First, the people who are most against it least need it. Usually they are columnists of the political right and the people who read them. Columnists without exception are of intelligence above the average, as are almost all of their readers. With few if any exceptions, they are well educated. Consequently they tend to be prosperous, savvy, and very likely to have good insurance.
They also have little or, more likely, no real contact with anyone who might need socialized medicine. For example in Washington, which I know well, the klaxons of left and right berate each other from the cocktail parties of Georgetown and Cap Hill, eat in posh restaurants, and vacation in the Greek Isles. They do not know the people of the truck stops and gas stations.
Second, opponents of socialized medicine seem to think that such a system would be subject to exploitation by grifters and scam artists. They are right. Note that the grifters would not be people receiving care, but Republican doctors who would pad their bills and otherwise skim off unwatched cream. We are all against corruption until it is our turn at the trough. Note also that a woman with a broken leg does not pretend to have two broken legs so as to get an extra cast.
It seems to me that the underlying question is not that of socialized medicine but rather: What is our attitude as a nation toward people who are not very smart? Who furthermore are culturally impoverished? Who are among the substantial fraction of Americans who can barely read?
They exist in large numbers. Half the white population have IQs below 100. The proportion among various non-white groups is much higher. Throw in legal aliens with fourth-grade educations and little command of English, and people in small towns where the idea of going to college is only slightly stranger than that of going to Mars.
Few of them are welfare cheats. Usually they have worked hard all their lives. Often they vote Republican. They are just…”stupid” is unkind but perhaps best conveys their condition, though some of the apparent stupidity is in fact ignorance. They can’t balance a checkbook, must less understand rollovers on a 401(k). They don’t understand what 18% interest on a credit card means, and can’t read, much less understand, a contract. (“The party of the first part, hereinafter….”) They aren’t smart enough to be entrepreneurs. Very likely, they have never read a book in their lives.
Try to imagine never having read a book. You can’t do it.
Word-crafters of my acquaintance rail against Hillary for supporting socialized medicine. They seem to think that the beneficiaries of the program would be people like themselves, only shiftless. “I studied and worked my way up and made something of myself, and I take care of myself. Why don’t these lazy bastards to the same?” Easy. Because these of my friends have IQs averaging in excess of 140, while the lazy bastards (who in fact are neither) check in at maybe 90.
I often hear it said that people should be able to invest as they think best the payments they make into Social Security. Of course what is really going on is an attempt by stock funds to get their hands on lots of other people’s money. Still, the argument is made that freedom and free enterprise demand that government not take, etc. “It’s our money. Let us invest it.” This ignores the fact that over half the population is absolutely, irremediably, hermetically incapable of investing intelligently.
Now, what do we do with people who have obeyed all the fabled American rules, who have worked, perhaps at pathetic wages and no benefits, and never cheated, and been honest citizens, and then the bottling plant went to China and they’re old and have nothing? What?
We could be good social Darwinists and let them rot. They are not cutting edge people, not Verilog mechanics or optical engineers or hedge-fund managers. Who needs them? All right. If this is your position, say so. Look me in the eye and say, “Screw’em. I don’t care what happens to them and I’m not going to spend a red cent on them.” Say this, and I will understand you.
An obstacle to thought here is that the people in the editorial suites and cocktail parties are twiddlers of abstractions. Waving a shrimp speared on a toothpick, holding a glass of vintage Sobriquet, they speak of second-order supply side multiplier effects of marginal increases in labor costs and what Burke and Adam Smith said. You’ve seen their websites: “Rothman on Kleinfelter.” “Kleinfelter on Fergweiler.” “Fergweiler on Theftwunkel.” Intellectual sparring is their world.
It’s different to Mary Sal Wooten in a decaying trailer somewhere on 301 South, with her retinas peeling like wallpaper from diabetic retinopathy, ankles swollen and darkening toward gangrene, and the hospital won’t take her because it isn’t an emergency and she can’t afford her medicine. Really, truly no-shit can’t afford it.
What do we do with people like her? People who just flat can’t handle the complexity of today’s world? It seems to me that anyone who wants to think about socialized medicine has to answer that question before starting.
When I was a kid in King George Country, Virginia, the answer commonly was the federal government. Dahlgren Naval Proving Grounds was there. It hired a lot of the local country kids, rednecks as we now say, as gate guards, truck drivers, maintenance workers, and so on. These jobs legitimately needed doing, and those hired did them well. The jobs carried benefits and pensions. But the private sector won’t if it can avoid it.
What other solutions are available? Many say, “It’s a job for private charity.” This is another way of saying, “Screw’em, I ain’t paying a cent.” Yet others say cut taxes and the resulting economic boom will lift all boats. This is another way of saying, “Screw’em, I ain’t paying a cent.”
But let’s at least have the dignity to say what we mean. The truth is that large numbers of people cannot take care of themselves beyond showing up at work every day and spinning lug nuts on the assembly line. They aren’t going to invest wisely from youth because they aren’t smart enough. Employers aren’t going to provide retirements unless forced to. Hospitals won’t take them if they can avoid it. Do we say, “Screw’em, let’em croak”? Apparently. Then let’s say so plainly.
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