Brian Beutler doesn't understand why I find flipping back and forth between arguments so annoying:
See, I don't find this tendency annoying at all. In fact, one of the things I like best about being in an argument is when I can win that argument on a handful of different grounds. For instance, I can make both efficiency and morality claims about torture, the death penalty, profiling, health care, and the Brian-deserves-more-free-money initiative now making its way through Congress, and my argument is all the firmer for it. And I should add that keeping in mind both efficiency and morality is an obviously excellent way of picking a health care system, or for that matter any other system that depends on both efficiency and morality to be effective.
What actually is annoying is the tendency of one's opponents in a multi-flanked argument to complain that the war is being fought on too many fronts instead of either hitting back strongly, or, more preferably, ceding the point altogether.
The problem is not that the arguments are multi-flanked; it is that the multi-flanked argument becomes a way of avoiding conceding any particular point. Just as you have pinned down the crux of some particular efficiency argument, your opponent says "Well that doesn't really matter, because what I'm worried about is the morality of it." Then, when you look like you might be winning a point about morality, your opponent suddenly says, "Well, that doesn't really matter, because my system is more efficient!" Aggregate claims have to consist of propositions that are individually true, but this sort of argumentative style prevents us from ever determining whether they are, or not.
Obviously, if you're trying to defend a predetermined position, this is a feature, not a bug. And it's certainly a bipartisan vice. But it makes the debate pointless, especially since I can play, too! The result is that we go around in circles, reassuring our echo chambers of like minded supporters without ever having any sort of productive discussion.
Multi-flanked arguments are fine. In the case of health care, they're even necessary; health care, after all, is only a means, so you have to know what ends you mean to establish. But to make a sound aggregate argument, you need to examine each of the pieces separately before you aggregate them, particularly if not all of the pieces have buy in from the other side.
At this point, I'm simply trying to nail down some small priors before proceeding. Those priors are:
1) People don't have a right to money from society simply because they have gotten sick; to the extent that they have a right to health care, it is that they have a right not to die or suffer from lack of funds.
2) The distributive justice claims for single payer are, on the advocates side, stronger than the efficiency claims. They would prefer a single payer system that is less efficient than the current American system, to efficiency improvements in the current system that did not cover the 45 million uninsured people. I know (I KNOW!) you think that single payer is both more efficient and more just. I'm simply trying to establish a rank ordering of priorities.
These are the first building blocks of an argument about single payer. I don't actually think they're really controversial, if you stop thinking eight moves ahead. Does anyone prefer their efficiency claims to their distributive justice claims? Do you think that we should give Warren Buffett money for health care, not as a side effect of arranging the most efficient transfer of resources to the needy or otherwise deserving, but as a moral end in itself? Is anyone prepared to argue that Warren Buffett deserves a special bonus from society--tens of thousands of dollars worth of health care--just because he's old?
I don't think anyone does believe these things; or certainly not many people. People are treating fairly straightforward propositions as if they were trick questions. They're not. I'm just trying to frame the argument in a pretty neutral way.
People are also acting as if I believe that, by nailing down these first points, I have made some sort of comprehensive argument against single payer. Obviously not. Such an argument is far larger than a blog post could manage (which is why I'm doing it in baby steps). Thus, many of them respond "But single payer is awesome!", when I haven't gotten anywhere near a discussion of its relative awesomeness to other possible systems. At this point, I'm just trying to lay out the criteria by which we might one day evaluate its awesomeness.