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.

Firings, Layoffs, and Other Intra-Office Hijinx

Some of you may have noticed the slow downturn in productivity around these here parts. If this were a regular corporate office, we could probably blame intrusive government tax infrastructure and a tightening of the commodities market as being key factors that have contributed to the gradual shittening of our product. Of course, if that were the case, you the consumer would probably blame goddamn illegal immigrants (read: Mexicans) from doing something to fuck up the system, like giving us the plague and stealing our Social Security numbers. And you're both right. In that nothing of the sort has occurred.

No, what has really happened is that we've simply dropped the ball. But it's not our fault entirely. Well, it is and it isn't. Let me explain.

If you take a look at our post count in the sidebar, you'll notice fluctuations in our post counts month to month. We hum along at a good clip for the most part, but we begin to die in November, tailing off into December and January. The natural assumption would be that Shitty Weather = S.A.D. and a lack of desire to offer our deliciously witty insights. But you fool, you didn't look at a big enough sample size! Notice that February saw a rise in postings, when weather has empirically been found to be at it's Shittiness Index Zenith. But in March, we saw our output decline again. Why?



It's because the authors all met each other in person and hung out together. And thus eliminated our desire to write. Because, really folks, the only reason we really do this site is to make each laugh; when we are physically in each other's presence, we really don't need the middleman of WDR to make our brilliant points. Hence, productivity declines.

But The Namesake has had enough of these shenanigans, and he has personally instituted some changes. First off, Joe Reefer has been temporarily demoted to LiveJournal postings as the result of a drunken voicemail message that disparaged the French and retards. He thinks that the punishment of acting like a 14 year-old post-Goth girl is certainly adequate. Second, Mr. Zhuang will have his coke privileges revoked, so hopefully we don't have any repeats of what happened in the lobby of that one Marriott. And I, Nic Ouzo, have been entered into psychological counseling as I attempt to deal with the tragic loss of my Pog collection.



Oh, and our accounting staff has been fired, and Rasheed has been let go. On the bright side, we're on the lookout to hire new interns!

The Immigration Hobgoblin

Immigration is the great bogeyman of politicians these days. It is responsible for all our social ills, from our crumbling schools to our crowded hospitals to the fact that I now have to dial '1' to receive service in English! Oh the humanity! It's going to be our downfall, because while you were content to just watch '101 Biggest Celebrity Oops!' on your HDTV (or you just had your attention held by that new shiny object with its purty colors), Pedro stole your job and Ahmed bought some fertilizer for his spiffy new bomb. You were asleep at the wheel, while our country was hijacked by foreigners (but not by Foreigner--"Hot Blooded" still is not our national anthem)!



This is an exaggeration of some of the reaction, but not by much. The hyperbole that has flown around this issue has truly been astounding, and demagogues like Lou Dobbs (who amazingly does not understand the basic concepts of international trade), Pat Buchanan, and Jeff Sessions have seized the moment. They prey on a populace that doesn't understand foreign policy and so can't really arrive at any solution to the situation in Iraq and elsewhere, but understand that those darn brown people are moving into their neighborhood! It's unsafe, dammit! So put up that Southern Wall, and keep 'em outta here!

(And forget about the fact about how easy it is to come in through Canada, and that Asians and European communities make up a significant part of the immigrant population. And that the terrorists of 9/11 entered the country through legal processes. These are convenient points to forget.)

And so we have events like what occurred last week, as the Senate debated their plan for comprehensive immigration reform. But the demagogues were able to truly get their message out: it was merely a cover for "amnesty"! I'm not even sure what that means, but I got to tell my Senator that I don't like the sound of that! It's the one sin that Reagan committed in his Presidency! So we had thousands of people jamming the phonelines on Capitol Hill parroting back this claim of "amnesty", coupled with the position that "we need to enforce the laws we already have on the books", without pausing to think what their solution would be.

What was their plan to deal with the 12 million illegal immigrants already in this country?



It sure would be hard to deport the whole lot of them. The logistics of such a maneuver are mind-boggling. And that doesn't even take into account the economic fallout. Yes, the influx of cheap labor keeps a lot of these low-skilled jobs at a stagnant wage label, but the consequence is that prices have remained low. For example, if we got rid of all the illegal immigrants working in the fields, not only would we have a whole hell of a lot less food available at our MegaMarkets, it'd be a lot more expensive as well. The other key area where immigrants help the economy is payment for Social Security--as the Boomers age, we'll have to begin payments for their entitlements, and without the input from immigrants we'd have a significant shortfall in that regard.

As for "enforcing those laws already on the books"--care to name a few? This is reminiscent of the claims during the Bush-Kerry campaign that during all his years in the Senate Kerry never crafted significant legislation. But ask just about anyone to name an example of significant legislation, you would draw total blanks beyond perhaps "McCain-Feingold". But if we repeat things enough, they must be true!

And the complaint that we first need to concentrate on security is also faulty. If we don't solve both ends of the problem, we still fail. Besides, we use one part as a carrot for the other side--we give in a bit on security measures, you give in a bit on the illegals already here. It's called compromise. It's what legislators are supposed to do.

And that is why the "path to citizenship" is a good idea. We can't afford to get rid of these workers, at least those that have been productive. But you can't exactly give them a free ride, so you make the process difficult and arduous.



Of course, this is the point in any commentary that one is contractually obligated to mention that ours is a nation of immigrants, though clearly a lot of people that some immigrants are created more equal than others. This is also the point in the commentary where the people that need to be reminded of this point the most tune out. We have had many points in our history where we've had an influx of immigrants, people panic, and shit goes down.

In the end, we end for the better because of it. The immigrants eventually assimilate, learning our language and adopting a lot of our customs, while teaching us traditions of their own and contributing to our culture.

Before I leave, I want to point out the biggest hypocrisy of the whole debate. Americans want to brag all the time about how great their country is, broadcasting to the world how the USA is #1. Yet when people risk their lives to become a part of that awesomeness, we reject them. We're saying, "Sorry you didn't win the lottery when you were born. Deal." We can't have it both ways. We must share the awesomeness.