Reihan: Healthcare and Family Values

I'm late to the story of the Frost family, but it perfectly illustrates the tension between "pro-family" conservatism and "anti-statist" conservatism. I use scare quotes because both terms are of course self-serving. Anti-statists could claim to be the real pro-family faction because they want to place families and not the state at the heart of economic life. On the other hand, it's not obvious that the present US healthcare regime is in fact less statist than a lot of the plausible alternatives: huge amounts of money are being shaped and spent by the state, but in a decidedly inegalitarian way. Real anti-statists need to do more than defend the status quo, and to their credit they generally do. (The solutions proposed are sometimes dotty, but that's another matter.)

Here's my question: Would the world really be better off if, say, the four Frost children saw far less of their parents than they already do? I ask because we could imagine a world in which the Frost parents worked (even) longer hours a jobs that provided health care benefits, which would take an emotional toll not only on them but on their children, particular in light of the impact of the car accident. The children of parents who work night shifts, for example, tend to do worse in school, and they tend to have more behavioral problems. And we're talking about run-of-the-mill families, facing no sudden medical catastrophes.

I realize that this will strike some readers as absurd: tough luck, you'll say. My own parents worked four jobs between them until my father lost his public sector day job, at which point he concentrated full time on his small business. My mother kept working two jobs until health concerns made that impracticable. From fairly early on, I was a latchkey kid and my two older sisters did a lot of the things (attend PTA conferences, monitor my homework) parents normally do. We were well cared for, and I think the three of us turned out reasonably well. So I can see, in theory, the source of resentment: we have to work, and so should you. But who thinks the Frost parents aren't doing their best to balance all of the needs of their children?

When small-government advocates argue that S-CHIP is supposed to be public assistance for the poor, they make an excellent point. Targeting aid to those who need it most makes sense when we're talking about scarce resources. But this begs the question: how scarce are the resources we're talking about, namely federal health care dollars? Are we really distributing these dollars in the smartest, most equitable way? Should a family like the Frosts have to plead poverty when they're raising four kids, who will grow up to make contributions to our tax coffers (to put this in the crudest possible terms) that more than outweigh the costs of keeping them healthy?

If S-CHIP is the wrong way to help families like the Frosts, and I don't dismiss this possibility, this requires an alternative strategy to meet their needs, not Dr. No politics. For me, the most relevant fact is the asymmetric shock: the impact of a car crash on the family's economic well-being.

I'm pretty uncomfortable talking about a particular family in this way. There's no way to fully understand the choices they've had to make. I will say that demonizing them is a lot worse than dumb, and I hope the person who cooked up the idea of putting a 12-year-old in the spotlight has a better appreciation of the dangers, not least of them exposure to crazy vitriol, involved.

Comments

gotta say, i'm getting to be an ezra kleinist on this. the terror of shocks immobilizes a lot of people and prevents them from taking risks.

Posted by razib | October 10, 2007 10:41 PM

You wer edoing great until your last sentence where you seem to be placing as much blam on whoever picked the 12 year old as on Malkin and her deranged ilk.

Shall go through the long list fo children the republican party has used to promte isues, snow flake babies posing with Bush, that 12 year old girl in the add, the 9 year old promoting SS reform, and on and on

But you do have one valid point, they can put all these kids in Republican campaigns wihtout thinking about this issue because quite simply there is liberal who will stoop to the levels of Malkin et al. Seriously, pick your worst bogeyman on the left, Ted Rall? Michael Moore? or whoever, find a single example of them attacking a kid the way Malkin does here.

And by the way you really need to read Ezra post with the quote from Malkin about her own insurance situation in 2004.

Posted by eric k | October 10, 2007 11:53 PM

Where exactly does Malkin, or anyone, attack the kid? Arguing that the parents, and/or the Democrats, shouldn't have put the kid up front is not attacking the kid. Neither is saying that the parents shouldn't qualify for government health insurance.

Posted by Dave | October 11, 2007 12:21 AM

Eric K: I hope it's obvious that the same "criticism" (pretty mild, I think) applies to anyone who uses kids. And please note that I refer to "crazy vitriol": it's clear who the bad guys are, and I think it's silly to think of this in political rather than human terms. Clearly I'm almost alone in this regard.

Posted by Reihan | October 11, 2007 1:55 AM

Reihan,

I get where your going, but your last sentence was a little harsh.

I tend to agree with you that having the kid be the spokesperson in the ad was a mistake, but for a different reason, I think it is schmaltzy and tacky and it is just as bad when either side does it.

As far as using the Frosts as an illustration of SChip they are an ideal model, a lower middle class family that now has 2 kids with a pre-existng medical condition making it virtually impossible to get insurance. John Cole's post was very apt, they are the very model of what the right claims to support.

The nonsense Malkin and her band of merry followers are spinning to make them look rich is probbaly going to help our side in the long run.

Posted by eric k | October 11, 2007 2:49 AM

I'm with all the folks who said you were doing great until the last sentence. Politicians (and advertisers and just about anyone who uses PR) use kids and other sympathetic folks as spokepeople all the time. It can be shmaltzy and manipulative (although I don't think it was here, as the kid was telling a true story) but it's really not especially unusual or risky.

The whole "the shouldn't have put the kid out there" argument is akin to the man with a baseball bat standing next to my smashed up car saying "this is your fault for parking it in the driveway."

What's frightening is that Malkin and her ilk seem to think that publically opposing Bush makes you fair game for any kind of harrassment and slander they can think of. That's just thuggery and should be acknowledged as such.

Posted by Justin K. | October 11, 2007 11:26 AM

Bingo -- this is why the conservative coalition is cracking up. People who take family values seriously cannot fit in the same tent as those whose first instinct when hearing the Frost family is to sneer.

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And yes, these tactics have a long history. Both Clinton and Bush loved to surround themselves with the beneficiaries of a law when they signed it. The Administration has long hid behind the military, as the recent "Betray-us" tempest demonstrated.

But having a 12-year old deliver the party's radio address does seem to cross a new threshold. Is this really what we want politics to be about? A series of debates about whether it's OK to criticize whatever sympathetic poster child the other side puts out there? I don't think that's going to get us too far.

It would have been much better for public discourse if the Democrats could have found a way to make their point without putting a family in the crosshairs. That doesn't make them wrong, but I don't think Reihan's out of line in calling the Democrats out on it.

Posted by JohnMcG | October 11, 2007 11:40 AM

JohnMcG: You're flat wrong. No new threshold at all was crossed by the Democrats here. As has been amply documented, Bush travelled with a nine-year-old to promote his Social Security plan, surrounded himself with "snowflake babies" when vetoing the stem cell bill, etc. Politicans use kids as spokespeople and poster children for the same reason the folks who sell Macaroni and Cheese do, because they're sympathetic.

The kid wound up in the crosshairs because a gang of assassins took aim. Malkin, Steyn, and co. bear full responsibility for the harassment the Frosts have endured. To say otherwise is moral astigmatism.

Posted by Justin K. | October 11, 2007 12:33 PM

I basically agree with Mark Steyn when he says: "I support lower taxes for the Frosts, increased child credits for the Frosts, an end to the "death tax" and other encroachments on transgenerational wealth transfer, and even severe catastrophic medical-emergency aid of one form or other. But there is no reason to put more and more middle-class families on the government teat, and doing so is deeply corrosive of liberty."

In other words, people do want the Frosts to have more money and time, but we want it done in a way that maximizes liberty and minimizes governmental encroachment -- and minimizes politicized increases in benefits every time it's renewed, *ahem*.

Posted by Joe Marier | October 11, 2007 1:13 PM

Joe, you and Steyn and whoever are going to have actually demonstrate that S-CHIP or some other gov't health insurance plan is actually "corrosive to liberty". Strikes me that, in the case of the Frosts, being without S-CHIP coverage, and winding up bankrupt and/or not getting their kids the treatment they needed would be far more corrosive to liberty than their current situation. The public health care programs we have now, like Medicare, S-CHIP, Medicaid, and the VA system, are, I'd argue huge boons to liberty, because being healthy with less bebt burden, and having some kind of guarantee that you'll get medical care gives you a lot more liberty than the alternative. This is why a national health care plan could really increase freedom in this country, freeing people from underpaying or stifling jobs that they stick with you health benefits, giving the currently unsinsured the security they need to take rests and self-determine, freeing people from crushing medical debt. Even if this requires higer taxes, I would say liberty is increased.

The sort of libertarian system some folks have been arguing for is actually incredibly limiting. If one mistake or run of bad luck can ruin you physically, financially, and otherwise, you'll live a cautious, scared life with little potential. Sadly, for many conservatives that seems to be a feature, not a bug.

Posted by Justin K. | October 11, 2007 5:49 PM

What Justin said.

Also, supporting catastrophic medical care for children but not ordinary medical care is incredibly short-sighted. Many serious pediatric health problems are precisely the sorts of things that can be averted with preventative care. Spending a dollar on S-CHIP could very well mean not spending $1,000 down the line on something that could have been prevented.

Posted by Dilan Esper | October 11, 2007 6:58 PM

Steyn quote: " "I support lower taxes for the Frosts, increased child credits for the Frosts, an end to the "death tax" [sic] and other encroachments on transgenerational wealth transfer,"

Of course, to put it in Sesame Street terms, one of these things is not like the other. The estate tax currently 'encroaches', iirc, only on the portion of the deceased's estate that exceeds 2 million smackaroos, and the extent of that encroachment is that the heirs receive - on top of the exempted 2 million - only 55% of the extra amount. Raise your right hand if you think an end to the estate tax is at all likely to help the Frosts. Ok, raise your left hand if you think an end to the estate tax would either not affect the Frosts, or that the resulting loss of gov't revenue might well lead to them facing slashed services or higher taxes.

"This is why a national health care plan could really increase freedom in this country, freeing people from underpaying or stifling jobs that they stick with you health benefits, giving the currently unsinsured the security they need to take rests and self-determine, freeing people from crushing medical debt."

Something I've been quoting a lot lately is John Holbo's excellent review of Frum's book Dead Right

"[Frum writes]“The great, overwhelming fact of a capitalist economy is risk. Everyone is at constant risk of the loss of his job, or of the destruction of his business by a competitor, or of the crash of his investment portfolio. Risk makes people circumspect. It disciplines them and teaches them self-control. Without a safety net, people won’t try to vault across the big top. Social security, student loans, and other government programs make it far less catastrophic than it used to be for middle-class people to dissolve their families. Without welfare and food stamps, poor people would cling harder to working-class respectability than they do not.”[end of Frum quote

The thing that makes capitalism good, apparently, is not that it generates wealth more efficiently than other known economic engines. No, the thing that makes capitalism good is that, by forcing people to live precarious lives, it causes them to live in fear of losing everything and therefore to adopt – as fearful people will – a cowed and subservient posture: in a word, they behave ‘conservatively’. Of course, crouching to protect themselves and their loved ones from the eternal lash of risk precisely won’t preserve these workers from risk. But the point isn’t to induce a society-wide conformist crouch by way of making the workers safe and happy. The point is to induce a society-wide conformist crouch. Period. A solid foundaton is hereby laid for a desirable social order.

Let’s call this position (what would be an evocative name?) ‘dark satanic millian liberalism . . ."

Posted by Dan S. | October 11, 2007 8:54 PM

Justin,

Listen, I don't like it when presidents sign statements in rooms with the most sympathetic benficiaries of their policies, etc. I wish they would stop.

But to have a twelve year old actually deliver and address, which is supposed to be the politician's job, is a new low. Yes, it's a matter of degree rather than kind, but an unwelcome one, in my book. The only response is to challenge their neediness, which is nasty, and politics becomes a game of who can dig up the most sypathetic poster child.

I agree with you that S-CHIP enhances freedom. As a father of a child with a chronic diseases, I would welcome the ability to have other work arrangements avalable to us.

Posted by JohnMcG | October 12, 2007 10:05 AM

Let me put the difference this way -- the Bush/Clinton tactic is surrounding yourself with sympathetic victims. What the Democrats did was shove the sympathetic poster children out in front.

Politicians are supposed to fight for their contituents, not the other way around.

Posted by JohnMcG | October 12, 2007 11:49 AM