Monday, April 29, 2013

Seize the Moment 4

I finished Richard Nixon's 1992 book, Seize the Moment: America's Challenge in a One-Superpower World.  In this post, I'll comment on three quotes from the book.

1.  On page 290, Nixon says the following about entitlements:

"Today, we are witnessing the rise of that new despotism under the cover of 'entitlements.'  We hear claims that by virtue of living in the United States, a person is 'entitled' not only to subsistence amounts of food, clothing, and health care, but to more and more of the amenities of life as well.  It is not just the poor who seek these entitlements.  Farmers who demand a guaranteed price for their crops, steelmakers who demand tariffs to protect their market share, retirees who demand Social Security payments far exceeding their contributions into the system, students who claim a right to subsidized loans, and dozens of other special interests all seek a guaranteed place at the federal trough.  Today, if entitlements continue to proliferate, we risk the demise of the virtues of self-reliance and individual responsibility and the triumph of the new despotism about which Tocqueville warned."

I'm all for individual responsibility, but self-reliance?  How can people rely on themselves when they cannot afford a college education or health care simply because they don't make enough money, even after working long hours?  (I agree with Nixon that not everyone needs to go to college and that apprenticeships are good for the non-college bound, but I think that more people than the rich should be able to attend college.)  What about the elderly, particularly those who are no longer able to work? 

2.  In a similar vein, Nixon says on pages 296-297:

"The threat of having to do without is central to a productive economy.  Some people work because they want to, but most people work because they have to.  If you eliminate the necessity, you remove the motivation.  Even worse, you introduce a spiritual rot that eats at the foundation of society itself.  Those who do work resent those who do not, and they also resent the system that rewards the lazy with leisure.  Seeing the lazy rip off the system and get away with it, they are tempted to rip it off in their own ways.  Society as a whole goes on a downward spiral of alienation and irresponsibility, which in turn fosters hostility, resentment, and even revenge."

Although I have issues with a system that makes people's very survival so insecure, I agree with Nixon that people should work.  Politicians on the left and the right have suggested that there be training programs for people with disabilities.  That, in my opinion, is not only a good idea, but it's an important idea.

But I also think that some welfare programs should be universal, such as Medicare.  That way, one group of people is not resenting another group because it gets health care benefits, for everyone is a beneficiary.  On the other hand, come to think of it, one group could resent another if the one group is contributing a lot to the system, while the other group is merely receiving.  Countries that pay for their health care with a Value-Added Tax (a tax that Nixon supports) may not have this problem as much, for everyone who buys something is contributing to the system.  The problem, though, is that the VAT is arguably regressive. 

3.  On page 294, Nixon touches on health care reform:

"...we have made a mistake in addressing issues such as the exploding costs of health care in ways that removed market forces from the equation.  We have erred by separating health care consumers from any concern about the costs of the care being provided.  We need to work out a system that includes a greater emphasis on preventive care, sufficient public funding for health insurance for those who cannot afford it in the private sector, competition among both health care providers and health insurance providers to keep down the costs of both, and decoupling the cost of health care from the cost of adding workers to the payroll."

I agree with a lot of what Nixon says here: preventive care, a public health care program for the needy (though I'm open to this public program being open to everyone), and detaching the cost of health care from the cost of employing people.  In my opinion, the third goal is a good reason to accept a national health care system or a public option: companies can then hire people and employ them full-time without worrying about the cost of health insurance, for the government would be taking care of that.

On competition, that's something both political parties claim to support.  Even defenders of Obamacare have maintained that competition will bring the cost of health care and health insurance down!  I hope that it would.  Personally, I think that certain monopolies should be broken up----for example, insurance companies should not have virtual monopolies in states.  But I have a hard time seeing competition as the end-all-be-all.  For one, people in emergency medical situations don't always know enough to weigh their options----plus they have to make a decision really fast.  Second, I read one critique of the pro-competition argument that said that it's not as if you can market some of this medical equipment on e-bay, allowing people to search for the equipment at a low price!  Something that does bring down costs in other countries is for the government to negotiate prices with the health-care providers.  

2 comments:

  1. A University of the Third Age group on philosophy has started up near me recently, and we are looking at the Harvard Videos on (Social) Justice with Michael Sandel. He is critical of the Libertarians (and Utilitarians), and is more of a Communitarian. It's very good to see the likes of him having some influence in America (or does he?). I suppose you have come across him?

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  2. The name sounds familiar. I did a search on him, and he looks like someone with interesting thoughts.

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