Saturday, July 25, 2009

Health-Care Reform - or - The History of the World, pt. 5b -Edit

These are in large part responses to some questions I've been hearing (and to be honest, re-hearing and re-hearing) in regards to health care in general in the US, mostly by US citizens who are fearful of losing rights and what they perceive as the slippery slope towards Communism. In lieu of a narrative or even a framing device, I give you points:

  • I do not consider myself to be a liberal. To me and many others, the term brings up images of naive folk who believe that people are, in their hearts, nice and good and gentle. We could all just get along if only we were allowed to. I tend to think that we all have goodness and corruption dwelling within us. And if the bad within us is not checked in social (and not just private) settings, well, some pretty monstrous and heretofore unimaginable events have happened just within the last century. People - in other words - need protection from people. And not just the scary, boogie-woogie men that lurk in shadows and alleys, either. We need protection from systems of people - which is where the worst that could happen not only does, but is condoned and justified (think Aushwitz, think Taliban, think Enron, think Manhattan Project).
  • If the federal government is something to be scared of, so are big, multinational corporations. And there's more money in those corporations than there are in the government. So, guess who has whose ear? But also, guess who, in terms of medicine and health care, is wasteful, uses large sums of government monies with no re-pay for their own profit, has immense overhead costs, limits patients' ability to see doctors and to get treatment off-campus, will deny coverage for pre-existing conditions, and is generally not affordable for members of the working-class who do not have jobs that pay a huge percentage of the insurance costs?
  • As the economy continues to suffer and bleed (although more slowly) while health care costs continue to rise, those companies will not be able to afford to foot the bills.
  • The Health Care bill making its rounds through the legislature is weak, ineffective and will probably end up doing more damage than good, convincing Washington and Joe SixPack that universal health care is a bad idea. Now, it may be a step in the right direction, and may be an impetus for some strong change, but I will not argue nor speak about the current health bill. As far as I'm concerned, it's a bad compromise, watered down by Big Pharm interests who are still threatened by it enough to send misinformation by paid think-tankers.
  • Who would dream of privatizing the military? Yet the military is run by Washington and is a pretty smooth machine.
  • And the post office. I constantly hear complaints that amount to a pandering, "We don't want our hospitals to be run like the post office." What?? Are you kidding me? The hospitals would be run by the staff and administrators, same as always. They would be paid by one single insurance company. That's the main difference: Single. Payer. Health. Care. Furthermore, if the insurance companies were to be run nearly as smoothly and effectively as the USPS, I would be a very, very happy man. I have lost less mail sending and receiving during my whole life than I have lost claims, files, and complaints sent to the insurance companies during my daughter's first year of life.
  • My wife and I easily spent the majority of our adult lives without any sort of health insurance. Where it not for SCHIP (an imperfect program, cf. the fourth point), our two year old would have been uninsured for most of her life as well - especially since my insurance ran out when she had turned two months old. Not a good spot to be in, for sure. To boot, we would have run in immense debt and would spend years trying to pay that off rather than, say, send her to preschool so she can begin her education amongst her peers.
  • Under SPHC, every one puts money into the pot. A three percent flat tax rate should be equal to or less than what is being paid now by most of those who are insured. As far as the companies, they will also pay at a rate around or less than what they pay now. Now, as per companies that do not now pay, I for one would be only too happy to see the largest retailer in the world finally give to the system that they have been stealing from. Although the costs may, at first, be a bit steep for many small and start-up companies, they will have the added advantage of not having to worry about hassling with a medical benefits package (and that would save money and time that would otherwise go to Human Resources and paperwork), and not have to worry about not having insurance as a carrot to get the better employees. Likewise, employees can relax and work where they want to and where they feel most needed and otherwise compensated as long as health insurance is not a worry.
  • Edit: Malpractice insurance will also drastically reduce. Think thusly with me, if you would: If the majority of money rewarded in a malpractice suit goes toward future operations to remedy the operation in question. But if all future operations are already paid for, that would reduce the settlements to, say, punitive and work-related damages, (reduced?) lawyer fees, etc.
  • All this talk asserting that socialized medicine will turn our country into another Communist/Marxist state is... I don't know, why don't you yell at Great Britain, Australia, Canada, France, Sweden, Denmark, Norway... you know, the Soviet Bloc run by Mao, Lenin and the Anti-Christ?
  • And the Republican strategy for reforming the health industry in the US is based on the promise of tax rebates. Tax Rebates? Seriously?? And not even guaranteed but suggested? How will this help the working poor? Seriously, they barely pay taxes in the first place. Who gives a crap about taxes? Seriously!! I can't think of a more silly idea. I'm offended by the idea...
For sure, there are other areas that could not be feasibly addressed by any government action yet would drastically cut costs while improving health and national proficiency. Regular exercise, cutting out of junk food, eating organic, alternative medicines, drastically reducing air and soil pollutants, perhaps making such dangerous and costly habits as excessive drinking as taboo as we have smoking, etc, etc. We also need to move away from this culture of medicine as business, where doctors prescribe what will get them the most money (some articles are attached below and they give examples, including the Mayo clinic and a community in Texas, will provide examples of what to do as well as what not to do), regardless of whether it's in the patient's best interest or not.

Some other reading that may or may not be about single-payer health care but may lead to an intelligent conversation about affordable healthcare in this country anyway:

NY Times on a hospital that pays its doctors by salary, thus drastically reducing its costs (yet, oddly enough, is not being modeled in the bills in DC).
A fairly exhaustive FAQ's page about Single Payer Health Care.
A long but extremely informative (and well-written) piece by Dr. Atul Gawande on the culture war of medicine as business and how it is destroying us.
Stephen Colbert interviews Aaron Carroll on SPHC.

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