One of the puzzling (when I'm being charitable) characteristics of modern "liberalism", aka progressivism, as practiced by the Left is the huge number of paradoxes. Not personal paradoxes, as former Senator Craig embodies, but rather paradoxes within their policies and principles.

John Edwards, one of the top three Democrat contenders for his party's nomination, has once again demonstrated this penchant. In doing so, he raises some interesting questions...

Edwards backs mandatory preventive care.
TIPTON, Iowa - Democratic presidential hopeful John Edwards said on Sunday that his universal health care proposal would require that Americans go to the doctor for preventive care.

"It requires that everybody be covered. It requires that everybody get preventive care," he told a crowd sitting in lawn chairs in front of the Cedar County Courthouse. "If you are going to be in the system, you can't choose not to go to the doctor for 20 years. You have to go in and be checked and make sure that you are OK."

He noted, for example, that women would be required to have regular mammograms in an effort to find and treat "the first trace of problem." Edwards and his wife, Elizabeth, announced earlier this year that her breast cancer had returned and spread.

Questions for debate:

1) How does Edwards' requirement square with the Progressive's purported commitment to individual freedom?

2) Do you think its likely that other candidates will adopt the same concept?

3) Do you think the concept is a sound one?

4) What do you think is the rationale for Edwards' position?

1) How does Edwards' requirement square with the Progressive's purported commitment to individual freedom?

Let's think about this more broadly, as a philosophical issue. The problem we all must consider in any "free" society is the proper balance between individual liberty and the welfare of individuals in society. There are many reasonable positions one can take on any particular issue. When it comes to health care, for example, the extreme libertarian position might be that each person must pay for her own medical care, or be denied it. The other extreme might be that every individual has the right to total medical care, to be paid for by taxes. The question is where the best place between the two extremes might be. The fact that there is not agreement about this is why politics exists at all.

To be more specific, apparently Edwards believes that the lost of liberty required by mandatory preventative health care is justified by the benefit of reducing serious illness and all the costs that it places on society. I personally think he has gone too far, but I can see his thinking. It's similar to the benefits to society of mandatory vaccination, but quite a bit more burdensome to the individual. I tend to think that people should be allowed to withdraw their children from mandatory vaccination programs, but that they jump through some hoops in order to do so. (Signed forms and the like.) I tend to think that they should not have to jump through hoops in order to withdraw from mandatory preventative health care.

Which really has little to do with the fact that all reasonable conservatives and liberals are in favor of individual freedom, and that none of them are opposed to it.

2) Do you think its likely that other candidates will adopt the same concept?

Probably not. As I have said, it goes too far. I suspect that other liberal candidates will favor strongly encouraged preventative health care, which benefits everybody. (The most powerful tool for this, of course, is money. Preventative health care should be cheap and easy, with financial benefits given to those who take advantage of it and those who provide it.)

3) Do you think the concept is a sound one?

As I have explained, I do not. There are better ways to deal with the problem of health care, and the failure of many Americans to make use of prevention.

4) What do you think is the rationale for Edwards' position?

As said above, he apparently thinks the benefit is worth the burden. I don't agree, but I can see his point, just as I can see the point of those who favor seat belt laws (as I tend to do) and those who do not.

Now can we get away from the whole controversy about whether conservatives and liberals are good or bad, and talk about specific policies?

I really don't see it as a contradiction at all. one doctors visit a year hardly amounts to oppression. Equating not seeing the doctor for twenty years as "freedom" is a bit of a stretch. If you go to the doctor and you descover a tumor has been slowly growing, or that you have a problem you never knew about, I don't think you would have a problem finding that out. After all, going undiagnosed would certainly impact your "freedom" later on as the cancer would spread or you would suffer a debilitating stroke that would be more of a limit to your freedom by putting you in the grave or in the nursing home. I think people are more concerned about having the "liberty" to get medical care in the first place, as opposed to just being left alone and not receive any care.



I don't believe so, the idea of preventive care is too cutting edge for them. I'm surprised they don't focus on it more as companies like Safeway have noticed that preventive care cuts the cost of medical care and that a majority of health costs are behabior related-certainly fixable. This is one important way to reduce cost, if not to ensure better access. The benefits are more than clear as to why preventive care is good for everyone.



[b]4)

It doesn't but I've never really thought of Progressives as being particularly concerned with individual freedom.
No. All one has to do is look to other countries with similar health care and it becomes clear this isn't a great plan.
In the UK they're looking at a points system wherein people who eat veggies will be awarded points and potentially won't treat people who live unhealthy lifestyles. Wanna talk about slippery slope?
He has to say something interesting.

But the thing about the Safeway plan that you mentioned is that it seems to encourage preventative visits, but doesn't mention at all how many people use them.

I found that the article only mentioned the deductible (which seems high). I'd have to see what it was like before, what the plan is now, etc to really feel like any progress has been made. That article sounded like a Russian propaganda piece.

Too cutting edge? I think that in the US, forced preventative care goes against the very grain of being American. I personally run, work out, eat better than most (admittedly not always healthy), don't smoke, etc. Why should I have to go to a doctor at some prescribed time? I give blood regularly (and get bp and cholesterol checks), etc. How invasive would these visits be? How long will they take, etc?

Now- if a healthcare plan allowed for discounts for going to the dr, living healthy, etc I'd be all for it. It would be MY decision to go (which $ is a great motivator to deal w/ the inconvenience). I think all healthcare plans should offer this.... maybe a 10-20% discount for people with low blood pressure, who have regular clean bills of health, etc.

Something the article you linked DID say is that 50-60% of health problems are behavior driven. Take a walk through my office. Go outside, hit the break room at lunch time. It's easy to see why Americans are getting fatter and less healthy. No one walks, people smoke, eat junk food regularly, etc.

I vote for discounts. It would motivate some people who are on the fence. I know alot of cheap people who might quit eating McDonald's if it would save them $100 a month (or whatever).

1) How does Edwards' requirement square with the Progressive's purported commitment to individual freedom?

If John Edwards is a Progressive then George Bush is a fiscal conservative...

Seriously, can we at least try to demonstrate an understanding of nuance when regarding politics? Not every registered democrat is a Progressive, and not every Republican is a conservative. This plan has nothing to do with Progressive politics (a nebulous term at best), and your attempts to link the two are either an act of ignorance or malice. A progressive plan would involve creating a system where everyone would have EASIER access to such checkups provided by the public infrastructure, as opposed to MANDATORY access.

1) How does Edwards' requirement square with the Progressive's purported commitment to individual freedom?

If something is mandatory, then it should be free. Fund the thing with tarrifs on imported oil, make the Hummer and prairie schooner crowds pay for it by levying the tarrif after the 15th gallon of gas purchased at the pump. Maybe a licence tag fee. Or tax the hell out of fast food with high fat content, high fructose soft drinks. Something like that.

2) Do you think its likely that other candidates will adopt the same concept?

Eh, could be. I'm not trying to figure out their positions on health care at this time. I'm actually not paying attention to anything other than Comedy Central and YouTube, an occasional glimps at newspaper.

3) Do you think the concept is a sound one?

I should really be getting yearly checkups. Last time I saw a doctor was in 1991, and he wanted to do all sorts of things to me. So, it's okay to do the mandatory checkup idea if funded as I suggest, but nobody should be required to follow doctor's orders. They are often wrong and their eyes make ca-ching sounds, dollar signs in them. Same for some dentists. Universal health care should not pay for yachts.

We also need better information on what health care is truly preventative and what is pushing expensive tests on people for no good reason other than they are expensive.

Heh, I suppose an argument can be made that certain lifestyle decisions shorten life, and thereby save on Social Security. Smokers should get SS after age 55. Smokers and drinkers should get twice as much. Smokers, drinkers and drug abusers four times as much, and if you ride motorcycle without a helmet to boot, YOU WIN A MILLION BUCKS! Just kidding.

4) What do you think is the rationale for Edwards' position?

Good preventative medicine prevents expensive disease treatments. A stitch in time saves nine.

Fair enough. The politico descriptors were used incorrectly giving the reader a mixed message. I think the word mandatory was used as a guarantee for universal access. Remember medical access is not consistent in America as the film Sicko has pointed out. Here the word was used as a non-discriminatory qualifyer.

1) How does Edwards' requirement square with the Progressive's purported commitment to individual freedom?
Freedom = Slavery. Or, as CS Lewis put it:
Of all tyrannies, a tyranny exercised for the good of its victims may be the most oppressive. It may be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end, for they do so with the approval of their consciences.

2) Do you think its likely that other candidates will adopt the same concept?
Only if they are honest. Government health care is "free," so people will have less incentive to moderate behavior on their own . Therefore, the government will have to coerce them to do so.

3) Do you think the concept is a sound one?
Preventative health care? yes. Government-mandated? no.

4) What do you think is the rationale for Edwards' position?
Well, obviously, he's just being consistent. For a dead-baby-channeling psychic medium / shameless fraud of a shyster trial lawyer, these two things mean the same thing:

Edwards on Abortion
Q: What is your view on the decision on partial-birth abortion and most of the public agreeing with the court's holding?
A: This decision by the Supreme Court is a perfect example of what's at stake in this election. The kind of people that will be appointed to the US Supreme Court by the next president will control whether a woman's freedom, freedom to choose, make her own health care decisions will be made by her or will be made by the government or by some men sitting on the US Supreme Court. Now, on the issue of abortion, I believe in a woman's right to choose, but I think this is an extraordinarily difficult issue for America. I think it is very important for the president of the United States to recognize--while I believe the government should not make these health-care decisions for women--I believe they should have the freedom to make them themselves--this is a very difficult issue for many people. And I think we have to show respect for people who have different views about this.

John Edwards on Mammograms:
women would be required to have regular mammograms

See? It's totally consistent. Women should make their own health-care decisions regarding abortion, but the government should make those decision in the case of mammograms. And preventative health care. And probably more down the road.


Yup. Not much oppression at all. It is for your own good, you know. The nice government is just helping you "choose" to get medical care at the point of a gun.

Don't worry, the government will stop right there at the once-a-year visit. They would never press their luck and start regulating your smoking, beef or fast food intake. That would be ridiculous (unlike, say, court-ordered mammograms). Naturally, the government would never enforce a maximum allowable weight, or ban motorcycles, or hire spies on your block to observe your risky activities. And really, we will all be dead and gone by the time they get around to mandatory abortion for birth defects (to control costs). I mean, that would be ridiculous, right? God forbid the government ever look at the risky activity associated with AIDS - boy would that open a can of worms.

In case anyone is missing my sarcasm - Government confiscation of wages in order to give you health care gives them the power to manage your health care. And to take it away. Coersion. Oppression. Slavery. The goal of programs like this is to put more power in the hands of the government, then to control people to your own ends. Seems obvious.

I am curious as how such a mandate would be enforced? Would it be jail time, fines, mandatory cranial x-rays?

I suppose the concept of privacy is no longer an important protection, a civil liberty, to John Edwards. I can not think of anything more private than ones own health. Having Government able to demand you to be examined will end the concept.

Such talk illustrates the ever growing need for a Constitutional amendment defining privacy and limiting government's ability to invade it.

Under the "progressive" - collectivist - policy - which states that they own our bodies and therefore can mandate us to stay healthy they will eliminate everything that they consider harmful. So get ready to say Good-bye to McDonalds, Las Vegas Nevada, etc, in the name of "national security, but of course. Say hello - again to - Mussolini Fascism:

" ...The Fascist State organizes the nation, but leaves a sufficient margin of liberty to the individual; the latter is deprived of all useless and possibly harmful freedom, but retains what is essential; the deciding power in this question cannot be the individual, but the State alone....

Benito Mussolini

Questions for debate:

1) How does Edwards' requirement square with the Progressive's purported commitment to individual freedom?
It doesn't. Requiring citizens to check in with the government (remember, the health care is "universal", i.e. government) once a year runs contrary to individual freedom.

Requiring citizens to turn their medical records over to the government runs contrary to individual freedom.

2) Do you think its likely that other candidates will adopt the same concept?
Depends on how much of a furor this raises.

3) Do you think the concept is a sound one?
I think its a sound concept for a rancher to insure that his cattle have a check up every year. As I'm not anybody's cattle (in the singular, although I have been known to toss such prodigious quantities of bull biscuits about that I could be mistaken for a herd on occasion), I am compelled to conclude that the idea is not a sound one.

4) What do you think is the rationale for Edwards' position?
The political rationale is that Edwards' thinks it will get him votes from the Nanny crowd. Moving beyond the political (which, as a snarky aside, I doubt Edwards ever does), the rationale is the same as the rancher's. It saves money in the long run and improves the health of the cattl, er, citizenry.


Well, Joe Talarico over at Daily Kos as well as David Mizner (apparently a progressive blogger of some note) as well as many others consider Edwards to be a Progressive. Talarico characterizes him as a "Progressive populist", and Mizner said this
"John Edwards gave the speech of everyone's life the other day, a masterpiece of progressive populism."



How do you define "freedom"? In the political context, I define it as "freedom from government interference.


Sigh, I shouldn't do this, given that I consider Edwards to be one of the 99% of lawyers and 90% of politicians that give the others a bad name, but...

Clarification from Edwards campaign

Thank you for clearing that up.

It did seem very odd that any politician would suggest mandatory physician visits, so Edwards' position makes more sense now. Whether it's a good idea or not is a matter of debate, but it doesn't seem so radical as it did before.

I might also note that the previously linked article about the UK's National Health Service -- the one about the possibility of health care being denied to people who don't earn "health points" because they are overweight, smokers, etc. -- concerned a suggestion made by a Conservative (Tory) politician. It's misleading to compare American politics to British politics, of course, but I hardly think this counts as "progressive."

In any case, it certainly makes basic economic sense for any health insurance policy to provide payment for preventative care, and for people who get preventative care to pay less for health insurance.

The willingness of many (most?) Americans to see big scary implications for any proposal that lets the government (which you can vote to get rid of if you don't like what they do) do a particular thing when you blink nary an eyelid at private business (which you cannot do anything to control) short of avoiding them altogether (an good luck on that if there are any anti-competitive practices going on that you don't know about) doing exactly the same thing you're scared of governments doing never ceases to amaze me.

This proposal would pass by without comment if a private health insurer was saying they would demand a regular medical check-up as a condition of providing cover. It DOES pass by without comment, because that's exactly what they ALREADY DO. So why the outrage now?

It's also worth pointing out that, despite rumblings from British Tory politicians that maybe the routine medical practice (in the USA as well) that smokers or the obese should have to quit smoking or lose weight before elective (not emergency) surgical procedures should be formalised in the NHS, no concrete steps towards that have been taken.

And there is significant resistance from left-leaning politicians (who are the ones that set-up, and believe in, the NHS as an institution in the first place, and who - crucially - are in government in the UK at the moment) along the lines of "Fat people pay taxes. The NHS is funded by taxes. Therefore fat people are as entitled to NHS treatment as anyone else."

And that NOWHERE are smokers or the obese not warned of the extra dangers of undergoing certain procedures, and for elective procedures they are ALWAYS told that it would be better to have the operation later, after having quit smoking or lost weight, than to go ahead straight away and ending up on the mortuary slab. That's not government interference in private life, or medical dictatorship - that's the kind of simple concern for patient welfare that we should expect from all medical professionals regardless of how their wages get paid and by whom.

Say what you like about queues and rationing and death rates from certain obscure cancers - comparative medical statistics still show that the USA, despite spending vastly greater proportions of GDP on health care, still lags behind most Western European countries on key indicators like infant mortality rates, all of which have some type of comprehensive state-funded health care (though they all vary somewhat in effectiveness and administrative implementation). The differences in clinical outcomes are fairly small, but the differences in spending as a proportion of GDP are massive. The UK spends less than half the proportion of GDP on healthcare that the USA does, yet gets broadly similar (lagging in some areas, leading in others) outcomes. Maybe you just want to pay over the odds over there... ?

Or maybe your healthcare system is broken, and rather than fix it you'd rather point at the cracks in the system next door. You'd rather have the cheerleaders chanting "Yay Yay USA" than have a team that can win games. Fair enough. It's your decision. It's a stupid decision, but it's yours to take.

1) How does Edwards' requirement square with the Progressive's purported commitment to individual freedom?

Freedom has limitations. You're free to buy your own healthcare if you don't like the state-funded system (and if you're morbidly obese, they'll probably tell you to lose weight before undergoing surgery, too).

2) Do you think its likely that other candidates will adopt the same concept?

I have no idea. It isn't a precondition in any other "socialised" medical system I've heard of (but is a requirement of every private medical insurer I've ever heard of).

Why is it worse for a private company to know intimacies about me in return for providing essential services than for a state-funded body to do so? The notion that private businesses are automatically good and state-run businesses are automatically bad and therefore the state should run nothing and private business run everything is as doctrinaire and as divorced from reality as the communist idea that private business should be outlawed and everything should be run by the state.

3) Do you think the concept is a sound one?

Not really. The British NHS doesn't require any check-ups at all. They recommend them, but they don't require them.

4) What do you think is the rationale for Edwards' position?

A misunderstanding - common to all Americans, it seems - of the myriad ways in which state health provision actually works. If John Edwards had spent any time working in, or with, the British, French, German or Dutch, Danish, Swedish, Finnish or Spanish, or any other on a long list of state-run or state-funded (the two are different) healthcare systems that function perfectly well outside the USA, then maybe he'd have some credibility. As it is, he's making it up as he goes along - just like all the opponents-on-principle of state-funded/state-run healthcare.





If by that you mean "no other country with similar healthcare to that proposed by Edwards requires compulsory medical testing", then you're absolutely right. If you mean "no country's with state-funded/run healthcare delivers anything worth having" you couldn't be wronger than if you claimed that the moon was made of cheese.



Want to talk about the difference between an opposition politican from a party that has never fully supported the NHS saying that it "should" do X, Y and Z and looking at the NHS itself and finding out what it "does" do?


There we agree




Or maybe it illustrates the continuing American paranoia concerning all things governmental while giving private businesses doing exactly the same thing right now a pass. And don't give me the old rubbish about how "businesses are democratic - all you have to do is buy stock and you can vote" line - ever heard of private equity?




Yup. All of Western Europe is under the boot-heel of fascism, and we don't even know it. **yawn** Wake me up when you wake up yourself.

Yeah, right. Ask the Cubans and the Venezuelans. The Russkies and East Germans finally got rid of their albatross after 70 years of death and suffering.

Every form of collectivism, ie, socialism, fascism, communism, progressivism... ad nauseam has been tried with disastrous consequences to their constituents. Those tragedies were amply documented in a book known as Cato's Letters. The Founding Fathers read the textbook reason they decided to create a government with specifically enumerated powers.

The monopolies that you complained about are only possible when sanctioned by the state. As a matter of fact the first statist intervention into the health care arena was done when the states granted the AMA exclusive monopoly powers back in the 1840's. Unfortunately, many Americans feel secured only when a bureaucrat has his/her fingers stuck in their nostrils. FDR's welfare-warfare state has created a bunch of parasites who are willing to trade freedom for security. And so it goes.

I believe the vast majority of people wouldn't mind getting in, which has been a problem with our current sytem, let alone being required to do it.



The most they could do would be to tax those items, much like they are doing now with tobacco products. The government can't do anything more than that if people engage in behavior that is self-destructive. I guess they'll let people have heart attacks and the like. Yep, don't want no gubberment interference in our personal lives, a guy should be able to have a heart attack on his own accord. That's the way to stick it to the man.



If preventive care and getting face time with the doc is "slavery," then I'd say people are sick of the "freedom" to be neglected and of foregoing care. Having absolute freedom in a forest isn't so liberating, ditto needing surgery or splitting medication because you are "free" to not have care because you can't afford it.

The requirement for “preventative care” ie annual physicals is common in the HMO model and is a good idea. Certainly Edwards didn’t invent this and imo this will be common in most healthcare system proposals.

What he does not clearly tell us is how it will be managed. If it is totally government run “single payer”, with the government deciding on what is covered etc – it will be a disaster as we have seen in other countries.