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I Do Matthew Yglesias' Homework

Last week, in a post lamenting the not-odd fact that the words and actions of politicians do not match, Matthew Yglesias wrote this:

My personal feeling, the longer I spend in DC and working in the political domain, is that I get better and better at understanding other people’s ideologies. I also feel that people writing about politics often caricature opponents’ views as part of a rhetorical strategy. But I’ve been back-and-forth on the main issues long enough that I’m pretty sure I could switch this blog’s point of view and do a credible job of offering critiques-from-the-right of the progressive liberal health reform movement and the progressive liberal approach to domestic policy generally. One happy consequence of this is that I find the stubborn persistence of principled disagreement less mystifying than I once did, and have a greater appreciation for what I now think of as a certain irreducibly Kierkegaardian element to ideological commitment that, in turn, helps explain why so many “normal” people have such fuzzy political views.

The words I placed in bold are important to remember while reading an entry Mr. Yglesias posted¹ yesterday:

There’s lots of great stuff in this Ed Pilkington story about the dark side of free market health care (via Tomasky) but my favorite bit was this part:

Eventually his lack of motor control interfered with his work to the degree that he was forced to give up his practice. He fell instantly into a catch 22 that he had earlier seen entrap many of his own patients: no work, no health insurance, no treatment.

He remained uninsured and largely untreated for his progressively severe condition for the following 11 years. Blood tests that could have diagnosed him correctly were not done because he couldn’t afford the $200. Having lost his practice, he lost his mansion on the hill and now lives in a one-bedroom apartment in the suburbs. His Porsches have made way for bangers. Many times this erstwhile pillar of the medical establishment had to go without food in order to pay for basic medicines.

This is the kind of thing that makes it so hard for me to take seriously the idea that we can’t have the government give people health care because it might subject them to “rationing.” Depending on the details, it may or may not be correct to believe that any particular government program is being too stingy. But how does giving people nothing at all resolve that problem?

There are two issues here, closely related to Mr. Yglesias' entry from last week linked above. The initial problem is glaring but only if you follow the link to the Ed Pilkington story. You wouldn't know this from his excerpt, but the paragraph continues (emphasis mine):

He remained uninsured and largely untreated for his progressively severe condition for the following 11 years. Blood tests that could have diagnosed him correctly were not done because he couldn't afford the $200. Having lost his practice, he lost his mansion on the hill and now lives in a one-bedroom apartment in the suburbs. His Porsches have made way for bangers. Many times this erstwhile pillar of the medical establishment had to go without food in order to pay for basic medicines. In 2000 Manley finally found the help he needed, at a clinic in Kansas City that acts as a rare safety net for uninsured people. He was swiftly diagnosed with Huntington's disease, a degenerative genetic illness, and now receives regular medical attention through the clinic.

Mr. Yglesias' excerpt is an incomplete representation of the complex facts, presumably to make the point - a caricature, if you will - that the free market has failed. But has it really failed?

Mr. Manley probably should've saved his money for potential later-life crises rather than buying a new Porsche every year, as the article states he did when his practice was strong. That is a relevant point, but it's little more than a distraction to the real issue underlying Mr. Yglesias' belief that everyone has an obligation to pay for everyone's care, especially where the free market (allegedly) fails. Regardless, we have the system we have, not the one either side wishes. It shouldn't have taken so long for Mr. Manley to receive the care he needed. Stating this needn't be considered a concession or profound.

What Mr. Pilkington, and subsequently Mr. Yglesias, failed to explore is the care that Mr. Manley eventually received.

[Dr. Sharon] Lee's clinic, Family Health Care, is a refuge of last resort. It picks up the pieces of lives left shattered by a health system that has failed them, and tries to glue them back together. It exists largely outside the parameters of formal health provision, raising funds through donations and paying all its 50 staff – Lee included – a flat rate of just $12 an hour.

Unlike Mr. Yglesias, I researched Family Health Care. It took approximately 10 minutes. Mr. Manley is getting care thanks to the "dark side of the free market." Consider the clinic's financial profile for 2005-2007:

The clinic receives 0% of its funding from government, meaning that the remaining 100% of its budget comes from the bank accounts of individuals, corporations, and non-profit organizations. Where is the free market failure to provide health care to those in need?

The structure of the American health care and insurance system is idiotic and needs reform. We should talk about that. The article even includes anecdotal stories to suggest problems that need to be addressed within the views of each side's extremes. But presumably that wouldn't have made the point for Mr. Pilkington or Mr. Yglesias that government needs to step in to protect the poor from the free market's alleged failures, which are, we are told, ignored by the mean-spirited right-wing capitalist liars opposed to President Obama's proposal. A neat, tidy box, indeed. That reaches closer to ideological commitment - propaganda, if you will - than journalism.

Update: I've struck the reference to propaganda. This isn't that. Rather, Mr. Yglesias' ideological commitment is more likely laziness embracing the appearance of victory.

¹ Normally I refuse to reprint an entire entry because links are survival. In this case, I can think of no other way to make my points.

Comments

Wait a minute - things got SO bad that he had to quit his practice and at no time prior to that point he thought maybe a blood test would tell him what was wrong?

Or that selling his Porsche might pay for the blood test before things got so bad he was destitute?

How does this story even pass the smell test?

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