Death cult

My dear reader, I do not care about your politics (other than, say, as an anthropological curiosity), but I would like to think that no matter your politics, you were put off by the cheering Ron Paul received at the recent GOP debate.   Paul was explaining his uber-libertarian ideas about health care, and was given a hypothetical case of an uninsured patient who needed emergency care.

“That’s what freedom is all about: taking your own risks.,” Paul said, repeating the standard libertarian view as some in the audience cheered.

“But congressman, are you saying that society should just let him die,” Blitzer asked.

“Yeah,” came the shout from the audience. That affirmative was repeated at least three times.

Paul did not actively endorse the cheers of the death-frenzied audience, but his longer answer would effectively lead to the same end:

Paul, who has always had a reputation for being a charitable man, disagreed with the idea that sick people should die, but insisted that the answer to the healthcare problem was not a large government.

“I practiced medicine before we had Medicaid, in the early 1960s when I got out of medical school,” Paul said. “I practiced at Santa Rosa Hospital in San Antonio. And the churches took care of them. We never turned anybody away from the hospitals. And we’ve given up on this whole concept that we might take care of ourselves and assume responsibility for ourselves, our neighbors, our friends; our churches would do it. This whole idea — that’s the reason the cost is so high. The cost is so high because we dump it on the government. It becomes a bureaucracy. It becomes special interests. It kowtows to the insurance companies, then the drug companies.”

This is one of the most nonsensical answers I’ve ever heard from a politician (that’s saying a lot, no?). First, he gives the Back When Giants Walked The Earth opening, one familiar to most medical students and residents.  This can be heard when an attending physician says things like, “When I was an intern, we collected and Gram stained all our own patients’ sputa, plated them out for sensitivities, administered the antibiotics ourselves, then collected the patients’ urine, and went to the chemistry lab to re-extract the antibiotics, and re-administered them. And I’m a better doctor for it.” Followed by looking at the floor, shaking his head at the inferior breed of doctor the year has inflicted on him.

I am skeptical of every statement made by Paul.  When the hospital refused to turn away patients, who bore the cost? Did “the churches take care of them?” If it was a Catholic hospital, the answer was probably yes, but of course patients would have had no access to birth control or abortion.  What about secular hospitals?  And do hospitals “turn patients away” now?

The first statement is full of the ignorance of someone who hasn’t practiced medicine in a very long time.  Hospital emergency rooms (at least those that benefit from any federal funding, which is pretty much all of them) cannot turn away sick people.  They are required at the very least to stabilize a patient and find a safe, suitable transfer.  In reality, the hospitals usually admit any sick patient and eat the cost of any unfunded care.  There is no magic coalition of churches to take care of an uninsured patient who wanders into an ER bleeding.  They are cared for and the hospital and we as a society eat the cost.   Hospitals that take care of a certain number of poor patients receive federal monies to help defray the costs, but this hardly covers it.  This system is easily strained.  There are a number of infamous cases, especially in Southern California, where hospitals simply dump patients on the street.  But in general, hospitals care for the ill who wander in.

What exactly is Paul proposing?  If you read his words, he is proposing that all uninsured acutely ill patients be cared for charitably.  By churches.  So should the uninsured carry some sort of passport stamped with their religion so that a bill can be sent to their church?  (I’m intentionally leaving off the atheist thing—I’m sure he’d fold that in.)  Or should all hospitals be turned over to being run by religious institutions in case uninsured patients show up?

His further sentences about cost being high because “we dump it on government” is a non sequitor.  The direct question asked by Blitzer was clearly stated: what do we do with an uninsured patient who is about to die?

The crowd cheered for death.

Paul turned his thumb.

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8 Comments

  1. Karen

     /  September 22, 2011

    The entire incident, and the concept of letting ANYONE die prematurely, scares me. There are people who believe that??? They’re Americans??? They vote???

    Suddenly eating dinner tonight doesn’t seem like a good option.

  2. Someone I know who is in his late sixties, former smoker, and has had quadruple-bypass surgery is absolutely convinced that he would have access to and be able to afford his healthcare in a Ron Paul-esque scheme. He and his wife worked for govt. agencies, enjoyed govt employee healthcare all their working lives, retired on govt. pension, and receive social security and medicare. I think sometimes people are so financially disconnected from the rest of society that they simply don’t have the mental capacity to understand what it’s like to be uninsured. Why they seem so hell-bent on voting against their own interests is beyond me.

    The good news is that Elizabeth Warren is making a strong case for the social contract.

  3. And that they cheer for the suffering and death of other people is appalling.

  4. Hrm. My only issue is this: I have heard people argue against being forced to buy health insurance (some explicitly say they should be allowed to decide what to spend their money on… not a question of being able to afford it or not). Now, recognizing that this doesn’t actually apply to most uninsured people today–I have argued to mandate objectors that sure, people can opt out–but someone who willingly and knowingly refuses to pay into the system (can buy insurance at a reasonable price and level of coverage but refuses) should have two choices: One, pay for themselves. Two, do without. My local paper actually had an article from a couple fighting the Obama mandate who said (and I am not making this up) that they could put the money towards a car payment instead. Will they expect me and other policyholders and taxpayers to foot the bill if their gamble doesn’t pay? If someone is exempt from Social Security withholding, they don’t get SS. If someone made a deliberate, informed choice not to contribute to the system, they shouldn’t expect to get anything out of it.

    I can’t stand Ron Paul, but his comments reveal the basic problem with the Republican attitude towards healthcare. He’s willing to state the truth, while his opponents in the party want to square the circle and not discuss the consequences of canceling the mandate. I don’t like his truth, but I have approximately 5% more respect for him for stating it, while Rick Perry would prefer to avoid the logical extension of his party’s position.

  5. DLC

     /  September 23, 2011

    Ron Paul is a fool. his “free market” nonsense. A man who’s having a heart attack or been gunshot does not have a choice in care provider. What’s he gonna do, log on to the web and comparison shop? “Oh, look, Hospital X is 14 miles away and has cardiac care for 599.95, but Hospital Z is 17 miles away and has cardiac care for 784.99 but with a 150.00 mail-in rebate!
    Look, you want to help reduce the cost of health care in the United States ? go to single payer, or legislate that no insurance company may own a primary or secondary care facility — no more HMOs; or give insurance companies the choice: lose your tort protection or return to non-profit status.

  6. What Ron Paul is proposing is a reversion to the “old days” when churches, not government, provided the “social safety net.” He and his fellow Rightists hope, thereby, to grant churches a kind of social and economic power they used to have but no longer enjoy.

    That’s right, this is about getting and wielding power over the lives of others. This comes from the very same party that claims to want to promote individual freedom. Yes, they are hypocrites, by any definition; they want for themselves something they decry in government.

  7. Alexis: He’s not stating the logical extension of the party’s position. What do you, or he, propose to do if that person who decides not to buy insurance comes down with a bad cough? Assume that it can’t possibly be whooping cough or tuberculosis, pay to diagnose and treat them, let them infect other people with potentially fatal diseases, or pay to lock them up until they die or stop coughing?

    It would be interesting to ask that same crowd “should the uninsured man be sent home to give your children a fatal disease?”

  8. Editor

     /  December 29, 2011

    Thanks for the article.

    For some of the work on voluntary solutions by the pro-Libertarians see http://www.LibertarianInternational.org the non-partisan Libertarian International Organization

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