Page 1 of 3 123 Last
  1. #1
    Wounded Ronin's Avatar
    Join Date
    Mar 2004
    Posts
    7,758
    Style
    German longsword, .45 ACP
    1

    Understanding political rage about government programs: really just identity?

    I found am amazing quotation in an article on Politico about use of government mandates for health care. In this case, the mandate in question is EMTALA, which was passed by Ronald Reagan and says that anyone who comes to an emergency room in the United States must be stabilized without regard towards ability to pay. If someone comes to the emergency room of a hospital that accepts funding for Medicare or Medicaid patients, it is illegal to turn someone away who is medically unstable. This includes people who are not necessarily inside the hospital, but come within a certain distance of the hospital, i.e. if someone were to collapse on the sidewalk outside the hospital.

    EMTALA is a fascinating subject because it is in fact "socialized health care" and it was passed by Ronald Reagan. However, it is arguably the "worst" way to pass socialized healthcare, in the sense it is the most expensive and least strategic way to handle health crises. The model in most of the rest of the world is to focus on primary care and broad society-level public health interventions, and not necessarily focus all the resources on emergency medicine, in order to impact the most peoples' health for the least cost. In the US it's sort of culturally the opposite; note the political rage against Obamacare because it tried to get people to make yearly doctor visits and mandated things like coverage for preventative vaccinations. Whereas, discussion of limiting highly aggressive end-of-life type interventions on the basis of reducing public costs seemed to inspire rage on the basis of being "rationing" and "death panels", from the same political corners that used to call for limits on government spending. For some reason, the global conventional approach seemed to be very controversial in the US and the discussion seemed to have little to do with the actual facts and elements of health care policy.

    Anyway, I found this paragraph that seems to suggest that the conservative rage against health care is actually just about identity. This would explain why the rage was very difficult to understand per my last paragraph.

    It’s a refrain Bebler hears constantly: America doesn’t look like it used to. My health care is too expensive and doesn’t cover my needs.

    Sometimes, the two gripes are married. Bebler said the main story he hears from patrons, over and over, is about people who don’t have insurance but who receive free care at the emergency room. Bebler, who doesn’t have health insurance, bristles at the thought. “I’d never do it in a million years,” he said. It’s a matter of pride and dignity.

    It’s a sentiment shared by his clientele, according to Bebler, and something many of them see as distinguishing themselves from immigrants and people of color. While “people who don’t have any money and really need government help” don’t accept handouts, Bebler said, channeling his customers, “too many minorities take advantage of stuff that they shouldn’t be able to take advantage of. That’s what I hear.”
    https://www.politico.com/magazine/st...olitics-222412

    So if this quotation is real, is suggests that the people with the rage don't really get into the details of how the health care works. They feel like they shouldn't take advantage of EMTALA, even though it was passed by Ronald Reagan, because they associate it with minorities. And then they conflate EMTALA with Obamacare, which of course is actually just Dolecare, i.e. Republican legislation originally proposed as an alternative to Hillarycare.

    So all the rage is totally meaningless and all the talk about repealing Obamacare was empty manipulation. But none of these people have noticed yet. Because the focus is not on looking up Dolecare and seeing it's the same thing as Obamacare and noting that there aren't apparently any better ideas for health care reform. It's all about somehow regarding EMTALA as a mandate that soley benefits minorities, and then in one's mind differentiating oneself from that group.

    If this is true it's disturbing. It means that manipulative nonsense is being allowed to sabotage and damage health care delivery in the US and that this is taking priority over actually doing things to improve healthcare. Under this logic, destroying healthcare for the people of the United States would be preferable to fixing it, because the only real priority is getting "the base" out to vote.


    What do you think? Is this interpretation of things accurate?
    Lone Wolf McQuade Final Fight: https://www.youtube.com/watch?v=VmrDe_mYUXg

  2. #2
    Nutcracker, sweet's Avatar
    Join Date
    Apr 2010
    Location
    KAUS
    Posts
    8,052
    Style
    BJJ/Judo/MT
    Quote Originally Posted by Wounded Ronin View Post
    I found am amazing quotation in an article on Politico about use of government mandates for health care. In this case, the mandate in question is EMTALA, which was passed by Ronald Reagan and says that anyone who comes to an emergency room in the United States must be stabilized without regard towards ability to pay. If someone comes to the emergency room of a hospital that accepts funding for Medicare or Medicaid patients, it is illegal to turn someone away who is medically unstable. This includes people who are not necessarily inside the hospital, but come within a certain distance of the hospital, i.e. if someone were to collapse on the sidewalk outside the hospital.

    EMTALA is a fascinating subject because it is in fact "socialized health care" and it was passed by Ronald Reagan. However, it is arguably the "worst" way to pass socialized healthcare, in the sense it is the most expensive and least strategic way to handle health crises. The model in most of the rest of the world is to focus on primary care and broad society-level public health interventions, and not necessarily focus all the resources on emergency medicine, in order to impact the most peoples' health for the least cost. In the US it's sort of culturally the opposite; note the political rage against Obamacare because it tried to get people to make yearly doctor visits and mandated things like coverage for preventative vaccinations. Whereas, discussion of limiting highly aggressive end-of-life type interventions on the basis of reducing public costs seemed to inspire rage on the basis of being "rationing" and "death panels", from the same political corners that used to call for limits on government spending. For some reason, the global conventional approach seemed to be very controversial in the US and the discussion seemed to have little to do with the actual facts and elements of health care policy.

    Anyway, I found this paragraph that seems to suggest that the conservative rage against health care is actually just about identity. This would explain why the rage was very difficult to understand per my last paragraph.



    https://www.politico.com/magazine/st...olitics-222412

    So if this quotation is real, is suggests that the people with the rage don't really get into the details of how the health care works. They feel like they shouldn't take advantage of EMTALA, even though it was passed by Ronald Reagan, because they associate it with minorities. And then they conflate EMTALA with Obamacare, which of course is actually just Dolecare, i.e. Republican legislation originally proposed as an alternative to Hillarycare.

    So all the rage is totally meaningless and all the talk about repealing Obamacare was empty manipulation. But none of these people have noticed yet. Because the focus is not on looking up Dolecare and seeing it's the same thing as Obamacare and noting that there aren't apparently any better ideas for health care reform. It's all about somehow regarding EMTALA as a mandate that soley benefits minorities, and then in one's mind differentiating oneself from that group.

    If this is true it's disturbing. It means that manipulative nonsense is being allowed to sabotage and damage health care delivery in the US and that this is taking priority over actually doing things to improve healthcare. Under this logic, destroying healthcare for the people of the United States would be preferable to fixing it, because the only real priority is getting "the base" out to vote.


    What do you think? Is this interpretation of things accurate?
    The rage conservatives have these days over free ER treatment is related to illegal immigrants, who - arguably - are not paying into the system in any way, shape, or form. Rayce was kind enough to point out in another thread that sometimes illegals will pool all of their stuff into a single tax return (which is both fraud and money laundering, of a sort). But I guess at least some money is going in? Just not enough.

    Then, consider the people who are most likely to show up at the ER, because they don't have and/or utilize the care that IS available to them via non-emergent channels.

    Finally, consider what we pay for out of our taxes or through our employers is health INSURANCE, not health CARE. There remains a huge gap, because not all medical treatments are covered, even partially, under insurance.

    Perhaps the argument was different when Reagan signed the legislation, that would be literally a generation ago.

  3. #3

    Join Date
    Sep 2015
    Location
    Italy
    Posts
    614
    Style
    Judo, Nippon Kempo
    My personal opinion about identity and government programs is that the relationship is the reverse: government programs generally are redistributive and at least to some degree people are OK with redistribution (eg. The quoted guy is OK with deserving poors using free Healthcare) but people who are pissed off by this redistribution will generally frame this as an handout to the undeserving poor, thus often using identity categories.

    Incidentally the distinction between deserving and undeserving poor is really old, I once read a book about the cultural conceptions on poverty in Europe in the early modern age and I think it came out in the 17th century (IIRC) about religious charities.

  4. #4
    Wounded Ronin's Avatar
    Join Date
    Mar 2004
    Posts
    7,758
    Style
    German longsword, .45 ACP
    Quote Originally Posted by submessenger View Post
    The rage conservatives have these days over free ER treatment is related to illegal immigrants, who - arguably - are not paying into the system in any way, shape, or form. Rayce was kind enough to point out in another thread that sometimes illegals will pool all of their stuff into a single tax return (which is both fraud and money laundering, of a sort). But I guess at least some money is going in? Just not enough.

    Then, consider the people who are most likely to show up at the ER, because they don't have and/or utilize the care that IS available to them via non-emergent channels.

    Finally, consider what we pay for out of our taxes or through our employers is health INSURANCE, not health CARE. There remains a huge gap, because not all medical treatments are covered, even partially, under insurance.

    Perhaps the argument was different when Reagan signed the legislation, that would be literally a generation ago.
    Thanks for your post. In regards to your first paragraph, why don't they simply say that? Instead the public discourse consists of them saying the word "illegal" repeatedly with palpable disgust, which suggests to listeners or onlookers that the speaker is xenophobic, and then things like "build the wall". I feel like if instead they simply stated, "We would like to ensure the availability of emergent health care services for all, so we have these concerns about the tax status of illegally employed foreign nationals." I feel like a few thoughtful words would probably heal the national divide. Why would people rather hear themselves chant nonsensical slogans and vague indignation?

    Regarding your other paragraphs about insurance not being the same as health care, this is true and a very real concern that affects many people. But the latest slogan play from the midterms was to try and rally conservatives against "Medicare for all." If the gaps in what insurance does is really a concern for conservatives, which it should be, it makes no sense to be broadly against democratic party efforts to reform health care. This should be a universal issue and if what you are saying is true it really seems that opposition is primarily about identity, I.e the other guy did it so it must be bad, and defunding it and destabilizing it will somehow magically help me.
    Lone Wolf McQuade Final Fight: https://www.youtube.com/watch?v=VmrDe_mYUXg

  5. #5
    Wounded Ronin's Avatar
    Join Date
    Mar 2004
    Posts
    7,758
    Style
    German longsword, .45 ACP
    Quote Originally Posted by MisterMR View Post
    My personal opinion about identity and government programs is that the relationship is the reverse: government programs generally are redistributive and at least to some degree people are OK with redistribution (eg. The quoted guy is OK with deserving poors using free Healthcare) but people who are pissed off by this redistribution will generally frame this as an handout to the undeserving poor, thus often using identity categories.

    Incidentally the distinction between deserving and undeserving poor is really old, I once read a book about the cultural conceptions on poverty in Europe in the early modern age and I think it came out in the 17th century (IIRC) about religious charities.
    I guess that this wedge play has quite a bit of history.

    How to defeat it, how can we make people see it is just another means of control?
    Lone Wolf McQuade Final Fight: https://www.youtube.com/watch?v=VmrDe_mYUXg

  6. #6
    Nutcracker, sweet's Avatar
    Join Date
    Apr 2010
    Location
    KAUS
    Posts
    8,052
    Style
    BJJ/Judo/MT
    1
    Quote Originally Posted by Wounded Ronin View Post
    Thanks for your post. In regards to your first paragraph, why don't they simply say that? Instead the public discourse consists of them saying the word "illegal" repeatedly with palpable disgust, which suggests to listeners or onlookers that the speaker is xenophobic, and then things like "build the wall". I feel like if instead they simply stated, "We would like to ensure the availability of emergent health care services for all, so we have these concerns about the tax status of illegally employed foreign nationals." I feel like a few thoughtful words would probably heal the national divide. Why would people rather hear themselves chant nonsensical slogans and vague indignation?
    When discussing illegal immigration with conservative/right winger/tea party/patriot/originalist types, it's probably helpful to understand that (probably the most egregious example) in 1994, guns they had legally owned were deemed illegal by fiat. Not the only grievance, but that one really stung.

    That some outside people can literally co-opt citizenship from our country is downright offensive, when you think about it, because the people that seem to be going after guns are the same people that seem to be extending olive branches and support and everything else to "the invasion." So, somemany people are beyond upset, and having a rational conversation becomes very difficult, if nigh impossible.

    ****, we can't have a real conversation about deporting the people that are currently here illegally, forget about the ones that are on the way. So, it's amnesty by default, and slights to every God Fearing Hard Working Real Man that just wants to put enough away to be able to watch Seinfeld reruns without having to worry if his monthly check is going to cover his expenses, and holy ****, maybe even leave a little over for his kids when he passes, so that his departure isn't too much of a burden on them, financially.

  7. #7
    Wounded Ronin's Avatar
    Join Date
    Mar 2004
    Posts
    7,758
    Style
    German longsword, .45 ACP
    1
    Quote Originally Posted by submessenger View Post
    When discussing illegal immigration with conservative/right winger/tea party/patriot/originalist types, it's probably helpful to understand that (probably the most egregious example) in 1994, guns they had legally owned were deemed illegal by fiat. Not the only grievance, but that one really stung.

    That some outside people can literally co-opt citizenship from our country is downright offensive, when you think about it, because the people that seem to be going after guns are the same people that seem to be extending olive branches and support and everything else to "the invasion." So, somemany people are beyond upset, and having a rational conversation becomes very difficult, if nigh impossible.

    ****, we can't have a real conversation about deporting the people that are currently here illegally, forget about the ones that are on the way. So, it's amnesty by default, and slights to every God Fearing Hard Working Real Man that just wants to put enough away to be able to watch Seinfeld reruns without having to worry if his monthly check is going to cover his expenses, and holy ****, maybe even leave a little over for his kids when he passes, so that his departure isn't too much of a burden on them, financially.
    Thanks again for your reply.

    I'd been under the impression that the right wing rage and schism within American society started with the Vietnam War, where society was divided along class lines. College educated well off people simultaneously had more ability to avoid serving in Vietnam while were also more likely to protest the war and direct extremely ignorant and mean spirited criticism towards people who'd actually gone and served. One Vietnam War memoir I read referred to how the "professionally sensitive" weren't sensitive enough to grasp what they were doing in that regard. I felt that was a very powerfully written insight.

    From reading and even asking people about their experiences at the time I also came to appreciate that many of the people who did get drafted didn't necessarily make an effort to avoid the draft because they felt that serving their country when called was the ethical thing to do, and not something to be cynically circumvented. The feeling of not being well received or even being stigmatized upon return must have been especially difficult. For my own understanding, this is the easiest way to understand the rage. Of course, it comes a number of years before the Assault Weapons Ban and actually occurred before I existed. I think of this because you say "not the only grievance".


    The Assault Weapons Ban is an interesting thing to contemplate because when I was a kid I hadn't grown up with guns and was pro gun control by cultural default. For reasons I perhaps can't fully articulate I nevertheless pursued training and interest in firearms once I was able and for a time was even a competitive shooter although I can't say I was any good. So I made a total reversal because now I'm against gun control of any kind which actually takes me further on this issue than many right wing people. From my perspective the Assault Weapons Ban is fascinating because it makes no sense. It's all about imagery and fear and about focusing on scary outlier events and not looking at the big statistical picture about mortality and morbidity which is rather where government should be looking. It would make more sense to ban cheeseburgers and restaurant meals that contain more than a certain amount of calories or saturated fats, than to ban military pattern rifles since heart disease kills many more than do military pattern rifles. At the same time, as a possibly unintentional side effect, I do feel it damaged the social fabric and cohesion of places where guns were an important part of culture. I see it as kind of analagous to how colonial powers tried to suppress traditional rituals and customs in places colonized, and tried to make the colonized people see themselves as being part of the colonial culture instead. One of the most famous examples of course is African kids being forced to say, "Nos ancestres, les gaulois..." in their education by French colonial authorities, when of course they weren't descended from Gauls.

    What's so staggering is the thought that politicians, who are supposed to understand the power of symbols and be good at manipulating people, didn't seem to understand the tremendous cultural impact of the assault weapons ban. I am not sure why they passed it, but it appears that in the long run it has caused them, and the nation as a whole, nothing but trouble. It's come again but I am still not sure that it gains the Democrats more votes than they lose. And once again I find myself asking, "Why????"

    People tell me that heart disease related deaths are different than those caused through criminal misuse of firearms. Not everyone seems to accept my logic.

    But, I feel like again, the right wingers would do so much better, and make the issue so much more sympathetic, if they stopped mindlessly repeating outlandish quotes from Wayne LaPierre, and simply stated, "Gun control is cultural imperialism", and made the same case I made above. I doubt that good hearted leftists could ignore such a message. So much division, heartache, and hatred, over sloppy language and poor choice of words.

    In my opinion due to Wayne LaPierre in the long run the second amendment is doomed because he's basically alienated all the demographics that will gain political power with time by his strident language and his blatant embrace of Donald Trump. It's almost as if he's more interested in short term donations than long term strategic victories.


    With regard to your point about citizenship, I thought it was very interesting because it highlights different ways of thinking about citizenship that exist in the US. Is it something sacred, or is it a legal status that indicates a reciprocal relationship of taxation (even expatriate taxation in the case of US citizens) with guarantees such as certain freedoms, access to healthcare, and so on? If it's seen as something sacred, it probably becomes possible to get offended over, say, foreign nationals gaming the system to gain said citizenship. Of course, the sacred way of looking at it is going to be vague in some ways, and doesn't lend itself to questions like, "why do many other Westernized nations have better social safety nets in specific ways X Y and Z, but for some reason we keep saying we don't deserve them or that gaining X is somehow equivalent to becoming the Soviet Union," and things like that.


    Anyway, it all goes back to language. I really do believe that if righties simply framed the issue of illegal immigration as being about supporting Western standards of labor laws and cracking down on businesses that knowingly break the law to cut corner on costs and safety, it would defuse a lot of the acrimony. There's no reason for all the language to be language of entitlement and outrage, or to be inarticulate. But for some reason no one steps up and says it in this way that isn't wrong and which would be a lot more diplomatic. Instead people get excited over forceful statements for the sake of being forceful statements.


    So the rage you're talking about is just too bad. If only people could let go of the rage, and realize that identity is arbitrary, there probably would be a much better political process. For myself I'm afraid that someone is going to be harmed by "angry policies" and my main motivation for voting etc. is harm reduction, to try and prevent anyone from being hurt. I don't buy into the idea of identity as being any kind of absolute truth. But I don't think that most people are ready for that mentality, so if that's not possible, I just wish they could let go of some of the rage and word stuff politely like I put above, so that politics would consist of something more than grandstanding.


    But who am I kidding? As I understand it, around the time the Assault Weapons Ban passed, Congress, lead by Joe Lieberman, also decided to investigate Mortal Kombat. Mortal Kombat was the threat. Not, say, the long term economic structural effects of globalizing trade. The attention of congress was turned towards military pattern rifles, and Mortal Kombat. Somehow that's the level we've been operating on.
    Lone Wolf McQuade Final Fight: https://www.youtube.com/watch?v=VmrDe_mYUXg

  8. #8
    Nutcracker, sweet's Avatar
    Join Date
    Apr 2010
    Location
    KAUS
    Posts
    8,052
    Style
    BJJ/Judo/MT
    Quote Originally Posted by Wounded Ronin View Post
    Anyway, it all goes back to language. I really do believe that if righties simply framed the issue of illegal immigration as being about supporting Western standards of labor laws and cracking down on businesses that knowingly break the law to cut corner on costs and safety, it would defuse a lot of the acrimony. There's no reason for all the language to be language of entitlement and outrage, or to be inarticulate. But for some reason no one steps up and says it in this way that isn't wrong and which would be a lot more diplomatic. Instead people get excited over forceful statements for the sake of being forceful statements.
    Damnit, I was going to bed, but you are articulate and respectful, so it's hard to at least not acknowledge your posts.

    So, apologies if this is a bit disjoint, but I'm working on 22 hours of consciousness, and a bit of wine...

    My earlier point should have been more clear. I believe that those on the right, and I guess I should include myself (so projection warning), have been on the "it's against the law," bandwagon for so long that patience has been lost in trying to argue that point. We know it's against the law, and the left knows it's against the law, otherwise "amnesty," would not be in our collective vernacular. So, immigrants are trying to do something which has "always," been against the law, but I (righties) can get prosecuted for something that was perfectly OK yesterday, and likely with more vim and vigor.

    I've been in business where something I did yesterday, completely legal, was then outlawed. It's a very sobering experience to learn that your job was just outlawed. AWB was a great example of that, it literally put companies out of business, almost overnight.

    Now, we can argue the morality of what they were doing, but when AWB wasn't renewed, that type of argument was kind of lost, except to theorists.

    So, put yourself in the position of just having your career abruptly ended, while at the same time watching tens of thousands of illegal immigrants get immunity for their transgression. It's unnerving, and that type of thing tends to curtail civil discourse.

  9. #9
    BKR's Avatar
    Join Date
    Jun 2009
    Location
    Bonners Ferry, Idaho
    Posts
    22,466
    Style
    Kodokan Judo/BJJ
    1
    Quote Originally Posted by submessenger View Post
    When discussing illegal immigration with conservative/right winger/tea party/patriot/originalist types, it's probably helpful to understand that (probably the most egregious example) in 1994, guns they had legally owned were deemed illegal by fiat. Not the only grievance, but that one really stung.

    That some outside people can literally co-opt citizenship from our country is downright offensive, when you think about it, because the people that seem to be going after guns are the same people that seem to be extending olive branches and support and everything else to "the invasion." So, somemany people are beyond upset, and having a rational conversation becomes very difficult, if nigh impossible.

    ****, we can't have a real conversation about deporting the people that are currently here illegally, forget about the ones that are on the way. So, it's amnesty by default, and slights to every God Fearing Hard Working Real Man that just wants to put enough away to be able to watch Seinfeld reruns without having to worry if his monthly check is going to cover his expenses, and holy ****, maybe even leave a little over for his kids when he passes, so that his departure isn't too much of a burden on them, financially.
    Not sure if rhetoric or not..

    The Assault Rifle Ban was not by fiat, it was an act of congress, in effect for 10 years.

    Any "assault" weapons or magazines already owned were grandfathered in as legal.

    It passed by a 52-48 vote in the Senate, and Bill Clinton signed it into law.
    Falling for Judo since 1980

    "You are wrong. Why? Because you move like a pregnant yak and talk like a spazzing 'I train UFC' noob." -DCS

    "The best part of getting you worked up is your backpack full of irony and lies." -It Is Fake

    "Banning BKR is like kicking a Quokka. It's foolishness of the first order." - Raycetpfl

  10. #10
    BKR's Avatar
    Join Date
    Jun 2009
    Location
    Bonners Ferry, Idaho
    Posts
    22,466
    Style
    Kodokan Judo/BJJ
    Quote Originally Posted by submessenger View Post
    Damnit, I was going to bed, but you are articulate and respectful, so it's hard to at least not acknowledge your posts.

    So, apologies if this is a bit disjoint, but I'm working on 22 hours of consciousness, and a bit of wine...

    My earlier point should have been more clear. I believe that those on the right, and I guess I should include myself (so projection warning), have been on the "it's against the law," bandwagon for so long that patience has been lost in trying to argue that point. We know it's against the law, and the left knows it's against the law, otherwise "amnesty," would not be in our collective vernacular. So, immigrants are trying to do something which has "always," been against the law, but I (righties) can get prosecuted for something that was perfectly OK yesterday, and likely with more vim and vigor.

    I've been in business where something I did yesterday, completely legal, was then outlawed. It's a very sobering experience to learn that your job was just outlawed. AWB was a great example of that, it literally put companies out of business, almost overnight.

    Now, we can argue the morality of what they were doing, but when AWB wasn't renewed, that type of argument was kind of lost, except to theorists.

    So, put yourself in the position of just having your career abruptly ended, while at the same time watching tens of thousands of illegal immigrants get immunity for their transgression. It's unnerving, and that type of thing tends to curtail civil discourse.
    I think we have legal processes for legal immigration. People who circumvent that, regardless of personal circumstance, are (alleged) criminals (Federal misdemeanor first offense).

    We need to follow and enforce our duly enacted immigration laws.

    Not any different than any other laws of the land.
    Falling for Judo since 1980

    "You are wrong. Why? Because you move like a pregnant yak and talk like a spazzing 'I train UFC' noob." -DCS

    "The best part of getting you worked up is your backpack full of irony and lies." -It Is Fake

    "Banning BKR is like kicking a Quokka. It's foolishness of the first order." - Raycetpfl

Page 1 of 3 123 Last

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

Log in