The Immorality of Medicare For Less Than All

“The Selfish Leftist Heart” pointed out that, despite presumed morality of their proposals and their apparent sincerity, viable American politicians never actually propose what they say they are proposing, “Medicare for All” (“MFA”). Instead, they propose MFA only for people who reside in America, all of whom are wealthy compared to the billions of vastly poorer people around the world (but, of course, those people cannot improve politicians’ election prospects).

With some exceptions,^[i] few, if any non-politician Americans clamor for MFA in order to gain personal benefits (though many personally do benefit from supporting MFA,^[ii] while others support MFA from immoral, fallacious or misguided reasons^[iii]). On the contrary, many, probably a majority of those people believe they will have to pay some part of the cost of MFA. They are happy to sacrifice for the goal they presume to be laudable. Their motivation is typically a belief that they are supporting a good cause, i.e., MFA is the moral thing to do. (Although a review of a couple of pages of search results produced no article in which the author(s) actually attempted a moral argument that supports the morality of their stance. Rather, the authors merely asserted MFA’s morality and proceeded on the strength of their unsubstantiated premise^[iv]—in so doing they also revealed that they do not understand what “moral” means.^[v]) Nevertheless, in order to sort out an important issue about MFA, let’s assume that someone has made a case that MFA for Americans is the moral thing to do. What about the billions of poorer people left out in the cold?

It is commonplace for MFA supporters to condemn those who do not support MFA as having insufficient (if not no) empathy. If, however, empathy is the reason to support MFA for those who cannot afford healthcare, how can those condemners justify limiting their empathy to the lucky few who happen to reside within America’s borders, i.e., people who already have much more access to healthcare (e.g., ambulance services, world-class hospitals and doctors and many charitable organizations) than the bottom few of billions in the world? If funding MFA by fleecing millionaire and billionaire is a morally acceptable way to achieve the glorious goal of MFA, how can good people morally deny the “human right” to healthcare to the more desperate billions of poorer people in the world? Are the MFA proponents vastly less empathetic than they believe themselves to be? Are they tribalistic, America First people? Are they just pretending to be empathetic? Do they have no heart? Whatever the reason, if asked about their heartlessness toward poorer people, supporters of MFA for Americans only would have some explaining to do.

On the other hand, I’ve never seen MFA champions asked/challenged about this conundrum, and I suspect that the vast majority of them have never considered how constricted and discriminatory their empathy must be to support those proposals. (Full consideration of a topic is typically not a strong suit of champions.) Confronting this issue would surely create cognitive dissonance. How might they deal with the dissonance?

My guess is that most of them would respond by attacking the questioner, but some would grapple with the issue and ultimately relieve their cognitive dissidence (from realizing that they have been supporting a racially discriminatory and insufficiently empathetic proposal) and restore their empathetic self-image by switching their demand to “Medicare For Everyone in the World.”  After all, it was not long ago that no American politician would dare insist that America’s MFA cover U.S. inhabitants who did not follow U.S. immigration law to get here. Recently, when enough leftists realized that excluding “illegal aliens” from MFA caused cognitive dissidence, leftists began insisting that “undocumented immigrants” be covered, and Democrat politicians jumped to the front of that parade.^[vi] If leftists believe, as many do, that healthcare is a human right and MFA is the moral thing to do, is there a reason to believe that they would not assuage their cognitive dissidence and restore their empathetic pose by demanding MFA for everyone in the world? I think not.

However, neither MFA for Americans only nor everyone in the world is a moral proposition. Let’s sort out why that is true in the next post.

^[i] The 30.4 million (11.3%) U.S. inhabitants who do not currently have healthcare coverage expect to directly and immediately benefit. See “Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2018.” [The 11.3 % figure adjusts the 13.3% figure presented in this report (which was the percentage of uninsured Americans younger than 65) to take into account the 15% of Americans who are covered by Medicare.]

^[ii] Many, perhaps most, people who support MFA gain from combinations of the following:

1. The dopamine rush from believing their support is doing something moral/noble,
2. Reducing the risk that they will be vilified, shunned, derided, ridiculed, or fired from their job by the mob that favors MFA,

^[iii] Some of the supports of MFA believe they will gain from some or all of the following reasons:

1. They believe their desire for revenge against you name it, (e.g., drug or insurance companies, political opponents, the millionaires and billionaires who they believe will pay for it, all of the above) will be satisfied,
2. A belief in the promises of politicians that MFA will lower their own cost of health insurance, and
3. A reduction in their risk of destitution and lack of healthcare if they lose their job or otherwise run out of money.

^[iv] See  “Ady Barkan makes a moral case for single payer at first-ever Medicare for All hearing” and “Bernie Sanders: Why We Need Medicare for All.”

^[v]     Consider the following claim in WE CAN AFFORD TO HAVE HEALTH CARE FOR ALL IN THE U.S:  “The core argument in favor of universal health care is the moral one, especially for people of faith. 26-year-old Alec Smith of Minnesota died in 2017 because he could not afford insulin. That is immoral.” In light of Webster’s definition of “moral:”

1      a: of or relating to principles of right and wrong in behavior : ETHICAL

//moral judgments

b: expressing or teaching a conception of right behavior

//moral poem

c: conforming to a standard of right behavior

//took a moral position on the issue though it cost him the nomination

d: sanctioned by or operative on one’s conscience or ethical judgment

//a moral obligation

e: capable of right and wrong action

// moral agent

As you can see, “moral” has to do with a person’s behavior. The moral “argument” made about Alec Smith in the above quote was “That is immoral.” Who in the story about Alec Smith did the immoral act, and what wrongdoing was committed by that person? The correct answers are no one in the Alec story engaged in immoral conduct. If the cat, who has no capacity to be moral or immoral, or misfortune caused the woeful outcome, the outcome cannot be is immoral—outcomes are not acts.

^[vi] See “Where Democrats Stand.”