Politics And Individual Responsibility

Nearly fourteen years ago I was "on call" in December and, given my geographic location, it was cold.  It had snowed early that year, and ice and snow were on the ground.  I was awakened by the phone ringing at about 2 AM, and upon answering I was informed that the Emergency Department at the main hospital for which I was "on call" was looking for me.  I dialed them, and was told that a woman had fallen and had a hip fracture.  The ED physician gave me the details of the break, and that she was otherwise uninjured and in good medical condition.  Being half asleep I took note of the name but did not ask a boatload of questions, knowing that I would have to re-ask them when I saw her.  After insuring that she would be admitted with appropriate measures taken for comfort and preparation for surgery the next day, I went back to sleep

Later that morning at 7 AM I went to the hospital to meet my new patient and to plan her surgery, and discovered that this was no ordinary hip fracture patient.  Sure, she had a standard impacted subcapital hip fracture, which would be amenable to pin fixation.  That was fortunate, in that she was 23 years old, as opposed to the usual patient with this isolated injury being over 65.  In young bone it's rare for this to happen, but her boyfriend had been carrying her on his shoulders and he slipped on ice outside a restaurant  They both hit the ground, she from much higher; he was uninjured, she broke her hip.

The surgery went well, and ultimately she healed the hip and recovered fully, wih no ill effects.  Why is this story important?  Because of what happened at the first post op visit, at about 10 days from surgery, when she came to the office for an x-ray check and suture removal.  I asked her whether she worked, as she was uninsured, and found out that she was a hairdresser.  The following conversation ensued:

"Well, it's not going to be possible for you to work for about six weeks, as you'll need to keep most of your weight off the leg until then."

"But I'm already back to work."

"You can't, you have to protect your hip."

"You don't understand.  I need to work.  I just opened my own hair salon and if I don't work I'm out of business.  I bought a rolling stool so I roll around in the shop to do my work.  Plus, I need the money to pay you and the hospital.  Don't worry, I'll protect the hip.  But I have to work."

That was 10 days out from surgery.  That's a responsible 23 year old.  She could have cursed her bad luck, defaulted on her lease for the shop, and gone to the state looking for help.  She could have gone on the dole.  She could have stuck her parents with the bill.  She could have sued the restaurant for the ice outside it (as if that never occurs in New England in the winter).  Instead of crying about being handed lemons she made lemonade.  She took care of her hip and her business and paid her debts over time.

Personal responsibility is highly underrated, and this SCHIP debate is bringing out that point in spades.  I've done exactly one post on SCHIP, and the only point I made related to Graeme Frost, the 12 year old boy from Maryland, was to castigate the Democrats relatively gently for using him in the way they did.  And yet, the entire conservative blogosphere gets labeled as "the politics of hate.  Screaming, sobbing, inchoate, hate...The shrieking, atavistic ritual of personal destruction the right roars into every few weeks is something different than politics."  I haven't seen it.  I've seen posts that I disagree with both in tone and substance, but I see those on both the right and left.  I've seen comments to posts, largely anonymous, that go way too far, but I haven't seen conservative posts themselves display that kind of vitriol.  Let's keep this on an individual basis.  Call out those who personally attack and display "hate" without lumping in those who don't.  Make them personally responsible.

Some conservative bloggers, individuals who haven't "savaged" anyone, have suggested bringing this back to a reasonable policy discussion, which it should have been all along.  Let's stick to the facts, shall we?  Let's stay away from personal attacks and leave the discussion where it should be, which is really the point at which personal responsibility ends and government responsibility begins.  There isn't a single family in America this side of Bill Gates for whom things wouldn't be easier if someone else pays some of their larger expenses.  There are lots of parents who'd like to work shorter than full-time hours, often for honorable reasons.  Unfortunately that doesn't usually get you health insurance in the deal.

Facts are facts.  I sympathize with the Frosts, as I think they've been unfairly drawn into play by both sides.  And I wish their children the best of recoveries. Yet:

• The threshold for coverage is part of the discussion.  In fact, it's the basis of the bill.
• The means and assets available to the petitioners are part of the discussion.
• The choices made and options available to families that might be affected are part of the discussion.
• The policy prescriptions, whether to continue the program that currently covers the Frosts, as the president wishes, or to greatly expand the program and remove most checks on it's application are part of the discussion.
• The inclusion of adults, even "children" two years older than the patient I described above, is part of the discussion.

Is such a discussion not possible without a tantrum?  SCHIP is not a bad thing.  But there are bad things being done by both sides in it's name, and that ain't right.  But the problems are with the actions and words of individuals.  Hold individuals responsible for their bad actions, left or right, and lets talk about policy.

I still go to see this stylist for my haircuts, as that kind of admirable assumption of responsibility and willingness to do what was necessary even if difficult needs to be rewarded.  The cuts don't cost $400, but my wife says she does a very good job.  And by the way, Mr. Klein, Scott Thomas Beauchamp is not just "a soldier serving in Iraq" but an adult who lied.  Best to protect the innocent first.

10/11/07 1444: Rick Moran also wonders who "smeared."

So far, no one on the left has bothered to explain how conservative blogs are smearing Graeme Frost. They use the term in their headlines and the body of their posts. They use the word in comments left far and wide on righty blogs. They use the word as if it is simply a given, as if “the smear of Graeme Frost” exists naturally in the universe and needs no explanation – sort of like the sun coming up every morning.

This would be mindless stupidity – if there wasn’t a purpose behind it...

And therein lies the debate. Not whether the Frosts have too much money to enjoy the coverage supplied by SCHIP but whether any family can make choices that force other families to pay for them. Yes, in order to afford insurance for their children the Frosts at the very least may have been forced to sell their rental property and perhaps even have one or both parents get a job where an employer provides health coverage. But there are thousands and thousands of families who are faced with those choices all the time and choose to make sacrifices so their kids are covered. Now those families are being told that, in effect, they’re a bunch of chumps for making those sacrifices because others who may even be better off are “smart” enough to avoid the responsibility and get coverage via SCHIP.

Where is the left’s outrage at this injustice? Where’s the hand wringing about the inequality of this situation?

There's a lot more there worth reading.

Comments

[SlimGuy]

One glaring point made by the Frost issue about ship is that the program does not present a good exit strategy for the clients.

The family has a valid need for the coverage provided for the care of the children and the relief offered by the special schooling for the daughter.

However if the family tries to increase their income they are close to the allowable caps which if crossed would throw them out of the program and the costs of the treatments would fall to them.

Plus trying to obtain insurance coverage would hit the pre existing conditions wall.

I have a suggestion that the program should incorporate an out transition aspect to allow and mitigate the withdrawal.

If for example they can increase their income above the caps for say an 18 month period, they can then purchase insurance with the pre condition clause but split the insurance responsibility between the insurance company and the program during the transition.

The insurance company would cover anything not directly related to the pre existing injury such a flu and cold or even a broken arm.

The program would cover all condition related treatment until the waiting period for the pre existing issue is passed by the new insurer of record.

This I believe is a workable compromise as an exit strategy.

[Giacomo]

Ah, a policy discussion, and a civil one at that! Hallelujah!

I agree. This is one of the (many) flaws with progressive tax policy, in that certain deductions will disappear suddenly, and the "next dollar" may, if you're at the wrong level, make your taxes rise much more dramatically than a fraction of that "next dollar."

[Eileen]

This brings up multiple questions.

If I have home insurance, and my house burns down, I can quit paying my insurance right after the house burns down, yet the insurance company is still responsible to pay for the burn damage.
But with medical insurance, I can develop a condition while insured with company A, but I have to keep paying the premium for company A to continue the coverage.
If I try to get insurance with company B, they won't insure the pre-existing condition.

Should everyone be entitled to heath care, OR should we just say no to those who can not afford it?

Should people be required to have health insurance for their kids.
IF we (our society) feels obligated to provide the health care, THEN it is fair to require that people be insured.
Not insuring one's kids could be considered child neglect.

Medical care is the result of the labor and hard work of others. So I don't think anyone is entitled to it.
But I do think we are a rich enough nation to provide it.

So who should pay?

You mention the adult who chooses to work part time, but what about the adult who works multiple part time jobs, because the employers would rather have multiple part time positions than fewer full time, to avoid paying the insurance.

IF we are going to require employers to provide benefits for full time employees, THEN shouldn't we require that they pay a percent toward the same benefits for part time employees (i.e. half time gets 50% as much as full time gets toward benefits, that when combined with their other half time job comes out to full time benefits).

My employer covers me, and I have pretty high co-pays that I can afford and don't mind paying.
I am pretty certain the insurance company is making quite a lot of money off of what my employer pays. Their profits are huge.
Then there is the issue of the company pulling all of our benefits piece by piece.
After 14 years with the company, they pull my retirement benefits, the main one being medical.
Legal? yes.
Fair?
Questionable.
But definitely putting me more in favor of National Health care coverage, just so I don't feel like I have lost much (not to be confused with my thinking it is something everyone has some right to).

I don't classify you into the "Politics of Hate" group, at all.
You are not even close.

I read 4 right leaning blogs pretty regularly. I only classify ONE of them into the "politics of hate" group.
And since it is authored by someone I went to high school with, who was very nice to me in high school, I have a soft spot for her.
(I was an unpopular kid, and she was very popular, but still treated me very kind, and I remember this.)