Ross is right to come down on Ezra for reckless and irresponsible hyperventilating on health care. But let me dot the i here.
Ezra Klein kicked up a hornet’s nest of controversy by accusing Lieberman of being “willing to cause the deaths of hundreds of thousands of people in order to settle an old electoral score.” That “hundreds of thousands” refers to the number of Americans who die every decade because they don’t have health insurance — or rather, it refers to one study’s estimate of that number. Other studies, cited by Michael Cannon and John Goodman, suggest that the number is considerably closer to zero — or else that the link between health insurance and mortality might be too murky too penetrate. But of course there are still other studies that tend to confirm Ezra’s numbers …
Anyway, without trying to adjudicate these competing claims, I’ll just say that I would be very surprised if extending health insurance coverage didn’t have some positive effect on life expectancy for the newly-insured. And what’s more, I think liberals are absolutely right to be laying their emphasis on this point: It’s the best argument (and, indeed, increasingly the only argument) in favor of the current legislation. But I think Ezra’s missing the point when he acts puzzled that anyone who accepts his statistics would object to the way he went after Lieberman.
[...]
In this regard, the claim that “health care reform will save lives” is very, very different from the statement that “opponents of health care legislation are willing to let hundreds of thousands of Americans die.” The two may be factually similar, but only the latter waves the bloody shirt. And the bloody shirt is the enemy of both reasonable debate and good lawmaking. It’s a conversation-killer, and a policy destroyer.
Ross is too kind in allowing Ezra’s original language — Lieberman will cause people to die — to translate freely with the more accurate language of letting people die. This isn’t simply a matter of grammar or style. Ezra did not attack Lieberman for supporting a bill which would merely get out of the way while some significant number of Americans happened to die. He attacked him for seeming “willing to cause the deaths of hundreds of thousands of people in order to settle an old electoral score.” Anyone who doesn’t support the right bill, you see, is killing Americans. And since this is obvious, you see, anyone who doesn’t support the right bill wants to kill those Americans, and wants them to die.
This is more than moral grandstanding or shirt-waving. It’s an intentional distortion of an ethical precept at the very foundation of our philosophy of law. It’s a lie mobilized to discredit one’s political opponents, not just politically but morally. In truth, of course, to kill a bill that would prevent people from dying is not to kill those people — just as refraining from saving a person in mortal peril is not causing them to die. Any law student who didn’t sleep through torts can tell you this distinction is essential. Though it rankles morally, the fundamental legal and philosophical distinction between letting somebody die and causing their death avoids the systemic injustice involved in forcing individuals to be Good Samaritans. Two key points emerge. We must be free not to act morally in order to act morally. And the sort of discernment that enables individuals to decide whether or not to act in a specific moral instance cannot be properly cultivated without that freedom. I suppose there’s a third point: we ought to continue to live in a world in which individuals can and do cultivate that kind of moral discernment.
All this can’t be bulldozed away in the name of any piece of legislation, or in the name of preventing any kind of present or future suffering. That’s not to suggest that Republicans or conservatives or whomever should pretend that Democratic health care reform wouldn’t actually lessen or eliminate the suffering of some number of Americans or save some statistically significant number of lives. The problem is that knowing this doesn’t settle the issue of whether it’s the right reform. Where Ross sees a conversation-stopper in the claim that opposing the current bill means being willing to let people die, I see the start of a crucial conversation. After all, as Ross notes, “Every side of every debate [...] can plausibly accuse its opponents of being ‘objectively pro-death.’” Nobody really requires that every policy and every law be structured above all to maximize the prevention of suffering and death, because, ultimately, the minimization of suffering and death is not the purpose of politics or even the definition of justice.
None of which is to say, to be sure, that we have no moral interest in mitigating suffering or decreasing our number of untimely deaths. We have a profound and inescapable moral interest, of course; one which conflicts in likewise inescapable fashion with our interest in political liberty and prudent governance. Ultimately, the stewardship of those goods has a moral character of its own. To speak and act as if there is no moral tension at the heart of the politics of health care is to give in to the temptation to deny that we ourselves, as citizens and human beings, have to suffer that tension.
December 17th, 2009 | 1:48 pm
Gee whiz, when something is hatched as a “Crisis”, hyperbole can be expected all around….particularly if the goal is to simply “get something passed” and if there are problems to be worked out, they can be addressed in “continuing legislative actions”. There’s nothing like a little Joementum to get under one’s skin.
December 17th, 2009 | 2:03 pm
[...] #5: James Poulos Possibly related posts: (automatically generated)It Takes A Nation Of Millions To Correct The [...]
December 17th, 2009 | 7:00 pm
A couple of quibbles. First, your ‘wants to kill those Americans and wants them to die’ is purely your own invention, and Klein’s original words are worth debating themselves, without adding your own grandiose subtext (or is that justifiable counter-bloody-shirt waving?)
Second: ‘just as refraining from saving a person in mortal peril is not causing them to die’. Pardon? If I am fully capable of reaching down to help a man up from a cliff, but I refrain, and he falls and dies, I didn’t ’cause them to die’? Your following justification for this assertion is based entirely in legalistic analysis, as if Klein was claiming that Lieberman should be held legally culpable for the deaths of the uninsured. I’m sure you agree that that’s both ridiculous and not at all what Klein was asserting, so it seems out of place. You yourself write ‘it rankles morally’ and that exact moral rankling was the leverage Klein was using to make his point.
Likewise, ‘Nobody really requires that every policy and every law be structured above all to maximize the prevention of suffering and death’. Of course not, but again, who said we ought? We simply have to acknowledge the consequences. Klein’s argument is that the consequences are (assuming the statistics are reliable) deaths in the thousands. And what is the gain balancing those consequences? Klein’s argument is that the gain is the satisfaction of Lieberman’s ego in sticking one to the Democrats. Maybe he’s wrong. Maybe Lieberman is more principled than that. But if so, that’s the correct counterargument.
The handkerchief-waving at the very indecorousness of pointing out that killing a bill that (arguendo) saves lives will result in lives being lost is what’s out of place.
December 17th, 2009 | 7:30 pm
I disagree that this contradicts “an ethical precept at the very foundation of our philosophy of law”. I would say that if actions is easy and has small consequence than it is morally imperative to act, and not to act is evil. But that is not as strong as what Christ would have us do, he would say that failing to do everything in our power, even if it drastically reduces our wealth or power, would be required to help others. If the law is not built around what is morally necessary, than what is it built around.
December 17th, 2009 | 7:37 pm
[...] Ezra Klein’s characterization of Lieberman’s moral failure on health care was “reckless and irresponsible hyperventilating.” Here’s the offending sentence in the offending post: That is to say, he seems willing [...]
December 17th, 2009 | 7:59 pm
AS the numerous comments at Ross’s blog indicate, there are two things wrong with this take on Ezra’s charge against Leberman:
1. Making it now, after months of ignoring both recent vice-presidential candidates and sitting legislators who opposed the bill talking about “death panels”–and not even acknowledging how much those deathers have already poisoned the debate–is just absird.
2. Because Lieberman supported the Medicare extension he now opposes as recently as three months ago, and openly cites his political opponents’ embrace of this proposal as a primary reason for his reversal, there is every reason to believe that even he believes that the policies he now opposes will save lives, and that he has set aside whatever “moral tension” he feels and is acting primarily out of political spite.
December 17th, 2009 | 8:26 pm
Liberty and free will and all that jazz aside, I have yet to hear a clear and honest explanation of this health care bill that convinces me that it WILL save lives…even one. And if it ends up including an abortion tax, among other things, it will destroy many more than it saves.
December 18th, 2009 | 10:37 am
This Health Care Bill is sure to save the lives of at least 100.98 Lobbyists.
December 18th, 2009 | 12:58 pm
While it is true that the distinction between intentional harm and harm as a result of inaction is a fundamental distinction that certainly underlies a lot of philosophy and certain parts of our legal system, that doesn’t really disprove Ezra’s point, which is that inaction can sometimes have really, really bad consequences and we shouldn’t look at people who are willing to torpedo potentially lifesaving legislation for petty reasons as if this is nothing more than “politics” and the consequences don’t matter.
Imagine, for instance, if someone had done something like this to the Voting Rights Act in 1965. Would it really be that out of line for a supporter to say “you’re willing to continue disenfranchising and disempowering blacks in the South in order to settle a political score”? Yes, the people who voted against the VRA weren’t personally doing the disenfranchisement– but disenfranchisement was certainly the consequence of killing the VRA.
Ezra was trying to remind us that lives are at stake when politicians play games.
December 18th, 2009 | 12:59 pm
The comparison to be made here is not with a person who refrains from saving a life, but with a person who actively prevents others from doing so. Lieberman may not be the actor responsible for the impending death, but he is going to some effort to prevent that situation from being corrected. It’s debatable as to whether this amounts to actually causing death, but he is clearly taking some action for which death is the expected result. We wouldn’t normally describe that as merely allowing death to happen, a phrase that implies no action or actions that are strictly value-neutral. So I’d have as much objection to your formulation as to Ezra’s.
Ross’ point–that framing Lieberman’s apparent position as pro-death rather than insufficiently supportive of life is unconstructive to the debate–is well taken. But Ezra is addressing not Lieberman’s apathy, but Lieberman’s actual contributions to the legislative process. This point would be lost if he phrased his objection as you suggest, and I think he is well within his rights to ignore you.
December 22nd, 2009 | 12:44 am
Klein has at other times argued for a more detached attitude toward the deaths caused by denial of care:
“[A]t the root of our health care problem is an almost pathological aversion to making hard choices…In other areas of life, decisions are made based on whether a particular use of money is a good value as opposed to other uses of that money….The American health care system doesn’t work like that. There is no budget. We don’t want one. We’re profoundly uncomfortable saying that a person’s life, or health, is not worth the price of a particular procedure….Better to let five people die passively than kill one consciously.”
http://www.prospect.org/csnc/blogs/ezraklein_archive?month=04&year=2009&base_name=why_american_health_care_costs_1
Klein there at once acknowledges the distinction between letting people die and killing them consciously and places his own position on the more “causing death” side of the spectrum.
ChiMaxx above calls hypocricy, noting the Death Panels rhetoric. One could play counter tu quoque (why is it okay for liberals to say that denial of care leads to death, but not okay for conservatives?) But, it is true that any health care decision-making process will allow some people to die who could conceivably have been saved. Clearly both sides of the debate object more to some deaths than others.
The conservative may argue that when policy causes people to become dependent on gov’t/insurance companies, suffering that results when these entities deny care is uniquely problematic; “death panel” rhetoric at least hints at this claim (the objection is to the panels, not just the death.) Progressives might argue that suffering that results from profit-driven decisions is uniquely problematic, but suffering that results from government’s deicions is not (and that dependence resulting from policies is not in itself problematic;) or that suffering resulting from being uninsured is more problematic than suffering resulting from insurance denying care. In his attack on Lieberman, Klein does not recognize the need to argue for such a position, or even to state it as an assumption.
February 5th, 2010 | 12:00 pm
[...] erudite James Poulos busts out his guns of conceptual analysis, busting Mr. Klein’s balls for trampling “an [...]
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