Health, wealth and wisdom
Right now, here is a great deal of frustration on the part of the health care reformer movement regarding the apparent success of the insurance lobby (read: teabaggers) to muddy the waters of the debate, shout down advocates and get granny cowering under her afghan, worried that she’s about to be shipped to the Soylant Green factory.
On Wednesday, Barack Obama will allegedly enter the fight in earnest, laying out what he wants out of a health care bill. Some fear that he will capitulate to the pressure, cave on a public option and basically endorse some sort of window dressing for reform, such as co-ops, and wash his hands of it all. This is unlikely.
The real sense is that Obama will resort to incrementalism, proposing the smallest doses of medicine that the right wing can swallow and putting his weight behind forcing the spoon through their pursed lips. This will probably take the form of the changes America has shown the least resistance to vis a vis private insurance: removing pre-existing condition snares, lifetime payout caps, and allowing insurance mobility when one changes jobs.
A needed start, but the real transformation will face the same resistance whether it comes tomorrow or today. The question neeeds to be answered, not by legislators, but by citizens: is our health insurance system obsolete?
It is just this discussion that the conservatives have been trying to derail with their divide-and-conquer strategy of obnoxious town hall putsches. By stoking the fears of a worsened health care system, the citizens are kept off balance from realizing that what they have right now really sucks.
The fact is that before genuine reform can come, the people have to decide that change is needed not simply for financial reasons, but for moral ones. This is tough in the Darwinian environment which Americans are told is our natural state. Americans are go-getters, individualists, non-gay cowboys, and so forth. Health care for all Americans? Why, it’s downright un-American!
Thats the chaw for the masses. Between the upper classes, the argument goes more like this: health care is a privilege bestowed on the productive citizens by dint of their hard work. It is only unaffordable to those who have fallen by the wayside in our “tough love” economy. If the weak had the talent to be the prime movers, or were of more than of average use to the over class, affordable health care would be within their reach.
You hear this shit a lot among Libertarians. Never mind that the country already decided long ago through Social Security, Medicare and Medicaid that dog-eat-dog rules need not apply in the wealthiest country in the world. But there is also the small matter of how the “unproductive” citizens have been getting fucked in the wallet since the seventies, when wages began to flatten out (and even decline) while the productivity of the American worker continued to increase on a steady curve, as it has for a hundred years. This has created  an increasing flow of profits to their employers that has failed to reemerge in the worker’s lives in the form of the things they really need, such as affordable and dependable health insurance.
So the matter is societal, dare I say social, and must be addressed on those terms. Do people in the richest nation in history deserve a health care system that works for everyone, as due their hard labor and decades of diminishing rewards, or will it remain an entitlement for millionaires and politicians?
Here (compressed for your pleasure) is everything the Republicans have to say about improving healthcare for the public. As you can see, it is long on nightmares and short on reform:
[youtube]http://www.youtube.com/watch?v=ACwCYkDPTY0[/youtube]
The right wing argument basically consists of two points: we cain’t affird it right now, and even were we could, we’re a free markit system dagnabbit!
The first point  is evergreen and deserves little credit. When hasn’t it also been made in a time of plenty? No, our budget is not made of inexhaustible flubber, but Washington has never lacked the will to shovel billions into enterprises like half-assed wars and banking bailouts, with the fruits of that largesse flowing upwards to the wealthiest friends of the Treasury secretary, arms merchants and boutique mercenary corps’. Forgive me if I feel that if there is a will, we will find the way.
As for the free market, how much longer are we going to be hentai-raped with that one? The free market exists to provide what the government shouldn’t, and the government for what the free market can’t. Has anyone heard a fresh scheme emerge from the “free market” that will correct the issue at hand: that the cost of health care is growing beyond the means of even the well-to-do?
If the private insurance system as it is now constituted cannot fulfill the need for which it exists, then it has outstayed its welcome. But its replacement, if it is to be fair to what the public wants, will not be inexpensive.
It need not, however, be a millstone. The majority of countries that enjoy our standard of living choose public health care, and their plans range from a government supervised free market to straight socialized medicine. Most are pretty happy with what they have. We, plainly, are not. What has to change are our priorities, and that means our fundamental attitude towards who deserves health care: all, or some.
We will not see an improvement until we are willing to say, flatly that affordable health care is a citizens’ right, paid for by our productivity, and with roots in our sense of justice. The Republicans? They’re still trying to convince you and I that strapping a man to a table and drowning him is what makes this country great.
Fuck ’em. And happy Labor Day.
I live in Sweden, and I can tell you that universal health care works somewhat decently but rather clunky. It’s not perfect, but I hope you guys can push this through, it’s at the very least preferable to a system where you get put in deep debt for a flu treatment
I’ve seen American socialized welfare. Its called Tricare. If you want to know what tricare is, it is the Military health plan. If you are treated on base, 100% free. You can get what ever you need with no charges to worry about. Just show your government ID.
What you do have is the longest fucking lines in the world if you need something beyond a quick nurse visit and some pills. It was a 2 month wait to get injected with radioactive potasium isotope to see if I was growing new bone. 2 months is a pretty long time when this is information needed to determine the course of treatment for a repetitive stress injury. So in the meantime all I could do was my weekly visits for pain management.
I’m not saying socialized health care can’t be done well. I’m saying I’ve seen what we’re headed for, and it really is just as dark as they’re predicting. Because you can’t medically discharge the worst off, and pass them onto the VA.
Disclaimer: I am a selfish, soulless bastard who doesn’t care about the suffering of others.
I’ll echo Dr. Fawkes, plus point out that, with military health care, you can NOT sue your doctor if he makes a mistake. The main reason health care is priced out of reach of so many is the lack of tort reform. Doctors have to pay through the nose for malpractice insurance, and this is passed on to the patients. Frankly, I don’t see why people choose to be doctors anymore. It’s been this way for far too long, and the number of general practitioners is not enough to support the current number of insured, let alone those that will benefit from any socialize health care.
Your statement that, \Most are pretty happy with what they have.\ may be true for the healthiest among them. However, if you are diagnosed with a serious illness, the United States is the place you want to be. The one common characteristic of all national health care systems is that they ration care. Tens of thousands of patients from around the world come to this country every year for treatment, treatment they can’t get in their own country. Yet the liberal’s choice for a US system is modeled on these same \successes\ in other countries.
And what does the free market provide? It attracts most of the world’s top doctors, hospitals and research facilities to the United States. Eighteen of the last 25 winners of the Nobel Prize in Medicine either are U.S. citizens or work here. Half of all the major new medicines introduced worldwide over the past 20 years have been developed by U.S. companies. Eighty percent of the most important medical advances of the past 30 years have significant American involvement. If socialized health care in other countries is driving doctors to our country, and that is taken away, what incentive will there be for anyone to choose to be a doctor? Does a lawyer ever have to worry about being sued for malpractice?
The better solution would be to grow the number of general practitioners, and to limit malpractice penalties. The trouble with this thought is that it takes time to become effective. Why wait 10 years when you can stuff a 1000 plus page document through in one summer, assuming no self-respecting lawmaker actually reads it?
I’m so not touching this one apart from genuine curiosity about H.M’s statement – do people over there really think you can go into deep debt for a flu treatment?
I am with K.L. that America leads the world in quality treatment, a statement I make with no evidence whatsoever. The question, of course, remains health care delivery. Tort reform? Bring it on! I am not an unreasonable man. Throw the Republicans a bone! Who can you sue when you are dying from never having been treated in the first place?
http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all
Also read this.
TL;DR, When doctors can just bill medicare for services, they do all the optional stuff, doubling the average per patient cost. From a health perspective, maybe this isn’t a bad thing. From a fiscal one, its awful.
Because Jason, some of us have real jobs that require us to pay taxes, and we’re the ones supporting this. we can’t all be starving, Heroin addicted webcomic artists.
(I kid, I kid. You seem more like a coke hound. PS Draw more comics.)
for the record, there should be joking-/joking tags around that last setance.
Nemo- I exagerate a bit yes, but from what I hear from friends in the US, the prices for a simple checkup seems ridiculous. I’ve lost counts on how many times I’ve heard stories from them about getting buried in bills when they get sick with the slightest things that needs medical treatment
I guess it doesnt really matter which way we go, people will get screwed over no matter which system is in place. I prefer the one that will result in the least misery
Hey. I’m still trying to avoid getting involved in this, but I can tell you my price for a simple checkup is $15. That included, last time, the EKG just to make me feel better (free).
I’ll agree that the current system was horribly screwed up. The idea of employer based coverage was supposed to force larger pools of coverage. It however severely disincentivised health care companies to encourage preventative care, since people might not stay with them long. Other bits of meddling are in the fact that doctors here have to do their own records/billing instead of one or two billing companies providing this service for doctors.
The idea of the system with the “least misery” is an interesting one. Since health care is clearly a limited supply resource, what will ensure least misery? Going for a simplistic “greatest good for greatest number” counter-intuitively could result in more misery by driving down incentive for greater production of drugs, advanced imaging, training and so on.
Many attempts at egalitarian systems in the past have resulted in systems that were manifestly not as pleasant as those around them.
In terms of lifespan, one major problem in America is, quite simply, diet and vices.
More babies die here, but it is mother’s smoking, drinking and drugs. Ditto diseases like diabetes and heart problems.
I rather have the system that Canada and Britain enjoy,just with less of the frustration of having to wait and some of the other issues that go along with it,because I have heard on the BBC channels of problems where people had to quite abit in waiting rooms without treatment.Then again,it’s just as bad here and worse if you don’t have insurance.Regardless of what direction a properly constructed health plan,be it public or government run goes,I hope it is done right because it has to be better than what we got now.
Can’t wish away scarcity. Only a finite number of goods in the world. Finite number of hours in a day. If it weren’t for scarcity we’d all live forever, eat whatever we wanted whenever we wanted and live in mansions on the shores of crystalline lakes while making love to the finest of women.
What we can do to reduce the problems of scarcity is reduce the barriers to production of goods and services:
1. End I.P. law. It lets patent holders (drug companies) charge exorbitant sums for their medicines and devices. Anybody can make the stuff and either charge for it or give it away if they like.
2. End the doctors’ labor union, the AMA. No more gate on the number of doctors because you can practice without “license.”
3. End the FDA. The agency was established exclusively for the purpose of protecting the powerful drug companies, while preventing startups.
By reducing the barriers to products and services making it to the people, a surplus results and prices go to floor. If you want “high quality” service, just like if you want a “quality” computer, you pay more. If you want quick-and-cheap you get what you pay for.
The only problem: Caveat emptor. People demand that somebody else do their research for them, or that they get high quality merchandise at a “cheap” price.
Oh, yeah, and while we’re at it. End the monopolists on violence, governments.