Double-Speakeasies - or - How I'm Taking It Personally Now

Freedom vs. Slavery.

photo © 2008 Tony | more info (via: Wylio)

That was the main meta-story in the US of the mid 1800's. Except it wasn't just the Northern abolitionists saying that about the Southern slave states. It was how Southern plantation owners framed the struggle to their poor white neighbors. "If the slaves were free, they would take all of your jobs, rape your wives, be a drain on the economic system, raise your taxes to serf-like levels. A free negro is a threat to our great civilization and will end your freedom as you know it, as well as their own."

Any of this sound familiar?

Yesterday I realized, for the first time, that my daughter has what could be described as a "pre-existing condition." After several months of a persistent, standing pneumonia that doctors could never quite figure out, over Thanksgiving weekend we found out she has bronchiectasis. There is no cure. We have to treat her half an hour three times a day by hooking her up to machines. Each day. For the rest of her life.

I lay awake at night and hear her struggling to breathe. I can feel her air trying to go through her airways, while they're blocked up with mucus that she can't get out of her system easily and automatically like most of the rest of us.

There are others who are in worse situations, of course. And I've long advocated for universal, affordable health care (preferably Single Payer, the system Canada uses). But now it's intensely personal. If the little gains we received under the recent health care reform bill were rescinded (without a better plan in its wake), my child's health will be affected intensely.

I wish that the current Republican crop weren't just trying to score cheap political points by comparing health care reform with slavery, or death panels, or whatever current lie is fashionable. Because it seems obvious to me that 1) universal health care works in every developed nation but this one; 2) leaving one-tenth of all Americans without insurance is

disgusting, uncivilized, and un-neighborly - it leaves tens of millions of Americans without recourse but intense debt and allows easily preventable diseases to build until they become lethal; 3) arguing against universal health care is immoral and indecent.

We can argue about the means to the ends of universal health care. Many of the suggestions for reform that Obama and the Democrats brought up last year were, in fact, originally Republican ideas - including the mandate. Including the public option. But then those suggestions were labeled toxic and slave-inducing by the same people who supported them some fifteen years prior.

But much of the rhetoric being used against the new reforms assume that covering everybody is murderous. It's the double-speak of the 1840's all over again. And again, the people that profit most from these lies are not those that are defending them (with their votes or lives), but those at the top that spew them. Those that are defending the lies actually have the most to lose. Consider the white sharecroppers who barely got by on the sweat of their brow but were led to believe it was the Africans' fault that they may die as poor as they entered into the world, if not worse.

The lie was, if the dark-skinned ones get free, the white worker will become their slaves. Forget the fact that they were just a step above the slaves themselves because of the practices and policies of the ruling class...

The lie is, if the uninsured are covered, there will not be enough medicine for the working class and the senior citizens. Forget the fact that the cost of insurance is rising astronomically every year so that businesses cannot afford to keep up anymore. Forget the fact that insurance companies employ teams and teams of numbers-crunchers to figure out how to deny care costs. Forget the fact that it's a public health issue. Forget the fact that we spend twice as much of our GDP as other countries (that actually cover everyone) do on health care, yet still 1/10th are uncovered, a significant fraction is under-covered, and many more claims are unfairly, unjustly denied. Forget the fact that racial and economic disparities in coverage lead to tens of thousands of deaths a year.

And I can't help but feeling that every time someone argues that any viable progress in reform leads us all to slavery, they are arguing that my daughter doesn't deserve to live.

Please explain this to me.

Weekend Links We Like to Link to: Health Care Edition

Don't know how everything is gonna pan out. At this point, nobody really does, right?

Does the US really have the best health care in the world?

How dare the Mrs. POTUS indoctrinate our kids to eat healthy food at a fair! We oughta knock that asparagus outta her hands and replace it with the cotton candy and merry-go-rounds that everybody everywhere associates with fairs - like the ones at job fairs and college fairs! And exercise?! SHAME!!

Pricing. "The block representing the prices paid by American health-insurance plans looming over the others [England, Germany, Canada, Spain, etc.] like a New York skyscraper that got lost in downtown Des Moines." That's it! And why didn't they say so sooner?

The clustersuck that is our system in treating, say, diabetics. Partially because insurance companies - who do not retain their base for any extensive period of time (vs. a comprehensive national plan like Single Payer, et. al.) - are more concerned about holding onto their monies until they need to.

[In] the byzantine world of American health care... the real profit is made not by controlling chronic diseases like diabetes but by treating their many complications.

Insurers, for example, will often refuse to pay $150 for a diabetic to see a podiatrist, who can help prevent foot ailments associated with the disease. Nearly all of them, though, cover amputations, which typically cost more than $30,000.

Patients have trouble securing a reimbursement for a $75 visit to the nutritionist who counsels them on controlling their diabetes. Insurers do not balk, however, at paying $315 for a single session of dialysis, which treats one of the disease's serious complications...

"If a hospital charges, and can get reimbursed by insurance, $50,000 for a bariatric surgery that takes just 40 minutes," she said, "or it can get reimbursed $20 for the same amount of time spent with a nutritionist, where do you think priorities will be?"

In case you missed the story of the fat baby denied health care coverage because he was over the 95 percentile. A little close to home for me, as our daughter has always been in the 99.99999 percentile.

Just. So. Weird. "These are critical days if you don't want health care." At least Sean Hannity Freudiantly spoke the truth. Which I'm sure confused the mess out of him...

Oh. And, just in case you thought some of the vicious reaction against "Obamacare" was due to the whole Black "Kenyan" outsider problem, the conservative freak shows once again reveal that they're also equally misogynist.

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.