Why am I paying taxes to take care of your brother-in-law?

A commenter believes the taxpayer should not ne supporting my disabled brother-in-law. What do you think?

Commenter Mike Kaplan asks the following question below my last post:

Why am I paying taxes to take care of your brother-in-law Vincent? He is your family – why don’t you take care of him? Why do you want to force me to sacrifice my time and labor – in taxes – to do what you are not doing?

All of us need to be responsible for ourselves and our families. The federal government currently borrows over 40% of what it spends. We just don’t have the money to continue this way.

I’ve been thinking about this. It’s reasonable to ask in the direct and sincere way Mr. Kaplan does. After all, I am a full professor at a leading university. I am not an economically disadvantaged person. 

I have my own views. I’m more interested in how RBC readers would answer this query. So what do you think? I hope you answer him directly, in a spirit of civility.

Author: Harold Pollack

Harold Pollack is Helen Ross Professor of Social Service Administration at the University of Chicago. He has served on three expert committees of the National Academies of Science. His recent research appears in such journals as Addiction, Journal of the American Medical Association, and American Journal of Public Health. He writes regularly on HIV prevention, crime and drug policy, health reform, and disability policy for American Prospect, tnr.com, and other news outlets. His essay, "Lessons from an Emergency Room Nightmare" was selected for the collection The Best American Medical Writing, 2009. He recently participated, with zero critical acclaim, in the University of Chicago's annual Latke-Hamentaschen debate.

92 thoughts on “Why am I paying taxes to take care of your brother-in-law?”

  1. Fundamentally the question is about who should pay for the care of those who cannot care for themselves. We can say that it’s Vincent’s own bad luck to be disabled, and so he should bear the consequences. We can say (and it seems you do) that its his family’s bad luck to he should be disabled, and they can bear the consequences, or we can say its societies combined bad luck that people become disabled, but the cost of caring for them is a lot more bearable, and the care they get a lot better, if we all chip in and pay for his care.

    Not only is this arrangement better for Vincent and Prof. Pollack, I sleep a lot better at night knowing that if I myself became disabled, I too would see some level of protection against the vagaries of fate.

    1. That was an *exceedingly* good essay and explanatory principle, although the link seemed to be broken earlier, but now apparently does work.

  2. An insurance pool consisting of only immediate family is, for the vast majority of people, bankruptcy and penury waiting to happen and a great burden on the family of the afflicted.

    An insurance pool consisting of a nation is for no one a great risk or a great burden.

    The government is by far the most efficient insurer and the body best capable of fairly spreading risk.

    1. I think this is well put.

      I would also remind Mr. Kaplan that even with significant support from the government these families still face enormous challenges. The amount of time, energy, and money that is involved can be difficult for those unaffected to imagine.

    2. “An insurance pool consisting of a nation” transforms us all into a combination of free riders and beasts of burden.

        1. I certainly hope to become disabled since I’ll get such a windfall from the government.

      1. “An insurance pool consisting of a nation” transforms us all into a combination of free riders and beasts of burden.

        That’s a fact. Just like the interstate highway system.

        1. Beat me to it.

          And there are few things I would be more proud of paying for as, a member of a civilized nation, than my disabled brethren. Public education and libraries are high on the list, but health care and support for the disabled probably top it.

          1. “An insurance pool consisting of a nation” transforms us all into a combination of free riders and beasts of burden.

            Said the free rider as he started up his car (beast of burden) and belched unburnt hydrocarbons and CO2 (freely) into the Commons.

        2. My aunt and uncle had no children. Nonetheless, they paid taxes, including property taxes, which went in large measure to support public education. Not once did they ever complain that they were “beasts of burden.” Nor did they ever contend either that their siblings who had children or their nieces and nephews were “free riders.”

      2. No man is an island; your average Internet libertarian would likely have been murdered by his cro-magnon tribesmen for being so clearly insane. We all take care of each other. The only question is to what degree. Some people believe that they are so lucky and/or superior that they can survive and thrive in a society with a minimal safety net. Other people — whether through compassion, common-sense or risk-aversion, believe in a more robust net.

        As a matter of indisputable evidence, our European friends all manage to offer comparable to better health care at much lower cost. If its a value judgment, then you best hope not to get hit hard by a car and live, or lose your job, or have a loved one suffer a debilitating stroke. Because under your view of the “ownership” society, you own those problems Jack; I’m spending my saved share of your care on vacation.

        1. The fundamental problem here is that a humane and empathetic group of Americans have ceded the national argument to a group of selfish and misanthropic Americans, Brett and Mike Kaplan included. I don’t call them this in any pejorative sense; I mean it literally. The Tea Party and the new American Right embrace selfishness and misanthropy-indeed, their heroes such as Ayn Rand subscribed to a “philosophy of selfishness.”

          This is a hard fact for those of us who care about our fellow humans, all of them, in an abstract sense. The public debate has been coarsened and our ability to care about each other lessened as a result of the modern Right. It’s tragic and also an intractable problem-because when you don’t care about anyone beyond your immediate family, you can pretty much say whatever hateful thing you want.

          1. The fundamental problem here is that some people define “humane and empathetic” as being willing to jail anyone who won’t contribute to their favorite causes. Rather than thinking, “This is a good charitable cause, I’ll try to persuade people to donate to it.”

            If you don’t grasp the moral difference between persuading people to donate to charity, and forcing people to, and why the latter makes you a bully, not “unselfish”, I certainly won’t be able to enlighten you. Some people just never reach the point in their moral/intellectual development where the concept of “other people’s stuff” being something you have to ask for instead of demand penetrates.

          2. Wow Matt you really struck a nerve. Even though you said you didn’t mean it as a pejorative Brett got mad and called you stupid. Hahah I love it.

          3. Nah, it’s quite possible to be smart, and still suffer from stalled social development. Granted, “mine vs not mine” is a distinction most people get quite early, but some very clever people never do quite accept it. I think the “clever” might even help them to rationalize why they’re entitled to dictate how other people’s stuff gets used, instead of having to settle for persuasion.

          4. Funny, Brett. You just proved my point. I wasn’t arguing that the left is unselfish, only that the Randian right is both selfish and misanthropic: existing at the pre-adolescent schoolyard level of yelling “mine!” about everything, unable to imagine what it means to say “ours” and to try to help each other out.

            I’d argue that you’re somewhere around a 2 on Kohlberg’s stages of moral development. You’ve realized your own individuality, and your capacity to own things and to beat up the people who suggest that occasional sharing might be a good idea (particularly in cases of serious illness or need.) Most of the people who regularly read this blog are probably closer to a 5. So please stop talking to me about moral/intellectual development.

          5. So you cite an article by known right-wing bloviator John Stossel and then in any way expect us to buy your argument about charity?

          6. That Stossel data is suspect anyway: in SF there are a lot of people who don’t even deal in cash, so how would they feed a Salvation Army bucket as they happen by? A lot of charity is invisible to these various studies because it never shows up on IRS forms-such as for anyone who does not itemize deductions-common in places with a high proportion of renters. Would ANY of my monthly charitable contributions register in ANY of the studies reported here? No.

            There is also no legitimacy in comparing between employer-based United Way drives, because high “donations” are usually coerced, and many more independent-minded employees simply refuse to participate in such things as a matter of principle-it is NONE of my employer’s business where my charitable contributions get directed! (Having a union job admittedly protects me from being punished for my stance, a luxury known by too few.)

            Furthermore, what are the “charities” that conservatives typically donate to? The Mormon Church, where most of Mitt’s (paltry, proportionally speaking) “charitable contributions” go? To right wing “think” tanks? Probably not to programs that provide help to people like Vincent.

            Charitable contributions should not be tax-deductible either, because why should my tax dollars offset the contribution choices of the likes of Mitt Romney? Why should his charity dollars be effectively worth more than mine? Let charity stand on its own and be done in private, and let the churches receive what people choose to give them without the promise of tax system kickbacks. Allowing tax deductibility is functionally taxation without representation, because it allows what would otherwise be tax dollars to be redirected to the charities of an individual’s choice, without any input from the taxpayers.

            The short version of why tax dollars should go to help people like Vincent: because we are a civilized society that does not let disabled people’s fate rely solely on their luck of the draw; because we believe that every human is due some basic dignity and care when they are in need; and ultimately because we do not want to live with the consequences of behaving otherwise and having to view the suffering and destitution caused by our inaction (finally, a form of selfishness I can actually support). I only wish were would go about this task a bit more seriously.

          7. Kathleen, your last paragraph eloquently sums up my idea of how a moral society should operate. Nevertheless, I suspect Brett will twist it and try to claim that his selfish, dog-eat-dog Randian dystopia is somehow morally superior to a society in which people actually care about one another. Mad Max as the Good Society.

          8. A riff on Brett:

            “If you don’t grasp the moral difference between PERSUADING people to [pay for establishing and enforcing laws to maintain control of ‘other people’s stuff’, and to obey those laws, and to pledge their fealty and if necessary lives to defend the state which establishes and enforces those laws] and FORCING people to [do so on pain of imprisonment or death], and why the latter makes you a bully, not “unselfish”, I certainly won’t be able to enlighten you. Some people just never reach the point in their moral/intellectual development where the concept of [people subscribing to a political and legal order] being something you have to ask for instead of demand [regardless of whether it serves their or their children’s interests, even to the point of extreme misery or death] penetrates.

      3. Without out it, we are still a combination of free riders, beasts of burden.
        those needing charity are still free riding, after all.
        Those providing the care are still beasts of burdern.

        It also adds more suffering, and more focused burden.

      4. Yes, exactly. It’s a thing called civilization.

        But it’s fine with me if libertarians want to have Idaho. They won’t be much in the way there.

        1. Idaho’s OK by me, but according to the blueprint, they want the Colorado Rockies. Soon as Brett invents the necessary perpetual-energy machine, they’re all going to take their marbles and go hide out in the mountains behind a force field while they have a nice game of monopoly.

      5. “…a combination of free riders and beasts of burden.” a good definition of the human social condition. All of us are both, certainly at different times, often simultaneously, to different degrees. Are you claiming that Vincent doesn’t contribute to society?

  3. What Tyler said, and that also has the advantage of taking care of people who don’t have family who can take care of them.

    1. Right, I sort of glossed over that because it doesn’t apply right here, but the reason we pay for most disabled people’s care is so that somebody will. The vast majority of people do not have a professor with six figures of income as a brother in law, and without government help, their lives in the face of profound disability would be just long enough to be vignettes of utter horror.

      I worked on an ambulance for a few years in college, and inadequate care for the physically disabled all too often means wasting away in a puddle of days-old excrement, urine, and bed-sore exudate.

  4. Because we don’t have a clan-based society. You are not expected to avenge crimes against your brother-in-law either; we have a criminal justice system, even though it would be cheaper not to. Nor are you expected to make good your brother-in-law’s bad debts. In the US, you get to choose the people you assume obligations toward, either explicitly as in marriage through some kind of action as in having a child.

  5. There are some good answers for his question here. However it should probably also be noted that his statement “We just don’t have the money to continue this way” is, to be as direct as he was, complete bullshit.

  6. “Why am I paying taxes to take care of your brother-in-law Vincent?”

    Why am I paying taxes that fund the roads you drive on, Mr Kaplan? Why am I paying taxes for the soldiers that protect you, Mr Kaplan?

    Ultimately, these questions come down to people realizing that we all pay taxes for things we might not individually require or endorse, but which enable our society to function in a reasonably civilized way. You can’t just pay for things you want and withdraw from the society that surrounds you for everything else. That’s the path to a barbaric anarchy, ruled by rich oligarchs.

    “The federal government currently borrows over 40% of what it spends. We just don’t have the money to continue this way.”

    End the Bush tax cuts - and the deficit will no longer be an issue. We do have the money - if you are prepared to do a little basic accounting and think about these issues rather than repeating slogans from the information-free community. Hell, we could even move to a single-payer system for health-care and improve health-care outcomes as well as the public finances!

    What we can’t do is keep giving the greedy rich tax cuts in the name of a liberty which is increasingly corroded by their corrupting influence.

  7. I note that Vincent is not Pollack’s brother, but his brother-in-law. Presumably Mr. Kaplan is envisioning a world in which paying, for life, for the care one’s wife’s disabled brother is just part of the package you get when you marry, which seems like it would discourage some number of marriages, for people who are not as well off as Prof. Pollack.

    1. People would fall into two categories in that event. Dupes, who decently and givingly enter into marriage for love anyway, for better and for worse, and sociopaths, like ayn Rand, who Just sleep with whoevertheylikeregardless.

      1. And speaking of Rand, let’s not forget that after her life of rubbing elbows with the high rollers she still ended up dependent on public health insurance and financial assistance. We’re probaly all still paying the interest on the bonds that funded keeping the poor wretch from dying in the gutter as her philosophy boldly proclaims she should have done.

  8. So instead of people being on their own with no one to fend for them, you’d have families be on their own with no one to fend for them? It’s the same problem at a higher level. Just as there are people whose misfortune exceeds their fortune, so too are there families.

  9. I agree with the comments above, but I’d add that I dislike Kaplan’s framing of the question.

    We are not paying taxes to take care of Vincent. We are paying taxes to take care of the disabled among us, and Vincent is unlucky enough to be in that group. So Kaplan’s preferred alternative is not just that the Pollack family sacrifice some more, it’s that those who have no such support die in the streets.

    Well, I don’t like that idea. Not only that, I want the society I live in to not let it happen. I, and those who agree with me, have a perfect right to use the political process to see that it doesn’t.

  10. What do we do when we are presented with a person who is stricken, but who does not have the funds or insurance or family funds to pay for care? Or what if this person has collapsed on the street, with no ID and no proof of insurance — should he or she be denied emergency medical care if it is available until we know that payment is forthcoming? Out of my narrow self-interest, I hope we provide the care first and ask financial questions later. But the care does have to be paid for. We could ask for private charity to fund the uninsured or effectively indigent cases (a large subset given the expense of much medical care) but who is to say that will be sufficient? John Stuart Mill provides a discussion with respect to able-bodied people; I think the case is even stronger for those who are not able-bodied. From Principles of Political Economy (http://www.econlib.org/library/Mill/mlP73.html#V.11.41, footnote omitted):

    “Though individuals should, in general, be left to do for themselves whatever it can reasonably be expected that they should be capable of doing, yet when they are at any rate not to be left to themselves, but to be helped by other people, the question arises whether it is better that they should receive this help exclusively from individuals, and therefore uncertainly and casually, or by systematic arrangements, in which society acts through its organ, the state….[discussion of the Poor Laws and of the able-bodied poor]… Subject to these conditions, I conceive it to be highly desirable, that the certainty of subsistence should be held out by law to the destitute able-bodied, rather than that their relief should depend on voluntary charity. In the first place, charity almost always does too much or too little: it lavishes its bounty in one place, and leaves people to starve in another. Secondly, since the state must necessarily provide subsistence for the criminal poor while undergoing punishment, not to do the same for the poor who have not offended is to give a premium on crime. And lastly, if the poor are left to individual charity, a vast amount of mendacity is inevitable. What the state may and should abandon to private charity, is the task of distinguishing between one case of real necessity and another. Private charity can give more to the more deserving. The state must act by general rules. It cannot undertake to discriminate between the deserving and the undeserving indigent.”

  11. This isn’t an answer to the question. I’m just struck by the fact that this sort of question can only be asked by someone who believes not only that society should not help families to bear the enormous financial cost of caring for a disabled person but also that he personally will never be struck by the dreadful randomness of serious illness or disability, that he will never need help beyond what his immediate family can provide.

    1. I call it Diaper-Boy syndrome. Usually a delusion suffered by a healthy white guy man who thinks he came into the world under his own power, and likewise believs he won’t go out of it having his diaper changed by a minimum waged female health-care worker.

  12. Sorry, Harold. But I don’t believe that sociopaths and moral autists like Messrs Kaplan and Bellmore deserve civil answers. As you regard Mr Kaplan’s directness and sincerity as virtues, I shall in deference to you refrain from giving him the uncivil answer he deserves.

    As for Bellmore, the Hofnarr of the RBC, I long ago decided that, although there is some value in pointing him up when he is engaged in outright lying or hackery, it is best otherwise to simply enjoy his irate capers and frustrated gibberings for the comedy they are.

    1. Hofnarr is such a lovely word, gnaedige Frau. Chapeau! Brett Bellmore also plays the aspirant twerp at Obsidian Wings every so often. We all have our ambitions, I suppose.

    2. Mrs. Tilton, I imagine you use “autist” in a neutral sense, but as the mom of a teen on the spectrum, I’d like to point out that people with autism do indeed feel empathy. They just sometimes have trouble expressing it in ways we neurotypicals can understand.

      But yes, the temptation to feed trolls should be resisted.

  13. Maybe Kaplan is a nice enough guy, but he’s not even thinking about the questions he’s asking or the statements he’s making. For example, Kaplan says, “The federal government currently borrows over 40% of what it spends. We just don’t have the money to continue this way.” But every borrower has to, by definition, have a creditor. And every borrower, by definition, contracted to borrow whatever was borrowed. So every creditor freely lent to the borrower. But does Kaplan bother to try and find out who is lending? Because if he did, he’d figure out that we are freely lending the money to ourselves.

    Now if Kaplan had said, “The federal government is spending more than its revenue” he’d be saying something quite different. But he didn’t, and the fact that he didn’t bother to even think through the nature of the statement says a lot.

  14. Mr. Kaplan is conflating two arguments. The first is that it’s morally wrong for his taxes to go to care for someone else’s family member. But that’s an argument that can be made about most taxes; they go to benefit mostly other people. The underlying theory is that we’re a society that rises or falls together.

    The second, and unrelated, argument, is that we are spending too much, or raising too little revenue, and that such activity is unsustainable. At some point, of course, he’s correct. But that’s a policy issue and not a morla one. The solution is to bring tax rates back into line with historical norms and to stop trying to be be everyone’s cop on the beat internationally.

    As someone who is responsible for a family member with a serious disability, I can assure Mr. Kaplan that far more of my family’s money and time has gone towards caring for that person than has anyone else’s taxes.

    1. Isn’t the argument that, however much obligation Kaplan has to help Harold’s brother in law, Harold must have an enormously greater obligation? So, why isn’t he taking care of it himself? I realize that a lot of liberals nominally believe in systems of ethics such as utilitarianism, where ones obligations of fellowship have absolutely nothing to do with physical, social, or familial proximity. I also notice that they don’t personally engage in the sort of charitable acts this would seem to imply are obligatory.

      This is actually one of the fundamental divides between liberals and conservatives: Conservatives think they demonstrate their empathic and kind natures by personally and voluntarily engaging in acts of charity. Liberals think they demonstrate their empathic and kind natures by requiring other people to involuntarily engage in acts of charity on their behalf.

      I don’t think this is a divide we’ll ever bridge, but it’s good to be aware of it.

      1. Brett, when I contemplate your collection of strawmen, I can only assume you live in terror of fire. That’s a shame - food is much better cooked, you know.

      2. Nice try, but liberals pay taxes too. And as has been said, if I have to pay for wars, then you should darned sure have to chip in for health insurance and other aspects of being civilized.

        Or, you can move somewhere else, since you can’t get your way politically.

      3. Isn’t the argument that, however much obligation Kaplan has to help Harold’s brother in law, Harold must have an enormously greater obligation?

        Have you honestly read Harold’s posts about Vincent and come away with the conclusion that he doesn’t believe that?

      4. Since Brett keeps bringing up how generous the more wealthy conservatives are than those poorer liberals when it comes to supporting charity:
        I was a founding member of a non-profit that has provided therapy for disabled folks (mostly children) for more than twenty years now. My personal expierience was that people of more modest means were far and away the most generous both financially and as volunteers. The wealthy often pledged big blocks of money but when it came time to actually give the cash they often seemed to find other uses for that money. I don’t know if that is the case widely but it is my personal experience.

        It should also be pointed out that non-profit oranizations are inherently inefficient at delivering bang for buck. Marketing and fund raising suck up vast amounts of money and man power. Add in that the whole idea of just letting well meaning (sometimes not so well meaning) people just do whatever they think is a good thing throws tons of scatter shot, vagueries, incompetense, duplication of services, lack of needed services,… I could go on but you see the point.
        At least with government provided service there is in theory an underlying policy, a method for efficient funding, a fair distribution of funding and a system of comparative evaluation by a publicly selected group. And of course the voters can always throw the bums out.
        Voluteer service is good for the soul of the community and has it’s place but when it comes to basic essental care a single payer system is by far the most economic way to provide those services. That is why the entire civilized world uses some variant of that idea. Wheather socialized medicine, single payer insurance or mandated not for profit insurance the entire world has that and wouldn’t give it up. Only the USA keeps throwing it’s healthcare money down the rat hole of for profit health insurance.
        I know. Don’t. Feed. The. Troll! But it had to be said.

        1. Those who prefer family care for economic reasons related to the health of the overall economy should keep in mind that it is not economically efficient to care for the severely disabled on a family-by-family basis. There are actually great economic benefits to society when a small staff takes care of a group of disabled people, rather than an entire family having to re-arrange its work, housing, and other economic activities. Then, the family contributes what it does best — love, companionship, guardianship, recreation that can be scheduled outside work hours, etc, etc.- but maintains the ability to work and contribute economically both to the family and to the society as a whole.

        2. Actually, I’m quite certain that I raised the issue of “wealth” not at all, and the survey I linked to actually pointed out that the wealthy are, on a percentage basis, less generous than the poor.

          Thanks for sharing your inability to distinguish your stereotypes from what people actually say, though.

          1. The “survey” you linked to, Brett, was mustachioed conservative gasbag John Stossel pretending to be a scientist by setting up Salvation Army donation bins in two different cities, and then seeing who donated more. It was an idiotic survey that proved nothing, except that you’re willing to believe whatever made up fake research will support your pre-formed, pre-digested world view.

  15. The first half of Kaplan’s argument contradicts the second half.

    The first half assumes that families can in fact “take care” of other family members - i.e., that families have enough in the way of money and resources to provide the necessary care to the Vincents of the United States.

    The second half asserts that “we” do not have enough money to do this and that if “we” don’t steel ourselves to allowing the Vincents to die in the streets “we” will “go broke.”

    So the arguments are contradictory. Which is not really a problem, seeing that they are both false.

  16. Mr. Kaplan fails to recognize that he and millions like him wake up every morning with the comfort of knowing that at least at some level, assistance is available to him should he or his family suffer misfortune that outstrips their financial means, even if they do not realize it or calculate its benefit into their daily happiness and feeling of security. Or perhaps I’m wrong, and he is sufficiently wealthy that no such worries would ever trouble him under any circumstances. But the fact is that most Americans in the secure middle or upper-middle class have not had the experience of seeing illness or accident drive a family from its home and into penury, because there are sources of help. We take for granted the level of comfort, and freedom from daily grinding worry, afforded by the fact that we can get some help from our fellow citizens should bad days visit us or our loved ones.

    I gladly pay a portion of my taxes to contribute to contribute to Vincent’s care and the care of others like him, not just because it is the right thing to do, but I know that such help would be available in some measure to my own family should misfortune occur.

    Some people just lack the ability to see that.

  17. Why? We pay for it because as a nation, we have voted to do this.

    We have a foster system to avoid orphans dying in the street, or suffering in orphanariums.
    We have disability insurance to avoid …

    It’s our choice, and folks who prefer a different system can vote to change it, or move to a different country.

  18. Because shit happens and it is better for society to socially insure against shit happening than individuals and families inadequately insuring against shit happening.

  19. Because the women would have to do all the caretaking work for free, and we’re just so over that.

    1. Hear, hear. Forgive my pedantry but this one needs emphasis. Any society needs a huge ration of dependent care work because there are always lots of people who can’t take care of themselves, and yet still today in 2012 the vast majority of that work gets done by women (Harold’s shining example notwithstanding). The more we make dependent care a private responsibility the more we feed gender inequality.

    1. And indeed, SOME people manage to suffer from stalled social and emotional development while considering themselves intelligent. Naming no names, of course.

  20. Then the LORD said to Cain, “Where is your brother Abel?” “I don’t know,” he replied. “Am I my brother’s keeper?”

    1. In this story, it always seemed significant to me that Cain disavows any responsibility for his brother’s well being after, in fact, having directly brought about his death (because of covetousness both for Abel’s belongings and God’s favor). This has never read to me as an honest question, but rather as the petulant attempt to escape opprobrium and punishment for having committed an act that Cain knew was wrong, and which was compounded by the greed inherent in the motive for the murder.

      When this is quoted to me in a contemporary context (not by you, Betsy, but by others who use this to question their responsibility for the welfare of those around them), I can never avoid that peevish tone of indignation at being held responsible for the results of actions they knew were selfish and wrong.

  21. The government should provide some guarantee of basic well-being, but not take control of issues that individuals would resolve on their own, yes?

    (if no, our philosophical differences are too great to address in an RBC comment thread…)

    My short version is that things with (a) many producers and (b) many consumers that are (c) not essential to life and exchanged (d) freely (not in desperation, with viable alternatives) with (e) good information available to both sides — should be left to individuals to figure out however they like.

    Long-term disability care health fails my test on (c), (d), and often (e). Information can (and should) be improved through laws, but long-term care for the honestly disabled is too expensive to be left to families (or even municipalities), and too important to ignore.

    It is my understanding that if essential health care were funded through taxes and paid straight to doctors (no insurance involved), and the government were allowed to negotiate drug prices (lookin’ at you, Medicare!), we could, in fact, afford pretty good health care for our entire population, indefinitely.

  22. Harold asks a terribly important question. And what is wanted is a vitally incisive answer. The left really needs to revisit this. It needs a go-to essay written for the modern palate: logical, emotional, legal, scientific, and moral. Not so long ago, on some thread I nearly challenged James Wimberley to this task. And I still do. And I now challenge Harold (I have my own views) too.

    There is as well an allied question: Why should the rich pay even more taxes than they already do?
    That question wants an equally modern cogent essay to delineate the argument.

    One more thing. Ultimately there should be an open writing contest with prize money for these essays. When I first created “Best. Liberal. Writing.” that was the motive behind my title. I wanted to create a space that would offer money for just that: The best liberal writing on core principles. That still wants doing. I encourage anyone having the time and money to make that happen…

  23. Because we have attempted to rise out of the Hobbesian nightmare that is the wild so that life could be more fair, not less. If you think that paying a little more in taxes, rather than being the disabled person, makes you the person being treated least fairly, I don’t know what to say.

    In a separate response, if you are worried about the ratio of government expense/receipts, you should start with corporations that pay little to no tax and end with the military industrial complex. Maybe after that we can talk about increasing the amount of aid the disabled receive.

    1. There is a small set of people who can say, “Life isn’t fair,” with the deep-seated conviction that this is a good thing.

  24. A rabbi friend told me that the social insurance argument runs that we help others in need, and those who are suffering, because one day that could be us, but that his faith taught a different message: Such people *are* us.

  25. While I am all in favor of medicare for all for example, I am equally in favor of presenting the estate of every elderly person a bill for the difference between what they paid into medicare (at a reasonable rate of return) and what they get out of medicare. Most estimates say this is roughly 200k. Similarly, while I am all in favor of there being a very generous safety net for disabled people - beyond what we currently have that is for sure - where there are extraordinary resources in the immediate family, I am in favor of the family being required to help.

    That having been said, I’m not sure a brother in law is what I would define as immediate family

    1. For that matter, why don’t we present estates with bills for the expenses of having educated the deceased, having provided them with police and fire protection throughout their lives, etc.? Snark off, as they say.

      In your scenario of families paying back Medicare, what I wonder is, what would family dynamics look like. ‘We don’t want you have that bypass Dad, else when the costs are finished being deducted from your estate, they’ll be no money left to send Junior to college. In fact, the sooner you die, probably the better.’

      On a slightly different note, why do you assume that families of people with special needs, even ones that don’t have extraordinary resources, don’t try to help their relative? It’s not often easy though, because Medicaid law puts a lot of limitations on what can be paid for without making the person ineligible for the benefits that pay to sustain them.

      You also may be interested to know that as the system presently stands, Medicaid does sometimes get paid back, through the mechanism of the Medicaid pay-back special needs trust. And of course, infirm, elderly people often do have to spend all of their savings before they are able to move off of Medicare to Medicaid. That in effect, is a “bill.”

      But keep on worrying that somewhere, someone who isn’t in the 1% might be benefitting a little bit from being a citizen of the world’s richest nation.

      1. Excuse me but this seems really odd: If someone uses more medicare then they paid in, someone has to pay for it. I’m simply saying that it is unfair to have poorer people pay for the health care of richer people so that the richer people can leave a (larger) estate. The current system and thus your proposal is unfair to poorer people and favors those with estates-and keep in mind the median net worth for those over 65 is only about 100k and at death is likely to be less. I’m perfectly happy to change my proposal to say that only people whose estates are more than the median for the elderly are subject to this tax and you can pass on the median wealth to your heirs without paying this tax but letting richer people pass on more money to their heirs because poorer people than they are paying for their health care seems awfully unfair to me. … And yes I’m all in favor of taxing the 1% with a high estate tax, but that’s not going to raise enough money to put medicare on a sound footing and in any case as I said I’m also not real interested in having poorer people pay more in taxes to benefit the heirs of upper middle class people.

  26. 1) To self-insure against everything would take about $3 million. The kind of social insurance that protects Vincent is hardly a burden to the whole community.

    2) America is not broke. It is insanely rich. The rest is accounting.

    3) It could have been me, and if it had been I’d want to be cared for. Rawls for dummies here.

  27. 1. Irrelevant. Let me count the ways in which my taxes also subsidize your behavior.
    2. Irrelevant. We have all the ‘money’ we can print.

  28. Ya gotta say, if extended families were responsible for medical care for their disabled members, genealogy would be the next robo-signing enterprise (and those mormon proxy marriages of the dead could end up causing new virtual cousins a bundle).

  29. “And the King shall answer and say unto them, Verily I say unto you, Inasmuch as ye have done it unto one of the least of these my brethren, ye have done it unto me.”

    Matthew 25:40

  30. My answer: because we still live in a fundamentally decent and well-run society.

  31. i realized, when it took 9 or 10 commenters repeatedly calling mr. bellmore out to get him to come up with a grudging admission that the shooting death of trayvon martin might have been unfortunate, that mr. bellmore is no role model for ethics, morality, or civility. his inhumane rationalizations in this comment section come as no surprise.

  32. Why should Harold pay taxes to support Mike Kaplan in the numerous privileges of contemporary US citizenship, since he doesn’t apparently want to pay its dues?

  33. I just wish to associate myself with many of the comments by Ohio Mom. Those of us who are “parents for life” due to having a child with autism have to stick together.

    1. Hi Dwight! So wonderful to see you again! Hope all is well with you and your family.

      (For everyone else: Dwight was one of the first autism parent bloggers I read, and one of very few autism bloggers I’ve found over the years to write about both disability and progressive politics. I learned a lot from him before he retired from blogging.)

  34. I can’t decide whether it’s more amusing or discouraging that Brett thinks the pinnacle of human moral and social development comes at age three.

      1. @doretta-you should read back through the archives on his comments on the trayvon martin shooting and florida’s stand your ground law.

        i once tried to envision mr. bellmore as a dead-pan, sarcasm comic. more lately i’ve been thinking of him as someone failing the turing test.

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