Guest post: Majority rules?
Opinion polls and democratic decision making
Anyone watching the recent health care vote on C-SPAN heard the same refrain from the Republican opposition: the healthcare bill (now law) is morally wrong because a majority of Americans oppose it. Many conservatives made this argument during the year-long slog, citing public opinion polls for support. Indeed, across the political spectrum public opinion polls are regularly used as a defense for or against particular legislation or government actions. But what do opinions polls really tell us? And what role should they have in deciding how we as a political society should act?
The impulse to invoke public opinion as a moral basis for democratic actions is understandable. Citizens in democracies are self-ruling. Acting contrary to the majority opinion is often seen as violating the public will. And opinion polls are as close as we can get in the short term at least, to taking the temperature of the public. Elections are held periodically, but they can only stop perceived injustices after the fact. For instance, assume Congress passes a wildly unpopular bill. It may take upwards of two years before the electorate can voice its disapproval through elections. But after two years, the damage may already be done. It is difficult to retroactively repair injustices. Opinion polls are all we have to assess the public will on a bill by bill basis.
But do opinion polls actually tell us the public will?
Buy this, citizen!
Constitutionally speaking, can Congress force individuals to purchase health insurance? Discussion at the Washington Post blog.
-Jake
Health care overload: whither inequality?
David Leonhardt’s “Economic Scene” column in today’s New York Times, entitled “In Health Care Bill, Obama Attacks Wealth Inequality,” is a must-read.
Equality, particularly of resources, is a much more popular topic among political philosophers than among politicians. After we get past the idea that all people are created equal, Americans tend to have an ambivalent relationship with equality and what it entails.
Many prize the value of personal responsibility and believe that inequality driven by working harder and better is, in some ways, a sign that our entrepreneurial capitalist system is working.
In debates about social welfare, discussions of inequality are largely veiled. Addressing poverty or promoting economic opportunity garner broader support than “narrowing income equality” or “redistributing wealth.”
Whether or not they arrive at similar conclusions, political philosophers tend to be much more candid about what’s really at stake in these discussions: equality (what kind, how important, by what means?). That’s a good thing. It’s one reason we have political philosophy–to introduce clarity to public debate over values.
Although no one has really mentioned it until now, David Leonhardt makes clear that the health care bill is the biggest, most active federal effort to promote equality in almost 50 years:
The bill is the most sweeping piece of federal legislation since Medicare was passed in 1965. It aims to smooth out one of the roughest edges in American society – the inability of many people to afford medical care after they lose a job or get sick. And it would do so in large measure by taxing the rich.
A big chunk of the money to pay for the bill comes from lifting payroll taxes on households making more than $250,000. On average, the annual tax bill for households making more than $1 million a year will rise by $46,000 in 2013, according to the Tax Policy Center, a Washington research group. Another major piece of financing would cut Medicare subsidies for private insurers, ultimately affecting their executives and shareholders.
The benefits, meanwhile, flow mostly to households making less than four times the poverty level – $88,200 for a family of four people. Those without insurance in this group will become eligible to receive subsidies or to join Medicaid. (Many of the poor are already covered by Medicaid.) Insurance costs are also likely to drop for higher-income workers at small companies.
Love it or hate it, health care reform is a big deal. The real question is whether it promotes the society we want, or erodes the one we have. Or both.
-Sam
Was health care reform illegal?
The Washington Post yesterday described the intention of the Virginia Attorney General Ken Cuccinelli to challenge the health care reform bill in court by arguing that requiring individuals to purchase health care – the individual mandate — exceeds the federal government’s authority to regulate interstate commerce. Today, liberal health care blogger Ezra Klein investigates whether or not Cuccinelli has a legitimate legal case against the health care bill.
-Marc
But if the Dems lose in November, was it worth it?
Health care reform and future uncertainty
At lunch today, I overheard a conversation about Sunday’s health care vote. The conversation began with an unexpected questions: “If the Democrats lose Congress in November, would passing health care reform have been worth it?” The question is simple enough, but determining how to answer it most certainly is not.
For the sake of this post, I will discuss the considerations those who support health care reform would make when answering this question. The same kind of considerations would apply to any other piece of legislation – conservative or liberal.
So, was it worth it?
The Tebow ad, Continued…
So here it is, as it aired:
Not much controversial material there (viewers were told to visit Focus on the Family’s website for the full story, including Christian references and anti-abortion argument), but we’ve all heard plenty about the ad’s intent by this point.
But there’s more to debate here than the ad’s propriety – what about the validity of the argument? The argument being made is a version of the famous “Beethoven example” used by the pro-life community:
“About the terminating of pregnancy, I want your opinion. The father was syphilitic. The mother tuberculous. Of the four children born, the first was blind, the second died, the third was deaf and dumb, the fourth was also tuberculous. What would you have done?”
“I would have terminated the pregnancy.”
“Then you would have murdered Beethoven.”
Convincing, eh? Had Tebow’s mother made what many pro-choice advocates suggest is the “right decision,” we wouldn’t have her successful son Tim. Richard Dawkins rebuts this logic, reminding us that by the same reasoning, we should equally condemn each act of abstinence; after all, every decision NOT to have procreative sex deprives the world of a potential genius. Also, in order for Tim to exist, some 40 million rival sperm lost out in the race to an egg. One of those sperm could have grown up to cure cancer. Is Tim Tebow the man who prevented that cure? These thought experiments are quite interesting, and worth thinking about if we want to get our logic straight on abortion.
(That’s setting aside the factual inaccuracies of the example, as Beethoven was the eldest child, none of his siblings were blind, deaf, or dumb, and his father did not have syphilis).
-Colin
Vaccines and Autism
Bad science and good PR
Over the past few years, there has been a building movement against vaccinations in the U.S. on the grounds that they are either ineffective, harmful, or perhaps even part of an insidious government plot. This isn’t coming from the usual anti-science suspects, either – it’s largely coming from Hollywood: comedian Bill Maher has said he “would never get a vaccine,” and that he doesn’t trust the government, especially with his health. Maher believes that vaccines are a “Western” misunderstanding of health, and that a natural, healthy diet and lifestyle will ward off most maladies.
Actor Jim Carrey and former Playboy centerfold Jenny McCarthy are the most prominent among the anti-vaccine crowd, warning primarily of a link to autism. Autism rates have increased rapidly during the same period of time that vaccines have become widespread, they say. But the Carrey/McCarthy camp was dealt a serious blow last week when the British medical journal Lancet retracted a 1998 paper linking vaccines to autism by Dr. Andrew Wakefield.
Can government ban fast food?
After writing this week about the perfectionism-neutrality debate, I came across an interesting and related article in the Washington Post on a lawmaker that wants to prohibit Prince George’s from issuing new licenses to fast food restaurants in areas with high disease rates. Not surprisingly, opponents argue that what people eat is a matter of personal choice. But supporters claim that there are clear connections between poverty and fast food eating and between fast food and obesity, diabetes, high blood pressure and heart disease. The article cites a state study that found nearly 40% of Prince George’s county children under 11 were overweight and that most came from lower-income families. Indeed, one third of children in Prince George’s eat three or more fast food meals a week.
So, should government get involved in determining what food options are available? And if so, is it possible to make the case on a neutral basis?
Dealing with death
The New York Times has a nice update to an issue I discussed months ago – end of life decisions in health care and the angst that accompanies them. Official guidelines call on doctors to begin “the conversation” (about how a terminally ill patient would like to spend their final days) at about 1 year away from estimated death. But it seems that there are diverging opinions on the viability of these guidelines; this “conversation,” after all, is perhaps the most difficult a person will ever face and such emotionally taxing questions are sometimes as difficult for doctors to broach as they are for patients to digest.
One one hand, there’s our desire to remain hopeful as long as possible, if not to the end. Many patients – even when faced with dire forecasts – demand that doctors continue chemotherapy and other intensive (and expensive) treatments even when their effectiveness has worn off. They want to live like Sisyphus, knowledgeable of their unwinnable predicament yet committed to fighting ’till the end.
But of course, fighting costs money, time, and diverts resources away from others, and when patients request major surgeries and experimental treatments in the face of extremely low or impossible odds, utility seems to demand that they be overridden. Can we do so, however, without succumbing to the “death panel” argument? Is there something just inherently wrong about telling the terminally ill to give up?
The existentialist in us says that we can come to terms with our finality without falling into despair, but something tells me that doctors don’t read Camus in medical school.
-Colin
Lights, camera, health care reform?
Should the final round of health care negotiations be televised?
C-SPAN President Brian Lamb is asking to film the remaining health care negotiations. Is Lamb’s request reasonable, or would television cameras simply turn important negations into political theater?
Under normal circumstances, when there are substantial differences between versions of a bill in the House and Senate, some members of each chamber meet to resolve the differences in conference committee meetings that are open to the public. However, to prevent Republicans from using their formal powers to stall a formal conference committee meeting, Democrats will instead resort to a series of more informal private meetings and send the bill back and forth between the chambers until differences are resolved. Read more
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