Tuesday, June 6, 2017

Dr Ferrari

Kevin Williamson wrote a piece last month in the National Review bemoaning the hand wringing he sees occurring across America surrounding the threat of millions of Americans losing their health coverage with the intended repeal of the ACA and its replacement with TrumpCare.  He calls this piece:  The "Right" to Health Care, with the scare quotes performing the task expected.  (What? Did you think you had a "right" to health care when you get sick, silly boy?) appended with the self-answering subtitle There isn't one boldly patched in the space before the opening lede.

He then goes on to construct a thought experiment utilizing children and apples to demonstrate that health care is a just scarce good and that all the nail biting over making sure all the kids get an apple is just cheap moralizing and coastal elite performative antics when, in the end, you only have 3 apples for 4 kids.  Market forces, you see.  Supply and demand.  What is needed is not a national reckoning--- the likes of which every other advanced western democracy has done--- with the idea that health care is a service/good that ought to be made available to all Americans, like schools and public safety and national interstate highways, but rather we just need to empower laissez-faire super entrepreneurs to plant a few more apple trees. This is thought-experimenting in its most primitive form, using the bare minimum of neurons.  Maybe 3 or 4 synapses get traversed at this cognitive level of "thought experiments".  This is like turning around and going home hungry because someone has placed a medium sized stone in the middle of the sidewalk on the way to the store.  The inability to conceptualize the apples as a totality, to be divided and sliced in such a way to ensure that everyone gets a fair nutritional share is punditry malpractice.  But Williamson doesn't care.  He has followed his thought bubbles to the terminus of his own choosing.

Rationing is posited as the true villain in this piece.  For Williamson, universal coverage is not worth the price we might have to pay in consequence; longer wait times for elective non-life threatening procedures, cost effectiveness barriers for new treatment approvals, lower profits for the holders of Capital etc etc.  This is his true dystopia, not the recent American past of a sparsely insured population wracked by medical bill induced bankruptcies.  For Williamson, health care is just another good on the market.  And the more it increases in demand, the higher its price ought to be.

And so we get this hopefully career defining quote:  "Rich people always get better stuff.  That's what it means to be rich." Let them take aspirin for their cancer, indeed.  Because hey, if you live in Africa and have HIV, that's all you get.  That's life.  Deal with it.

Meanwhile back in the world of Kevin Williamson, when a head cold just won't seem to run its course, he usually just struts into his fancy doctor's office in the suburbs, brandishing his American Express Platinum card, to see a doctor who is "always pleased to see me because I paid him out of pocket".  His insurance plan, you see, is called "American Express".  Cash is best.  What is wrong with all you dolts?  Are you plebeians not able to just whip out some plastic or peal off a couple hundies when it comes time to settle up with ol Doc Blowhard?  Not mentioned is the "thought experiment" of what might happen if Kash-man Kevin didn't need just a little Z-pack and, instead, came down with viral meningitis or perforated diverticulitis that resulted in a 12 day ICU stay and a charge master hospital bill of $79,850.  Even elite credit cards have maximums.

As Kevin gazes around at the opulent setting of his favorite doctor, he notices several pictures of Ferrari sports cars on the walls.  He kiddingly, nudge-nudge wink-wink, queries Dr Wonderful about the Ferrari's, suggesting that maybe he might be paying him too much.  And the good doctor replies: "Do you really want a doctor who can't afford a Ferrari?"  Yes, that groaning you hear is not some pipe swelling with the temperature change in your basement.  Kevin Williamson is the one person out of 100 who is impressed by a guy bragging about his luxury car.  I mean, I can just smell the overly administered Drakar Noir cologne emanating from my laptop as I read that.  This is either a doctor who does not exist or he is a guy who obtained a medical degree from the boardwalks of Jersey Shore, undid the top two buttons of his contrast collared Oxford, perfected his best shit-eating grin and went about the business of marketing himself to insecure but healthy dunces like Kevin.  It's a good gig if you can stand it.

Somehow, in a very short piece, Kevin Williamson of the National Review was able to accomplish more than even a well written parody could ever hope to achieve.  Parody works best when the target is limited and precise.  Nuance and complexity are the enemies of successful satire.  Somehow Kevin is able to be both obtuse (not understanding how health care is not a "good" like, say, lawn chairs or sausages to be purchased on the open market) while also revealing himself to be the embodiment of the crass materialistic John Galt elitist superman, so easy mocked by second rate late night talk show hosts.  He is the guy who thinks the dude with the muscle car revving at a stop light is the coolest person on Myrtle Beach.  He is the guy who thinks the tank-topped meat head grunting and squelching at the Gold's Gym must be "really strong and masculine".  He is the guy who notices when other men wear cuff links, and what kind.  He is the guy who must find out what car you drive within 10 minutes of meeting you in order to more properly form a judgment of your character and usefulness.  

Not to mention the complete lack of moral imagination that would prompt most intellectuals, from both the right and the left of the spectrum, to wrestle with the discordance of finding ourselves living in the richest nation in the history of human civilization while still somehow being unable to provide affordable, accessible healthcare  to 100% of its citizens......

1 comment:

Anonymous said...

You have a problem with John Galt, Atlas Shrugged and the free market doesn't care. Would love your thoughts on Steven Crowder's visit to "go behind the scenes" of the Canadian health system? Universal Healthcare for all and feigning access to this care is disingenuous and irresponsible.