Monday, July 30, 2007

Absurdity


Last week’s subject got some strong responses from my three regular readers. So, this week I’d like to share something about Hungary and attempt to link this cultural note to last week’s debate.
The map above is what Hungary looked like in and around 1900. When that map was current, the Hungarians were doing well. They had recently won something close to autonomy from the Austrians, giving them title credit in the Austro-Hungarian Empire. They held sway over a vast amount of territory. There were natural resources, a flourishing art scene, a developing intelligentsia, and there was money.

Then, however, there was World War One. Hungary and her allies lost. That led to the Treaty of Trianon. Through that treaty, the victorious Allies of WWI stripped Hungary of its status as an empire, handed two-thirds of its territory to rival neighbors, and effectively halved the empire’s population.

The nation of Hungary was outraged and humiliated. People here saw Trianon as a slap in the face, a slap that must eventually be answered in kind (thus they joined the Axis in WWII). Hungarian students used to start the day with a prayer appealing to God to reverse the treaty. God declined to do so.

It's been a rough century ever since. Things didn’t get better until very recently.

What stuns me today is the tenacity of many Hungarians’ anger over Trianon. In the streets, I often see bumper stickers in the shape of pre-Trianon Hungary.
This picture is from just outside my apartment building.

There are Hungarians who still believe the territories of Greater Hungary ought to belong to the nation of Hungary.

There are several sticky issues there. First, it is difficult to take back territory that changed hands in an internationally recognized treaty. Second, Hungary has not done much to sooth the often troubled relations it has with its neighbors. Third, Hungary was an Empire when it held those territories. Now it is a nation-state. The antiquated form of government it once used to rule Greater Hungary is no longer a tenable possibility. Forth, and for me the most important, the international systems of governance that are now in place, such as the EU, NATO, the WTO, and the UN, cannot be dismantled or ignored. These institutions would not allow Hungary to take back old territories through negotiations or force.

Still, anti-Trianon sentiments remain strong. The voices have been marginalized, but there are a lot of voices. You see the stickers. You can buy maps of Greater Hungary as a souvenir. It comes up in political speeches. It continues to affect international relations. A couple years back there was even a referendum that would’ve, if passed, offered Hungarian citizenship to ethnic Hungarians living in neighboring countries.

The sentiment is very real, but it is misguided.

I don’t want to condemn the concept outright. There is a lot to this that I cannot describe here. Just to scratch the surface, Hungary lost most of its natural resources and has been economically handicapped ever since. Also, ethnic Hungarians in Romania, Slovakia, Croatia, and Serbia have been persecuted, often violently. And of course, there is a lot to national pride and heritage that I cannot understand because my country is so young compared to Hungary.

All that said, calls for the expansion of Hungary are absurd. I choose the word absurd very carefully: Absurd (adj) ludicrous; ridiculous because of being irrational, incongruous, or illogical.

It can’t happen.

So, how does this link to the debate over American health care?

Well, I read a lot of opinions on the great injustice of private health care in the US. The solution often put forward is: “The government should run health care.” That solution, in my mind, is like asking for Hungary's territory back.

1) Like Hungary trying to take land back from its neighbors, it would be very difficult to take health care away from the gigantic industry that has been built up around insurance and hospitals.

2) The American government hasn’t exactly proven itself capable of handling large logistical problems. I imagine the people calling for government health care were not in the post-Katrina Superdome.

3) American political history is one that has resisted socialist reform (for better or for worse). We have little-to-no experience dealing with large scale social programs.

4) Lastly, and perhaps most importantly, the institutions that are in place now (insurance companies, HMOs, state and federal government) won’t allow the transition.

I like this last one because like the EU, NATO, the WTO, and the UN, the institutions currently in charge of health care are inept and sloppy.

This does not mean there is no way forward. The US government does have a responsibility to its citizens and their health. I firmly believe that. For this reason the federal government should pass firm and unforgiving regulations on any company that makes money providing health care. Here are some rules I'd put in place: doctors and patients decide treatment, everyone is insured, and a percentage of profits must go toward research. Beyond that, offer tax breaks to companies that offer low-cost/no-cost insurance. Give hospitals subsidies for providing preventative care. And bolster the non-profits already out there in the trenches.

What do you think?

8 comments:

Bradley said...

i love when people say, "fuck off with my body goverment" or "government does everything so shittly, how on earth can they provide the healthcare". it's clear that less and less people believe in the feds as capable of delivering the goods. the statement about how the feds reacted to katrina is totally absurd when used in a argument against nationalized healthcare. feds reacting slowly to national disaster = feds unable to provide a system of universal healthcare? please. this argument could then be used against ANY and ALL new government programs. and at the end of the day this pleads a case against the feds doing ANYTHING at all. ya that'd be sweet and for the win for sure. FOR FUCKS SAKE we need to see a concept of how national healthcare COULD work before everyone jumps on the "the feds can do jack shit right" bandwagon.

but at the end of the day i like some americans are part of the "haves". people that somehow got a solid education/up bringing and make more or less good choices on how to live in a ultra-capitalist society. i really have no need for universal healthcare, i'm highly employable and in general very healthy. i can work and get all my basic needs met, and then some.

so do i care about the people that didn't get the same roll of the dice as me? a little bit, but not enough to really change the system, i'll just rant about it.

Dan said...

Let's be honest--the "health care debate" isn't about health care. It isn't even about health for that matter.(If it was it's leading spokesman couldn't be 350 lbs.) This call for "reform", like every other (with the possible exception of the 19th amendment) is about the expansion of federal power. And no, that doesn't require something as crude as nationalizing an industry.(Other than seizing privately owned gold FDR didn't nationalize a thing, but look at how The New Deal expanded federal authority. Or-granted, a more trivial example-we have no national drinking age in America, but every state's age is 21. How come?) You seem to be calling for regulation to the point of control, while denying any such transfer of control will take place. ("firm and unforgiving regulations"--that's vaugely threatening language) This is one we're going to have to agree to disagree on. Without considering the other's position "absurd".

Kelsey said...

Hogan,

I would like to let the record show that I am a regular reader. I read what you write and chew on it in my own way, but don't often feel I have anything to add to the debate.

I do think we need some sort of reform, my sister, who actually has health insurance, has had a terrible year dealing with the fallout from tearing her Achilles tendon. I can't imagine what a major illness or accident does to someone without health care, after watching what she's gone through.

But I'm at a loss for what needs to be done. I see what the government and No Child Left Behind (aka, no child left untested) is doing to education and I cringe. So asking them to solve the health care problem seems. . . unlikely.

I am at a loss for answers.

Hogan said...

A few questions for Bradley: When have the feds delivered the goods? When, in recent history, has government managed money and services in an efficient manner? Also, what about the other points I brought up? Do you think the government should dismantle the current system (lots of employees, and a huge chunk of the economy)? Do you think they are capable of that?

Then for Dan: Strict regulation is not called for in every instance, but Bradley does have a point about the unjust disparity in the health care system. The private sector can manage health care, but without "firm and unforgiving regulations" the rule of the market will A) leave +50 million uninsured and B) force competitive companies to cut corners in an arena where corners shouldn't be cut.

And finally, Kelsey, I'm happy to hear you're reading. You curse less than Bradley, and disagree in a less confrontational manner than Dan. Also, thank you for bringing the personal element to this argument. The current system forces care-givers to make odd choices, choices that often leave patients feeling cheated. I'm not sure if my ideas are the right ones, but if there is going to be reform, I believe people need to start looking at the problem from a less angry perspective and start making constructive suggestions.

Dan said...

Sorry about that man. God I hope I'm not turning into Cartman.

Bradley said...

"When have the feds delivered the goods?"

You posed the example of the interstate system. I would say that any federal program has it's benefits/problems/inefficiencies. How about the national park system? Does that count as a success more then a failure?

"When, in recent history, has government managed money and services in an efficient manner?"

In comparison to other governments or the private sector?

"Also, what about the other points I brought up? Do you think the government should dismantle the current system (lots of employees, and a huge chunk of the economy)? Do you think they are capable of that?"

HA! I gleefully think anything is possible Hogan. Throwing up arms and saying that a huge broken system should be left alone because it is too much to change is lazy defense.

The proposals you have mentioned to fix the current system creates more government bureaucracies, and oversight from the feds of the current medical system, so why do you see that as okay considering your perceived massive list of federal failures.

Not to attack you Hogan but ave you ever been to the hospital in the States? Have you looked at medical bills? Do they make sense to you? Do you know how it feels to need medical treatment while being insured and STILL not knowing what will be covered/what will not be covered, or how much it will all cost? My former employer paid my health care cost in a abstracted manner, maybe about 250-300 dollars a month, so about 3600 a year. This is money I never saw period, so it's pretty much like a tax alreay removed from every paycheck, and shit I didn't get to pick the insurance company. I have a co-pay every time i see go to a medical facility. Then I depending on who I see, and what they do, those costs are sent to the "Matrix" and a bill pops out from the Insurance company on what I know owe.

It's like going to buy a product in a store with no price tag. When you get to the check out counter you just pay 10$ for anything you pick out. Then a few weeks later in the mail you get a bill for how much the product costs, and you've gotta pay, they have zero return policy.

Hogan said...

Brad,
While I'll admit the US Interstate is impressive, it is a money pit famous for corruption.
Plus:
There is logging going on in the National Forests because a certain party is in the White House. Do you want those providing health care to change major policies on the whim of someone elected by just half the population (or less in some cases)?

Throwing my arms up would be a lazy defense if I weren't offering alternate suggestions.

So you think a regulatory board (like the one that oversees the stock market) would be more bureaucracy then putting the whole thing in the hands of the fed? Hard to follow that logic.

To accept anything as possible is not a strategy for moving forward. I have yet to see one plan for Federal health care that would meet the public needs.

Meanwhile, there is a mechanism in place, and while I accept that it is broken, I'm not ready to throw the baby out with the bathwater. Reform is a better way forward. If we move everything into the hands of the federal government, we will end up spending two decades haggling over which partisan plan will take effect.
If, on the other hand, we establish a set of regulations and appoint a group to act as an oversight watchdog, a moral compass of sorts, then we can force the existing companies to solve the problems you mention.

This stand I am taking is somewhere between the hard left and the hard right stance. I want the government to fix this problem, but I don't want their claws to dig too deep into an already established system that deals with public welfare, the economy, and privacy protection.

Hari Simran said...

Ok, well first off, when the company you work for pays for health insurance they are not deducting it from your check, and they rarely offer to give you the cash if you decline the insurance. It is known as a "benefit" and is not ever considered part of your salary - part of your "package" perhaps, but let's not touch that one. So when you say that this is money you never see, that is correct, you will never see it, but it is also not owed to you.
But therein lies the problem. Health care in this country is not a right, it is a priviledge. Should it be a right? Yes. Should the government provide and regulate it? NO!
But frankly, right now, the insurance companies run things - they determine what tests we can get, what treatments we can get and what medicines we can get. Doctors do not make these decisions. They can diagnose, and if the treatment they feel is the best is not covered by your insurance, you will most likely not be able to afford it. So you will be given the treatment the insurance company decides it will pay for, and how they decide this is a mystery.
So, like most things, it turns out to be about money.
And insurance companies are also in trouble because these days when someone is hurt or sick they feel they can sue somebody over it and receive enough money to become a rich person. Not just enough to cover their care and a fair amount to see them through the rough stuff - enough to retire in style. And the lawyers take a huge cut of that, so you never even see the big settlements you think you won.
It is very corrupt.
But to say the government should offer or even regulate health care does not ensure that this system will be any better.
We could make health insurance manditory for employers to provide. We could put caps on "pain and suffering" insurance settlements. We could get tax subsidies for free clinics for the underpriviledged. We could put students through medical school in exchange for several years of lower paid service when they graduate and staff clinics with these doctors. We could offer lower insurance rates to those who adhere to healthier life styles - non smokers or whatever. I dunno, there are a lot of things we could do if we wanted to.
But it's business folks - and it's all about how to make the most money for the least cost. And having the government offer it will not really change that. It will just give the government a place in my life that I do not feel is appropriate. And they will still be lining the pockets of whoever the Haliburton of health care might be.
Building roads? hell yes. Telling me what doctor I can see? No. No no no.

Am I really one of only 3?