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America’s Defining Choice: Endless War or Healthcare?
President Obama and Congress will soon make defining choices about health care and troops for Afghanistan.
These two choices have something in common - each has a bill of around $100 billion per year. So one question is whether we're better off spending that money blowing up things in Helmand Province or building up things in America.
The total bill in Afghanistan has been running around $1 million per year per soldier deployed there. That doesn't include the long-term costs that will be incurred in coming decades - such as disability benefits, or up to $5 million to provide round-the-clock nursing care indefinitely for a single soldier who suffers brain injuries.
So if President Obama dispatches another 30,000 or 40,000 troops, on top of the 68,000 already there, that would bring the total annual bill for our military presence there to perhaps $100 billion - or more. And we haven't even come to the human costs.
As for health care reforms, the 10-year cost suggests an average of $80 billion to $110 billion per year, depending on what the final bill looks like.
Granted, the health care costs will continue indefinitely, while the United States cannot sustain 100,000 troops in Afghanistan for many years. On the other hand, the health care legislation pays for itself, according to the Congressional Budget Office, while the deployment in Afghanistan is unfinanced and will raise our budget deficits and undermine our long-term economic security.
So doesn't it seem odd to hear hawks say that health reform is fiscally irresponsible, while in the next breath they cheer a larger deployment of troops in Afghanistan?
Meanwhile, lack of health insurance kills about 45,000 Americans a year, according to a Harvard study released in September. So which is the greater danger to our homeland security, the Taliban or our dysfunctional insurance system?
Who are these Americans who die for lack of insurance? Dr. Linda Harris, an ob-gyn in Oregon tells of Sue, a 31-year-old patient of hers. Sue was a single mom who worked hard - sometimes two jobs at once - to ensure that her beloved daughter would enjoy a better life.
Sue's jobs never provided health insurance, and Sue felt she couldn't afford to splurge on herself to get gynecological checkups. For more than a dozen years, she never had a Pap smear, although one is recommended annually. Even when Sue began bleeding and suffering abdominal pain, she was reluctant to see a doctor because she didn't know how she would pay the bills.
Finally, Sue sought help from a hospital emergency room, and then from the low-cost public clinic where Dr. Harris works. Dr. Harris found that Sue had advanced cervical cancer. Three months later, she died. Her daughter was 13.
"I get teary whenever I think about her," Dr. Harris said. "It was so needless."
Cervical cancer has a long preinvasive stage that can be detected with Pap smears, and then effectively treated with relatively minor procedures, Dr. Harris said.
"People talk about waiting lines in Canada," Dr. Harris added. "I say, well, at least they have a line to wait in."
Based on the numbers from the Harvard study, a person like Sue dies as a consequence of lack of health care coverage every 12 minutes in America. As many people die every three weeks from lack of health insurance as were killed in the 9/11 attacks.
Health coverage is becoming steadily more precarious as companies try to cut costs and insurance companies boost profits by denying claims and canceling coverage of people who get sick. I grew up on a farm in Yamhill, Ore., where we sometimes had greased pig contests. I'm not sure which is harder: getting a good grip on a greased hog or wrestling with an insurance company trying to avoid paying a claim it should.
Joe Lieberman, a pivotal vote in the Senate, says he recognizes that there are problems and would like reform, but he denounces "another government health insurance entitlement, the government going into the health insurance business." Look out - it sounds as if Mr. Lieberman is planning to ax Medicare.
The health reform legislation in Congress is imperfect, of course. It won't do enough to hold down costs; it may restrict access even to private insurance coverage for abortion services; it won't do enough to address public health or unhealthy lifestyles.
Likewise, troop deployment plans in Afghanistan are imperfect. Some experts think more troops will help. Others think they will foster a nationalist backlash and feed the insurgency (that's my view).
So where's the best place to spend $100 billion a year? Is it on patrols in Helmand? Or is it to refurbish our health care system so that people like Sue don't die unnecessarily every 12 minutes?
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40 Comments so far
Show AllHow many guesses do we get?
To the author's allegation that healthcare costs go on forever but the US can't sustain troops in Ir-Af-Pak forever I ask...why not????
As long as Obama and his successors are owned by the military industrial media complex, war money will be borrowed and when no more lenders can be found, funding for domestic things that the working class rely upon (in addition to healthcare) will be diverted to the military industrial media complex and taxes on the working class will be increased. That is how other third world countries operate.
The author must have slept through the 7th grade history class where they addressed the Athenians and the Spartans.
No. Ever hear of the rhetorical question?
Socrates made it popular.
Hugo Penteado characterizes the economic model/dominant economists as virtually "autistic":
– It is a vision in which the economy is considered a super-system, the planet is considered a sub-system, equivalent to a vision that humanity already held in the past that the Earth was the center of the universe, and that the sun rotated around it. Today, the economists have a vision that the planet rotates around the economy, and that the economy is the center of the universe. In reality, the planet is the greater system, it dictates the rules. -
Interdisciplinarity might be a good thing eh?
Economics exists in a bubble - hence we get bubbles - used to be that was a derogatory term for an air headed hedonist...guess it still fits.
There is of course no question that we should spend $100 billion on healthcare as opposed to war and destruction, if forced to make that decision. But Kristof's question is classic Washington-think, or major newspaper think. Reality poses this question: Would we prefer the status quo, or cheaper and better healthcare while also slashing the military budget?
We're not getting much of anything we want from the military budget, so it is essentially a very toxic financial waste, at least $400 billion wasted per year.
We're also not getting very good results from medical dollars, not because we don't inject enough dollars into that industry, but because so much cash ends up in the pharmaceutical and insurance industries, just to name one big problem. There is also large financial waste in treating anyone who comes to the emergency room while basically denying 40 million people routine physicians visits, mammograms, etc. So things that can be handled for $100 a year end up costing tens of thousands of dollars as they're treated in an advanced stage.
Saying we need to spend more on healthcare is like saying it'll cost us to cut carbon and address global warming. In reality, companies that are aggressively cutting carbon, and doing this wisely, are saving billions per year, because energy costs money. This is where liberalism is so vulnerable to conservative criticism, because while the conservatives tend to run up even bigger deficits, the liberals can't look at a problem without spending more money, and it's valid to say they love spending over solutions.
Societies are still highly irrational, and we will tend to see federal budgets fall if we actually solve our problems, though sometimes there is a short period of extra investment, just as a restaurant buys $50 worth of CFLs to cut its lighting bill $200 annually. The medical system is so far off course that any extra expenditures will tend to be paid off within a year through big savings.
In comparing our health insurance system to the Taliban, Kristof poses a more useful question. Which causes more deaths?
Jim Shackelofrd
Some sanity from the NYT.
Will this be the metaphorical slap in the face to Americans to get them back to reality, to stop the suffering of Americans, to stop wasting money on endless war.
I hope so.
First you'd have to have a government that had decided to refurbish our health care system instead of the current effort to increase profits and taxes.....STILL leaving the same number of people uncovered.
BS is BS....no matter which side is issuing it to their eager consumers.
I say that this is the kind of poor writing that will turn off moderates and independents who make up the most number of voters. The sympathy for sue is needed but we must go beyond playing the sad stories and make others care. There is a better way to reframe this war vs health care issue so that moderates and independents will like it and progressives can win.
The first thing that must happen is dropping this "proud leftist" outrage and paying attention to reality. Does it not occur to some that one side is sounding exactly like the other?
Next, we now come to the crucial part, putting these two issues in moderate terms. What is single payer? Single payer means government pays for your basic health care coverage so that insurance companies cannot rip you off by pretending competition and then jacking up the prices for even basic care. At some point, one draws the line and turns to supplemental coverage. In essence, people save money in terms of both taxes and insurance fees. Since this will appeal to both moderate liberals and moderate conservatives, that is why single payer is really a moderate position. Single payer advocates need to get their campaigning and framing correct by showing that it is the true compromise while anything else isn't. Now we turn to the issue of war. War spending is not a truly moderate position. Defense spending should be seriously limited to protecting the homeland rather than venturing into endless wars. That is what moderate independents want to see. To redefine the center is to win. To allow your opponents to define the "center" for you to follow is to lose.
I think if you asked the average Tea Bagger if they would like to have Medicare instead of endless war, they would have to think a while at least but if you said, "war or Single Payer?" they would choose war because socialism is their "Boogy Man" but they stand out there with signs "Hands off my Medicare".
Calling anything single payer is a semantic trap and use of language is not Progressive's strong point.
Classic example of False Dilemma, as neatly summed up in the headline. Don't they teach Logical Fallacies in journalism school?
http://en.wikipedia.org/wiki/False_dilemma
To oppose false dilemma, one could say that it is possible to moderate the war spending and limit it to homeland defense. That would make room for a moderated health care reform called single payer to cut down insurance premiums and save the taxpayers. I don't think that most people here want any spending related to defense or war just like the conservative sites don't support government putting taxpayer funds towards providing basic health care coverage for everyone.
"one could say that it is possible to moderate the war spending and limit it to homeland defense. That would make room for a moderated health care reform called single payer to cut down insurance premiums and save the taxpayers. "
Thank you for your response. But there are other ways to "make room" as you say, and nothing prevents congress from increasing the debt cieling or the fed to print more money. Indeed, it is entirely possible for Congress to end up fully funding both options, in spite of the false choice between the two as presented by the author. The point is that this "journalist" should know that the two subjects, Afghanistan and Health Care Reform should be argued on their own merits and not arbitrarily linked together.
Bull.
They are not arbitrarily linked. This is the central question of our time - what is the appropriate use of government funds. Continuing a pointless, endless war when Americans are dying by the hundreds of thousands by denying them health care is immoral and unAmerican (it's not part of my America and how I want my taxes used).
EVERY other advanced economy on this PLANET has a form of heavily regulated or single payer health insurance. Why should Americans suffer from denied health care when Obama can change this my simply a signing a piece of paper.
Jake, you need to change your perspective.
Did you read the article I posted? Here are the simplified possibilities:
Spend Money on both Health Care Reform or Afghanistan.
Don't spend Money on either Health Care Reform or Afghanistan.
Spend money on Health Care Reform but not Afghanistan.
Spend money on Afghanistan but not Health Care Reform.
The simplified False Dilemma presented by the author allows a situation where only one of the last two are possible, but in fact either of the first two are also possible. This should be obvious. Since any of the four outcomes are possible, the link between the two is arbitrary.
Now here's the important part: The two issues must each be considered on their own merits, and not arbitrarily linked together.
"you need to change your perspective."
Right back at you. Read the article I posted, and study more on "False Dilemma".
Your logic is impeccable, your politics wanting.
I view the author's dichotomy as a political metaphor for the choices Americans need to make.
You keep hearing from Congress and the MSM that a government plan for health care is too expensive and that Medicare is about to go broke. Dennis Kucinich recently issued a news release, "Why is it we have Finite Resources for Health Care but Unlimited Money for War?" And it's in this light that I read this article.
It's a good question that needs to be debated. I believe that seeing "false dilemmas," although valid, somehow misses the point.
"Your logic is impeccable,"
Thank you *blush*
"your politics wanting."
My point transcends politics. We might expect an essay from the right reversing the discussion 180 degrees, lamenting how we can spend so much on a massive health care bill when we need to be fighting terrorists in Afghanistan. I would accuse the author of such an essay of the exact same thing.
"I view the author's dichotomy as a political metaphor for the choices Americans need to make."
That's OK by me, as long as you understand that we don't have to choose between the two, as with the Boolean Exclusive Or, we can also go with Both or Neither.
"Unlimited Money for War?"
The limit comes from political support, which seems to be waning.
"It's a good question that needs to be debated. I believe that seeing "false dilemmas," although valid, somehow misses the point."
You are entitled to that and it's a reasonable position, but I think it's sloppy journalism that muddies the waters. Why not concentrate on making the case for each thing, one at a time? Is spending on the "war" in Afghanistan bad for the US? Than don't spend on that because it's bad for the US. That's all the reason you need, once you make a good case. Linking to other issues detracts from whatever case there is that it really is bad for the US.
phasor, jake isn't giving an opinion on war or healthcare. He was giving the technicals of spending and all the possibilities. I share both the author's and your sentiments on the double standard spending mentality. Saying there is no money to spend on health care reform but then spending endlessly on wars is certainly not good government representation. The funding for endless war spending is coming from borrowing from China. It is possible that China put a stipulation on how to spend endlessly but we're screwed regardless but that's just my guess.
To clarify: The Opportunity Cost usually associated when you or I spend a dollar or an hour on something doesn't apply to the US government, as long as they can raise taxes, sell bonds or print money. And even if it somehow did, they should focus on the individual projects and programs on their own merit.
I can confirm that is true having worked with companies contracting to different government agencies and departments. One thing I learned from government's spending ways is they use politics to help them judge the merit of spending on specific projects and programs. You would be amazed that even the Pentagon doesn't always want to spend so much despite the politicians giving them the money while some other departments such as Interior and Energy could use some more funding. The trouble is even those running the Pentagon will be replaced by the politicians for not spending what's given to them. Big monied lobbyists also have control via their connected politicians on controlling how money is spent.
I am quite sure what you say is true. The thing is that the bills passed by Congress have a *price* tag that can be more or less easily discerned. But "price" is not "cost", and we cannot often determine the true cost of what the government does until way after the fact.
"This is the central question of our time - what is the appropriate use of government funds. "
We agree here, just so you know, but for each possible area where you might apply funding that funding should be considered on it's own merits.
You are wrong Jake, your argument is totally sophomoric because printing more money is a worse option.
You also say "Afghanistan and Health Care Reform should be argued on their own merits and not arbitrarily linked together."
Wrong again, it is not arbitrarily linked, since everything is linked including spending, it is a good example of a rhetorical question.
It is about time, the question was posed in an article.
"your argument is totally sophomoric because printing more money is a worse option."
But it is a *fact* that they are constantly increasing the money supply, so that takes care of that. They don't even need a press now, they just increment the balance in certain key bank accounts. They likely just send an email and it happens instantly.
"it is not arbitrarily linked, since everything is linked"
Let me propose a situation where I would agree: A program to attain "energy independence" for the US would have fairly obvious links to a program to limit emissions into the atmosphere, since much energy generation involves burning carbon material which causes emissions. But the link is there because I spelled out the specifics of how the two programs are related. That hasn't been done by the author or anyone else here except through the vague commonality of "spending". But given the fact that they can do one, the other, both, or neither, should tell us there really isn't any link. IOW, you can't just say "everything is related because it involves spending". If there is a true relation, then you need to spell it out specifically.
OK I will spell it out.
F-U-N-G-I-B-L-E
Money is Fungible.
And printing (borrowing more debt) does not cover anything as the writer points out:
"On the other hand, the health care legislation pays for itself, according to the Congressional Budget Office, while the deployment in Afghanistan is unfinanced and will raise our budget deficits and undermine our long-term economic security."
The title of the article says more than your long rant about every possible stupid choice.
You miss the point because the article is about the "defining choice" not sophistry.
Here is the idea not as a rhetorical question but the same message:
"Endless War is expensive and evil, Healthcare is expensive but Good."
But If you still don't get it, that's OK with me.
"Money is Fungible."
Fungibility of money is irrelevant to the fact that congress can choose one, the other, both, or neither. Congress can choose this way with either a fixed money supply or one that has been debased by the fed as continues to happen.
"And printing (borrowing more debt) does not cover anything"
They are two very different things, first off, and second, printing and borrowing *have* been covering every single act of congress requiring funding up to the present point.
And it is a *debatable* point as to whether or not the current bill is deficit neutral.
"You miss the point because the article is about the "defining choice" "
Nonsense, I got the point perfectly. Framing the issue as such is the root of the problem. There is no choice of one vs. the other, period.
"Endless War is expensive and evil, Healthcare is expensive but Good."
An even sloppier expression of the same False Dilemma, this time loaded with additional Logical Fallacy, namely "Begging the Question". There is no historic precedent for an "endless" war, and the presumption that the current "wars" will be "endless" is ridiculous. All wars eventually end. The idea that *government controlled* healthcare is "good" is currently being hotly debated, in case you haven't been paying attention.
The arbitrary linking of two separate issues is designed to jerk on *your* emotional strings, but only muddies the water.
"But If you still don't get it, that's OK with me."
Back at you.
"nothing prevents congress from increasing the debt cieling or the fed to print more money."
You nailed it. When I took finance, not only did I come across that reference in the book but the next sentence said that plenty others wished they had that privilege. State governments cannot raise the debt ceiling though or print endlessly. I wonder if a Constitutional amendment to restrict raising debt ceilings would work. On printing money, Ron Paul is trying to pass a bill to audit the Fed so that endless printing can possibly stop. I hope he can undo the amendment damage that creep Congressman Watt did to that bill. Like Paul, I feel that abolishing the Fed is the best idea towards putting a lid on endless money printing.
Jennifer: I have reservations about going to a gold standard due to it's rigidity and logistical issues in the transition, yet debasing the dollar essentially by sending an email overnight seems like too much risk of abuse. The latter is what we have been doing for some decades now, and there are no other countries doing anything different regarding their monetary policies.
Somewhat related is recent evidence that we have already passed "peak gold", i.e. production is going down even in the face of rising demand. The issue revolves around lower and lower grades of available ore.
I thought Nixon did away with the gold standard. I was thinking of switching to a barter system when currency is a fiat. If other countries are also following the same monetary policies, I wonder what the economic wars would be like. Thanks for bringing up peak gold. That too could make the economic wars as nasty as the resource wars for oil. I think a global economic depression is inevitable. :(
"I thought Nixon did away with the gold standard."
There were some intermediate steps ahead of that.
"I was thinking of switching to a barter system when currency is a fiat."
All currency in the world is fiat. The problem with barter has to do with collecting taxes. :-) Also there is the traditional problem of the coincidence of need. Money is useful that way.
"If other countries are also following the same monetary policies,"
They are in the sense that money isn't backed by anything besides "full faith and credit" as they say in the US.
Remember, taking a mere 10% off the bloated military budget and putting it back into our own infrastructure would allow us to have decent healthcare, decent education, end homelessness and provide for the maintenance long deferred, repairing bridges and highways, etc. Ten lousy percent! Yet, every time we turn around, the Congress gives another two or three hundred billion to the Pentagon and the wars.
A few months ago, some official from the Fed or the Treasury addressed Congress. He said that, to survive, America must learn to practice austerity. Cut back on such frills as Social Security, Medicare, education, etc.
There was no mention of cutting back the military. In fact, within days, the Congress had voted another 300 billion to the warmakers.
The day that Congress votes 300 billion for health care or to help the homeless get their homes back, you can bet that the bill has been massaged until 295 billion of that goes into the pockets of Big Pharma, Big Medi, and big banksters.
"There was no mention of cutting back the military."
I think that is because the military and financial giants ARE the government in this country and have been since after WWII. It's called the national security state, and it is leading us to collapse.
Let's hope so. Best thing that could ever happen to this god-forsaken place!
I got an idea! Let's take $50 million of the $100 billion and have a legitimate inquiry into 9/11. Maybe after we find out who's really responsible for buildings exploding and planes vaporizing we could put the remaining $99,950,000,000 toward Single Payer.
Interesting idea. If 9/11 had been investigated; the real culprits brought to justice, would the bank bailout have occurred? Would the health insurance industry et al, be licking their chops for their wildest dreams coming true and everybody forced to buy their lousy product?
Lieberman: "the government going into the health insurance business." The business of government is war, of course, and without it the economy would be broken totally.
Tough choice ... $100 billion for the MIC or $100 billion for the Insurance/Pharma cabal?
It would be a better philosophical question if there was actual health-care reform involved.
War! War! War! I vote for war, how bout y'all?
Ha! I think America's choice is absolutely irrelevant, that's been proven time and time again. It's only the 1% at the top whose choice counts and war shall make rich, filthy rich so war it is!
well, there has always been a clamor for a proper healthcare raised by the people getting tired of having those wars. the affiliate code review bonus
The United States Government loves war. The weapons makers love war. The banks love war. The people of the United States love war. I don't see the problem.
This country chose CONSTANT WAR 45 yrs ago...the END of poverty FOREVER in this country was IN SIGHT. Lifetime stable employment was on the horizon. YES. FACT. We had the greatest distribution of wealth among white males ever seen in 6000 years of human history. BUT. To end poverty forever, to provide that lifetime stable employment, white America (87% of the population then) had to make an equal starting place for everyone at the table, they had to REJECT the Vietnam Colonial War of Aggression, and they had to let our (nearly) moribund richfilth Oligarchy FINALLY die as a social caste as a direct and intended result of Roosevelt Legacy taxation. To have Democracy in this country the richfilth animals had to go the way of the Dodo, Divine Right of Kings, and Barrow Mounds. Sorry about the Bird.
WHITE AMERICA SAID "NO!!!" with all the snarling psychotic ferocity of humans whose core identity was challenged and threatened. And their core identity was: (White) Male Supremacy; Gender Slavery; Constant War; and Feral Blood Drinking Oligarchy to bind the shitcake together. That's why they wanted the Black people put back "in their place", those uppity mouthy women put back "in their place", and they wanted those anti-war protesters shot down like dogs in the street - and we were. We refer to them as our "Culture Wars" as if it were some polite intellectual inquiry of the past. And nothing consolidates power and wealth into the hands of richfilth animals like WARRRRRRRR. Vietnam gave those animals a ten year infusion of massive wealth. Ever since Johnson/McNightMare escalated to 500,000 troops. The next infusion of wealth came when the animals broke the East Coast Unions in the early 70's and moved their jobs first to the deep south where they never lost their feudal roots (slavery does that to people), and then to the Machiladoras and then the slave pits on the Pacific Rim. That's where your future went, back to slavery....
6000 years of feudal slavery and our people had a chance, had a real clear alternative to the feral bestiality. They had a Free opportunity to say "Yes" to Life, and they tortured it and mangled it and after they turned what was left into gobbets of bloody goo, they scorned it. Try uttering the words, "Human Potentials Movement" among any cross section of adults. Ignore the blank uncomprehending states for a moment, and listen for the sniggers and muttering sarcasm....just an experiment. I might be wrong....
And now White America and their victims stand on the threshold of the 12th century: No health care for ANY of them; No education for ANY of them; No Medicare or SSI for ANY of them; No stable employment for ANY of them; No pensions ANY of them. I invite you to view my comments as overheated purple prose. But before you do that, check out the role Larry Summers played as head of Klinton's emissaries to Russia in '93 and check the life expectancy of Russian males as a direct result of his NeoLib policies. HEEEESSS Baaaak! He's just waiting to dance his steel toe flamenco and he didn't forget the castanets. Our POTUS hasn't yet emptied the entire treasury into the hands of our richfilth animals. Af-Pak escalation as a debt multiplier shouldn't keep Brother Larry for very long. I think he's tying the laces of his dancing shoes while you read this. Yes. It will hurt. Larry thinks human die-back is a good thing.
Peece.