Calvinists, Libertines and the Medicaid Debate

John Calvin — lousy fashion sense, but otherwise misunderstood.

by James A. Bacon

So, we learn from Peter G. in the previous post that conservatives who oppose the willy-nilly expansion of Medicaid in Virginia are either preppies who dress like they just walked off the plantation after giving the darkies a good hard whipping or are hard-right cheapskates with a Calvinist bent. This is essentially the same message of a Washington Post article today, though without the inflammatory rhetoric.

Believe it or not, conservatives are not immune to the sufferings of the poor. Conservatives would like to see poor people enjoy the benefits of health care insurance. But unlike liberals, conservatives are concerned with results. The United States has fought a 60-year war on poverty, but we seem to be the only ones who noticed that poverty won. Liberals, for whom moral posturing and do-goodism appear to be ends in themselves, appear to have missed the fact that the expenditure of trillions of dollars has created a sub-culture of poverty that is even more deeply entrenched and more dependent upon government largess than ever. Of course, many liberals don’t have a problem with dependency — Americans who rely upon government spending are reliable voters for liberal politicians.

But conservatives, as I said, are interested in real-world results and we fret about unintended consequences. We worry what will happen if Virginia expands the number of people dependent upon the government, either through Medicaid or through federally funded health care exchanges. We worry what will happen to them when the federal government can no longer support its monstrous debt and can no longer fulfill its promises. Who will care for the wards and dependents of the leviathan state when federal finances collapse? How will the poor cope when the rug has been pulled out from under them? How much misery will ensue?

Liberals don’t worry about such scenarios because they don’t believe they will happen. To their mind, fears of a fiscal apocalypse are nothing but scare mongering by hard-hearted conservatives who want to dismantle the social safety net. All I can do is remind readers of a few facts. The national debt is $16.5 trillion a year and growing by close to $1 trillion a year. And that’s during a period of record-low interest rates. Should interest rates ever return to their long-term norms of 4% to 5%, interest on the national debt will balloon by some $600 billion a year as the debt rolls over — far more than we can ever cut spending or raise through taxes. If that happens, we will enter a vicious cycle from which we cannot recover.

The only way interest rates won’t rise is if economic growth remains tepid, creating little demand for credit and debt. If that happens, economic growth will fall below the long-term budget forecasts, which means that tax revenues will fall chronically short… and deficits will run higher than projected. And, oh, by the way, none of the long-term budget forecasts allow for the possibility of another recession over the next 10 years, which is patently absurd. Current budget forecasts, as worrisome as they are, are pure fantasy.

To Peter’s mind, the act of committing elementary mathematics constitutes a form of Calvinism. To my mind, the liberal inability to see past the day after tomorrow constitutes spend-thrift libertinism. I believe strongly that within our lifetimes, the moral bankruptcy of welfare state liberalism will be plain for all to see. The only question is whether liberals will be held to account for all the lives they destroyed.

20 Responses to Calvinists, Libertines and the Medicaid Debate

  1. I could not agree more with your analysis. I heard a number of folks voting in 2012 say, “But I’m a teacher, voting for Romney is voting for the Tea Party. They just want to destroy society.”

    Now, I’ll grant you, the Tea Party and I don’t mix. I think while some of its motives may be ok, a majority of its members advocate policies bordering on insanity.

    However, that doesn’t completely discredit fiscal restraint. If the welfare state goes belly up, who is going to pay for the teachers? Who is going to pay for the poor?

    At some point, folks on the left are going to have to wake up to the fact that the war on poverty and all of these social problems can be traced back to a failed public education system. None of these problems is going to get any better until we completely revamp our education system. It’s easy to mock those who say “vouchers” which isn’t a solution in and of itself, BUT….what exactly is the alternative? A public education system that repeatedly fails impoverished children?

  2. I agree. But unfortunately our failure to educate impoverished children, however heinous, it only a part of the ways we’ve failed. As earlier asked on this website, consider what’s happened since Kennedy died. Take a snapshot of poverty then and Poverty today. The money spent. The result.

    How what began as Lyndon Johnson’s War of Poverty destroyed whole generations of those it was designed to lift out of poverty, leaving them instead caught in a vicious cycles of dependency, hopelessness and despair. Check out the number of unwed mothers it created. Check out rates in incarceration. Check out rates of unemployment. Check out rates of disability. Check out poverty of fatherless kids. And, as you suggest, check out education standards of kids in need. Note the corollary between money spend by government against harm it did.

    And all this harm takes us up only until today, during a time our nation was wealthy beyond the wildest imaginations of generations past.

    Does not the past experience teach us that we must try sometime new. Find new ways to solve these problems chronic now for nearly 50 years. Ways that liberate far more people in need from dependence on the government. Ways that give them America’s original promise instead. Ways that give their lives the independence they need to success on their own. Ways that get them standing up on their own two feet so they’re able to build their own success. Only then will our impoverished have the power and the tools to maximize their opportunity for their own success. And only then will we be be able to take care of those remaining whose circumstances demand it.

  3. re: ” But unlike liberals, conservatives are concerned with results.”

    The real world provides universal health care for 1/2 what we provide horribly ineffective health care that costs us big time on our own insurance premiums and again when we hit the hospital.

    what “results” would you be after if not the ones that are in – say Singapore where health care costs are 1/3 of ours and they have longer life expectancy and few infant deaths?

    what more “result” would you want?

    the problem with conservatives these days is that they are all about ideology and not about problem solving.

    they’d rather gridlock govt than compromise. What earthly reason would someone have to reject getting back some of your own tax dollars to provide more cost-effective health care for those that we are going to pay for anyhow?

  4. In a society affected by a global economy, the cost of government is national overhead. While the legal incidence of the costs for government (taxes and fees) are generally imposed on a progressive basis, the economic incidence often falls regressively on those with few marketable skills and lower education. More recently, however, more of the economic incidence is falling higher on the food chain. Look at what has happened to raises and bonuses for those in the middle.

    Second, in the private sector market, most of the economic power has shifted from producers to consumers. Look at how much less of a percentage of income we pay for food, clothes, etc. Also, look at the decline of organized labor in the private sector.

    In the public sector, much of the economic power remains with the producers. Look at the number of administrators added to public schools, colleges & universities, local government agencies. This adds to the overhead.

    We can have big government or we can have economic growth for the working and middle classes.

    Larry, on Medicaid expansion. Why don’t the proponents propose a mandatory reduction in health care insurance premiums to pass along the “savings” by insuring more lower income people under Medicaid? If they had, I be more likely to believe Medicaid expansion was a benefit to society and not just another plan to plump up the public sector. See above.

    • Excellent points!

    • TMT – I think you made some good points but there’s a bit of a paradox. How can consumers have the upper hand when we have so many unemployed and underemployed?

      would you consider overall weakness in aggregate demand part of what is going on with consumers having the upper hand?

      re: mandatory reduction in health care premiums.

      well – they ARE proposing a reduction in reimbursements to ERs for uncompensated care … which may or may not lead to equivalent reductions in premiums.

      I do not think this will take place overnight.. it will evolve gradually and may require mis-course corrections.. and there is always the chance of more unintended consequences.

      I’m looking at a Medicare Bill:

      it says this: procedure: 100.00 amt charged
      69.01 – medicare approved
      55.21 – medicare paid
      13.80 – you may be billed

      now the providers are hollering about quitting Medicare but I read somewhere that almost 40% of most providers revenues are Medicare and MedicAid so not too many are going to quit it unless they are really, really good and have more demand for their services that they can meet so they’ll just skim the cream.

      the other thing – my providers are now using electronic medical records.
      it’s not complete yet but my doctor can now easily go back and look at my last several blood screens and determine trends without touching my paper jacket.

      and she got that data electronically – not from paper or fax.

      things are changing but not there yet as she cannot get electronic data from all other providers yet.

      why did she convert to electronic records? two reasons. Medicare required it and there was a grant than paid for it.

      Bacon talks about the “free market”. I like real examples and Singapore is one of the best. universal health care, all electronic records, govt requirements on posting prices and medicare-like restrictions on top end prices – and the results: 1/3 our costs per capita, longer life expectancy, and lower infant deaths.

      until I see a better result from the “free market”, I say we should go for the 1/3 costs model.. and if we can do better with free market -by all means but let’s not let that “vision” or “hope” keep us from moving forward right now.

  5. re: ” I doubt that the blog post converted the heathen to our way of thinking. But maybe it put them on the defensive.”

    heh heh… in the accusation against Peter – Bacons own perspective is downright cartoonish with respect to those dratted ‘liberals’.

    I know I am considered such here by some but I continue to point out that I am way more fiscally conservative on some key issues that those who claim to be conservatives here.

    to say that NONE of the anti-poverty programs have ‘worked’ is a simplistic as it is … well.. ignorant.

    there have been failures..no question about it – just as DOD has a long list of weapons systems that have failed but they also have some darn good ones as are some of the anti-poverty programs that have survived.

    Ronald Reagan himself said this about one: ” President Ronald Reagan called the EITC “the best antipoverty, the best pro-family, the best job creation measure to come out of Congress.”* Similarly, Mark Everson, who served as IRS commissioner under President George W. Bush, called the EITC “one of the government’s most successful anti-poverty programs.”

    Now.. if I had made that statement – Mr. Bacon would immediately seize on it as yet another example of “failed” thinking about poverty.

    but that’s par for the course with the reactive right these days.

    only when you invoke the name of Saint Reagan.. do they recoil in horror instead of attacking “failed liberalism”.

    ;-)

    the latest kerfuffle over Head State is another example. head start does indeed accomplish it’s goal of catching at-risk kids up to pre-k but because kids fall back in the later grades ( if head-start type support is not continued), the narrative from the right is that Head Start is a failure – rather than looking at WHY the kids do GOOD in head start but fall back later.

    that’s pretty much sums up a lot of the right these days.

    they simply are not interested in ANYTHING that might actually work and especially so if it violates contemporary conservative orthodoxy.

    we have had a long hard road with blacks escaping the legacy of decades-long slavery … it was never going to be easy and it has not but we have made progress… important and substantiative progress.. but more along the lines of two steps forward, one step back rather than spectacular non-stop advances.

    I do not begrudge wealth and I do not think we can fix our fiscal problems just by taxing the rich but I also don’t think we can fix our fiscal problems by pretending that only cuts can do it.. when our total revenues are about 1.3T and our expenditures for national defense alone are over 1T.

    the most amazing thing to me about the deficit is that we got here in just 10 years and now it looks like we cannot get free for 20 or 30 years if at all and we have crazies running around shouting we are doomed no matter what.

    we have lost our common sense but more important we have lost our civility.

  6. Larry, your comments about “consumers” being unemployed or under-employed proves my point. Employment, wages, benefits relate to the producer side, not the consumer side. They still can get lower prices through the Costcos, Walmarts, & online shopping, but they don’t have much economic power as to the quality of their jobs and wages.

    Insurance premiums. Absent premium cuts, I don’t buy the economic benefits to taxpayers of expanding Medicaid. Put the premium cuts out two years. But without them, all I see is more Democratic redistribution.

    • TMT – people who don’t have jobs or low paid jobs do not cause aggregate demand except for the basics they need to survive. You can do all the supply-side stuff you want but it won’t change the fact that the low-paid can only afford food and rent.

      re: premiums – isn’t this how the universal health care works in all the other industrialized countries including Singapore?

      the question is – how do we get from where we are now to where Singapore is now with 1/3 our costs and better life expectancy?

      sounds like you are opposed to any efforts at all.. unless they “prove” to you that they will absolutely work before-hand.

      doesn’t that mean – we don’t do anything at all?

  7. Poverty won? Really? While there is still plenty of poverty you are, as usual, making sweeping opinions as fact and we are expected to accept it. In fact, conservatives historically try to cut many programs to address the problems.

    • The people I respect, whether liberal, conservative, or whatever, are those who demand that anti-poverty programs work. To work a program must give people in poverty the the means to become financially and emotionally free and independent, self empowered through work, jobs, and family.

      To do this we must eliminate or fix programs that perpetuate poverty. These include programs that increase the dependence of those in need on government handouts, and increases the dependence of their children, and children children on such monies, that enslaves people and destroys lives.
      Such unintended consequences have been going on for almost 60 years. Meanwhile, over these many decades, they have drained vast sums of public monies away from those who cannot help themselves, who need continuing care by reason of age, infirmity, and severe disability.

      The people I respect, whether liberal, conservative, or whatever, are those who demand that we cut or fix programs that have worked to keep people financially and emotionally dependent on public monies for generations. And people who instead demand that the monies saved by cutting such immoral programs be transferred to programs that work to liberate the poor and their children from a scourge that has going on for far too long.

      And so the people the people I respect, whether liberal, conservative, or whatever, want to do just Lydon Johnson had promised, had wanted, and originally intended to do, eradicate poverty through programs that worked.

      President Johnson had an excuse for his failure. His programs were new, untested, and put together without the hindsight of nearly 60 years of experience. We do not have this excuse; our failure is inexcusable.

      • Reed – do you think everyone agrees on what has failed and what has not?

        would you respect those who would disagree with you on principle?

        tell me which poverty programs YOU THINK have succeeded… do you have any? how about your top 3?

        do you think Johnson was the FIRST or the LAST POTUS to advocate for and/or establish anti-poverty programs?

        let’s flesh out a little your specific views…

  8. That answer tells me all I need to know Larry.

  9. me too.. and the weasel word comes to mind.

  10. So you’re again reduced to name calling.

  11. nope.. you run away from your own positions… using weasel words…

    I asked some pretty simple questions – like what poverty programs do you consider to be successes… and how did you respond?

    is your answer none? is that why you did not name any and ran away?

  12. No, Larry, you over dramatize the matter. When I lose respect for someone, and no longer take them seriously, I simply walk away.

  13. there is no over-dramatize Reed. I asked you a simple question and you ran away..

    if you want to say that Johnson failed at ALL anti-poverty programs and someone asks you if there are ANY anti-poverty programs you would consider successful – and then you say you “lost respect”? what?

    I asked you a simple question guy and you evaded it.

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