ASEVoIS: Health Care, Redux

One of the first articles we wrote back in the early days of WDR was an article on health care in this country. Back then, I was arguing that instead of wasting our time talking past each other on immigration (when a real solution would have merely involved a simple compromise), we should spend our time discussing a real problem like health care. It only took us two years to reach this point, but it looks like we've finally awakened to the problem.

Except what we have on our hands is not an argument, but the usual demagoguery and the like. This doesn't even speak to the issue that's been dominant in the media portrayal, the raucous nature of the town halls. To tell you the truth, besides the usual fear of having crazy-ass bastards bringing loaded guns to Presidential events, I don't have a problem with these events as a whole. I don't buy into the "Astroturf" arguments advanced by the left--these are no repeats of the Brooks Brothers riot for the most part, but instead the actions of a (mostly uninformed) citizenry. By attempting to deride the nature of these protests, the debate ends up being nothing but a series of ad hominem attacks that obscure the genuine issues on the table.

We understand the nature of the reforms being discussed at this point, with the main focus being on the public option. We've heard the potential benefits--lower costs, get uninsured on the rolls, free lollipops. So instead we should take the time to address some of the concerns.


Why the public option? We're a republic, we need a free-market solution! Free-markets!

Sure, free-markets are great. In theory, they're just about the best thing we have, and are a brilliant instrument. The problem is, even as it stands now, health care as a free market is broken. Free markets depend on the exchange of information and choice, and what we have now is neither.

Think about this: how much choice do you as a recipient of insurance have in choosing your provider? If you're like me and million of others, you have absolutely none. I just use the one that my school has signed with, and I don't even get dental. You're also probably with whatever provider your employer has made a deal, and they probably did that without any input from you. Or, to take another approach, if you live in some states, there's a 94% chance you're signed with BlueCross or some other conglomerate. In other words, there is no "choice" in this system.

Or think about the possibility of checking out your own insurance provider. You're not going to have any idea how effective they are with their coverage, because it often requires personal experience with the exact crisis--it may be great for that workplace back injury, but you just might get fucked over when that tumor on your pancreas develops. If you were going to make an actual choice, you need information--and it is in scarce supply.

But free-markets are efficient
Our free-market is so efficient that we spend more per-capita on health care than any other nation, yet our health care is only 37th best. Our health care is so efficient that we spend 16% of our GDP on it, while France at number 1 spends 9% (and insures all of their citizens). Clearly, the greatest benefit of the free market has not borne fruit when it comes to health care.

Consider the overhead costs of public versus private plans. Whereas overhead in private insurance (money that is sent to administrators and the like) can reach as high as 30%, the same costs in Medicare and other government health programs are in the low single digits. So much for "government waste".

I don't want someone choosing my doctor/plan/operation for me
Have you ever dealt with an insurance company? That is EXACTLY what already happens--you can only see their doctors, go to their hospitals, etc. And god forbid you ever had to negotiate with an insurance company over whether or not your operation could be covered or not.

The point is that for the most part, these decisions are ALREADY BEING MADE for you. The only thing that will change is that the person that may do this for you will be wearing a different suit, provided of course you end up with the same coverage (and considering the number of people that are currently underinsured, this is unlikely).

Get the government out of my Medicare!
Sir, put down the ether.



DEATH PANELS DEATH PANELS DEATH PANELS
This has been discussed rationally and in-depth by everyone. But people, if you're getting your facts from Sarah Palin, noted language-expert, well...you need a new source.

We need to cut costs
YES. That is exactly what we need to do, thank you. That's why the public option is so integral to the process--by using the government's negotiating power of millions of citizens, better prices can be negotiated, and help force downward pressure on ever-escalating costs. And with an aging population, this is more of an issue than ever before.

So this is an issue that both Republicans and Democrats agree on. Yet the Republicans can only attack the Democrats, and just continue to spout CUT COSTS. Of course, if you asked them about their plans and what costs they would cut, they shut the fuck up and just offer a two-page outline of a "plan". They also create DEATH PANEL rumors. See guys, I'd love to hear your solution, but you have to offer something.

What about tort reform?
Getting at the lawyers is always a good idea. But you know, this is really not the answer to the problem. And this is not just because I'm working to becoming a lawyer myself--hell, I don't think I could stomach doing things like personal injury.

The thing is, medical malpractice suits represent such a minimal percent of total health care costs that reform would barely make any dent on the process. And if you look at this article, it also is explained how despite those extremely large settlements you hear about, it's NOT the driving factor behind rising costs. Of course, those cases represent but the smallest minority of potential malpractice claims, and usually involve a catastrophic injury of some sort--putting a cap on losing your legs at $250,000 sounds pretty ridiculous.

Tort reform advocates also ignore the fact that while there are cases of frivolous lawsuits, these are usually pretty rare. They also ignore how the cards are stacked against the plaintiff in these cases--the reliance on expert medical testimony, the influence of doctor panels, etc., are all heavily biased in favor of the defendant. So when these cases do succeed, there's usually clear and convincing evidence, and many unsuccessful cases may in fact be the result of gross negligence. So yeah, tort reform is not the answer.


Have you read the 1200 page bill
There is no bill. There are multiple bills--one House bill, and probably around four Senate bills. Nothing is final yet, so it's stupid to get in a tizzy over half-made sausage. And for the record, only about a quarter of that 1200 page bill is anything but boilerplate.

Obama is a Nazi Kenyan Marxist Alien!
Who let Lyndon LaRouche into this forum?

Besides, all you people who are apparently so concerned about the Constitution, they should be mad with Obama for other things. I'm not sure what the Constitution said about health care (Ed. Note: it says nothing), but it does say a lot about rights to a trial and use of executive power. Jesus people, read more Glenn Greenwald and get angrier about Obama's preventive detention policy and his Justice Department's attempts to expand the use of the state's secrets privilege. Oh wait, I forgot, this only concerns "fereners," so you don't give a shit.

We are not Canada! We are not France!
True enough. But it is amazing when you have people like Daryl Issa and Jack Kingston, both Republicans, talk about the efficiencies of the French Health Care system (see last week's Real Time with Bill Maher), yet deride the proposed reforms. These reforms are only halfway approximations of those models, yet this is taking the wrong approach. Amazing.

Hopefully this helps answer some of the questions you've had. If it doesn't, I don't know, look it up some place that Glenn Beck won't look into--that'd probably be a good start.

Health Care is Not Funny (And Don't Even Think About Patch Adams)

I apologize for the rambling nature of my previous post. This is what happens when you don't work with an editor, and you just fire things out stream-of-consciousness style. So broad points are made in hopes that something sticks (mainly in an attempt at humor), without really constructing a well-crafted argument. Not to worry, it's not as if I've been spending most of my time the past few years trying to get into law school or anything...

The point that I was trying to make was that the immigration debate by and large has been totally misrepresented. And to tie it into the introduction to this series, even though it is a problem that we should solve, it is not a crisis. Do you need evidence? Well, we didn't pass the legislation. It's probably going to be a long time for legislation to actually get passed, since it takes time to draft it and vet it and so on. And we're still standing, though I do believe we have a few additional pickup trucks selling fresh fruits along our beautiful highways.



The demagogues have been silenced. They have found their victory. It was not in actually succeeding in getting anything done that would fix the problem, no, that would make too much sense. They are content in relaxing now that the process has stalled. That really makes sense.

Bah, enough of that. How about a real problem? Try our nation's health-care system.



The argument has boiled down to two different systems: 1) the private-insurer system that is in place now, done usually through one's employer OR 2) single-payer state-run system that is similar to that of W. Europe and a good portion of the world. Each have their advantages and drawbacks, and they have been rehashed numerous times. Each side decides to repeat the same claims, without taking the time to listen to the other. It's really productive, as you can clearly see.

Well here's my slightly educated contribution.

With the private-insurer system, we have over 12% of our population without any coverage, and with countless more that have limited and insufficient coverage. But we also have the finest medical technology, qualified and well-compensated professionals, among other things.

The irony is, that though we have a market-driven system, it is completely inefficient. In the US, we spend more per-capita than any other country on health care, yet we rank 37th in terms of quality of care (as has been oft-repeated in reviews of Sicko). We are not getting our bang for our buck; in fact we're getting screwed. There is a failure somewhere that is not being corrected.



The single-payer method allows for universal coverage and great service, but the expense is long waiting lists, and well, expenses. Higher taxes, that's the way you got to pay for them. My question is, considering that we already have an abundance of medical facilities and professionals that have the ability to staff these facilities, if we switched the method of payment shouldn't we be able to account for these lines? And how much more inefficient can taxes be, considering that we get so little for what we pay for these days? Shouldn't redistributing some of that burden help out a bit, AND allow for more people to fall under coverage?

My point is that we already know what works and what doesn't in these systems. Why don't we do something like adopting a hybrid--allow for a baseline coverage for all, and allow some to opt out if they choose?

The status quo is crap. We can do something, one way or another. We just need to demand change.



And thanks to both Mr. Zhuang and Joe Reefer, for bringing back the funny. I'll join in again soon.