From the Vault: Austin Cline on Health Care: Testing the Presumption of Good Faith

I originally wrote this during the summer of 2009 to blow off some steam, but I never published it. More than health care, this post is about discussion itself and what constitutes a fair and honest exchange of ideas. Austin Cline runs a very informative blog on Atheism at About.com. A heads up, though, to anyone who feels tempted debate him in the comment threads following his articles: I recommend using your own blog and taking home field advantage. ~tg


When listening to others speak about current events, politics, policy, and the like, it is my policy always to presume good faith on the part of the person to whom I’m listening.  Others have written about this practice.  For example, it is a behavioral guideline for Wikipedia editors.

There is something cheap and unsatisfying about calling one’s opponent in argument a “liar”—even if it’s true.  It really doesn’t matter to me whether my opponent in debate lies.  The real issue is whether my opponent is right, or wrong.  If a guy happens to be consistently wrong, that’s reason enough to distrust him.  One doesn’t gain much more by correctly identifying his subjective malice.

Presuming good faith is not just polite, it also enhances understanding.  What may appear to one party to be a bad-faith attempt to mislead, confuse, and evade the issues may actually be the other party’s attempt to address an important and overlooked issue.  It is only through listening and continued discussion that one may discover one’s opponents underlying concerns.  Those concerns may turn out to be vital.

So rather than dismiss an opponent by calling him or her a liar, I try to presume good faith.  If a guy says something that I feel to be in error, I try to identify it as an error and then move to correct it.  No accusations.  No hard feelings.

But some people really try me.

Consider Austin Cline, atheist commentator for About.com.  Generally, Austin writes what I consider to be very sensible blog posts critical of religious dogma and institutions. That is how I have come to follow his blog.  As an unbeliever myself, I agree with him on most of those issues. Occasionally, however, Austin will take some off-quote from a conservative Christian and use it as a springboard from which to launch his own statist political sermon.

In a piece entitled “Conservative Christians are Against Health Care Reform,” Austin interjects his partisan political views regarding big government’s role in providing health care to its citizens.  Austin Cline’s vision for correcting America’s health care woes is relatively simple.  From the main blog post:

Personally, I think that for a health care system to be “working,” never mind “best,” it would have to provide basic health care to all people regardless of how much money they have and that medical decisions are made by doctors rather than corporate executives whose only motive or interest is to increase profits and corporate share value.

In comment  #14, Austin suggests one way to achieve this goal:

One suggestion: slide the minimum age for Medicare eligibility to birth.

One suggestion: slide the minimum age for Medicare eligibility to birth.

Now, nothing in the context of comment #14 suggests that sliding the minimum age for Medicare eligibility to birth is Austin’s preferred method of achieving his goal.  Still, he put on that simple plan on the table, and he did not oppose it.  I felt this was reason enough to interject and explain why this simple plan is untenable.

So in comment #27, I posted links to the following videos of an address by former Comptroller General David Walker, in which he discussed the financial condition of our nation, especially in regards to entitlement programs like Medicare:

[Editor’s note: The following video was formerly posted on YouTube in two parts. Those videos are no longer available at the links I provided in Austin’s comment thread. The video is currently available in one part at vimeo.com.]

With the videos, I issued a challenge of my own to anyone who felt that simply sliding the minimum age of Medicare eligibility to birth could be a workable solution:

I say: "Show me the money!"

I say: "Show me the money!"

Austin responded in comment #28, not with a balance sheet or any other sort of hard evidence to demonstrate the financial viability of his Medicare for all idea, but rather with this general hypothesis and prediction for future success:

Austin's first response.

Austin's first response.

There’s going to be a lot of bad noise coming up about how I engaged in fallacies and evaded the real issues, so let’s lay out for the record some of Austin’s fallacies and evasions.

First is the equivocation.  From Wikipedia:

Equivocation is classified as both a formal and informal fallacy. It is the misleading use of a term with more than one meaning or sense (by glossing over which meaning is intended at a particular time).

Austin’s use of the term “unfunded obligations” is completely different from former comptroller general David Walker’s use of it.  David Walker used the term to represent promises that the government has made to Medicare recipients that it as yet can not afford to keep. Austin, on the other hand, uses the term “unfunded obligations” to represent consumer demands for health care for which health care providers must find funding, lest they break Austin’s utopian mandate that health care be provided to all people at all times.  I asked Austin to tell us specifically where he would find funding for his utopian project.  Austin’s response, essentially, was that because his project would be the cheapest way to satisfy his utopian ideals, there was no need to spend time on such details.  Austin did not consider the possibility that his utopian ideals might not be sustainable.

Next comes an invalid deduction.  From Wikipedia:

An argument is valid if and only if the truth of its premises entails the truth of its conclusion.

Austin argued that:

Since Medicare has less overhead than private insurance, any “unfunded obligations” of Medicare will ultimately prove lower than whatever it would cost for private insurance to pay for the same obligations.

Austin’s premise is that Medicare has less overhead.  Austin’s conclusion is that the cost of Medicare will ultimately prove lower than whatever it would cost for private insurance to pay the same obligations.  Austin’s conclusion does not necessarily follow from his premise.

Austin erroneously assumes that “lower overhead” is a sufficient condition for lower health care costs.  In reality, many other factors contribute to a system’s cost.  One such factor is the fiscal discipline of those running the system.  Anyone who has witnessed the consistent raising of the debt ceiling under ballooning public debt should understand that our representatives in Washington have little fiscal discipline.

Next comes the straw man fallacy.  From Wikipedia:

A straw man argument is an informal fallacy based on misrepresentation of an opponent’s position.To “attack a straw man” is to create the illusion of having refuted a proposition by substituting a superficially similar proposition (the “straw man”), and refuting it, without ever having actually refuted the original position.

I posted a video of David Walker, the government’s former accountant, going through some actual hard data tending to show the unsustainability of current Medicare spending.  I requested of anyone believing that Medicare could sustainably be extended to cover all Americans to show some hard data tending to support that belief.  I was looking for a column of expected income compared with a column of expected expenditures, but Austin replied with a litany of hypothetical vagaries.  He said a lot, none which was responsive to my request.  Austin responded to a straw man.

Lastly, to justify his unresponsiveness, Austin employed a two wrongs make a right fallacy.  From Wikipedia:

Two wrongs make a right is a logical fallacy that occurs when it is assumed that if one wrong is committed, another wrong will cancel it out. Like many fallacies, it typically appears as the hidden major premise in an enthymeme—an unstated assumption which must be true for the premises to lead to the conclusion. This is an example of an informal fallacy.  It is often used as a red herring, or an attempt to change or distract from the issue.

Austin believes that he does not need to provide any hard data tending to show that his proposal is financially viable until proponents of a private health care system do the same for their proposals.  Yet Austin himself admitted from the start that “corporate executives[‘] only motive or interest is to increase profits and corporate share value.” Profits are a measure of sustainability.  If a health care industry is profitable, it is likely to remain in business to serve future customers.  Only the unprofitable, debt-ridden enterprises like Medicare require special assurances of future solvency.  Still, the burden is Austin’s to demonstrate the sustainability of his proposal to our satisfaction irrespective of how private health insurance companies are performing.

Now, I’ve debated Austin in the past, so I’ve come to be familiar with some of his argumentative strategies.  One of Austin’s strategies is to fold his arms and demand of his opponent the he satisfy his burden of proof.  Austin describes the theory behind the strategy in an article entitled Who has the burden of proof?:

An even more basic principle to remember here is that some burden of proof always lies with the person who is making a claim, not the person who is hearing the claim and who may not initially believe it.

Observe how Austin applied this strategy in comment #13, responding to a commenter identified as Curiosis:

Austin to Curiosis: defend your position.

Austin to Curiosis: defend your position.

In a prior debate with Austin, he asked me to defend my assertion that the value of Social Security is difficult to ascertain.  In response, I asked him to precisely ascertain this value for me.  I reasoned that if Austin attempted to ascertain the value, and found the task to be simple, then he would have proven my assertion wrong.  If, on the other hand, Austin found the value difficult to ascertain, it would have been a confirmation of my assertion, and that Austin would have been forced to admit that my assertion was correct, at least as applied to him.  In comment #7 of that thread, Austin declined to participate in my little experiment:

Austin on Social Security: I don't have to answer your questions.

Austin on Social Security: I don't have to answer your questions.

The burden was all mine.  Austin would have no part of it.

Now, I can play this game just as well. Rather than pointing out all of Austin’s follies and accusing him of making bad-faith evasions, misdirections, and obfuscations, I tersely indicated that Austin had not met his burden of proof:

Austin: I will be vindicated.

Austin: I will be vindicated.

Austin fumed in comment #33:

Austin's second response

Austin's second response

First observe Austin’s claim to the meaning of the word “prove”.  Austin arrogantly presumes that his use of the word prove should be the baseline against which all future uses of the word are to be measured.  In fact, my use of the word “prove” referred to my earlier comment #27, in which I demanded of anyone who supported extending Medicare to all Americans that they provide a balance sheet detailing the financial viability of this proposal.  My only mistake was that I did not use the word “prove” to describe what I was asking for.  Austin seized upon this oversight to stake a claim to the word “prove” so that it would apply henceforth only to his straw-man hypothetical diversion.  Austin would condemn as fallacious all future attempts on my part to use the words “prove” and “proof” to represent my original request for proof in comment #27.

Next observe Austin’s desperate attempts to shift focus from his proposal to mine.  We both know that the burden is not mine to disprove Austin’s assertions; rather, the burden is Austin’s to support them.  Whether I’ve “troubled myself to disagree” with Austin has no bearing at all on whether Austin is actually correct. The burden is no more mine to refute the viability of Austin’s Medicare proposal than it was Austin’s to refute my assertions regarding Social Security.  I’d like to presume good faith here, but I can’t help but feel that Austin knowingly changes the rules of the debate to suit his purposes.

Lastly, notice how Austin abandoned the presumption of good faith.  He accused me of evading the issues and lying about what he said, and then he threatened to delete any post of mine that he considered to be irrelevant.  If Austin were interested in achieving an understanding, he would promote discussion, not shut it down.  Austin is not interested in achieving an understanding because he haughtily presumes he already has an understanding.  Austin is interested only in talking this “understanding” down to us.

I’m interested in learning.  I invited Austin and all of his readers to explain to me how they intend to sustainably fund their universal health care system.  I’d like to know whether it would retain all of the services that Medicare currently provides to seniors, or whether some services will be dropped.  I’d like to know what they have in mind for rationing, or what, to them is an acceptable time to wait for service.  I’m curious as to how they intend to hold providers to this time limit.  I want details, not vague hypotheses.

I posted one final comment clarifying my request for further evidence in  support of the cost-effectiveness of Medicare.  I tried to resist accusing Austin of foul play, either for his manifest and consistent use of logical fallacies or for shifting the rules of acceptable debate invariably to his advantage.  I made one final attempt to steer the conversation back to the financial viability of Medicare.  For reasons that will soon become clear, the comment has been paraphrased:

It is easy to say that Medicare is more cost effective than private health care, but the saying of it does not make it a reality.

On one hand we have David Walker, former Comptroller General of the United States, who warns that Medicare is in debt to the tune of tens of trillions of dollars, threatening to bankrupt the entire nation. On the other hand we have Austin Cline, Atheist blogger and critic of religion, who assures us that Medicare is more cost effective because it has “lower overhead”.

Show us, Austin! Show us this low overhead! Show us these great savings! Explain to us how such an efficiently managed program can run up such outrageous debt! Explain to us how expanding the program will turn the tide! A link to some outside information might be helpful.

I don’t know how many senses of the word “proof” there are. There’s one sense in which a person backs up what he says with references to outside sources of information. I guess there is another sense in which a person pontificates his opinion, claims it is an “undeniable fact” that does not require proof, and then threatens to silence everyone who disagrees with him.

Please do not lecture me about honesty and other things in classes by themselves. Have fun with you [sic] blog controls.

I believe I clarified for Austin exactly what type of “proof” I was looking for.  Yet Austin followed through on his threat and wiped the comment right off of the page, presumably because I “evaded taking a position on which option is better”, as Austin demanded.  Austin proceeded in comment #34, responding to a fellow commenter named Mobathome, who also believed my comment #29 lacked substance:

Austin ignores every one of my direct questions.

Austin ignores every one of my direct requests and focuses on the word "proof".

What is Austin trying to say here?  If we take him literally, understanding the meaning of the word empirical, he appears to be claiming that we have already experimented with extending Medicare to all, that these experiments were observed to have been cost effective as compared to a private health care system, and that these observations have been recorded in a public record that Austin has conveniently declined to reference with any specificity.

It is easy to dismiss a claim like this as a patent delusion, but again, I’d rather presume good faith.  This, I felt, should include presuming that my adversary is marginally sane.  I continued as if Austin were merely mistaken, rather than utterly delusional.  Austin’s final comment crystallized his argument:

Austin Cline: laughably hypocritical

Austin Cline: laughably hypocritical

This time, Austin crudely and unapologetically appealed to consequences and to pity to support his proposal.  What ultimately happens to me is irrelevant to the question of whether Austin’s proposed health care solution is financially viable.  But none of this matters to Austin.

In his view, the whole question of financial viability is irrelevant to the health care question.  All this time, in Austin’s view, I was merely attempting to “puff myself up and looking good” by demanding proof of financial viability.

All that is relevant to Austin is his ideology that all customers must be served, regardless of ability to pay.  All else flows from this Utopian standard, from his convenient definition of “unfunded obligation” to his adamant refusal to support his proposal with hard data.  I should be grateful to Austin for spending so much time explaining his hunch as to why his proposal might be cost-effective.

Since Austin asked, and now that I finally understand his argument, I can propose what I think would be a preferable alternative:

Rather than allowing dogmatic, utopian ideologies concerning what constitutes a “working” health care system inform our perception of the cost of health care and how we should account for it, we should reverse this process and allow diligent, creative cost-accounting to inform our perception of what a viable health care system is capable of accomplishing.

I never even suggested to Austin that we should reject a government health care program, so congratulations to Austin for responding to that straw man at the end of his comment #33.  On the contrary, I specifically invited Austin to “be my guest”.  All I asked of Austin, and of anyone else interested in reforming health care, is that they do their cost-accounting before they do their Utopian demagoguing.  Of course, now I’d be happy to explain all this to Austin and his readers, but unfortunately he has banned me from posting on his site.

If Austin wants to prune his comment threads a little and cut off some comments that he believes to be irrelevant, I understand that.  I recognize a good faith interest in improving the flow of discussion.  But it did not take long for some likely unintended consequences of this heavy-handed policy to arise.  Mobathome writes in comment #37:

Mobathome was unable to find what Austin deleted.

Mobathome was unable to find what Austin deleted.

You can’t rightly review a comment thread when the editor is deleting things behind him. Thanks to Mobathome for at least attempting to review my arguments. (And no thanks to Mobathome for throwing me under the bus after my alleged “straw man”, while stamping his imprimatur on Austin’s double standards, repeated fallacies, invalid deductions, and manifest imprudence.)

Mobathome, of all people, should have known better than to expect Austin to preserve his comment threads for future reference.  Have a look at Mobathome’s comment #11 following my debate with Austin after his post Limited Government? No. Thanks…:

Austin Cline makes an editing gaffe.

Austin Cline makes an editing gaffe.

I can assure Mobathome that I did not invent that quote.  The simple answer to Mobathome’s question is that Austin edits his comment threads at his convenience.  If Mobathome wishes to review any of Austin’s discussions, then he should use versionista.com or some similar service to track the changes Austin makes to his pages.  I posted a comment saying so, and that comment, of course, is now gone.

Dreadful Scathe wrote in comment #41:

Dreadful Scathe has, indeed, seen the last of me, but not for the reason she assumes.

Dreadful Scathe has, indeed, seen the last of me, but for other reasons.

Dreadful Scathe will probably never know that I did, in fact, respond to this post, and that Austin promptly deleted the response:

Austin Cline fails to cure his readers' naïveté.

Austin Cline fails to cure his readers' naïveté.

Austin finally issued the requested disclaimer as a passive-aggressive edit to the end of his previous comment #35:

Austin Cline's comments have no integrity.

Austin Cline's comments have no integrity.

Apparently, Austin could not resist an ad hominem attack on my character. Because Austin felt that he already made his case completely, he would have felt at liberty to move on to non-substantive matters.  But you can see why it has become increasingly difficult for me to continue under the presumption that Austin is interested in a good-faith discussion of the health care issue.

As a quirky epilogue, Austin has recently posted an article in which he asks: What is Critical Thinking?.  Four days after claiming infallibility,  silencing his opposition, and editing his own words post facto—with all the charm of a totalitarian dictator—Austin answered, in part:

As a general rule, critical thinking involves developing some emotional and intellectual distance between yourself and ideas — whether your own or others’ — in order to better evaluate their truth, validity, and reasonableness.

A person who wishes to think critically about something like politics or religion must be open-minded. This requires being open to the possibility that not only are others right, but also that you are wrong. Too often people launch into a frenzy of arguments apparently without taking any time to consider that they may be mistaken in something.

Of course, it is also possible to be too “open-minded” because not every idea is equally valid or has an equal chance of being true. Although we should technically allow for the possibility that someone is correct, we must still require that they offer support for their claims — if they cannot or do not, we may be justified in dismissing those claims and acting as if they weren’t true.

Incredible.

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