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A Bit More on Madness

I actually thought Will Wilkinson's takedown of me was going to be a bit more pointed than it was, given that I misspoke significantly this morning. Instead he spins off to promote an old paper he wrote on Social Security privatization. For all that, Will, and many of my commenters, were right that it's silly to say "there is no evidence for [the] claim" that the government is capable of madness. Iraq, the World War II internment camps and much else provide plenty of evidence for occasional bouts of madness.

But as I said in the next sentence, and meant more broadly, there's no evidence for madness in government health-care systems. Medicare does not have death panels. Medicaid does not promote euthanasia. Dozens of other countries have universal health-care systems, and none of them approaches the health of its citizenry with a tenth the cruelty and capriciousness on exhibit in our system.

Indeed, if any of them made a conscious decision to let 20,000 of their citizens die because the government judged them too poor to deserve health-care insurance and then made a further decisions to force millions of families into bankruptcy because a loved one got sick and cost the state money, that would be an excellent example that nations can indeed lose their minds and do terrible things. But that describes a single year in our system, not in theirs. And we escape judgment because we haven't made a decision to kill those people or rip through their savings. We have simply made a decision not to stop it from happening.

As for the question of democracy, here's my point, stated more clearly: Whether you believe our government capable of staffing death panels, only a loon would survey members of this Congress and think that they were actually building such things into the legislation. This is a bunch that's scared to create a public option, or tax health benefits worth more than $15,000. But they're going to vote for death panels?

Members of Congress are elected -- and, every two years, judged -- by the voters. Those voters may agree with you on the public plan or disagree with you on the public plan, but when we begin to imagine them capable of sanctioning a committee that will execute your child, we're hitting a pitch of polarization, and an absence of faith in your fellow citizens, that's decidedly scary.

By Ezra Klein  |  August 11, 2009; 4:06 PM ET
Categories:  Health Reform  
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Comments

is there anyone who doesnt find these times to be ominous and scary?
when voices of reason are drowned out and irrational, angry forces prevail in times of economic instability, it is a cause for great concern.
when people like rush limbaugh and sarah palin become the legitimized and empowering face of a political movement, and the mainstream media sensationalizes and inflames all coherent discussion beyond recognition, it begins to look like a bad genie has been let out of a bottle.

Posted by: jkaren | August 11, 2009 4:28 PM | Report abuse

"But as I said in the next sentence, and meant more broadly, there's no evidence for madness in government health-care systems."

The Tuskegee Syphilis Experiment is clear evidence that evil is possible in government healthcare systems.

Posted by: D12482 | August 11, 2009 4:31 PM | Report abuse

"And we escape judgment because we haven't made a decision to kill those people or rip through their savings."

This permeates much of conservative "logic" when it comes to death. They will raise an uproar against abortion but don't care at all about deaths of both the born and unborn that are the result of lack of access to affordable healthcare. So long as the causation is sufficiently phychologically removed from them personally, they don't care.

Posted by: bluegrass1 | August 11, 2009 4:39 PM | Report abuse

The other logical gap (not that anyone accused the teabaggers of an excess of logic) is the belief that the only thing keeping Obama and the feds from implementing Death Panels is a piece of legislation. Seriously, Obama really wants to kill Granny, but he's not gonna do it unless a piece of paper says he can? That's some mighty faith in the laws and due process.

Posted by: _SP_ | August 11, 2009 4:42 PM | Report abuse

Thank you for putting your finger on the creepiest part of this! I'm going to a healthcare town hall later today and I expect to be in the company of furious people who casually believe that I personally support the slaughter of the old and disabled. They'll look at me and believe that. And that's a lot scarier than a political fight.

Posted by: qalice1 | August 11, 2009 4:50 PM | Report abuse

Okay, behind the scare tactics here's why the GOP and their corporate allies don't want the public option.
In today's NYT:
http://www.nytimes.com/2009/08/12/health/policy/12insure.html?_r=1&hp

Posted by: cmpnwtr | August 11, 2009 4:55 PM | Report abuse

I think many of the supporters of the Democrats' health reform plans, Ezra included, fixate on rebutting the euthanasia charge to avoid talking about the elephant in the room - the high cost of the plans and the unpalatable alternatives for paying for them.

It's clear the Democratic leadership has decided the best way to address criticism of their plans is to demonize health insurers - that old chestnut - and suggest, improbably, that their opponents are all in the insurers' pay or dupes.

Obama's not acting at all like the post-partisan president he promised to be. Far from raising the quality of the debate he's fueling the partisan rancor. He's impugning the motives of his critics on a daily basis and calling on his proxies (e.g. Organizing for America) to fight fire with fire.

Posted by: tbass1 | August 11, 2009 5:10 PM | Report abuse

"But as I said in the next sentence, and meant more broadly, there's no evidence for madness in government health-care systems."

Abortion-related gag rules?
Abstinence-only requirements in AIDS funding?
Stem-cell research restrictions?

Posted by: tomtildrum | August 11, 2009 5:20 PM | Report abuse

I think many of the supporters of the Democrats' health reform plans, Ezra included, fixate on rebutting the euthanasia charge to avoid talking about the elephant in the room

Pardon me, but this is ludicrous. There are hyperventilating, ignorant people saying insane things at these town halls, bringing guns to "make a point", threatening congressmen and painting swastikas on public property, all over a bit of healthcare policy that Thatcher would consider too stingy. And you want to say that the Democrats are "focused" on this? I would absolutely friggin love for all of this mayhem to be laughed at and dismissed immediately if we could get on with the real nuts and bolts of this, and I am pretty sure that I am not the only person that feels this way.

Posted by: fishermansblues | August 11, 2009 5:39 PM | Report abuse

The takedown of you should have been on grounds other than that government has, indeed, been capable of acts of madness. Rather, it should have been for anthropomorphizing the relationship between citizen and government. It is not the same as a healthy one between spouses, or even friends. The founders never spoke of trust or "healthy" relationships. They always thought there needed to be all kinds of institutional checks. They foresaw the possibility that public servants could be seen, or could in fact be, failing to serve those who elected them, and this wasn't the end of the world. It's not like a breakup, a divorce, or even the end of a friendship. It's just not that bad. Let upcoming elections decide. In the meantime, can we have more civics education in the public schools?

Posted by: truck1 | August 11, 2009 7:34 PM | Report abuse

fishermansblues -

"Pardon me, but this is ludicrous. There are hyperventilating, ignorant people saying insane things..."

On both sides. I've generaly learned about the opponent's over-the-top claims from hearing supporters' repeated rebuttals. Methinks they doth protest too much.

"..at these town halls, bringing guns to "make a point", threatening congressmen and painting swastikas..."

I don't think disruptive behavior has been either respresentative of or exclusive to the opponents of the Dems' reform plans.

"... and I am pretty sure that I am not the only person that feels this way."

Believe me, your not. But, as I said in my ealier post, I'm unimpressed by the President's efforts to raise the level of discourse. I think he and his party's leadership have concluded they'd rather this fight be whether Americans hate insurance companies than the merits of their reform plans. Given the choice, he took the low road. That shouldn't be surprising unless one really believed Obama when he talked about being a different kind of "post-partisan" leader - or expected more from him than, say, a talk radio host. He's turned out to be an all-too conventional pol, IMO.

Posted by: tbass1 | August 11, 2009 8:18 PM | Report abuse

I'm trying to wrap my head around "millions of families forced into bankruptcy every year," and I just can't make the numbers work. Citation, please?

Posted by: tnac1 | August 12, 2009 1:38 AM | Report abuse

Government (and people in general) are capable of long term madness by creating programs that benefit constituents and people in the short term but that are unsustainable and can't be paid for in the long term.

Posted by: staticvars | August 12, 2009 8:53 AM | Report abuse

"Whether you believe our government capable of staffing death panels, only a loon would survey members of this Congress and think that they were actually building such things into the legislation. This is a bunch that's scared to create a public option, or tax health benefits worth more than $15,000. But they're going to vote for death panels?"

The majority of them DON'T EVEN KNOW what's in those 1,000+ pages of legislation that they're voting for! And even the Congressmen and Senators who are highly involved and do actually know and understand what's in the legislation they're voting on can't control the ways in which the legislation is interperted and implemented by the various agencies that will actually do the work - and, as Ezra knows (or at least should), that's done deliberately.

And unlike the members of Congress, the ones who will actually be putting the bill into practice aren't up for election, or even evaluation by the public who will be subject to their actions.

Which is, in itself, a form of madness.

Posted by: starkllr | August 12, 2009 9:22 AM | Report abuse

"Bernard Madoff used a random-number generator, old stationery, a “phantom” trading platform and an aging computer to hide for decades the world's biggest Ponzi scheme." Stay out of the gutter. It's full and getting fuller. Fools are still always fools. Wapo numbers look up and that's not random-number-generation. I have an aging computer, but it's paid for. Now we are going from the SEC to the new HEC so they can save lives with big fed programming. Whatever. Drink Drano for all I care.

Posted by: Dermitt | August 12, 2009 9:45 AM | Report abuse

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