Tag Archives: Health Care Reform

General discussion

Argumentum ad argumenti longinquitatem

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Time is short, folks. We don’t have all day to sit around and listen to arguments and puzzle through scholastic distinctions. Perhaps for this reason, some genius has come up with a new form of refutation:

“your argument is too long; mine is better because it’s shorter”

Here’s a recent version:

 

The length of such bills has been an argument against health care reform since 1993. We talked about this argument (in 2009) here.

I think it’s obvious (is it not?) that the length of our arguings have no direct relation to their quality. It’s not even a pragmatic indicator. Perhaps it even goes the other way. The longer an argument, the more likely it’ll be better (or address your objections!).

Anyhoo. What to call it? Sticking the with the Latinism popular among fallacy theorists: argumentum ad argumenti longinquitatem (argument against the length of an argument). Even the name of the fallacy is long. Get it?

Academics, Plain Bad Arguments

There once was a union maid

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Driving to work at my unionized (no contract at the moment however) government job, I heard a story on NPR about "Cadillac" health care plans and higher wages.  Some unions, you see, have negotiated for themselves some pretty good health benefits.  They did this even though it meant sacrificing higher wages.  They must have done some math somewheres, and figured it's better to have better benefits than higher wages.  One would suppose, in any case, that they did this.  Not NPR, however.  Here is how they framed the story:

RENEE MONTAGNE, host:

The fate of Congresss health care overhaul is unclear after this weeks election of Republican Scott Brown of Massachusetts to the U.S. Senate. One of the major issues thats been holding up the health care bill is how to pay for it. The Senate wants to impose a Cadillac tax. That is a tax on the most expensive health care plans. Executives with gold-plated plans don't like it and neither do labor unions, whose workers have generous plans. But many economists say it could help everyone in the long run. Here are Planet Moneys Chana Joffe-Walt and David Kestenbaum.

DAVID KESTENBAUM: Economists on this issue feel lonely, sad and very misunderstood.

CHANA JOFFE-WALT: Well, yeah, because economists use math and charts to make their arguments. Labor unions use emotion and advertisements featuring sympathetic characters with asthma.

Something tells me there is a chart somewhere in the union argument.  Nonetheless, the interchange that follows is hilarious.  It is a discussion between a union worker and a professor of economics, one who holds an endowed chair.  He, the professor, argues that if AT&T were forced (by the Cadillac tax) to abandon "expensive" health benefits, they would increase wages.  The union maid argued there was no evidence of that particular entailment.  Unable to provide any, the professor changed tactics. 

JOFFE-WALT: And to Valerie, the idea that she should be taxed in the first place is just insulting to her. She has given up wages over the years to get better benefits, great benefits she says she needs.

KESTENBAUM: Steve pauses, and says well, maybe not.

Prof. STEARN: When was the last time you had a medical emergency?

Ms. STANLEY: I went to the ER seven years ago when I broke my arm.

Prof. STEARN: It sounds like you dont need the health benefit plan that you have. On the whole, my guess is youre losing money on your health insurance. You would benefit from having a worse health benefit plan and taking that extra money and getting higher wages.

The sheer dumbness of that argument boggles the mind.  But the amazing thing is that the professor seems not to understand that someone must have done some math and figured generous benefits were better for the workers–even if they weren't necessarily going to have a medical emergency.  Indeed, if one knows anything about family medical costs, incrementally higher wages mean nothing–nothing–in comparison to the costs of one serious (and eventually likely) medical episode.

Ad hominem circumstantial, General discussion, weak man

My distortions are your fault

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There was a time when a young Robert Samuelson insisted that cost should not count if something like an invasion of Iraq was necessary. He wrote:

A possible war with Iraq raises many unknowns, but “can we afford it?” is not one of them. People inevitably ask that question, forgetting that the United States has become so wealthy it can wage war almost with pocket change. A war with Iraq would probably cost less than 1 percent of national income (gross domestic product). Americans have grown accustomed to fighting with little economic upset and sacrifice.

He regretted writing that. Having spent something like a lot of money now on Iraq, one might reasonably ask whether Samuelson should be listened to on matters of cost. I would say not. In any case, so Samuelson makes his argument against health care reform by the well-known device of attacking someone’s motives:

The campaign to pass Obama’s health-care plan has assumed a false, though understandable, cloak of moral superiority. It’s understandable because almost everyone thinks that people in need of essential medical care should get it; ideally, everyone would have health insurance. The pursuit of these worthy goals can easily be projected as a high-minded exercise for the public good.

It’s false for two reasons. First, the country has other goals — including preventing financial crises and minimizing the crushing effects of high deficits or taxes on the economy and younger Americans — that “health-care reform” would jeopardize. And second, the benefits of “reform” are exaggerated. Sure, many Americans would feel less fearful about losing insurance; but there are cheaper ways to limit insecurity. Meanwhile, improvements in health for today’s uninsured would be modest. They already receive substantial medical care. Insurance would help some individuals enormously, but studies find that, on average, gains are moderate. Despite using more health services, people don’t automatically become healthier.

Let me state first that Samuelson isn’t talking here about the specific plan (he does later, but he relies on the Lewin group, an insurance company funded “research” group–so, really, please), he’s talking about the general concept of reform. For anyone with a minimal knowledge of other industrialized nations, who spend at most about half of what he do and get a lot more, this is just an insult. For more on that, see here.

But more basically, Samuelson is doing a bit of straw man–weak man actually–and a bit of ad hominem circumstantial. It’s a weak man because he picks on the weakest of the pro-health reform moral arguments. There are other good moral reasons to support health care reform, and they involve arguments against the very real threat of medical bankruptcy, recision, denial of coverage of pre-existing conditions, and so forth.

The ad hominem accompanies the weak man–so weak are these arguments (which Samuelson has imputed to pro-reform people), that they must rather be dishonest attempts to score political points. Now that’s just a double-wammy. It’s a bit like saying this: “the weak argument I have dishonestly imputed to you is so bad that I question your honesty in making it.”

On the arguments against the specific plan, I’d say Samuelson needs to look beyond anti-reform sources of analysis and information. It’s a fair question whether the current plans being discussed will help, so we ought to have an honest discussion of that. But that perhaps is just hoping for too much.

But let me close by going back to something Samuelson said in defense of his poorly thought-out defense of the Iraq invasion:

But I am certain — now as then — that budget consequences should occupy a minor spot in our debates. It’s not that the costs are unimportant; it’s simply that they’re overshadowed by other considerations that are so much more important. We can pay for whatever’s necessary. If we decide to do less because that’s the most sensible policy, we shouldn’t delude ourselves that any “savings” will rescue us from our long-term budget predicament, which involves the huge costs of federal retirement programs. Just because the war is unpopular doesn’t mean it’s the source of all our problems.

Other considerations that are much more important. Indeed.

David Broder, Plain Bad Arguments, Unqualified Authority

Does David Broder read the Washington Post?

Two short points today. We’re still working out the kinks here.

First, my view is that we ought to redo our health care system. I think this is a matter of national security, much more say than the imaginary weapons of a fictional dictator. People here actually die from lack of adequate health care. Now, since it’s a matter of national security, and since we continue to pay richly for imaginary threats to our national security, we ought to not complain about things that are real. This is why this kind of stuff from David Broder) raises one’s blood pressure:

Acknowledging that “clearly, we need radical reconstructive surgery to make our health-care system effective, affordable and sustainable,” Walker cautioned that “what we should not do is merely tack new programs onto a system that is fundamentally flawed” — and rapidly driving the national budget into ruin.

He proposes a four-part test of fiscal responsibility for any health reform plan: “First, the reform should pay for itself over 10 years. Second, it should not add to deficits beyond 10 years. Third, it should significantly reduce the tens of trillions of dollars in unfunded health promises that we already have. Fourth, it should bend down — not up — the total health-care cost curve as a percentage of” gross domestic product.

If only people had made this argument about Iraq and Afghanistan.

Next point, the Lewin group is an insurance company-funded group. One ought not to cite them as independent and impartial observers. Following directly from the above:

An analysis by the Lewin Group shows that the Energy and Commerce Committee bill that was the basic blueprint for the House measure comes close to meeting the first of those tests and fails the other three, according to Walker, “by a wide margin.”

A separate Lewin Group study of the Finance Committee bill from which Majority Leader Harry Reid is working on the Senate legislation shows it is almost as much of a fiscal failure. It fails the fourth test, falls short on the third, and passes the first two only by assuming that future Congresses will force reductions in reimbursements to doctors and hospitals that lawmakers in the past have refused to impose.

Here is the Washington Post on the Lewin group on 7.23/2009:

Generally left unsaid amid all the citations is that the Lewin Group is wholly owned by UnitedHealth Group, one of the nation’s largest insurers.

Doesn’t Broder read his own paper?