Fungibility of Money & Abortion in healthcare
I was disappointed to hear one of today's guests on the Diane Rehm show being dismissive of the Fungibility of Money issue with respect to the discussion of abortion within the healthcare debate.
Essentially, for anyone unfamiliar with the argument, it essentially goes something like this. If Federal subsidies are used to fund the purchase of health insurance through the kinds of exchanges the bills currently in congress envision, and some of the insurance plans so subsidized are structured in such a way that they provide elective abortions as a covered service, then that would constitute a violation of the Hyde Amendment and the amount to the use of Federal Funds to cover abortions.
The counter to this is that there are clauses which state that the Federal money must be cordoned of and not used for abortion services.
And the counter to this counter, which was dismissed (I feel without giving it its due hearing) is that money is fungible. That is to say -
Imagine you have $5 for a trip to the grocery store, and you want beer and bread but can't afford both. If you don't get money from somewhere else, you have to just buy the bread, since that's what you really need. Let's say I give you another $5, but only on the condition that you don't spend that $5 on beer.
So you take my $5 and spend it on the bread, then take the $5 you already had and spend it on the beer. Left to your own devices, you would not have been able to buy beer, but my $5 made it possible for you to do so. The "segragation" of my money from the beer purchase was illusory -without my $5 you would not have bought the beer, now with my $5 you were able to.
The same can be said for the use of Government funds by banks to provide generous bonuses to their employees. A bank may say, "well, we funded those bonuses from our own incomes, and didn't use Federal Money to pay them," but that's a disengenous statement at best. If the banks had not recieved the Federal Funding, they would have had to redirect their incomes towards covering their losses and paying expenses, and would not have had leftover money to spend on bonuses. With the Federal Funds helping to cover their operating expenses, their incomes from other sources were freed up to pay bonuses. The Government money enabled the bonuses to be paid - hence the American people's outrage.
These "separations" "pools" or "fences" we put up around public money in these situations are little more than political performance. They have no effect on the reality of the fact that the money is going to support the institution in question. Would we support US government aid to the North Korean government, on the condition that they would not use it to fund the police forces they use to squelch opposition? Of course not. The instant we gave them that money, they would send our money to their public transportation network ministry, move money from public transit into their police force funds, and the conditions on our conditionary aid would be rendered meaningless.
To provide Government support to an institution is to aid that institution in *all* aspects of what it does. The fungibility of money doesn't allow for anything else.
A discussion of abortion's relation to a new healthcare structure in this country is fine, and I'd be a happy and willing participant, but I'd prefer we did it without these kind of political smokescreens and willful ignorance.
Essentially, for anyone unfamiliar with the argument, it essentially goes something like this. If Federal subsidies are used to fund the purchase of health insurance through the kinds of exchanges the bills currently in congress envision, and some of the insurance plans so subsidized are structured in such a way that they provide elective abortions as a covered service, then that would constitute a violation of the Hyde Amendment and the amount to the use of Federal Funds to cover abortions.
The counter to this is that there are clauses which state that the Federal money must be cordoned of and not used for abortion services.
And the counter to this counter, which was dismissed (I feel without giving it its due hearing) is that money is fungible. That is to say -
Imagine you have $5 for a trip to the grocery store, and you want beer and bread but can't afford both. If you don't get money from somewhere else, you have to just buy the bread, since that's what you really need. Let's say I give you another $5, but only on the condition that you don't spend that $5 on beer.
So you take my $5 and spend it on the bread, then take the $5 you already had and spend it on the beer. Left to your own devices, you would not have been able to buy beer, but my $5 made it possible for you to do so. The "segragation" of my money from the beer purchase was illusory -without my $5 you would not have bought the beer, now with my $5 you were able to.
The same can be said for the use of Government funds by banks to provide generous bonuses to their employees. A bank may say, "well, we funded those bonuses from our own incomes, and didn't use Federal Money to pay them," but that's a disengenous statement at best. If the banks had not recieved the Federal Funding, they would have had to redirect their incomes towards covering their losses and paying expenses, and would not have had leftover money to spend on bonuses. With the Federal Funds helping to cover their operating expenses, their incomes from other sources were freed up to pay bonuses. The Government money enabled the bonuses to be paid - hence the American people's outrage.
These "separations" "pools" or "fences" we put up around public money in these situations are little more than political performance. They have no effect on the reality of the fact that the money is going to support the institution in question. Would we support US government aid to the North Korean government, on the condition that they would not use it to fund the police forces they use to squelch opposition? Of course not. The instant we gave them that money, they would send our money to their public transportation network ministry, move money from public transit into their police force funds, and the conditions on our conditionary aid would be rendered meaningless.
To provide Government support to an institution is to aid that institution in *all* aspects of what it does. The fungibility of money doesn't allow for anything else.
A discussion of abortion's relation to a new healthcare structure in this country is fine, and I'd be a happy and willing participant, but I'd prefer we did it without these kind of political smokescreens and willful ignorance.
Replies to This Discussion
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Permalink Reply by John Antonelli on -
So then we get rid of the Hyde ammendment.
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Permalink Reply by Matthew - NC on -
Fair position. I just wish we were having an open discussion about that instead of papering the issue over and pretending it isn't there out of fear of it's divisiveness stalling the bill.
Frankly, we should be having a lot of discussions about what services should be covered in these Government subsidized plans. If we're creating a baseline minimum of coverage, what services exactly are included in that? Certainly abortion could be addressed in that discussion, as could other things like in-vitro fertilization, anti-depressant medication, viagra... what is a necessary service and what isn't?
What specifically are we trying to do with this bill? Ensure a baseline minimum of services we deem necessary for survival? Or open up the full resources and expertise of our medical community to all citizens? What about people who choose to engage in risky behaviors such as smoking or drunk driving? What is and isn't covered has dramatic cost implications (look at the differences in health insurance prices in states that mandate more coverage vs. less, they create annual cost disparities in thousands of dollars on an individual/family level), and I'm surprised there's been as little discussion of what will be covered as there has been.
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Permalink Reply by John Antonelli on
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While aborttion is banned buy the Hyde ammendment, Viagra is not. hmmmmmmmmmmm
Matthew - NC said:Fair position. I just wish we were having an open discussion about that instead of papering the issue over and pretending it isn't there out of fear of it's divisiveness stalling the bill.
Frankly, we should be having a lot of discussions about what services should be covered in these Government subsidized plans. If we're creating a baseline minimum of coverage, what services exactly are included in that? Certainly abortion could be addressed in that discussion, as could other things like in-vitro fertilization, anti-depressant medication, viagra... what is a necessary service and what isn't?
What specifically are we trying to do with this bill? Ensure a baseline minimum of services we deem necessary for survival? Or open up the full resources and expertise of our medical community to all citizens? What about people who choose to engage in risky behaviors such as smoking or drunk driving? What is and isn't covered has dramatic cost implications (look at the differences in health insurance prices in states that mandate more coverage vs. less, they create annual cost disparities in thousands of dollars on an individual/family level), and I'm surprised there's been as little discussion of what will be covered as there has been.
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Permalink Reply by Matthew - NC on
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Yeah, Viagra would most definately fall under the "should not be covered" catagory in any plan recieving a subsidy. I would also put fertility treatments on that list, since they're expensive and a child may be something you want but a baby can hardly be called a medical necessity. I would be against defining elective abortion as a "necessary" service but only *if* the program did cover pre-natal care to the nines. It wouldn't make sense as a matter of policy to refuse to cover abortions while forcing women to pay pre-natal costs out of pocket.
Again, that's all hypotherical, since, I'm still against the idea of the Government taking such a heavy role in our healthcare system to begin with. I'm Libertarian by nature and not a fan of subsidies for anything, but, if we *had* to do the reform proposed, limiting what's covered to a narrow group of things that are truly necessary would do a lot to keep the cost of the program as a whole down - the more we cover, the heavier a burden it will be on our budgets if it passes.
John Antonelli said:While aborttion is banned buy the Hyde ammendment, Viagra is not. hmmmmmmmmmmm
Matthew - NC said:Fair position. I just wish we were having an open discussion about that instead of papering the issue over and pretending it isn't there out of fear of it's divisiveness stalling the bill.
Frankly, we should be having a lot of discussions about what services should be covered in these Government subsidized plans. If we're creating a baseline minimum of coverage, what services exactly are included in that? Certainly abortion could be addressed in that discussion, as could other things like in-vitro fertilization, anti-depressant medication, viagra... what is a necessary service and what isn't?
What specifically are we trying to do with this bill? Ensure a baseline minimum of services we deem necessary for survival? Or open up the full resources and expertise of our medical community to all citizens? What about people who choose to engage in risky behaviors such as smoking or drunk driving? What is and isn't covered has dramatic cost implications (look at the differences in health insurance prices in states that mandate more coverage vs. less, they create annual cost disparities in thousands of dollars on an individual/family level), and I'm surprised there's been as little discussion of what will be covered as there has been.
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Permalink Reply by jim on -
Maybe the American Taliban can form one of the Co-ops, then they won't have to worry about what the rest of US are doing at the Doctor's office !
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Permalink Reply by Leslie Monroe on -
Not a big fan of fungibility and I love your bread and beer argument. Very similar to how people use their food stamps to buy the basics and then use their own money to buy things they don't need. Good analogy.
Leslie
JRS Medical
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Created by WAMU 88.5 May 13, 2008 at 9:58am. Last updated by Jason Novak (WAMU 88.5) Sep. 22, 2008.
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Created by Jason Novak (WAMU 88.5) May 13, 2008 at 9:55am. Last updated by Jason Novak (WAMU 88.5) Aug. 28, 2008.
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