garrison state issues free candy
opponents of garrison state offer rousing cheerAt Salon, the eminently sensible Glenn Greenwald raises an eyebrow at the news that federal officials are unable to find records of the Virginia Tech shooter's medication history in their files:
Is there any good reason whatsoever why the federal government should be maintaining "files" which contain information about the pharmaceutical products which all Americans are consuming? The noxious idea has taken root in our country -- even before the Bush presidency, though certainly greatly bolstered during it -- that one of the functions of the federal government is to track the private lives of American citizens and maintain dossiers on what we do.I very much agree, but I've also bookmarked Greenwald's post for future reference when the debate begins in earnest over the implementation of single-payer health care. Because, yes: When the government pays for all of your medical care, then they will of course have all of your medical records, and they will know what medication you take.
If you oppose the surveillance state erected by the Bush adminstration over the last six years -- the NSA's domestic eavesdropping and the abnegation of FISA laws, the FBI's national security letters, the Patriot Act provision for obtaining library records without a warrant, watch lists on top of watch lists -- but favor single-payer health care, I'd like to hear how you build that argument.
Or try this: If you oppose the Partial-Birth Abortion Ban Act, and deplore this week's Supreme Court ruling on that law, and think your body is none of the government's business -- but favor single-payer, in which case the government will in fact see all of your ob/gyn bills -- how do you reconcile these two sets of political beliefs? How will the government pay for your prenatal care without maintaining a "dossier" on it? How then would a successful abortion ban not be enforced through law enforcement access to your medical records?
Or put it this way: If Bill Frist's diagnosis-by-video of Terri Schiavo turned your stomach, and you thought the Republican Congress should have stayed out of the question of her ongoing care, do you think the Republican Congress would have had more power to intervene or less power to intervene if they had been paying all the bills for that care?
The bottom line is that the successful implementation of single-payer in, say, 1999, would have meant that George Bush would have been in charge of your health care for the last six years. The successful implementation of single-payer in 2009 means that President Romney will be in charge of your health care in 2010.
I'm baffled that legions of sensible people have correctly identified the element of unbounded state power in the actions of the Bush Cult, but see no such implications in single-payer, which would apparently just be a really neat chance for the government to help. Like Irving Kristol said, defining neoconservatism back in 2003, the new conservative paradigm is to aggressively use state power to helpfully shape a neat new culture:
The steady decline in our democratic culture, sinking to new levels of vulgarity, does unite neocons with traditional conservatives -- though not with those libertarian conservatives who are conservative in economics but unmindful of the culture. The upshot is a quite unexpected alliance between neocons, who include a fair proportion of secular intellectuals, and religious traditionalists. They are united on issues concerning the quality of education, the relations of church and state, the regulation of pornography, and the like, all of which they regard as proper candidates for the government's attention.Anyway, I can't wait until Sam Brownback has funding authority over AIDS treatment -- just think progressive the outcome will be.
posted by Chris Bray @ 5:39 PM
11 Comments:
If you oppose the surveillance state erected by the Bush adminstration over the last six years... but favor single-payer health care, I'd like to hear how you build that argument.
I don't think there's any inconsistency here. I favor effective, legitimate collection and use of information by the government and oppose unconstitutional collection and illegitimate use. I don't oppose the FBI or NSA, I oppose misuse of those organizations. Similarly, I favor giving the government access to the information needed to operate national single-payer health care but oppose letting them then use that information for other purposes.
There is always the potential for misuse of information but that needs to be balanced by the potential benefits and, I think, should be accompanied by more rigorous oversight.
People who oppose national health care because then the gub'mint will be able to see their private information ignore the fact that the government could always access their private information if they were willing to violate the law. Just ask Daniel Elsworth.
I think you're right, Chris, that the potential for abuse is real. However we have ways of limiting that: the Federal Reserve Board system, for example, or the rarely-compromised confidentiality of the IRS.
President Romney? Seriously? And you came back to this country?
Dude, "President Rachel Paulson," on tap for 2028.
"...accompanied by more rigorous oversight..." Like a kind of maybe FISA court thing?
The thing is, the state always slips boundaries. The national security letters that were supposed to be for time-sensitive terrorism investigations? The FBI IG now says the organization uses them to go after, like, shoplifting on federal property. And they don't keep complete records, sorry 'bout that.
RICO laws were for the mafia, until federal prosecutors figured out they could use them on unicorns, puppies, and the Girl Scouts.
I've been trying to google up the story about the local prosecutor who cleverly decided to use his state's post-9/11 chemical weapons statute to file WMD charges against drug dealers, on the legal theory that drugs are a chemical and people sometimes die from taking too much.
And when the state has records of medical care, some clever fuck somewhere is going to get the idea of using them to police (take your pick) drug use, sexual behavior, and/or pregnancy. They'll have the records! Oversight punishes; it catches people later, standing over the body with the gun.
The state has a significant role; I'm not a Lochner nostalgist, and I (heart) the regulatory state, within its well-guarded boundaries. (I often say, in discussion with an old friend who thinks we should just shut down everything but the fire department, "yeaaaah, I really miss the days when people died from drinking milk.") But direct responsibility for another sixth of the economy?
(Apparently I lean heavily on the semi-colon, late at night.)
The state grows. Always. Our job is to hammer it back into its box. Why help it? The government is Audry; we're Seymour; and it's all, like, "Feeeeeed me, Seymour!"
Not me, man. I'm a pruner.
"President Jeb Bush."
"President Strom Thurmond IV."
"President Dick Che--"
Okay, that one actually hurts.
I understand your despair but (probably because I'm too chicken to face the future squarely) I don't share it. I don't think having universal health care makes a President Romney more likely or, given the tools government already has, significantly more dangerous.
We have a President who tortures people, locks up citizens without trial, evesdrops on their conversations without a warrant, and fires federal prosecutors for being insufficiently loyal. Do you really think he's staying up nights wishing he could peek in your medical records because then he'd have some real power? Well, not your records and not mine because the government already has those from our time in the service. And not anybody covered by Medicaire and Medicaid of course. And not those of anybody in two thirds of the US since those states already maintain such records. I'm not one of those who feels comfortable giving power to a Governor Schwarzenegger or Governor Bush that I'm afraid to give to the federal government.
I guess the bottom line is that any government power involves both risks and benefits. I am willing to accept a relatively limited risk of abuse of private information in return for medical care; something which almost everybody will need and many can't afford. I'm less willing to accept that risk in return for marginal improvements in the ability of the government to stop already vanishingly rare terrorist acts or to keep my neighbor from smoking pot.
(And abuse of semicolons rulez!)
Wait, your neighbor is smoking pot? Um... What would John Doe do?
My hope is that, if a discussion about single-payer becomes serious in this country, we'll get a detailed comparison (from our four remaining newspaper reporters) of the experience of other countries that already have it. Have politicians used their funding authority over medical care to try to implement social controls? Annnnd so on. I've been drinking the booze, so don't count on an articulate argument, here. Uh...
Oh, right: "We have a President who tortures people, locks up citizens without trial, evesdrops on their conversations without a warrant, and fires federal prosecutors for being insufficiently loyal."
Well, then, let's expand his authority into our bodies! Hmm.
I don't think Bush is "staying up nights wishing he could peek in your medical records because then he'd have some real power." But I do think that he'd have more real power if he had them -- if he had everybody's, since he already has mine -- and I do think that he'd want to use it. And the John Yoos of the world would be happy to help him figure out how.
In other news, my eight-year MSO ran out at midnight. I'm a civilian, completely and finally. Which, yep, explains the drinking.
Off to bed.
As a fervant supporter of single-payer: it's a fair cop. There's no free lunch, and you don't get universal coverage without universal aggregation of patient data (at least I can't imagine any way to do so that wouldn't be as much of a time/money sink as the current nightmare). And yes, misusing that data will be a red-hot temptation to the usual suspects in the "national security" apparatus.
I'm also not sure how much of a change from the status quo it really represents: right now, there's nothing at all that stops the FBI from dropping a National Security Letter on your doctor, hospital, pharmacist and librarian and getting all that data: single-payer might reduce the FBI's workload a bit in this case, but not necessarily by very much.
For me, this falls neatly under the heading of "problems I desperately wish we had, or were even on the verge of having to seriously worry about." Other countries have managed to implement universal health care without turning into police states: I'm optimistic that we can perform the same trick. In the meantime, I'd like to stop having to watch friends and family members go without basic medical care for once.
Congratulations on your freedom, Chris!
Thanks -- the army is being very army about the whole thing. I called the Human Resources Command this morning, and the nice person on the phone allowed that my contract was up, but added that my release orders haven't been posted. But the official position here at Team Cherkis-Bray World Headquarters is that Sgt. Bray no longer exists, so neener neener if you try to send him active duty orders again. I sent an "I'm done" letter, and we'll see what the response is.
It'll be a shame to miss out on Iran, but they'll muddle through without me. Maybe some of the millions of able-bodied young war supporters will enlist to take my place, he said with a shit-eating grin.
Ah, you did your time, and then some. If they want you, they'll have to draft me first!
And they probably will....
As far as I know, this isn't something that the Canadians or the Brits bitch about when they're asked about their systems.
Unless you're paying for it out of pocket, your insurance company has access to your medical records. At least Bush (Romney, Nixon, whoever) is term limited and impeachable. What was the vote in the last election for president of Blue Cross/Blue Shield?
Anyway, if the government gets into the medical records, it will piss off the doctors. If that happens, whichever party does it is dead meat.
I say we institute a draft before anyone has to go one day beyond what they reasonably expected. (Of course, by that I mean get them the fuck out of there.)
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