingers do not seem to have realized the scope of this problem – the extent to which it undermines the very legitimacy of the type of state they have been promoting. The best proposals that have been made from the right have focused on the ideology of anti-governmentism rather than a focus on the market-state expansion of citizen opportunity that was the true core of Reagan’s success. For example, John McCain, in a bold move, sought to overthrow the system of health care insurance as we know it – and to place the responsibility for paying for health care squarely on the shoulders of individual citizens – instead of the collective pools that spread out such risk, whether organized by employers or the government. This would hold down health care costs – because individuals would be constrained from making health decisions by the amount of money they had to spend. The theory behind this was that the increasing costs of health care stemmed directly from the fact that consumers were going to the doctor or hospital or otherwise using health care more because they did not bear the direct consequences of their decisions. Of course, being out of power and with their ideas generally unpopular with the public, Republicans have instead merely sought to minimize or deny the clear problems with health care and simply be obstructionist.

Alternately, liberals, progressives, Democrats describe health care as a place in which the market has simply failed. As Paul Krugman has recently pointed out, health care economists have long maintained that:

[T]he standard competitive market model just doesn’t work for health care: adverse selection and moral hazard are so central to the enterprise that nobody, nobody expects free-market principles to be enough.

Their are various solutions being worked out by the Democrats – to create regulations that prevent health insurance firms from maintaining their exploitative business model; to create a competitor to these firms that will operate on a different model to keep them honest; to link payment of health care to outcomes instead of time and services.

The great irony is that if the Democrats are successful in reforming health care, they will have legitimized the market-state which many on the left are suspicious of – but they will have done so by firmly rejecting the Republican dogma that the government is always the problem. As Bill Kristol wrote in his famous 1993 memo on Bill Clinton’s attempt at health care reform:

[T]he long-term political effects of a successful Clinton health care bill will be … worse … It will revive the reputation of the party that spends and regulates, the Democrats, as the generous protector of middle-class interests. And it will at the same time strike a punishing blow against Republican claims to defend the middle-class by restraining the growth of government.

Today,  it is only the Democrats who will be able to preserve the legitimacy of the market-state in the midst of this crisis.

[Image by FoxTongue licensed under Creative Commons.]

Categories
Humor Law

Justice Ginsburg Loses a Shoe

Emily Bazelton in interviewing Supreme Court Justice Ruth Bader Ginsburg for the New York Times magazine this weekend prompts Ginsburg to tell this small, charming story behind how a rumor about her health had gotten started:

[S]ome reporter said something like, it took me a long time to get up from the bench. They worried, was I frail? To be truthful I had kicked off my shoes, and I couldn’t find my right shoe; it traveled way underneath.

[This image is in the public domain as it is an official work of the U.S. government.]

Categories
Foreign Policy History The Bush Legacy

Henry Kissinger on Obama

The German weekly Der Spiegel ran an interesting interview with Henry Kissinger about the Treaty of Versailles and Barack Obama’s foreign policy. There are those who simply condemn Kissinger as a war criminal and choose to ignore his opinions – but by most accounts, his tenure as Secretary of State and National Security Advisor under Presidents Nixon and Ford were a virtuouso performance as he exercised American power at a time when many saw it being diminished. I do not seek to defend Kissinger’s green-lighting of the Chilean coup or his sabatoging of the Paris peace talks with Vietnam to ensure Richard Nixon’s election in 1968. This last act was certainly treason – and his role in Chile led to the reign of the convicted war criminal, Augosto Pinochet and the removal of the elected leader of that country.

But existing alongside these amoral acts – and underlying these acts – are an understanding of power – as it is, rather than as it should be. Kissinger saw – with Nixon – that by persuading China to seperate itself from the Soviet Union’s world order, he would strengthen America’s hand significantly – and help end the stalemate that the Cold War had become. With Richard Nixon succumbing to alcoholism late in his term, it was Kissinger who single-handedly ran America’s foreign policy – managing crises and coups d’etat throughout the world.

Unsurprisingly to some (Stephen Walt had already described Obama’s foreign policy as “Kissingerian“), Kissinger seemed to have a more substantial understanding of Obama’s foreign policy approach:

Obama is like a chess player who is playing simultaneous chess and has opened his game with an unusual opening. Now he’s got to play his hand as he plays his various counterparts. We haven’t gotten beyond the opening game move yet. I have no quarrel with the opening move.

Unlike Ahmadinejad’s useful idiots from McCain to “Smart” Girls to Ajami, Kissinger credits Obama for having a strategy, while witholding judgment about its effectiveness.

Kissinger offers a revealing criticism of Wilson’s Fourteen Points and America’s role in the Treaty of Versailles – which also rather neatly contradicts the Bush doctrine:

The American view was that peace is the normal condition among states. To ensure lasting peace, an international system must be organized on the basis of domestic institutions everywhere, which reflect the will of the people, and that will of the people is considered always to be against war. Unfortunately, there is no historic evidence that this is true.

And of course Kissinger also came out with this quotable line:

I believe more suffering has been caused by prophets than by statesmen.

[Image by DarthDowney licensed under Creative Commons.]

Categories
Criticism Foreign Policy

Defending American Empire

To paraphrase Samuel Johnson, all the arguments attempting to prove that America’s “full-spectrum domination” of world power is just like every other empire, that current economic policies are really re-named colonial policies in which the rich ruthless exploit the poor, that the apparent reticence in the use of force actually hides equally brutal use of force, that capitalism is another form of slavery, that the relative lack of great crimes conceals the greatest of crimes – the fact that people must labor to convince others of these points demonstrates their lack of verisimilitude. It is because these contentions are not self-evidently true that we must be convinced of them.

It is not that I believe that America’s role in the world in inherently exceptional or inherently good. It is that, on balance, I tend to believe that America has pushed the world order in a positive direction. The end of Europe’s colonial empires was pushed by and managed by America at the end of World War II. It was America that restrained Europe’s colonial ambitions in Latin America until the 20th century. It was America that restrained the growing Soviet empire. It was America that pushed for an international order that judges regimes based on how they value the human rights of their citizens. It was America that pushed for the founding of an international deliberative body to maintain a world peace. Through all of this, America has often fallen short of the values it has pushed the rest of the world to accept – often for momentary tactical or strategic gains in whatever conflict was current. But it has progressively changed the world order to accept these values – and has found itself restrained by and sometimes bound by these values.

To some extent, America was merely at the forefront of pushing structural changes in the world order that were already occuring. After World War II, Europe could no longer afford to maintain their colonial empires, for example. In an age of nuclear weaponry, the nature of war changed. With the technology of destruction increasing and the nature of the state changing, victory in war became harder to achieve. With the increasing availability of worldwide communications, internal actions of states increasingly came under international scrutiny. In each of these areas, America was at the forefront of pushing these technological or even political changes.

Les Gelb in his most recent book asks what other empire would have restrained itself from invading Cuba as America did. He points to all the elaborate steps initiated to take down Castro – especially by the Kennedys – but asks what restrained America from acting – and still does, almost 50 years later. America had and has the power to take out this belligerent nation just 90 miles off its shore. But it has chosen to limit what options it was willing to use to accomplish this. The way in which Russia invaded Georgia last year only demonstrates the uniqueness of America’s response, even today.

In terms of judging America’s historical acts, I think it makes sense to consider something Henry David Thoreau wrote, that:

A man is wise with the wisdom of his time only, and ignorant with its ignorance.

The same is true of the men and women who lead nations.

Finally – it is my impression that among those who criticize American empire most stridently, they fault the United States for all of the faults in the global status quo of which America is the protector and credit it with none or few of the praiseworthy aspects. Thus America is blamed for the millions in poverty in capitalist nations – but not credited with the millions brought up from poverty by this same system. Thus America is blamed for the dictatorships it supports but rarely credited with the democracies.

America’s power in the world is significant – and it is the main force that maintains the status quo. But what is the better option? To become a revolutionary power? I’ve generally found it difficult to understand what those who denounce American empire propose as an alternative.

Responses are welcome.

[Image by Macsoundhine licensed under Creative Commons.]

Categories
Russia The Media The Opinionsphere

The Goal of the Commentariat

Ellen Barry of the New York Times quotes Russian “television commentator Mikhail V. Leontyev, who has built a career on his relentless hectoring of the West” on what he does

My task on television is to verbalize, in a certain formula, the real public consciousness that exists. So people will hear what they want to hear. So they can say, ‘Yes, that is what I thought!’

My impression is that Barry was trying to convey the idea that Leontyev was a propagandist for the Russian state – but his explanation of his job struck me as a pretty honest description of what most talking heads and columnists aim for – and what Glenn Greenwald so derides – as they claim to and aspire to explain what the American people think about a matter.

It’s always a bit fuzzy though – in either state-controlled media or our more free press at home – whether these thoughts are what people thought before, or if these ideas have been planted by the commentator – or if there instead exists some delicate balance between the two.

Categories
Law

Our Lady of the Law

[digg-reddit-me]About a year and a half ago, looseheadprop at Firedoglake posted about a speech he called “Our Lady of the Law.” I’ve contacted Governor Cuomo’s offices a number of times in the past year asking if they could provide me a copy, and allow me to publish it on this blog, and last week, they graciously did.

Governor Cuomo gave this speech at a dark moment in the winter of 2007 as George W. Bush’s radical national security policies undermined the Rule of Law at home – from warrantless wiretapping to torture to the misuse of signing statements to the politicization of the Department of Justice to the unsupervised jailing of non-combatants under the authority of the executive branch. At the same time, the Lawyers Movement in Pakistan fought to restore the Rule of Law in Pakistan and marched against President Musharaff. looseheadprop quoted a line which isn’t in the prepared text I was given in which Governor Cuomo called on lawyers in America to follow the example of their brethren in Pakistan:

If US lawyers are marching in the streets in support of the rule of law in Pakistan, why aren’t we marching in support of the rule of law here?

Knowing human nature and his history, Governor Cuomo pointed out the George W. Bush was attempting to subvert the Rule of Law and “inflate the presidency into unconstitutional shape and power.” In this dark time, the winter of 2007, as revelation after revelation of George W. Bush’s misdeeds became public, Governor Cuomo called on the lawyers to fight for the Rule of Law – for Our Lady of the Law. He concluded with a call to arms – not against George W. Bush but to protect the institutions that enable us to be a state of consent and the liberal democracy that the Founding Fathers envisioned:

Surveys tell us that we believe our nation is not heading in the right direction and we have no clear notion as to how to change course.

It’s more than just the war in Iraq and threats of still another war that concerns us.

We have no heroes, no heroines, no soaring ideologies.

We are tired of, and frustrated by, political answers that seem impertinent, too shallow, too short-sighted or too harsh.

We are not even sure what we wish to be as a nation. We’re tempted to see ourselves as 300 million disassociated individuals struggling for survival and dominance in a dog-eat-dog world, instead of seeing ourselves as a fully integrated society, interconnected, interdependent, growing stronger together.

Some of us are frightened by 9/11 and terrorism into thinking we can be saved by a more powerful presidency even at the risk of creating the kind of monarchial power the Founding Fathers sought to protect us from in the Constitution.

We need something more ─ something better to believe in. To hold onto. To be guided by.

Something wiser than our own quick personal impulses.

Something sweeter than the taste of a political victory.

It would take more than the time we have now ─ and perhaps more than the wisdom that resides here today ─ even in this very gifted group ─ to find and to describe all we must do to relieve this profound discomfort.

But there is one thing we lawyers know will help relieve the unsureness that troubles us.

And that is “Our Lady of the Law,” as she comes to us in our Constitution ─ the nation’s bedrock.

Our 200 year old legacy of law and justice has been the foundation on which we have built all that is good about America. We must not allow that foundation to be weakened or even defaced by a political system whose claim to morality is the latest urge of the American people ─ however distracted, however mislead we may be on occasion.

We must not allow our eager presidents and timid Congress people to combine to weaken our system of checks-and-balances and threaten our republic by allowing a single individual to exercise monarchial powers.

For 200 years “Our Lady of the Law” has proven stronger than the sins of her acolytes and has made us better than we would have been.

Now she must be lifted above the political melee and the confusion before she is brought down and her guiding light is no longer visible to us.

Someone must lend their shoulders in the effort to do that.
If not, the lawyers, then who?

As we continue to experiment with national security laws, this message still rings true. We still need a Lawyers Movement in America to keep Barack Obama and our government honest – to ensure that they continue to protect the Rule of Law.

I’ve published the full text of the speech below the jump.