Consider the following argument: "Now some folks say we should abolish slavery. But tell that to the little old lady from Savannah who's too weak to get out of bed in the morning, so she needs her house boy to fetch her breakfast."
Logicians refer to this form of reasoning as argumentum ad misericordiam, defined as a calculated appeal to pity or compassion for the sake of getting a conclusion accepted. It's a standard fallacy in that it doesn't address the necessity or practicality or even the morality of the conclusion. (Indeed, as in the case above, the conclusion can be profoundly offensive and wrong.) Rarely has the technique been more shamelessly utilized than in the Democratic push for health care reform. It's not an exaggeration to say that ad misericordiam arguments were both the style and the substance of the Democratic case.
Last February's health care summit at the Blair House, for example, should have been scored not by the Congressional Budget Office but by violins and cellos. President Obama set the tone is his introductory remarks by mentioning his older daughter Malia's sudden asthma attack and his younger daughter Sasha's bout of meningitis -- recalling how he'd wondered, both times, as he sat in the hospital emergency room, what would've happened if he hadn't had adequate insurance coverage.…
The President's recollection opened the floodgates, and afterwards the sob stories came fast and furious:
House Speaker Nancy Pelosi told of a man from Michigan whose medical bill for his bedridden wife might cause him to sell his home because he was too proud to ask his grown children for help, and of a woman from Michigan whose insurance deductible was going to come out of her family's food budget. Senator Majority Leader Harry Reid then recounted the hardships of a young restaurant owner in Nevada whose daughter was born with a cleft palate; her surgeries were not covered by his insurance policy, leaving him $90,000 in debt. Next came Rep. Steny Hoyer with the story of an uninsured acquaintance who was diagnosed with a tumor; she and her working class husband had to shell out $25,000 for her operation.
Rep. Jim Clyburn mentioned his encounter that morning with a C-SPAN caller who was about to have transplant surgery but was told Medicare would only cover three years of post-operative treatment. Clyburn was one-upped by Rep. Louise Slaughter who claimed that a constituent of hers was forced, presumably by lack of insurance, to wear her dead sister's dentures. "Do you ever believe," Slaughter asked, "that in America that's where we would be?" (It should be noted that Medicaid covers dentures in New York.) Senator Tom Harkin then whipped out a letter from a 57 year old Iowa farmer whose health insurance premiums were about to rise 14 percent, putting his farm business at risk.
Senator Jay Rockefeller chimed in with the story of an eight year old boy with leukemia whose insurance ran out. "And then he died," Rockefeller stated, "because there was no insurance. Could they have cured his cancer? I don't know, but that's what insurance is for." Next came Rep. Henry Waxman who told of another eight year old boy, this one with a hole in his heart -- which would be classified as a pre-existing condition if his mother changed insurance carriers, which meant she was locked into a policy which costs her almost as much per month as her mortgage payment. Senator Dick Durbin then declared that he was against caps on malpractice lawsuits against doctors (which actually might lower the cost of medical treatment and thus insurance premiums). Such limits, he insisted, would impact a constituent of his whose face was scarred during surgery when her oxygen mask caught fire. "Are you saying that this innocent woman is only entitled to $250,000 in pain and suffering? I don't think it's fair!"
It was left to Senator Patty Murray to tie a ribbon 'round the pity party by recounting the plight of an eleven year old boy whose single mom got sick, lost her job, lost her health coverage -- and, thus, "couldn't get in to see a doctor" and died. (Again, however, not a word about Medicaid eligibility.)
It's natural to be moved by the litany of hard cases put forward by the Democrats at the health care summit -- really, you'd have to be a monster not to be moved. But the conclusion that a dramatic overhaul of the health care system is therefore necessary, or practical, or moral doesn't follow. Which brings us to the fundamental problem with ad misericordiam arguments: They can be invoked both for and against virtually any policy position. We don't yet know the miseries that will result from the passage of Obamacare. But it's not hard to imagine them: The father of four who dies of a cerebral hemorrhage -- he thought he just had a sinus infection -- because his primary-care doctor is too backlogged with new patients to see him for a month. The retiree forced to eat cat food as her premiums rise because younger, healthier people, knowing they cannot be turned down, are putting off buying insurance until they desperately need it. The single mom laid off because her employer wanted to keep his company under 50 workers -- since any business with over 50 workers will be compelled, as of 2014, to offer a government-approved health plan.
Such stories are certain to emerge as Obamacare is enacted over the next decade. But if Republicans reflexively cite them in their attempts to roll back, or even repeal, the legislation -- if, in other words, they hold their own pity parties -- they'll only be sinking to the Democrats level. (Indeed, subtract ad misericordiam and ad hominem arguments from the Democratic rhetorical toolbox and you're left with finger wagging, eye rolling and the exclamation "Puh-leeze!") The dirty little secret of American political discourse is that Democrats do lowbrow better. It's what their base responds to.
Thus, the more honorable approach for Republicans is likely the more effective approach -- which is to argue from principle, not from woeful anecdote, to say going forward what none of them had the intestinal fortitude to say during the health care summit: Life is tough. Within a population of 300,000,000, you're always going to be able to track down people who suffer because of the status quo… but also people who will suffer because of a change to the status quo. Yet those are the only two options. You either keep the status quo or you change it. Either way, someone, somewhere is going to be hurting.
Which leads, at last, to the higher principle behind the case for rollback or repeal: It is not the proper role of government to dry one person's tears by confiscating another person's tissues. Obamacare, at its core, is nothing more than a transfer of grief. It's an attempt to alleviate current suffering at the cost of creating future suffering. The fact that the former is visible and the latter, for the moment, invisible doesn't alter the morality of the effort.
The challenge for Republicans is to make that case -- and to make it without violins and cellos.
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