It’s nice to think of ourselves, and the trajectory of history, as always moving in a positive, progressive direction. America’s record is essentially stainless, unless you count that whole slavery thing, or perhaps the Trail of Tears, or even the My Lai massacre; but, ultimately, we Americans surely mean well. That is why Peter Singer’s “Why We Must Ration Health Care” is one of the more blatantly disturbing articles to emerge from either Singer or the NYT magazine lately: it revives a certain historical sin that should stay buried in the past. If only the NYT would stick to showing us the latest fashions from Bryant Park or something else less dangerous.
Singer starts out with a reasonable enough premise, namely, that you cannot wish away rationing via the political process:
Health care is a scarce resource, and all scarce resources are rationed in one way or another. In the United States, most health care is privately financed, and so most rationing is by price: you get what you, or your employer, can afford to insure you for. But our current system of employer-financed health insurance exists only because the federal government encouraged it by making the premiums tax deductible. That is, in effect, a more than $200 billion government subsidy for health care. In the public sector, primarily Medicare, Medicaid and hospital emergency rooms, health care is rationed by long waits, high patient copayment requirements, low payments to doctors that discourage some from serving public patients and limits on payments to hospitals.
Libertarians and conservatives have been pointing out for some time that all scarce resources are rationed somehow. With government-controlled healthcare, the rationing is usually by time (long waitlists) instead of price. But the libertarians and conservatives are ignored, because they conclude that the government should get out of healthcare rationing. Singer gets prominent positioning in the NYT not only for pointing out what has been obvious for some time, but because he concludes that centralized control is the way to go. In other words, that there is no problem with a centralized system run by experts and bureaucrats—just a problem with its patients and victims. I may be a little slow on the uptake, but I’m seeing over and over that when a statist “solution” runs into problems, the people it is meant to help are the first to be discarded, not the system itself.
What is infinitely disturbing about Singer’s argument is that he explicitly says that an elderly person is worth less than a teenager:
As a first take, we might say that the good achieved by health care is the number of lives saved. But that is too crude. The death of a teenager is a greater tragedy than the death of an 85-year-old, and this should be reflected in our priorities. We can accommodate that difference by calculating the number of life-years saved, rather than simply the number of lives saved. If a teenager can be expected to live another 70 years, saving her life counts as a gain of 70 life-years, whereas if a person of 85 can be expected to live another 5 years, then saving the 85-year-old will count as a gain of only 5 life-years. That suggests that saving one teenager is equivalent to saving 14 85-year-olds. These are, of course, generic teenagers and generic 85-year-olds. It’s easy to say, “What if the teenager is a violent criminal and the 85-year-old is still working productively?” But just as emergency rooms should leave criminal justice to the courts and treat assailants and victims alike, so decisions about the allocation of health care resources should be kept separate from judgments about the moral character or social value of individuals.
On this year’s 4th of July, a friend of mine read the Declaration of Independence, and was shocked by its description of Indians as “savages.” He also wondered how on earth the atrocious “three-fifths person” valuation of blacks came about. What racist idiots we are descended from! People were so ignorant and backwards then! And here we are, in the 21st century, with Singer calculating that a senior is a 1/14 teenager. In a very respectable periodical, no less. One would think this negates his horrible views on abortion and infanticide—after all, a very young human has approximately 90 life-years to look forward to, provided Singer’s utilitarian system of “ethics” doesn’t get in the way.
Of course, this isn’t actually a contradiction of Singer’s views, because he has rather famously taken into account the worth of the currently helpless or disabled—they just don’t have the same rights to life as an adult human with his or her faculties and abilities intact:
If we return to the hypothetical assumption that a year with quadriplegia is valued at only half as much as a year without it, then a treatment that extends the lives of people without disabilities will be seen as providing twice the value of one that extends, for a similar period, the lives of quadriplegics. That clashes with the idea that all human lives are of equal value. The problem, however, does not lie with the concept of the quality-adjusted life-year, but with the judgment that, if faced with 10 years as a quadriplegic, one would prefer a shorter lifespan without a disability.
Now we get the disabled as half-persons. Got it. And again we see Singer start out with reasonable premises that he twists into monstrous conclusions:
[P]reserving our belief that everyone has an equal right to life is, however, a double-edged sword. If life with quadriplegia is as good as life without it, there is no health benefit to be gained by curing it.
There are so many things wrong here. For one thing, if we are always going to appeal to capital-s Science to justify our murderous agendas, well, there is plenty of happiness research going on right now that would contradict Singer’s views on quality of life. This research, roughly summarized, says that most people have a happiness baseline from which they deviate in times of great pain or good fortune (becoming paralyzed, or winning the lottery, respectively) but to which they return in six months or a year. Therefore it is wrong to always assume that disability equals despair, or that being able-bodied automatically guarantees happiness.
Another mistake: Singer confuses the “goodness” or “happiness” of a life, by whatever arbitrary measures he means to employ, with its value. I know I’m just a crazy doctrinaire libertarian, but I believe that everyone has an equal right to life whether or not Peter Singer thinks a particular life worth living. To say that “everyone has an equal right to life” is not the same as saying that “life with quadriplegia is as good as life without it.” Singer is correct to assume that quadriplegia could very well affect quality of life, to its detriment. But it does not follow from there that the life is no longer worth living, or is quantifiable in relation to a healthy young teenager’s life. And even if quadriplegics do return to their former baseline happiness, without intervention, that is not the same as saying that “there is no health benefit to be gained by curing [quadriplegia].” I may be depressed and contract pneumonia; if the pneumonia is cured but the depression remains, there is still an objective improvement in my health, even if I continue to slither around the house like a wounded bug.
Also, given what I’m sure is Singer’s faith in capital-s Science, shouldn’t he be optimistic that we will eventually figure out a cure for paraplegia, or vegetative states, or whatever health problems currently vex us? How ethical would it to be to, say, let paraplegics “die with dignity” only to find a year later that they could then be cured?
Finally, if some arbitrary “quality of life” measure is used to justify the withholding of treatment, how would we treat, say, disadvantaged minorities and women? Much of public health these days is concerned with racial disparities in health outcomes, with racism taking much of the blame. Would Singer argue that a black man presenting with diabetes should be turned away from costly care, since it is unlikely that he will live as long as a white with the same symptoms, or suffer from racism even if he should survive? Do women get preferential treatment since they can expect, on average, a longer lifespan; or, conversely, will they be turned away since the suffering of gender-based oppression, widowhood, etc. means that the quality of their final years will be depressingly low?
I read, and admired, Singer’s “Animal Liberation” when I was ten. I don’t remember much of it; I only know that it is frustrating that an honest concern for animal welfare seems to go hand in hand with a disdain for the value of human life. [I'm sure there'd be unprecedented ranting here on this blog if I were to pick up the book again.] I’m amazed to see my peers become outraged at the idea of market-based healthcare—or, Lord, eating meat—yet uncritically swallow Singer’s swill about rationing, so long as it means the State is in control.
This is What a Feminist Army Looks Like
July 23, 2009
Perhaps you’re sick of the story, but I never fail to be shocked and disgusted anew at watching so-called feminists cozy up to the war machine (like it’s a new vibrator! Couldn’t resist.) From Tom Hayden at the HuffPo:
Pentagon Enlists Feminists for War Aims
Over a decade ago a young woman approached me on the California Senate floor with a petition against the Taliban. Women are being repressed, tortured and killed by religious fundamentalists, she said. I signed on. The Taliban seemed like a Ku Klux Klan aimed at women. I was disgusted that the State Department and oil companies would negotiate with them over pipelines, with cursory regard for women’s rights. I still feel that way.
But I had no idea then that I was joining The Feminist Majority in a coalition with the Pentagon to invade and occupy Afghanistan. Given the respect I have for Ellie Smeal and Kathy Spillar, among others, it’s still hard to believe that they think Afghan women can be liberated by an invading, bombing, imprisoning American army. It’s hard to believe that Predators, drones, Special Forces, detention camps and foreign occupiers are solutions to Taliban fundamentalism.
It was so easy to see through Bush’s claims that the war in Iraq had anything to do with advancing women’s rights there. But Obama’s war in Afghanistan is somehow a different story. I’d say that doing the same thing over and over and expecting different results is supposedly indicative of psychosis, but what do I know? Psychiatry, as we know, is sexist. War, on the other hand, has always been an indispensable tool in advancing feminist agendas. Right?
Unfortunately, we are dealing with statist-minded feminists who think that because increased government intervention has not yet solved the problem, the only solution is to escalate the intervention. Let’s look at how much Western occupation has already accomplished:
Even the US-supported Kabul government showed its real character this year by passing a law requiring women to obey their husbands in sexual matters, in violation of the country’s own constitution and international norms.
A top United Nations official this month told a Kabul audience “that violence against women is not being challenged or condemned.” This was eight years following the Bonn Agreement which included human rights at its core. In northern areas under Western occupation, the UN report found that in 39 percent of rapes “that perpetrators were directly linked to power brokers who are, effectively, above the law and enjoy immunity from arrest as well as immunity from social condemnation.”
It’s safe to say the Kabul government will not be recognizing any NOW chapters among its local non-governmental organizations in the foreseeable future.
That is probably for the best. If the feminists think bombs are the answer, who needs enemies?
The FMF is not only wrong, but also evasive:
The Feminist Majority chooses to be uncharacteristically obscure in advocating more American troops as the solution. Its website speaks of more “peacekeeping forces” rather than an escalation of the occupation. They write that “virtually everyone knows that a military solution alone won’t work. Yet, we cannot ignore that security and the Taliban are among Afghans’ top concerns”, whatever that means. They quote an Afghan human rights activist, Sima Simar, who obliquely says “security must be re-established until the Afghan army and police can take over.” But they fail to note that the current Pentagon plan for establishing an Afghan security force will take at least ten more years.
Within some feminist circles it is practically a truism that “the master’s tools will never dismantle the master’s house,” yet the FMF seems all too eager to get their hands on the Pentagon’s tools:
The Feminist Majority is being used by the Pentagon to advance its war aims. Perhaps they believe they are using the Pentagon, though they don’t say it. One result is division and confusion within the peace movement. In soliciting support from genuine peace groups for Afghanistan, for example, The Feminist Majority is less than candid that the funds are linked to the escalation of the war.
My headline promised to show you what a feminist army looks like. Unfortunately, it looks an awful lot like this:
Steven Green
US ex-soldier guilty of Iraq rape
Chris Hedges, in his book “What Every Person Should Know About War,” reports that “in peacetime, male U.S. military personnel are less likely to commit rape than are male civilians of the same age. In the heightened aggression of combat, all violent acts are more common, including rape.” This means rape of the civilian population as well as their fellow soldiers: according to the LA Times article “Rapists in the Ranks,” women serving in the U.S. military are more likely to be raped by a fellow soldier than killed by enemy fire in Iraq.
I doubt that American feminists would want an army of men with guns to set them free from perceived abuses, yet they are all too willing to ship them overseas, where the men are known to become more violent. Many of these feminists are probably slightly put off by guns, men with guns, and especially groups of men with guns, but this distaste seems to evaporate as soon as it comes to forcing feminist agendas in remote lands. Your average feminist, particularly a lefty one, is probably disgusted by the attendees at a NASCAR race, for heaven’s sake; but replace their beers with AK-47s and put them in service of supposedly women-friendly goals, and everything’s suddenly fine?
If these feminists are at all honest, and not simply in love with power for power’s sake, then they are inadvertently making the same mistake that conservatives are often guilty of: assuming that a government which bumbles at home is going to suddenly accomplish its stated goals, efficiently and compassionately, as soon as you give it guns, planes and money. But, as painful as it is to say here, it is increasingly difficult for me to believe that mainstream feminists have women’s best interests at heart. The pursuit of power seems to have superseded the desire for equality.
Incidentally, from the statement Steven Green read at his conviction, it seems that he learned the hard and horrible way that war tends to bring out the worst in a soldier. What does it mean when a convicted rapist and former soldier can see that war is wrong and repent his involvement in it, but comfortable stateside feminists cannot?
Before I was in the Army, I never thought I would kill anyone, and even after I was in the Army, but before I went to Iraq, I never thought I would intentionally kill a civilian. When I was in Iraq, something happened to me that I can only explain by saying that I lost my mind. At some point while I was in Iraq, I stopped seeing Iraqi’s as good and bad, as men, women, and children. I started seeing them all as one, and evil, and less than human. When that happened, any natural, learned, or religious morality, that normally would have stopped this, was gone.
…I know that I have done evil, and I fear that the wrath of the Lord will come upon me on that day. But, I hope that you and your family at least can find some comfort in God’s justice.
I see now that war is intrinsically evil, because killing is intrinsically evil. And, I am sorry I ever had anything to do with either.
